Agnes Arnold-Forster

In 1904 a rank and file clinician, A. T. Brand, narrated an incident in which, “a man presented himself…suffering from cancer of the…penis.” On further analysis, the tumour was “found to consist, not of penile tissue, but of uterine cervical elements.” It was then discovered, “the the man’s wife was suffering from an ulcerated uterine cervical carcinoma.” For Brand, the explanation was clear: “this was a case of undoubted direct transmission of cancer from one individual to another, and as such it must be accepted as proof of the transmissibility…of cancer.”

This doctor believed, in other words, that the man had ‘caught’ his penile cancer from having sex with his wife, who herself suffered from late stage cancer of the uterus and cervix. Far from extraordinary, Brand’s experience mirrored similar claims made throughout the previous century, with many doctors alluding to such cases in their interrogations of cancer.

A giant claw pierces the breast of a sleeping naked woman (Wellcome Images)

What, then, can such sexualised snippets tell us about how doctors conceptualised cancer in the long nineteenth century in Britain? In some ways, they reveal that doctors used sexual contact as a way of thinking through cancer’s transmission. For them, cancer was a venereal disease to be considered alongside syphilis and gonorrhoea. Such stories also reveal how sexual values sometimes informed how actors moralised cancer, and associated it with deviant behaviour. But more often than not, this moral overlay was patchy and incomplete. 

Sexual contact provided a mechanism to explain the epidemiology of cancer in a period marked by mystery and debate. Doctors, scientists, and public health practitioners studied cancer on the macro scale of population health, through the microscope, and in the clinic. Still, in 1911 the British Medical Journal lamented, “at the present time, when the nature and cause of so many diseases have been thoroughly elucidated, the aetiology of cancer continues to baffle investigation, and remains enveloped in a veil of mystery.”

Much of nineteenth-century cancer discourse abounded with pessimism, and medical men repeatedly recognised the limits of their knowledge when it came to the ‘dread disease.’ While there was marginally more consensus on treatment – it was “a most painful and loathsome disease,” one that, “kills by inches, and seldom admits of any cure except by the knife, and even that remedy does not always succeed.” Most medical men, and they were almost exclusively men, agreed that cancer’s cure still evaded the profession.

Within this intellectual space, a diverse community of health ‘professionals’ put forward a range of theories about cancer. It was well known that certain diseases could be passed via sexual contact. The development of germ theories in the 1870s and 1880s elaborated this understanding as scientists learned that specific microorganisms caused specific diseases. While this process was uneven and contingent, the rapid discovery of various disease agents in the period, such as the syphilis spirochete in 1905, captured the professional and public imagination. As scientists and doctors sought to understand the origins and transmissions of cancer, they thought about this disease through germ theory and models of sexual contact.  

Surgery for the removal of the mammary gland, 1846 (Wellcome Images)

Venereal diseases all share sex as their vector of transmission; however, they also come with layers of moral meanings. Such diseases, doctors and commentators maintained, were not simply passed via neutral infection: they were the wages of sin. When applying the venereal disease model to cancer, doctors sometimes imported these moral frameworks. Equally, some doctors asserted that sexual immorality actually caused cancer. Professor Velpeau – a French surgeon with wide-ranging interests – wrote in 1841 that “venereal ulcerations of the lip frequently degenerate into cancer.” In 1816 Thomas Denman, a surgeon at the Middlesex Hospital in London, wrote, “It is admitted that Cancer more frequently affects parts concerned with the venereal appetite than others; but it has not appeared how far the unreasonable indulgence of that appetite may dispose to this disease, though it may to many other punishments.” Cancer seemed most frequently to affect sexual organs, and in particular those of women.

However, these associations were sporadic rather than constant; fringe rather than mainstream.  Cancer was not cloaked in the kinds of moralised reprimands, invasions of privacy, and contraventions of individual liberty that infiltrated public health approaches to syphilis in the nineteenth century. While it did share an aetiological framework with ‘other’ venereal diseases, cancer was not a sexually transmitted infection in the sense that it resulted from bad behaviour. In fact, the main trajectory of cancer theory in the nineteenth century worked to divorce cancer from poverty, shame, and immorality; instead functioning to closely associate the disease with wealth, health, and propriety. One commenter observed that promiscuity could not explain cancer’s increasing incidence in Ireland: “Syphilis is a rare disease among the small farmers and labourers of Ireland, whose sexual morality, to say nothing of Irish women, is the highest in Europe.” Moreover, in every incident narrated by medical professionals, cancer was passed from husband to wife (or vice versa). It was a product of orthodox heterosexuality.

United States Public Health Service, Increase of Cancer, 1941 (Wellcome Images)

Cancer’s configuration as a sexually transmitted disease allows us to question our assumptions of both cancer and the category of venereal disease itself. This history allows us to rethink cancer – a disease that is in so many ways so familiar to inhabitants of the twenty-first century. Cancer was made and then, to an extent, unmade as a sexually transmitted infection. The flexibility of cancer’s designation suggests that we, too, require a more flexible approach to the study of all diseases. This history of cancer as venereal disease also raises fundamental questions: Does the history of cancer make us question what we really mean by venereal disease? Do we mean a collection of maladies that share a mechanism of communication? Or, do we mean the social and cultural costs of a disease transmitted via sexual contact? Cancer in the nineteenth century had the former but not the latter – does it, therefore, even ‘count’ for this series on the history of venereal disease?

Headshot of Agnes Arnold-FosterAgnes Arnold-Forster is a PhD Candidate at King’s College London, researching the history of cancer in nineteenth-century Britain. She is broadly interested in issues of gender, sexuality and race, as well as NHS reform and global health. She works for a small women’s health charity that advocates for sexual and reproductive rights in sub-Saharan Africa. She tweets from @agnesjuliet.

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