Historical survey of carcinoma of the pancreas

The ancient Egyptians probably recognized cancerous lesions on the surface of the body. Hippocrates described cancers of the skin, larynx, breast, inguinal region, uterus, and vagina. For centuries, the treatments were excision, cauterization, ointment application, and fomentation. The development of anesthesia, antisepsis, and disinfection, and the discoveries of X-rays and radium in the nineteenth century, have greatly promoted advances in surgery in the twentieth century. At the beginning of this century, it became possible for surgeons to extirpate tumors from previously inaccessible body interiors, and today surgeons are able to remove affected organ systems and even entire regions of the body with safety because of advances in physiology, anesthesia, transfusion, and anti-infective agents. The surgical results for most gastrointestinal cancers have improved markedly in recent years, only with pancreatic cancer showing no improvement in results. Drastic extensive surgery has not led to better results. A small carcinoma less than 1 cm in diameter may not always be an early carcinoma. Early cancer in duct cell carcinoma may be one localized in the mucous membrane of the pancreatic duct. There is now an expectation that early diagnosis will be possible by using magnetic resonance cholangiopancreatography and cytological diagnosis of the pancreatic juice.