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64.
“a type of population control”:
Patricia Braus, “Why Does Cancer Cluster?”
American Demographics,
March 1996. [
http://connection.ebscohost.com/c/articles/9603061697/why-does-cancer-cluster
]

65.
the median age for diagnosis of breast cancer:
“SEER Stat Fact Sheets: Breast,” National Cancer Institute, Surveillance, Epidemiology and End Results website. [
http://seer.cancer.gov/statfacts/html/breast.html
]

66.
“there is an environmental connection”:
Braus, “Why Does Cancer Cluster?”

67.
reading about how this might have happened:
My first stop was Robert A. Weinberg, “How Cancer Arises,”
Scientific American
275, no. 3 (September 1996): 62–70.

CHAPTER 3
The Consolations of Anthropology

1.
When Louis Leakey sat down to recount:
He gave at least three versions of the story: L. S. B. Leakey,
The Stone Age Races of Kenya
(London: Oxford University Press, 1935), 10–11; Leakey,
By the Evidence
(New York: Harcourt Brace Jovanovich, 1974), 20–22, 35–36; and Leakey,
Adam’s Ancestors
(London: Methuen & Co., 1934
)
, 202–3. I also referred to Virginia Morell,
Ancestral Passions: The Leakey Family and the Quest for Humankind’s Beginnings
(New York: Simon & Schuster, 1995), 65–71, 80–93.

2.
deposited … in Early Pleistocene time:
Morell,
Ancestral Passions,
85.

3.
“not only the oldest known human fragment”:
Leakey,
Stone Age Races,
9.

4.
Java man and Peking man:
Piltdown man had not yet been exposed as a hoax.

5.
One of his detractors thought:
P. G. H. Boswell, “Human Remains from Kanam and Kanjera, Kenya Colony,”
Nature
135, no. 3410 (March 9, 1935): 371. Morell describes the controversy, including some bungling of the evidence by Leakey, in
Ancestral Passions,
69, 80–93. For an excoriating interpretation of the event see Martin Pickford,
Louis S. B. Leakey: Beyond the Evidence
(London: Janus Publishing Company, 1997). Pickford and the Leakey family have been bitter enemies (Declan Butler, “The Battle of Tugen Hills,”
Nature
410, no. 6828 [March 29, 2001]: 508–9), [
http://www.nature.com/nature/journal/v410/n6828/full/410508a0.html
] and it can be difficult to separate the science from the politics. Pickford is also coauthor (with Eustace Gitonga) of a
book about Louis Leakey’s son entitled
Richard E. Leakey: Master of Deceit
(Nairobi: White Elephant Publishers, 1995).

6.
a more distant relative like
Australopithecus:
Kenneth P. Oakley, “The Kanam Jaw,”
Nature
185, no. 4717 (March 26, 1960): 945–46. [
http://www.nature.com/nature/journal/v185/n4717/abs/185945b0.html
]

7.
Neanderthal man:
Phillip V. Tobias, “The Kanam Jaw,”
Nature
185, no. 4717 (March 26, 1960): 946–47. [
http://www.nature.com/nature/journal/v185/n4717/abs/185946a0.html
]

8.
or
Homo habilis:
That was the assessment of Harvard anthropologist David Pilbeam, who told Morell that the fossil may be as much as 2 or more million years old (
Ancestral Passions,
9, note 11). He reconfirmed that in an e-mail to me, April 30, 2012.

9.
others have come to believe:
In “A Reconsideration of the Date of the Kanam Jaw,”
Journal of Archaeological Science
2, no. 2 (June 1975): 151–52, Kenneth P. Oakley theorized that the fossil “may have been enclosed in a Middle Pleistocene surface limestone block which was down-faulted in a fissure penetrating the older Kanam Beds.” The Berkeley anthropologist Tim White concluded that the jaw is probably Late Pleistocene. See Eric Delson et al., eds.,
Encyclopedia of Human Evolution and Prehistory
(New York: Garland, 2000), 739.

10.
no more than about 700,000 years old:
E-mail to author, May 7, 2012, from Richard Potts, director of the Human Origins Program at the Smithsonian Institution’s National Museum of Natural History in Washington.

11.
carefully cleaning the specimen:
Leakey,
By the Evidence,
20–22.

12.
diagnosed it as sarcoma of the bone:
J. W. P. Lawrence, Esq., “A Note on the Pathology of the Kanam Mandible,” in Leakey,
Stone Age Races of Kenya,
appendix A, 139.

13.
There was also a thin fracture:
For a description of Kanam man’s anatomical details see Leakey,
Stone Age Races,
19–23.

14.
impossible to tell what Kanam man’s chin had been like:
M. F. Ashley Montagu, “The Chin of the Kanam Mandible,”
American Anthropologist
59, no. 2 (April 1, 1957): 335–38. [
http://onlinelibrary.wiley.com/doi/10.1525/aa.1957.59.2.02a00140/abstract
]

15.
Another anthropologist disagreed:
Tobias, “The Kanam Jaw.”

16.
an entirely different cancer:
G. Stathopoulos, “Letter: Kanam Mandible’s Tumour,”
Lancet
305, no. 7899 (January 18, 1975): 165. [
http://www.ncbi.nlm.nih.gov/pubmed/46076
]

17.
Others were not so certain:
A. T. Sandison, “Kanam Mandible’s Tumour,”
Lancet
305, no. 7901 (February 1, 1975): 279. [
http://www.ncbi.nlm.nih.gov/pubmed/46423
]

18.
Brothwell concluded:
Don Brothwell and A. T. Sandison,
Diseases in Antiquity: A Survey of the Diseases, Injuries and Surgery of Early Populations
(Springfield, IL: Charles C. Thomas, 1967), 330.

19.
scanning the mandible with an electron microscope:
J. Phelan, T. G. Bromage, et al., “Diagnosis of the Pathology of the Kanam Mandible,”
Oral Surgery,
Oral Medicine, Oral Pathology, Oral Radiology and Endodontology
103, no. 4 (April 2007): e20. [
http://www.journals.elsevierhealth.com/periodicals/ymoe/article/S1079-2104(07)00036-4
]

20.
“bone run amok”:
Timothy Bromage, e-mail message to author, July 1, 2010.

21.
“the giant sloth”:
Details are from a sign at the museum. My visit there was in May 2011.

22.
Leakey had sliced through the mass:
He reported that “a section was cut through the mandible in the region of the first molar” (
Stone Age Races,
2). He also mentions x-ray radiographs.

23.
a small group of Greek and Egyptian oncologists:
Spiro Retsas, ed.,
Palaeo-Oncology: The Antiquity of Cancer,
5th ed. (London: Farrand Press, 1986), 7–9.

24.
“As a crab is furnished with claws”:
Alexander Haddow, “Historical Notes on Cancer from the MSS. of Louis Westenra Sambon,”
Proceedings of the Royal Society of Medicine
29, no. 9 (July 1936): 1015–28. [
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2076239
]

25.
“because it adheres with such obstinacy”:
Haddow, “Historical Notes on Cancer,” 24.

26.
“[I]t attaches itself to the body of a young crab”:
Haddow, “Historical Notes on Cancer,” 25.

27.
by placing a live crab on top of it:
Haddow, “Historical Notes on Can- cer,” 28.

28.
“With treatment they soon die”:
Retsas,
Palaeo-Oncology,
45.

29.
a category of growth called
“praeter naturam”
:
Erwin H. Ackerknecht, “Historical Notes on Cancer,”
Medical History
2, no. 2 (April 1958): 114–19. [
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1034369
]

30.
“a tumor malignant and indurated”:
Retsas,
Palaeo-Oncology,
46.

31.
“The early cancer we have cured”:
Retsas,
Palaeo-Oncology,
49.

32.
“When a cancer has lasted long”:
L. Weiss, “Metastasis of Cancer: A Conceptual History from Antiquity to the 1990s; Part 2: Early Concepts of Cancer,”
Cancer Metastasis Reviews
19, nos. 3–4 (2000): i-xi, 205–17. [
http://www.ncbi.nlm.nih.gov/pubmed/11394186
]

33.
diagnosed in people fifty-five or older:
“Cancer Facts & Figures 2012,” American Cancer Society website. [
http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2012
]

34.
hovering around thirty or forty years:
For a discussion of the difficulties of estimating past longevity, see J. R. Wilmoth, “Demography of Longevity: Past, Present, and Future Trends,”
Experimental Gerontology
35, nos. 9–10 (December 2000): 1111–29. [
http://www.sciencedirect.com/science/article/pii/S0531556500001947
]

35.
the Saxon skeleton whose tumorous femur:
Brothwell and Sandison,
Diseases in Antiquity,
331 and 339, figure 11b.

36.
comb through the bones:
One in 100,000 people gets osteosarcoma. See Lisa Mirabello, Rebecca J. Troisi, and Sharon A. Savage, “Osteosarcoma Incidence and Survival Rates from 1973 to 2004: Data from the Surveillance, Epidemiology, and End Results Program,”
Cancer
115, no. 7 (April 1, 2009): 1531–43. [
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813207
]

37.
Iron Age man in Switzerland and a fifth-century Visigoth from Spain:
Edward C. Halperin, “Paleo-oncology: The Role of Ancient Remains in the Study of Cancer,”
Perspectives in Biology and Medicine
47, no. 1 (2004): 1–14 [
http://www.ncbi.nlm.nih.gov/pubmed/15061165
];; Brothwell and Sandison,
Diseases in Antiquity,
331; and Arthur C. Aufderheide and Conrado Rodriguez-Martin,
The Cambridge Encyclopedia of Human Paleopathology
(Cambridge: Cambridge University Press, 1998), 379.

38.
a medieval cemetery in the Black Forest Mountains:
K. W. Alt et al., “Infant Osteosarcoma,”
International Journal of Osteoarchaeology
12, no. 6 (December 24, 2002): 442–48. [
http://onlinelibrary.wiley.com/doi/10.1002/oa.647/abstract
]

39.
“to die a painful death”:
Alt et al., “Infant Osteosarcoma,” 447.

40.
“The large size of the tumor”:
Eugen Strouhal, “Ancient Egyptian Case of Carcinoma,”
Bulletin of the New York Academy of Medicine
54, no. 3 (March 1978): 290–302. [
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1807435
]

41.
Traces were found in the skull:
Kurt W. Alt and Claus-Peter Adler, “Multiple Myeloma in an Early Medieval Skeleton,”
International Journal of Osteoarchaeology
2, no. 3 (May 23, 2005): 205–9 [
http://onlinelibrary.wiley.com/doi/10.1002/oa.1390020304/abstract
]; and C. Cattaneo et al., “Immunological Diagnosis of Multiple Myeloma in a Medieval Bone,”
International Journal of Osteoarchaeology
4, no. 1 (May 27, 2005): 1–2. [
http://onlinelibrary.wiley.com/doi/10.1002/oa.1390040102/abstract
]

42.
Most skeletal cancers by far come from metastases:
Tony Waldron, “What Was the Prevalence of Malignant Disease in the Past?”
International Journal of Osteoarchaeology
6, no. 5 (December 1, 1996): 463–70. [
http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1099-1212(199612)6:5<463::AID-OA304>3.0.CO;2-Y/abstract
]

43.
discovered in Egyptian tombs:
Eugen Strouhal, “Tumors in the Remains of Ancient Egyptians,”
American Journal of Physical Anthropology
45, no. 3 (November 1, 1976): 613–20. [
http://www.ncbi.nlm.nih.gov/pubmed/793419
]

44.
in a Portuguese necropolis:
S. Assis and S. Codinha, “Metastatic Carcinoma in a 14th–19th Century Skeleton from Constância (Portugal),”
International Journal of Osteoarchaeology
20, no. 5 (September 1, 2010): 603–20. [
http://onlinelibrary.wiley.com/doi/10.1002/oa.1084/abstract
]

45.
in the Tennessee River valley:
Maria Ostendorf Smith, “A Probable Case of Metastatic Carcinoma from the Late Prehistoric Eastern Tennessee River Valley,”
International Journal of Osteoarchaeology
12, no. 4 (July 1, 2002): 235–47. [
http://onlinelibrary.wiley.com/doi/10.1002/oa.618/abstract
]

46.
in a leper skeleton from a medieval cemetery:
Donald J. Ortner, Keith Manchester, and Frances Lee, “Metastatic Carcinoma in a Leper Skeleton from a Medieval Cemetery in Chichester, England,”
International Journal of Osteoarchaeology
1, no. 2 (June 1, 1991): 91–98. [
http://onlinelibrary.wiley.com/doi/10.1002/oa.1390010204/abstract
]

47.
near the Tower of London:
M. Melikian, “A Case of Metastatic Carcinoma from 18th Century London,”
International Journal of Osteoarchaeology
16, no. 2 (March 1, 2006): 138–44. [
http://onlinelibrary.wiley.com/doi/10.1002/oa.1390010204/abstract
]

48.
excavated a 2,700-year-old burial mound:
Details of the discovery are described on the website of the German Archaeological Institute: “Complete Excavation of the Kurgan Arzhan 2 including an Undisturbed Royal Grave (late 7th century B.C.).” [
http://www.dainst.org/en/project/russian-federation-tuva-arzhan
] More information is on the website of the State Hermitage
Museum in St. Petersburg: “Restoration and Reconstruction of the Arzhan-2 Complex of Artifacts.” [
http://www.hermitagemuseum.org/html_En/13/hm13_3_020.html
] I described this and some other cases more briefly in “Trying to Estimate Cancer Rates in Ancient Times,”
New York Times,
December 27, 2010. [
http://www.nytimes.com/2010/12/28/health/28cancer.html
]

49.
his skeleton was infested with tumors:
Michael Schultz et al., “Oldest Known Case of Metastasizing Prostate Carcinoma Diagnosed in the Skeleton of a 2,700-year-old Scythian King from Arzhan (Siberia, Russia),”
International Journal of Cancer
121, no. 12 (December 15, 2007): 2591–95. [
http://www.ncbi.nlm.nih.gov/pubmed/17918181
]

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