Byzantine, Really?
I found an abstract on Penile Cancer. I am posting it here for some historical perspective.
One of the striking things about penile cancer is how often patients feel as if they are entering a forgotten corner of medicine. PSCC is rare. The language around it is difficult. The stigma is heavy. Progress can feel slow.
That is why this historical paper is so surprising.
The authors looked back at Byzantine medical texts and found that physicians such as Oribasius of Pergamus and Paul of Aegina were already describing tumors of the glans and foreskin in remarkable detail. They used the term “thymi” for fleshy growths on the penis and distinguished between benign and malignant forms. They understood that some lesions could be removed locally, while others behaved more aggressively, bled, recurred, or worsened after being cut.
What stands out is that these physicians were not simply performing radical removal. They described local excision of penile tumors, followed by burning with cautery or caustic substances to reduce relapse. In modern language, this resembles a form of penile-preserving surgery with adjuvant local treatment — remove the tumor, then treat the margin or surface to lower the risk of recurrence.
The paper’s strongest point is historical and human: what we now call organ-preserving treatment was not invented only in the modern era. Byzantine surgeons were already trying to treat penile tumors while preserving as much of the organ as possible. They even warned against treating internal and external foreskin lesions at the same time because the tissue was thin and could be damaged or perforated. That detail shows a practical surgical awareness that feels unexpectedly modern.
The authors also note that Paul of Aegina recognized features of malignancy and described cancer as rough, uneven, darkish, painful, sometimes ulcerated, and capable of spreading. He also discussed hardened glands in the groin, neck, or armpits and recognized that painful malignant glands were difficult to treat surgically. For PSCC patients today, that matters because lymph nodes remain one of the most important parts of staging, risk, and treatment planning.
For me, the lesson is not that ancient medicine was better than modern oncology. It wasn’t. Modern pathology, imaging, chemotherapy, immunotherapy, genomic testing, sentinel lymph node biopsy, and reconstructive surgery have changed what is possible.
The lesson is different.
Even centuries ago, physicians understood something we are still fighting for today: penile cancer care should not begin with shame, silence, or automatic disfigurement. It should begin with careful observation, early treatment, preservation when possible, and respect for the whole person.
That is the thread connecting Byzantine surgery to modern PSCC advocacy.
The tools have changed.
Patient’s needs have not. Respect, care, minimize waiting, prioritize effective treatment and follow on surveillance.
ABSTRACT SOURCES: https://pubmed.ncbi.nlm.nih.gov/26011363/