Limelight: To kill a killer By Lubna Abdel-Aziz Once banished from Paradise, man began to dread his many killers. As if set on his destruction, Nature unleashed her wrath upon him in a variety of catastrophic outbursts -- fires, floods, famines, earthquakes, and epidemics. He was quick to assist her by inventing wars, genocides and weapons of destruction to bring down his fellow man. Throughout history his biggest killer has been disease in all its shapes, colours and forms. Besides massive killer epidemics like the Black Plague of yesteryear, and AIDS of today, the persistent, silent, solid killer has been cancer, the big C! Cancer is a disease in which cells multiply without control destroying healthy tissue. It occurs in animals, plants, and humans of all ages. Contrary to popular belief, cancer is not the by-product of our modern age, the child of fast foods and cigarettes. Since the earliest times, cancer has been described in the history of medicine. Dinosaur fossils have revealed cancer cells as far back as 70-80 million years. In 1932, famed anthropologist Louis Leaky found the oldest reported malignant tumour in the remains of an Australopithecus hominid that lived 3.9--4.2 million years ago. Cancer cells were discovered in 5,000 year-old Egyptian mummies. An ancient Egyptian papyrus describing tumours of the breast (3000-1500 BC) is the oldest record of the disease. Even the rarest of cancers today, existed in ancient civilisations. Tumours were removed surgically in Babylon by 1750 BC, and ancient Egyptians diagnosed and distinguished between benign and malignant tumours. Some were removed by cauterisation (1600 BC), others were treated by various modes of medicine and magic. With the decline of the ancient Egyptian civilisation, no medical records exist until the rise of the Greeks. Hippocrates (c. 460--370 BC) dominated medical thinking for several centuries. Known as the "Father of Medicine", and author of the "Hippocratic Oath", still recited by physicians today, he lifted medicine out of the realm of magic, superstition and religion, where it had languished for years, and defined disease as a natural process. Hippocrates is responsible for the word 'cancer'. On observing the swollen blood vessels of the central tumour, and the finger-like extensions around it, he was reminded of a crab. He called it "karkinos" (Greek for crab), translated into English as "carcinos" or "carcinoma". It was another Greek who practised in Rome, Claudius Galen (129--216 AD) who is considered medicine's first oncologist. Although Galen surgically removed some tumours, he considered cancer to be incurable in the majority of cases. After the fall of Rome, Constantinople became the seat of knowledge. The ancient teachings of Galen spread to the known civilised world -- Cairo, Alexandria, Athens, Antioch, during which time, Europeans still continued to use magic spells and myths to cure disease. Efforts to cure cancer were dormant, or at best, slow to progress. By the 17th century, Europe had come out of the darkness, and the knowledge of the human body and disease found their place in the foreground of scientific endeavour. By the 18th century Dutch surgeon Adrian Helvetius (1715--1771) performed both "lumpectomy" and "mastectomy" surgery for breast cancer. Famous Scottish surgeon John Hunter (1728--1793) conceded "as long as the tumour had not invaded nearby tissue and was moveable, there is no impropriety in removing it." The discovery of X-Ray technology by Wilhelm Conrad Roentgen made it possible to kill cancer cells with radiation. Then came mustard gas, a chemical warfare agent used in WWI. During WWII it became apparent that exposure to this agent resulted in damage to white blood cells rendering them abnormally low. It was easy to conclude that if mustard gas damaged the rapidly growing white blood cells, surely it could have a similar effect on cancer cells. Several patients with advanced lymphomas -- a form of cancer of the white blood cells -- were given the drug through their veins rather than breathing the irritating gas. The experiment proved effective, launching the widespread discipline of chemotherapy for treatment of cancer. No matter how fast or how far advances were made, it was never fast or far enough. The big C would lash at will indiscriminately, killing seven million people worldwide in 2001 according to the World Health Organisation (WHO). Of course we helped accelerate its triumph by smoking, alcohol, pollution, and a diet deficient in fruits and vegetables, lifestyles that are known to be predisposing factors in the genesis of cancer. According to WHO, 21 per cent of deaths by cancer in 2001 were related to smoking, five per centto alcohol, five per cent to a diet deficient in fruits and vegetables, two per cent to obesity and inactivity, one per cent to urban pollution, and 0.5 per cent to the household use of solid fuels. Numerous organisations housing uniformed combatants around the world are now dedicated to the fight against those killer cells. Armies of scientists and physicians confine themselves between the walls of hospitals, medical schools, research institutes, government agencies and voluntary groups, seeking strategies to beat the enemy. Their labour has been fruitful. The last decade has brought a bushel of good news in man's struggle against cancer, giving new hope to the fate of mankind. Two incredible battle victories against the killer crab occurred in 2006. A breakthrough anti-cancer vaccine has been available since April, effective for more than four years in fighting five strains of HPV (Human Papilloma Virus) known to be responsible for cancer of the uterine cervix. The latest breakthrough was announced last week by Dr. Steven Rosenberg of the National Cancer Institute (USA). Researchers have taken specialised cells called T cells that are normally responsible for immunity, and genetically engineered them to recognise and attack life-threatening malignant skin cancer cells. A very fortunate patient, Mark Origer, 53, with only four months to live, can now enjoy a long and cancer-free life. Though the treatment was only successful in two of 17 patients, it brings more hope to millions of cancer victims waiting for the final defeat of the big C. There is more work ahead, but perhaps the end is near, leaving us to concentrate on other man-killers, even deadlier than cancer. "While there are several chronic diseases more destructive to life than cancer, none is more feared." In reference to the "Letter to the Editor" by M Waly (issue 31 Aug-6 Sep), Al -Ahram Weekly regrets the typographical error, omitting the symbol "squared" (2), integral to Einstein's equation, E=mc squared, in the article "100 Years of relativity". Unfortunately the symbol is not available on our computer library. The equation E=MC2 is also incorrect.
