Michaela Binder, Durham University and Neal Spencer, British Museum
Cancer is one of the world’s most common causes of death today, but there is little evidence from before industrialisation: almost nothing is known about the history of the disease in the past. We generally assume cancer is strongly related to modern lifestyle and environment. But the analysis of skeletal and mummified human remains recovered during archaeological excavations can provide insights into such diseases in the distant past.
Until now, only a small number of skeletons with evidence for cancer have been identified. While the oldest primary bone cancer is around 6,000 years old, the earliest example of bone metastases related to a soft tissue cancer dates to around 3000 BC. However, because only the skull is preserved, there are doubts about the accuracy of the diagnosis. Only nine more individuals with – often tentative – evidence of cancer predate the first millennium AD. The majority of these individuals come from Ancient Egypt. This is perhaps mainly because the long history of archaeological research has resulted in a very large amount of skeletal and mummified human remains becoming available for study. They are very well preserved and have received a great deal of attention from medical doctors and physical anthropologists since the 19th century.
In February 2013, the skeleton of a man who died between the age of 20 and 35 years was excavated in a tomb at Amara West, in northern Sudan. Founded around 1300 BC in the reign of Seti I, the town was designed as a new centre of the Egyptian control of Upper Nubia (Kush). The British Museum has been working at the site since 2008. Excavations in the town allow us glimpses of ancient lives: how houses were refurbished, what people ate, religious and ritual practices, where rubbish was disposed – and how the town changed over two centuries of occupation. Bioarchaeological work in the cemeteries is providing further insights into the ancient inhabitants: their life expectancy, diet and health.
This individual (skeleton 244-8) was buried in a large underground chamber tomb (G244), perhaps used for a family around 1200 BC. The body was placed in a painted wooden coffin, with an Egyptian-style scaraboid placed in the hands. The bones of the torso, upper arms and upper legs have a large number of holes, 5-25mm in diameter. Radiographic examination of the bones revealed the holes are even larger beneath the bone surface. These holes were caused by metastatic carcinoma spreading from a soft tissue cancer: the oldest complete skeleton of a metastatic cancer found, anywhere, to date. The study, jointly conducted by researchers at the British Museum and Durham University is being published in the Public Library of Science journal PLOS One.
What caused such a case of cancer? Schistosomiasis, a parasitic disease which was and still is a major health problem in the Nile valley, can cause breast cancer in men. Smoke from woodfires within houses continues to be a problem in modern Sudan. At Amara West, most of the small houses were provided with cylindrical bread ovens, often three side-by-side in a small room. Careful excavation has revealed that many of these oven rooms were roofed: these would have quickly filled up with smoke, exposing people to potentially harmful substances.
Understanding the evolution, history and factors that could have caused cancer prior to the onset of modern living conditions is important not only for archaeology but even more so for medical research. Skeletal human remains, set within a well-documented historical, archaeological and environmental context are a key element for any such attempts. This may in future be crucial to develop new research strategies and therapies in order to tackle what has become the world’s deadliest disease.
The identification of such cases, and other diseases, among the population of towns such as Amara West, provides a more direct sense of ancient experience than those provided by ancient texts, architectural remains or the objects people left behind.