Free The Cancer Chronicles by George Johnson

men. They had spread throughout the skeleton ofa LateHolocene hunter-gatherer exhumed in theArgentine Pampas.Men do get breastcancer, but only very rarely.Lung cancer can also leave osteolytic marks, but it is believed to have been exceedingly uncommon before cigarettes. Hisdiagnosis was left hanging. It was another case of what oncologists call “primary unknown.”
    Those words still haunt me when I think about the weeks that passed before finding the source ofNancy’smetastasis.Like 90 percent of human cancers it was a carcinoma. It makes sense that these would be the most common.Carcinomas arise in the epithelial tissues that line the organs and cavities of the body and envelop us with skin. As the layers are worn by the passage of food and waste or exposure to the elements, the outer cells are constantly dying. The cells beneath must divide to form replacements. And with every division there will be mistakes in the copying of genes—spontaneousmutations or ones caused bycarcinogens in food, water, and air.Forchildren, who are just beginning to withstand life’s wear and tear, only a fraction of cancers are carcinomas.
    When it comes to hunting ancient cancer, primary carcinomas would almost always be lost with the decomposing tissues. And those that had metastasized would haveoften spread first to the lung or liver, killing the victim before a record was left in bone.Egyptian medical papyruses make ambiguous references to “swellings” and “eatings,” and some evidence has survived inmummies.Arectal carcinoma in a 1,600-year-old mummy was confirmed with a cellular analysis of the tissue. Another mummy wasdiagnosed withbladder cancer. Elsewhere in the world, a rare muscle tumor called arhabdomyosarcoma was foundon the face of a Chilean child who lived between 300 and 600 A.D. In Peru, two pathologists reportedmetastaticmelanoma in skin and bone tissue ofnine pre-Columbian Incan mummies. In a whimsical digression, they quote an eighteenth-century ode in praise of femalebeauty marks and then wryly remark: “Whereas [the poet] was inflamed, as were his contemporaries, by the beauty of a lady’s moles, we—some 240 prosaic years later—are romantically unmoved by any of them. They have given us nothing but trouble.”
    Other evidence of ancientcancer may have been destroyed by the invasive nature of Egyptian embalming rituals.To prepare a pharaoh for passage to the afterlife, the first step was removing most of his organs. The brain was pulled out though the nostrils. The torso was sliced open to take out the abdominal and chest organs (with the exception of the heart, which was believed necessary for the ethereal voyage). Each organ was wrapped in resin-soaked linen and then placed back into the body or in what was called a canopic jar. There were other variations. To slow the process of decay a turpentine-like solution was sometimes injected as an enema to dissolve the digestive tract.
    Butembalmed tumors can survive. Treated more gently, the mummified body ofFerrante I of Aragon, who died in 1494 in his early sixties, harbored anadenocarcinoma that had metastasized to the muscles of his small pelvis. Some five hundred years after his death, a molecular study revealed a typographicalerror in the DNA code that regulates cell division—a G had been flipped to A—ageneticmutation associated withcolorectal cancer. Maybe this was caused, the authors speculated, by an abundance ofred meat served in the royal court. Or, for all we know, by an errant cosmic ray.
    Altogether Icounted about two hundred suspected cancer sightings in the archaeological record. As with the dinosaurs, I was left to wonder how big an iceberg lay floating beneath the tip. Mummies are a curiosity, and most skeletal evidence isstumbled on by chance. Only recently have anthropologists really begun looking for cancer—withCT scans,x-rays, biochemical assays, and their own eyes. What they will never see, even in bone, are clues lost through what