Madeleine Carlson, Programs and Communications Intern
Before the end of breast cancer awareness month, we’d like to highlight how cancer affected people in the Victorian era and compare our modern understanding of the illness. In our educational programming and lectures, we explore the daily lives and struggles of the average person in Victorian times, often with a focus on how strict patriarchal society affected every aspect of women’s lives. In this case, it led to a severely warped medical understanding of women’s bodies.
By the mid-19th century, it was widely believed that cancer disproportionately affected women as breast cancer was the most visible type and could be diagnosed with more accuracy. In 1854, the author of the standard textbook on cancer at the time, Walter H. Walshe, stated that: “There is no fact in the history of cancer more absolutely demonstrated than the influence exercised by sex on its development,” continuing to explain that women are affected by cancer at a rate “2 and three quarters” greater than men. [2] Cancers specific to men were still diagnosed and recognized, though their illnesses were often attributed to a poor diet or simply poor luck, whereas women’s cancers were explained through pathologizing every aspect of the female experience.
While breast cancer had been a known killer for centuries, the cause continued to elude doctors into the Victorian era. It was a common theory that repeated wearing of tight corsets was a leading cause of breast cancer. Other widely agreed upon risks included frequent pregnancy, as well as never being pregnant, irregular menstruation, menopause, and not breastfeeding one’s children. It appeared that any deviation from traditional feminine gender roles and expectations of motherhood was not only a moral issue, but suddenly posed a serious medical threat. These popular theories only magnified feelings of shame in patients already suffering, convinced they had brought the disease on themselves as a result of their behaviour.
A cure without pain
An ad for Dr. Chamlee’s cancer-specific tonic.
Photo via Wellcome Image Collection, distributed under CC-BY 4.0 license.
Mastectomies had been described in medieval texts and were likely performed without any record for centuries prior with low odds of survival. While surgery proved to be the only true hope for breast cancer remission, the idea of undergoing this at a time before anesthesia and proper infection prevention saw some fearful patients turning to the many patent medicines boasting wild claims of curing cancer without pain. This industry was able to profit off the fear and desperation of patients for many years before any laws were introduced to target their false advertising.
It wasn’t until the late 19th century that a more effective surgical treatment emerged, along with the widespread use of anaesthesia and guidelines for aseptic and antiseptic techniques. The radical mastectomy, introduced by Dr. William Halsted in 1894, had a higher chance of complete remission but came with a cost of almost guaranteed loss of mobility. The surgery was even more life-altering than the procedure we’re familiar with today. Surgeons would cut all the way down to the breastbone to remove every trace of tissue and muscle. This technique was practised up until the 1970s when it was discovered that preserving the pectoral muscles yielded comparable results and the technique was modified.
Treatment Today
Medicine has advanced beyond what was thought possible in Victorian times, but the impact of these harmful beliefs about women’s bodies can be felt today in the continued dismissal of women’s concerns and pain in the medical field. We are severely lacking historical accounts of breast cancer from the point of view of the patient. Nearly all records of the radical mastectomy procedure were written by male doctors and observers, rarely including any follow-up appointments documenting the patient’s quality of life after the operation. An underlying lack of empathy for women in Western medicine could be a result of the lack of firsthand writing, and the extensive studies published by men seeking evidence to support their theories of total female inferiority. Women of colour are especially affected by dismissive behaviour when seeking healthcare.
The shame and fear of their own bodies that Victorian women held should not be present today, but this precedent of attributing immorality to women’s physical illnesses seems to linger in the modern age. The fear of judgment, unnecessarily painful procedures, and that their concerns will go unheard are all unfortunate obstacles that women face in medicine to this day.
References
1. Plesca, M, et al. “Evolution of Radical Mastectomy for Breast Cancer.” Journal of Medicine and Life, U.S. National Library of Medicine, 18 Mar. 2016
2. Walshe Walter Hayle, “The Nature and Treatment of Cancer”. London: Taylor and Walton, 1846, pp. 152–153
3. Moscucci, Ornella. “Gender and Cancer in Britain, 1860-1910: The Emergence of Cancer as a Public Health Concern.” American Journal of Public Health, U.S. National Library of Medicine, Aug. 2005
4. Skuse, Alanna. “Mastectomies Have Been Performed for over 500 Years – yet We Still Can’t Talk about Them.” The Conversation, 17 Sept. 2020
5. American Medical Association. Nostrums and Quackery. Press of American Medical Association, 1912
6. Arnold-Forster, Agnes. “Culture, Continuity and Breast Cancer | History Today.” Www.historytoday.com, 31 Mar. 2015.
7. Skuse, Alanna. Constructions of Cancer in Early Modern England. Springer, 11 Nov. 2015, pp. 40–60.