Two Hundred Years of Cancer Research

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Abstract
In the 200 years since the New England Journal of Medicine was founded, cancer has gone from a black box to a blueprint. During the first century of the Journal's publication, medical practitioners could observe tumors, weigh them, and measure them but had few tools to examine the workings within the cancer cell. A few astute observers were ahead of their time, including Rudolf Virchow, who with the benefit of a microscope deduced the cellular origin of cancer in 1863,1 and Stephen Paget, who in 1889 wisely mused about the seed-and-soil hypothesis of metastatic disease,2 a theory that is coming into its own today ( Table 1 ). Other key advances were the discovery of a viral cause of avian cancer by Peyton Rous in 19113 and the proposal by Theodor Boveri in 1914 that cancer can be triggered by chromosomal mutations.4