100 Years of Progress in Oncology Treatment

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In his powerful 2010 best-seller, The Emperor of All Maladies: A Biography of Cancer (Scribner), Siddhartha Mukherjee, MD, chronicles the evolution of cancer from the oldest known description of the disease written on a papyrus from about 1600 BC to the present day’s understanding of the biology of cancer. The papyrus, writes Dr. Mukherjee, “is believed to contain the collected teachings of Imhotep, a great Egyptian physician who lived around 2625 BC.” And while Imhotep’s description of “Bulging tumors of the breast mean the existence of swellings on the breast, large, spreading, and hard; touching them is like touching a ball of wrappings, or they may be compared to the unripe hemat fruit, which is hard and cool to the touch,” conjures up a vivid mental image of a probable case of breast cancer, it does not have the immediate impact a visual image produces.

Nor do words tell a complete story the way a photo does, said Stanley B. Burns, MD, FACS, an ophthalmologist and Clinical Professor of Medicine and Psychiatry at NYU Langone Medical Center in New York, and Founder of The Burns Archive, a treasure trove of more than a million historical and medical photographs dating back to the mid-1800s.

The Burns Archive of Photographs

“When you see an original, untouched photograph of an event, it is pretty close to what was going on in that moment,” said Dr. Burns. “Once I realized that a picture gave more than 1,000 words of information, I knew that the written word had to be supplemented by the visual. Many times you have only a visual record [of an event] and no written record and you get much more information from a photograph than the written record because you have information on all different aspects [of that event].”

Established in 1977, The Burns Archive houses one of the world’s largest photographic collections showcasing both the horrors and miracles of early medical and oncology practice, including the first demonstrations of breast surgery, the use of nonsurgical therapies such as radium and radiation, and two major breakthrough advances between 1845 and 1875, the discovery of general anesthesia and the emergence of antiseptic principles. The collection, said Dr. Burns, is the first photographic historical work that documents the establishment of oncology as a modern specialty and provides a chronology of the changing nature of disease, medical advances, and how oncology was practiced.

The Era of Modern Medicine

Having a photographic record of medical advances, according to Dr. Burns, took the practice of medicine from the dark to the modern age and provides a vivid legacy of how both physician and patient coped with disease. “The photographs show the evolution of the physician from butcher to scientist, this is especially true in surgery where you see doctors posing with pieces of people in the early 19th century and then posing with the latest surgical instruments and x-ray and radium devices going into the 20th century to show that they were technologists,” said Dr. Burns.

In addition to memorializing the progression of medical achievement, the advent of photography in 1839 also helped alter people’s perception of medicine and their fear of disease. “People were afraid of going to the doctor,” said Dr. Burns. “With these visual images, especially the photos of surgeries, you can see how each year the patient got closer and closer to full visualization of [the advances of] medical practice. Patients’ fear disappeared once doctors were no longer associated with death.”

Recording History

The Archive’s historical photographic collection spans such diverse categories as medicine, death and memorial, war and conflict, crime and punishment, occupations and industry, social and cultural history, and African American history, among others, and has been called “one of the six most important collections in the world,” by Aperture magazine. The photographs have appeared in over 100 museum exhibitions, including the Metropolitan Museum of Art in New York and the Musée d’Orsay in Paris, and thousands of images have been donated to The Smithsonian Institution, the Museum of Modern Art, and the J. Paul Getty Museum.  Images from the Archive have also been used as resource material for several television shows, including The Knick, a period-based medical drama on Cinemax, and appear in a variety of documentaries, including the upcoming 6-hour documentary by filmmaker Ken Burns (no relation) based on Dr. Mukherjee’s book, The Emperor of All Maladies, scheduled for broadcast on PBS stations next spring. Dr. Burns is also a medical and historical adviser on these programs.

The History of Oncology

Dr. Burns has published a four-volume series of books tracking the history of oncology medicine titled Oncology: Tumors & Treatment, A Photographic History, which are divided by year and medical advance. They include, The Anesthesia Era 1845-1875; The Antiseptic Era 1876-1900; The X-Ray Era 1901-1915; and The Radium Era 1916-1945. Several images from these books, along with their edited captions, appear in the sidebar at left. The photographs are courtesy of Stanley B. Burns, MD, and The Burns Archive. ■

To learn more about The Burns Archive and to view a sampling of its photographic collection, go to Watch future issues of The ASCO Post for more images from oncology history.


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