United Kingdom

THE UNITED KINGDOM, located in northwest Europe, was formed by mergers between England and Wales (united since 1535–42), England and Scotland in 1707, and Great Britain with Ireland in 1800. In 1922, with the creation of the Irish Free State (later the Irish Republic), British rule in Ireland was limited to Northern Ireland. The United Kingdom had a population of 60,209,500 in 2005, with 164 doctors and 500 nurses per 100,000 people. An example of cancer incidence rates in the United Kingdom includes 286.6 cases of cancer in males per 100,000, according to the International Agency for Research on Cancer.

In medieval England and Scotland, barber-surgeons were involved in the removal of some tumors, with limited success rates. It was a period when surgeons were trying to prevent barbers from being involved in surgery, but the surgeons had limited progress at achieving [Page 939]this ban. However, there were some advances made in cancer research. One of the early English contributions was that of John of Arderne (1307–90), who studied at Montpellier in France and became a surgeon during the Hundred Years' War. It was during the Hundred Years' War that Edward III's eldest son, Edward, the Black Prince, rose to fame as a warrior. The Black Prince, who died in 1376, suffered for 6 years from a wasting disease that, at the time, was thought to be a fever but is now believed to have been a type of cancer.

Gradually, the number of surgeons operating in most cities and towns throughout England increased, with surgery being used to deal with cancers until the 19th century. Some of these surgeons became famous for their skills, one of whom was the Portuguese-born Dr. Lopez, who became entwined in English spy intrigues in the court of Elizabeth I and was executed for high treason in 1594. He is best remembered as the partial model for the character of Shylock in William Shakespeare's The Merchant of Venice.

Cancer and tumors claimed the lives of many people during the 17th and 18th centuries, including Elizabeth, daughter of Oliver Cromwell, who died from cancer in 1658. Many literary figures also were affected by cancer during this period: writer Lady Mary Wortley Montagu (1689–1762), who died from cancer after returning from Italy.

It was surgeon John Hunter (1728–93) who set the basis for scientific surgery, with his book Lectures of the Principles of Surgery. Hunter managed to demonstrate that there were several different causes of cancer: age, heredity, and climate. He also found that the places most likely to be affected by cancers were the breast, the uterus, the lips, external parts of the nose, the pancreas, and the gastric pylorus. He never made any mention, in his writings, of lung cancer, colon cancer, or rectal cancer, and he does not appear to have linked lymphomas and leukemias with cancer.

At the same time Hunter was making progress with his surgical techniques, in 1775, London surgeon Percivall Pott (1714–88) was able to explain the existence of scrotal cancer in chimney sweeps as resulting from the sweeps' regular exposure to soot, thus establishing the basis of occupational cancer for the first time.

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