Bridging the Gap. James Eugene Munson
can be difficult but is easy to cure. That means that a patient should live. This accumulation mass, related to yin and a disorder of the zang organs (five depots) has the same qualities of what is now perceived as a malignant tumor given the structure, definitive location and shape. By contrast, a concentration is described as being a problem with the fu organs (six palaces), thus related to yang, not maintaining a specific area or shape. In a clinical perspective, the concentrations were most likely assumed to be benign, perhaps that of a lipoma or fibroid. In essence, ancient TCM doctors could already classify cancer as a disease that affected the whole system, not merely limited to external causes. Further, one’s internal constitution and overall health determined, to some extent, the absolute strength of pathogenic factor.
Back in the West, by 1540, a physician named Andreas Vesalius unknowingly challenged the humoral theory made by Hippocrates. This occurred through Vesalius’ dedication to understanding human anatomy by way of autopsy on human cadavers, something Hippocrates was unable to perform for religious reasons during the Grecian era. Through detailed anatomical research Vesalius determined that the black bile referenced by Hippocrates and Galen did not physically exist.43 Through autopsy he discovered the pale, watery fluid of the lymphatic system, the blood vessels holding blood, and the liver holding yellow bile.44 Black bile was not found, which challenged Vesalius not only on a professional and academic level, but also on a personal level through his dedication to his predecessor, Galen. In his search, without realizing the outcome, he produced extensive diagrams of veins, nerve pathways, and the circulatory system, culminating in the first medical anatomy book, The Seven Books on the Structure of the Human Body. As a result, the humoral theory was cast aside and physicians began to search for another source of cancer, which lead to the lymph theory.
Lymph theory proposed that the cancer formation was caused by another body fluid, lymph. This idea was supported largely through the 17th century and suggested that the human body was formed of lymph, which was responsible for the ongoing movement of blood and fluids. Blood released tumors into the body’s circulatory system, eventually leading to cancer in that local region. Not long after this theory was introduced, the evolution of cancer biology made significant progression in the medical field with the discovery of cellular biology. As scientists could examine cellular structure in closer detail, it became evident that cancer is actually made up of cells derived from other cells. Thus, the observed character of the disease continued to become more illuminated, as science, technology, and physicians identified its mechanism.
This cellular discovery led to the blastema theory, developed by pathologist Johannes Muller in 1838 who recognized the cellular composition of cancer.45 He proposed that cancer was cellular and not lymph fluid believing further that cancer cells were a separate entity from normal healthy cells. His student, Rudolf Virchow, became one of the foremost leaders in pathology. His scientific research led to the understanding that entire organisms do not get sick, but it is the cells or groups of cells within the organism that do.46 Thus, cancer cells did not originate from body fluid but from other cells. Virchow played a significant role by initiating the field of cellular pathology following the advent of the microscope. As such, Virchow revolutionized the field based on two tenets: first, similar to the bodies of animals and plants, human bodies were made up of cells and second, cells arise from other cells.47
This greatly influenced the practice of medicine as physicians began to recognize that disease progression occurred by pathological and anatomical changes not merely as a result of symptom changes. Physicians could then make more effective medical diagnoses and treatments, ideally with better outcomes. The similarity of animal’s anatomical structures shed light on the pathology and physiology of humans, which was the advent of harnessing animal research into human biology and medicine. Virchow proposed a hypothesis about the distinction of cellular human growth, which differentiated between hyperplasia and hypertrophy. Virchow defined the primary method of cell change, hyperplasia, as a growth of cells increasing in number, versus hypertrophy, where the number of cells did not change, but rather individual cells grew in size. It’s possible to delineate the structure of human tissue by hypertrophy and hyperplasia. For adult animals, fat and muscle grow through hypertrophy. By contrast, internal organ structures such as the liver, intestinal tract, blood and integumentary system all grow through hyperplasia.
As a result of Virchow’s knowledge and studies on cellular pathology, he proposed cancer was a result of pathological hyperplasia. With a microscope, Virchow examined abnormal cellular progression, identifying a significant aspect of uncontrolled cellular growth — hyperplasia. The structure of cancerous cells appeared more clearly through this process allowing a distinct point of view. Essentially, cellular division occurred autonomously in a different, new form; hence the term, neoplasia, “novel, inexplicable, distorted growth.”48 As a consequence, these cells expanded into dense masses, invading normal tissue with the drive to metastasize to surrounding organs and other distant sites such as the brain, bones or spinal cord.
By the 19th century, the complexity of cancer was gaining momentum in the scientific community. The biology and evolution of the disease were more clearly delineated by scientists Watson and Crick who discovered the deoxyribonucleic acid (DNA) helical structure in 1953 and subsequently received the Nobel Prize in 1962. Following this discovery, geneticists were able to identify how genes worked, as well as how they were damaged by mutations causing cellular division. Encompassing this discovery was the integral component of carcinogens, like chemicals affecting DNA structure, as well as changes in cellular integrity by viruses, radiation, or genetics.
In 1970, the discovery of two gene families provided even more information on cancer cell biology. Proto-oncogenes are normally responsible for controlling the frequency to which a cell divides, and the degree to which it differentiates. When these genes mutate uncontrollably or abnormally, they become malignant, and an oncogene is created. Oncogenes are not always activated or turned on, but when triggered, it may lead to neoplasm. Tumor suppressor genes were also identified. Normally these genes control cell division, the repair of damaged DNA and instruct cells when to die off. If the tumor suppressor gene does not function, this impairs the control of cells causing overgrowth and division. Both oncogenes and tumor suppressor genes are negatively impacted by chemical exposure and radiation. In addition to these groups of specific gene families, scientists also found genetic predispositions to cancers such as those that affect the thyroid, pancreas, colon, kidney and ovary.
As modern medicine evolved, so did the ability to treat cancer more effectively, as illustrated by the various methods employed by oncologists today. The current treatment of cancer has fortunately extended beyond “the fire drill” procedure from ancient Egypt, to more modern and mainstream treatments like surgery, chemotherapy and radiation. The early administration of conventional medicine was far from flawless, requiring numerous attempts and many years to refine techniques in cancer care.
Allopathic Forms of Cancer Treatment
Surgery
Surgical removal of tumors was the first form of cancer treatment. In ancient medical approaches to cancer, physicians recognized that cancer would likely return even after surgery.49 Due to limitations of sanitary surgical procedures, as well as proper tools and anesthesia, surgery was risky and complicated. There were higher rates of blood loss and often death. Once anesthesia was developed in 1846, surgeons were able to perform more complex surgeries to remove tumors. This era was referred to as the “century of the surgeon.”
The physician commonly identified with oncological surgery is Dr. William Halsted, a surgeon in the late 19th century. He is regarded as the doctor most responsible for developing the radical mastectomy. His assertion was that cancer could be eradicated through local removal of the tumor and surrounding tissue, which began with the removal of the pectoralis minor, then extended into the chest, collarbone, surrounding lymph nodes, anterior mediastinum, and for his disciples, there are records of removing ribs, amputating a shoulder and collarbone.50 He determined, if there was a reoccurrence, it was due to a new neoplastic disease process and not related to the primary cancer that was eradicated. This radical mastectomy became the