Cancer and Emotions

Physicians have been aware of cancer for at least 4,500 years. The disease that was known for caus­ing tumors to grow in the human body with­out any clear rea­son was given its name by Anci­ent Greek physi­cians about 2,400 years ago. Because the shape of some tumors reminded them of crus­taceans, they derived its name from the Greek for ‘crab’. The growths were untreat­able and when they broke through the skin they formed grue­some wounds. The first theory on the cause of can­cer also dates to this era. It was thought that an excess of black bile led to an imba­lance of the four humors (blood, yellow bile, black bile, and phlegm), causing the deadly disease.

In the mid-19th cen­tury, cel­lu­lar patho­logy replaced the ancient humoral patho­logy. Since then, cancer has been under­stood as a disease caused by the muta­tion of healthy cells. This “degene­ra­tion” first arises in one spot on the body and then spreads. The new under­stand­ing of the disease paved the way for modern onco­logy. It signi­fi­cantly im­proved the chan­ces of sur­vival for cancer patients, with heal­ing becom­ing pos­sible more and more often. The feel­ings that move us when we are confronted with cancer have also changed drama­tically since then. This vir­tual exhi­bi­tion focuses on this change and its effects.

Fotografie. Ausstellungsansicht, schwarz-weiß, von 1930: Blick in die Abteilung „Kampf dem Krebs“ der Schausammlung des Deutschen Hygiene-Museums. Zu sehen sind verschiedene Schautafeln, die über Krebs informieren.
Fotografie. Ausstellungsansicht, schwarz-weiß, von 1930: Blick in die Abteilung „Kampf dem Krebs“ der Schausammlung des Deutschen Hygiene-Museums. Zu sehen sind verschiedene Schautafeln, die über Krebs informieren.
Fotografie. Ausstellungsansicht, schwarz-weiß, von 1930: Blick in die Abteilung „Kampf dem Krebs“ der Schausammlung des Deutschen Hygiene-Museums. Zu sehen sind verschiedene Schautafeln, die über Krebs informieren.
Fotografie. Ausstellungsansicht, schwarz-weiß, von 1930: Blick in die Abteilung „Kampf dem Krebs“ der Schausammlung des Deutschen Hygiene-Museums. Zu sehen sind verschiedene Schautafeln, die über Krebs informieren.
Fotografie. Ausstellungsansicht, schwarz-weiß, von 1930: Blick in die Abteilung „Kampf dem Krebs“ der Schausammlung des Deutschen Hygiene-Museums. Zu sehen sind verschiedene Schautafeln, die über Krebs informieren.

Educating about Cancer

Fotografie, schwarz-weiß, um 1950: Das Foto zeigt einen Mann und eine Frau an einem Tisch sitzend. Der Mann schreibt, sein Blick ist gesenkt. Die Frau betrachtet ein Tinten-Kleks-Bild

The “Cancer Personality”

Is there a con­nec­tion between emo­tions and can­cer? From anti­qui­ty to the 18th cen­tu­ry, scho­lars explored the link between can­cer and melan­choly. How­ever, in ancient times melan­choly was under­stood in a dif­fe­rent way. The term refer­red to multi­form mind-body dys­func­tions caused by black bile, the com­mon symp­tom of which was anxiety, fear or sad­ness. With the 19th and 20th cen­tu­ries came new assump­tions about the body, psyche, and disea­ses (can­cer) that would fun­da­ment­ally change the per­cep­tion of their con­nec­tions to each other.

Around 1900, the theory that ner­vous exhaus­tion could cause can­cer had gained trac­tion. Pick­ing up on psy­cho­ana­ly­ti­cal con­cepts, in the 1910s psy­cho­soma­tic thera­pists began dis­cuss­ing the extent to which repressed trou­bles, unful­filled desi­res or fee­lings of guilt could con­tri­bute to can­cer. From the 1950s on, psycho­soma­tic thera­pists sus­pected that people, espe­cially women, with cer­tain psycho­logi­cal cha­rac­te­ris­tics (de­pressed, inhi­bited, sub­mis­sive, incap­able of authen­tic fee­lings) were more likely to develop can­cer. Ulti­mately, the theory of the so-called “can­cer per­so­na­lity” could not be empiri­cally proven. Today within the field of onco­logy, this idea is con­si­dered a mis­conception.

Fotografie, schwarz-weiß, von 1955: Das Foto zeigt einen Patienten und einen Arzt in einem Behandlungszimmer an einem Schreibtisch sitzend. Den Patienten sieht man von vorne. Der Arzt wird in einer Dreiviertelansicht von hinten gezeigt.

Talking about

In the 19th century, a can­cer dia­gno­sis was con­sidered a horri­fic death sen­tence. Typi­cally, patients were not inform­ed of their can­cer dia­gno­sis. The know­ledge of having can­cer, doctors believed, would rob people of all hope, destroy their will to live and, there­fore, shor­ten their remain­ing toler­able time. In the 20th cen­tury, the voi­ces of those oppos­ing this prac­tice grew louder and louder. How­ever, it was not until the 1980s that it became more com­mon to notify patients of their dia­gno­sis. Today, cri­tic­ism is no longer cen­tered around the deci­sion of whether or not the dia­gno­sis should be com­muni­cated, but rather tar­gets how it should be communicated.

Christoph Wilhelm Hufeland

* 1762 in Langensalza,
† 1836 in Berlin

  • Physi­cian, royal per­sonal physi­cian, medi­cal di­rec­tor of the Charité, social hygien­ist and popu­lar edu­cator
  • Repre­sen­ta­tive of the life force theo­ry and founder of the “doc­trine of long life” (macro­biotics)

“Is it not decided that fear, espe­cially of death, anxiety, and ter­ror are the most dan­ger­ous poi­sons and directly para­lyze the vital force; and that hope and cou­rage, on the other hand, are the grea­test invi­go­ra­tors, often sur­pass­ing all medi­cines in power, indeed with­out which even the best reme­dies lose their power? The phy­si­cian must, there­fore, above all things, be invested in the pre­serv­ing hope and cou­rage of the sick, pre­fer­ring to make the matter easy, to con­ceal all dan­gers […] To announce death is to give death, and this can never, must never be the busi­ness of one who is there purely to spread life.”

Christoph Wilhelm Hufeland, Enchi­ri­dion medicum oder Anlei­tung zur Medizi­ni­schen Praxis. Ver­mächt­nis einer fünfzig­jährigen Erfah­rung, Berlin 1836.

Albert Moll

* 1862 in Lissa (today Leszno),
† 1939 in Berlin

  • physician, psychiatrist, sexo­lo­gist, sharp critic of contemporary human experiments
  • advo­cated the communi­cation of can­cer diagnosis so that patients could give informed con­sent to inter­ven­tions and therapies

“It may be dif­fi­cult for the physi­cian to inform the patient about the ter­minal nature of his suf­fer­ing. It may be done in a gentle way, he may leave him a glim­mer of hope, espe­cially since he must con­sider that all know­ledge and pre­dic­tions have only a con­ditio­nal vali­dity […]. But the doc­tor, who was only asked for an expert opinion, must not tell a lie […]. In such a case, it is also unac­cept­able to give an ambi­guous answer, which is sup­posed to hide the pain­ful truth. […] It will be said that such behavior of the doc­tor is inhuman. On the other hand, I would like to note that inform­ing the patient […] is also a medi­cal and a human duty […].”

Albert Moll, Ärztliche Ethik. Die Pflichten des Arz­tes in allen Bezie­hungen seiner Thätig­keit, Stuttgart 1902.

Albert Krecke

* 1863 in Salzuflen,
† 1932 in München

  • Surgeon, ship doctor and foun­der of a pri­vate clinic
  • esteemed by Kurt Tucholsky for his kind­ness, ope­rat­ed on the sons of Katja and Thomas Mann, among many others

“Should we now tell a patient, who knows the poor chan­ces of curing can­cer, the true nature of his suf­fer­ing and thus con­demn him to a depress­ing hope­less­ness for the rest of his life? Some doc­tors say, ‘We must reveal to can­cer patients the nature of their suf­fer­ing because other­wise they can­not be per­suaded to under­go the only pro­per treat­ment, sur­gery.’ […] It always seems to me a cruelty to try to force the sick per­son to have an ope­ra­tion by tell­ing him that he is suf­fer­ing from can­cer. […] The majo­rity of can­cer patients come to the doc­tor so late that surgi­cal treat­ment is no lon­ger pos­sible. […] How can we give these patients new hope every day, how can we lead them with firm­ness and con­fi­dence through the depths of their suf­fer­ing and over their des­pair, this must be the most ardent con­cern of every true physician. […]”

Albert Krecke, Vom Arzt und seinen Kranken, München 1932.

Johannes Heinrich Schultz

* 1884 in Göttingen
† 1970 in West Berlin

  • psychiatrist, psycho­therapist, inventor of auto­genic train­ing
  • advocated the mur­der of disabled people under Natio­nal Social­ism

“Today, the cou­rage to tell the truth is one of the most impor­tant de­mands of our time. The new Germany wants cou­rage­ous people who also have the cou­rage to face the truth. The German man should not only be able to live cou­rage­ous­ly, but also to die cou­rage­ous­ly. Never­the­less, there will always be cases where it is not appro­pri­ate to tell the full truth, as in the case of chil­dren, the ner­vous, the hyste­ri­cal, the men­tally infer­ior, and so on. One will have to make one’s decis­ion there on a case-by-case basis. “Dying people” and “dying people” are two dif­fe­rent things. [...] In the case of unstable, inward­ly fra­gile people, what is to be done will have to be decided between the doc­tor and pas­tor. Other­wise, the rule is that truth­ful behav­ior best secures the physi­cian’s true authority over the sick and their rela­tives.”

Soll man dem Kranken die volle Wahr­heit sagen? Tagung der Arbeits­gemein­schaft zwischen Ärzten und Geist­lichen am 2.9.1937. LAB Berlin A Rep. 003-04-03, Nr. 55.

H. D. Claus

(no life data,
no portraits known)

  • Radiologist
  • Chief physician of the Radia­tion Insti­tute at the Erla­brunn Miners’ Hospital in the Ore Moun­tains

“Every experienced tumor thera­pist will confirm, how­ever, that to live through weeks and months of uncer­tainty as to the exis­tence of a tumor, a recur­rence, or meta­sta­ses, to eva­sive­ly answer often repeat­ed, appro­pri­ate ques­tions, is tanta­mount to a men­tal terror in an intel­li­gent patient who keeps a close watch on suspi­cious chan­ges in his body, the damage of which may be incom­par­ably greater than the shock which an appro­pri­ate com­muni­cation of the pre­sence of a mali­gnant tumor is likely to pro­duce. If one tries to de­ceive the pa­tient about this with trans­pa­rent phra­ses, a ten­sion of dis­trust and insin­cerity ari­ses between doc­tor and patient, which has a con­ceiv­ably unfavor­able effect on the behavior and atti­tude of the sick per­son towards the doc­tor, nurs­ing staff and other patients […].”

H. D. Claus, Zu einigen prak­ti­schen Fragen der Meta­phylaxe nach Strahlen­therapie der Geschwulst­leiden, in: Das deutsche Gesund­heits­wesen 17 (1962), 35, S. 1489-1498.

Hildegard Frieda Albertine Knef

* 1925 in Ulm
† 2002 in Berlin

  • actress, chanson singer, author
  • learned in 1975 that she had breast cancer, wrote a novel about her illness

“The faces of my baker’s clerks had been con­trite. […] ‘It is …,’ one spoke, break­ing off as if, after wad­ing through the first and second acts, he had dis­cover­ed the night­mar­ish text hole from which there is no escape. ‘It is …’ he began again, bravely and piti­fully. But I, as the imperi­ously frightened lead­ing role bearer, let hear: ‘Tell the truth, I demand the truth.’ […] Now they nodded, as if I had taken over the saving work of the fail­ing promp­ter, as if I had given the signal, set the course of memory. ‘The fro­zen sec­tion was suspi­cious,’ came fluidly, the sen­tence sure. And the second: ‘I went to the lab, the last test confirmed it.’ Now a cough, a long-drawn-out ‘yes’ mudd­led follows: ‘It’s a car­ci­noma, cherry-sized.’ […] The verdict was in.”

Hildegard Knef, Das Urteil oder Der Gegen­mensch, Wien u.a. 1975.

Fritz Meerwein

* 1922 in Basel
† 1989 in Heidelberg

  • psychiatrist and psycho­analyst
  • important pioneer of psycho-onco­logy

“The physician’s full duty to inform, which is desired by most sick per­sons, has con­tri­buted con­sider­ably to reduc­ing the dan­ger of under- and mis-informa­tion of patients at this stage. […] In a second con­sul­ta­tion scheduled shortly after the ini­tial infor­ma­tion, the patient should usually be given the opportun­ity to dis­cuss fears, anxie­ties, and fan­ta­sies, […] in detail with the first treat­ing physi­cian. […] If the duty to inform is hand­led care­fully, the contact between patient and physi­cian usually develops openly and truth­fully in the ini­tial stage. Under the impres­sion of the mea­sures to be ini­tiat­ed now and the expla­na­tion of the the­rapy options and goals by the physi­cian, the patient can often well over­come the ini­tial shock and the psycho­logi­cal sense of iso­la­tion and doom that the dia­gno­sis ‘cancer’ has trig­ger­ed in him.”

Fritz Meerwein, Die Arzt-Patien­ten­beziehung des Krebs­kranken, in: ders. (Hg.), Ein­führung in die Psycho-Onko­logie, Bern u. a. 1981, S. 84-165.

Fotografie, schwarz-weiß, vermutlich aus den 1920er Jahren. Das Foto zeigt das Portal zur chirurgischen Poliklinik der Charité. Die schwere Holztür steht offen.
Fotografie, schwarz-weiß, vermutlich aus den 1920er Jahren. Das Foto zeigt das Portal zur chirurgischen Poliklinik der Charité. Die schwere Holztür steht offen.
Fotografie, schwarz-weiß, vermutlich aus den 1920er Jahren. Das Foto zeigt das Portal zur chirurgischen Poliklinik der Charité. Die schwere Holztür steht offen.

Expe­ri­enc­ing the transi­tion


Barbara Seuffert’s book is one of many memoirs, which tend to be writ­ten by women. In addi­tion, since the 1980s, more and more guides to cancer have been pub­lished by psycho­logists.

Barbara Seuffert, 2001 | Berliner Medizin­historisches Museum der Charité

Fotografie, schwarz-weiß, um 1910: Das Foto zeigt fünfzehn Personen in einem Operationssaal. Sie tragen OP-Kleidung, Im Vordergrund liegen OP-Instrumente auf einem Rolltisch, ferner sieht man einen Sterilisator und zwei Emaille-Schüssel mit Wasser.

Operating on cancer

Early on, surgeons at­tempted to cure can­cer with sur­gery. With the new under­stand­ing that most can­cers develop locally, sur­gery gained scien­ti­fic legi­ti­macy as a treat­ment option. Thanks to the intro­duc­tion (1846) and devel­op­ment of anes­thesia, sur­geons were now able to remove deeper tumours. Addi­tio­nally, hygie­nic stan­dards in ope­rat­ing rooms improved dras­ti­cally in the second half of the 19th cen­tury. The mor­ta­lity rate of patients under­going sur­gery declined making the risks of sur­gi­cal can­cer treat­ments appear increas­ingly accept­able.

Cervical cancer
Bowel cancer
prostate carcinoma


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Cervical cancer

The case history
of Auguste B.

On May 26th, 1907, Auguste B. went to the Charité women’s clinic.

Although, at 59 years old, she hadn’t had a period for ele­ven years, she had been bleed­ing through­out Jan­uary and February.

Short­ly there­after, she notic­ed aching in her lower left ab­do­men. In the beginn­ing of May, the pain became in­creas­ing­ly severe and she start­ed bleed­ing again.

The symptoms she de­scrib­ed con­cern­ed the gy­ne­col­ogist. A thor­ough exa­mi­na­tion con­firm­ed the doc­tor’s su­spi­cion: Auguste B. was suffering from advanced cervical cancer.

Black and white photography: University Women’s Clinic in Berlin, before 1906

Fig. 1/4 Uni­ver­sity Women’s Clinic in Berlin, before 1906

The tumor was already large.

It had grown into Auguste B.’s blad­der and vagina, which meant there was no lon­ger any pro­spect of a cure.

Nevertheless, the doc­tors decided to ope­rate, know­ing that the ope­ra­tion was highly risky.

Later, a doctor who was an intern at the time of the sur­gery, justi­fied the de­ci­sion in a scienti­fic arti­cle by stat­ing that sur­geons must prac­tice sur­gi­cal tech­niques in order to per­fect them for the bene­fit of future patients.

Medical drawing: Pelvic exenteration

Fig. 2/4 Medical drawing: Pelvic exenteration

The operation took an hour and a half to complete.

They removed Auguste B.’s ute­rus and a pair of her glands. When they tried to detach the tu­mor from the pos­te­rior pel­vic wall, it dis­integrated.

The day after her ope­ra­tion she was writh­ing in pain, could hard­ly move and was con­stant­ly vo­mit­ing. She was also run­ning a high fever.

Doctors and nur­ses im­medi­ate­ly re­co­gniz­ed that the pa­tient was suf­fer­ing from in­flam­mation in her ab­domi­nal ca­vity. At the time, this was a fre­quent and fear­ed com­pli­ca­tion of this operation.

Black and white photography: Aseptic operating room, around 1910

Fig. 3/4 Aseptic opera­ting room, ca. 1910

It was an in­fec­tion that caused Auguste B.’s death, not cancer.

It’s true that sur­geons washed their hands before every ope­ra­tion and used ste­rile sur­gi­cal ins­tru­ments; pa­tients’ skin was thorough­ly clean­ed and ope­ra­tions were no lon­ger per­form­ed in crowd­ed lec­ture halls, but in se­pa­rate, asep­tic areas.

Micro­bio­logic­al re­search had im­pres­sive­ly pro­ven the es­sen­tia­lity of pro­per sani­ta­tion in ope­rat­ing rooms.

Never­the­less, in 1907, when the ute­rus was re­mov­ed, one fifth of pa­tients still died due to ope­ra­tion-re­lat­ed in­fec­tions or other complications.

Black and white photography: Surgical operation in a lecture hall, before 1905

Fig. 4/4 Surgical operation in a lecture hall, before 1905


Treatment of
bowel cancer

The case history
of Wilhelm K.

November 1913: Wilhelm K. went to a general prac­ti­tio­ner in a pri­vate practice.

He had been suf­fer­ing from severe ab­domi­nal pain for se­ver­al weeks and was con­stant­ly exhausted.

The doctor per­for­med a thorough phy­si­cal exam and then re­com­mend­ed that the pa­tient go to a clinic.

To avoid caus­ing Wilhelm. K. to worry, the doc­tor chose not to tell him that he had symp­toms of cancer.

Black and white photography: second Medical Clinic of the Charité, around 1910

Fig. 1/7 Charité, II. Med. Clinic, 1909/10

Around 9:00 am on Decem­ber 3rd, 1913, the pa­tient arrived at the sur­gic­al wing of the Charité.

The large building, its bare corri­dors with op­pres­sive sig­nage, and the smell of dis­infec­tant inti­mi­dat­ed the 59-year-old man.

He was feel­ing agi­tat­ed as fear well­ed up inside him.

When a cover­ed pa­tient was car­ried past him on a stret­cher, Wilhelm K. want­ed to leave the hos­pi­tal immediately.

Black and white photography: Charité, Hospital admission, 1910

Fig. 2/7 Charité, Hospital ad­mission, 1910

At the hospital, Wilhelm K. was com­pre­hen­sively examined.

X-ray imag­ing con­firm­ed the suspi­cion: Wilhelm K. had bowel cancer.

He was taken to the sur­gi­cal ward where seven hos­pi­tal beds were al­ready oc­cu­pied: three pa­tients with bro­ken bones, one case of ap­pendi­ci­tis, a gun­shot wound to the ab­do­men, and two am­putations.

Doctors tried not to put new can­cer pa­tients and post-ope­ra­tive can­cer pa­tients in the same room to avoid expos­ing them to sur­ge­ry sto­ries. Frigh­tened patients needed stron­ger anesthe­sia, which increased the risk of surgery.

Black and white photography: X-ray examination in Berlin, 1912

Fig. 3/7 X-ray examination in Berlin, 1912

Wilhelm K. didn’t find out what he was suf­fer­ing from in the hospi­tal either.

The doctors only dis­clos­ed which organ they would ope­rate on.

He was also left in the dark about the se­ver­ity of the ope­ra­tion. Doc­tors them­sel­ves couldn’t always cor­rect­ly pre­dict this before the ope­ra­tion. At that time, x-ray images were often ambi­gu­ous.

The sur­geon re­mov­ed suspi­cious tis­sue from the anes­thetiz­ed pa­tient, which was sub­sequent­ly examin­ed at the In­stitu­te of Patho­logy. The dia­gno­sis was con­firm­ed, and the doc­tors de­cid­ed to per­form ra­di­cal surgery.

Black and white photography: Aseptic operating room of the Charité, around 1910

Fig. 4/7 Charité, Aseptic operating room, ca. 1910

Wilhelm K. woke up from anesthe­sia in a changed body.

He now had an arti­fi­cial intesti­nal open­ing, or stoma, on his ab­do­men where excretions could escape.

No one had pre­par­ed him for this up­sett­ing sur­prise and he won­der­ed how the ope­ra­tion would change his life.

The attend­ing doc­tors had de­liber­ate­ly left the pa­tient out of their de­ci­sion-mak­ing process. The know­ledge, they thought, would cause un­necess­ary fear in their pa­tients. In­stead, they would be faced with a fait ac­com­pli and forc­ed to resign them­sel­ves to reality.

Black and white photography: Hospital hall of the Charité, 1909

Fig. 5/7 Charité, Hospital hall, 1909

Discharged “cured”?

After being dis­charg­ed from the hos­pi­tal, Wilhelm K. had to learn how to live with a stoma.

The fecal in­con­ti­nence could be con­troll­ed, to some ex­tent, by a strict diet and daily ene­mas. The gas, how­ever, was un­con­troll­able, so he hard­ly ever went out in public.

He had regular check-ups because the doc­tors anti­ci­pat­ed a re­lap­se or new meta­sta­sis, but they didn’t tell Wilhelm K. about that either. In­stead, they told him that after ope­ra­tions, benign ulc­ers could some­times form and should be treated quickly.

Black and white photography: Entrance hall of the second medical clinic of the Charité, ca. 1910

Fig. 6/7 Entrance hall, Charité, II. Med. clinic, ca. 1910

Wilhelm K. is a fictitious patient.

However, many real cancer patients had simi­lar ex­perien­ces at the be­ginn­ing of the 20th century.

Doctors usual­ly left them in the dark about their disease as well as the sur­gi­cal pro­ce­du­res and their outcomes.

In an effort to pre­vent can­cer pa­tients from dy­ing at all costs, they made full use of the new me­di­cal pos­si­bili­ties. The pa­tients’ qua­lity of life there­af­ter often seem­ed to be se­cond­ary to them.

Black and white photography: Directors’ room of the second medical clinic of the Charité, ca. 1910

Fig. 7/7 Charité, II. Med. clinic: direc­tors room, ca. 1910


Treatment of a
prostate carcinoma

The case history
of Alfred P.

In 1987, Gertrud P. urged her hus­band to see a urologist.

Alfred P. had been hav­ing dif­ficul­ties uri­nat­ing for some time, but he brush­ed it off.

It was just because he was gett­ing ol­der, he said, and he didn't need to go to the doctor for every little thing.

When his symp­toms be­came more se­vere, Alfred P. final­ly went to see a spe­cial­ist, who re­ferred him to a uro­lo­gy clinic. There, doc­tors found a mali­gnant tumor in the pros­tate gland (pros­tate cancer), the most com­mon type of can­cer in men.

Black and white photography: Elderly couple, 1981

Fig. 1/5 Elderly couple, 1981

Alfred P. was informed of the diagnosis.

The uro­lo­gist in­form­ed Alfred P. about the di­sease and gave him de­tail­ed ex­plana­tions of the treat­ment op­tions and their side ef­fects.

An analy­sis of the tumor’s de­velop­ment show­ed that it was the only tumor and it was grow­ing, but there was no evi­dence of lymph node in­volve­ment or meta­stas­is. The pa­tient’s over­all health was good; his aver­age life ex­pec­tan­cy was still about 10 years.

Based on these cha­rac­teris­tics, the uro­lo­gist ad­vis­ed a com­ple­te re­moval of the pro­sta­te gland. Alfred P. asked for time to think it over.

Medical drawing: Removal of prostate, 1991

Fig. 2/5 Medical draw­ing: Removal of prostate, 1991

A friend advised him to see a special­ist in alter­na­tive can­cer medicine.

Alfred P. went to a well-known sur­geon who firm­ly re­ject­ed the “can­cer scare” and ra­di­cal treat­ments that he be­liev­ed were asso­ciat­ed with it.

He held that mali­gnant can­cer was a “di­sease of the soul” and a “bio­lo­gi­cal pu­nish­ment from God” for de­ca­des of sinn­ing against oneself.

The sur­geon in­vit­ed Alfred P. and his re­la­tives to a meet­ing where he ad­vis­ed the pa­tient to under­go de­toxi­fi­cation treat­ments, nude out­door bathing the­ra­py and to focus more on life enjoy­ment.

Book-Cover, Julius Hackethal, Don't be afraid of cancer, Ullstein publishing house, 1987

Fig. 3/5 J. Hackethal advocated alter­native can­cer medicine.

Ultimately, Alfred P. decid­ed to have a radi­cal prosta­tectomy.

An ex­perienc­ed sur­geon re­mov­ed the pros­tate, the se­mi­nal ve­sicle and the vas deferens.

After the ope­ra­tion, Alfred P. dealt with in­conti­nence and could no lon­ger get an erec­tion. The post-ope­ra­tive ef­fects caus­ed him men­tal anguish.

But the con­se­quen­ces of the ope­ra­tion were only tem­por­ary: after three months he was able to get erec­tions again, and a year and a half later he could con­trol his urination.

Black and white photography: Surgical team, 1996

Fig. 4/5 Sur­gical team, 1996

Alfred P.’s recovery was fa­cili­tat­ed by his stay in a re­ha­bili­ta­tion clinic.

There, he received both medi­cal and psycho­logi­cal care. He learned how to deal with his body’s new limi­ta­tions caused by the ope­ra­tion and he met patients who he could talk to for sup­port. That gave him courage.

Such after-care clinics were inno­va­tions set up in the post-war period, first in the GDR and later in the FRG.

Understand­ing that tran­si­tion­ing from the hos­pi­tal to every­day life was dif­fi­cult and could jeo­pard­ize the suc­cess of ex­pen­sive can­cer the­ra­pies mo­ti­vat­ed the estab­lish­ment of these clinics.

Color Photography: Rehabilitation center, 1993

Fig. 5/5 Reha­bili­tation center, 1993


The case history of Auguste B.


Fig. 1/4 Uni­ver­sity Women’s Clinic, before 1906.

Charité, Thiele, Bild-Nr. 001371

Fig. 2/4 Med. Drawing, from: E. Bumm, Zur Tech­nik der Becken­aus­räu­mung beim Uterus­karzinom, in: Charité-Annalen, hg. v. der Direk­tion des Königl. Charité-Kranken­hauses zu Berlin, 1907, S. 429-438, hier: S. 434.

Charité, Insti­tut für Ge­schich­te der Medi­zin und Ethik in der Medi­zin, Berlin

Fig. 3/4 Charité, Aseptic operat­ing room, ca. 1910.

Charité, Lichte, Bild-Nr. 001460

Fig. 4/4 Prepar­ing for sur­ge­ry in the lec­ture hall of the Sur­gi­cal Clinic of the Charité, before 1905.

Charité, Lichte, Bild-Nr. 001455

The case history of Wilhelm K.


Fig. 1/7 Charité, II. Medical Clinic, 1909/10.

Charité, Lichte, Bild-Nr. 001504

Fig. 2/7 Charité, Hospital ad­mission, 1910.

Charité, Institut für Ge­schichte der Me­dizin und Ethik in der Me­dizin, Berlin, Bild-Nr. 001506

Fig. 3/7 X-ray exami­nation in Berlin, 1912.

Scherl/Süd­deutsche Zeitung Photo, REF 108677

Fig. 4/7 Charité, Aseptic operat­ing room, ca. 1910.

Charité, Lichte, Bild-Nr. 001488

Fig. 5/7 Charité, Hospital room, 1909

Charité, Lichte, Bild-Nr. 000895

Fig. 6/7 Entrance hall of the II Med. clinic, ca. 1910.

Charité, Lichte, Bild-Nr. 001492

Fig. 7/7 Charité, II Med. clinic: directors room, ca. 1910.

Charité, Lichte, Bild-Nr. 000887

The case history of Alfred P.


Fig. 1/5 Elderly couple, 1981.

Werner Otto/Alamy Stock Foto, Bild-ID BA3RAW

Fig. 2/5 Med. Draw­ing: Re­moval of the pro­state, from: H. Froh­müller und M. Wirth, Die radi­kale Prosta­tekto­mie, in: R. Ackermann, J. E. Altwein, P. Faul (Hg.), Aktuel­le Thera­pie des Prostatakarzinoms, Berlin u. a.: Springer-Verlag 1991, S. 100-121, hier: S. 110.

Staats­bibliothek zu Berlin

Fig. 3/5 Julius Hackethal, Keine Angst vor Krebs, Frank­furt/M. und Ber­lin: Ull­stein Verlag 1987.

Staats­bibliothek zu Berlin

Fig. 4/5 Surgical team at the Nurem­berg North Hospi­tal, 1996.

Karin Rummel/Süd­deutsche Zei­tung Photo, REF 80120

Fig. 5/5 Le Noirmont, Centre Juras­sien de ré­adap­ta­tion cardio­vascu­laire, (Rehab Center, Jura, Switzer­land), 1993.

ETH-Biblio­thek Zürich, Bild­archiv / Fotograf: Zsolt, Somorjai / Com_FC19-2340-003 / CC BY-SA 4.0

Fotografie, schwarz-weiß, von 1918: Das Foto zeigt eine liegende Frau auf einer Holzliege. Ein Bestrahlungsgerät bestrahlt die linke Seite ihres unteren Leibs.   Die rechte Seite ist abgedeckt. Im Hintergrund sieht man einen Holzschrank und verschiedene Apparaturen.

Radiating cancer

Radia­tion thera­pies have com­ple­mented sur­gi­cal treat­ments since the 1910s. Just a few years prior, X-rays and radium rays were dis­cover­ed. Not yet fully under­stand­ing the effects of the high-energy rays, physi­cians immedia­tely tested their thera­peu­tic bene­fits. They dis­covered that mali­gnant tumors sof­tened and shrank when irra­diated, but what dose of radia­tion was required to des­troy a tumor? How much radia­tion could the patients tole­rate? How could the tumor be tar­geted? And how could healthy tissue be pro­tected? To this day, these que­stions pre­oc­cupy radia­tion onco­logy, which estab­lished itself as an inde­pen­dent dis­ci­pline in the post­war period.

Penile carcinoma
Breast cancer
Cervical cancer


Please Click

Treatment of
penile carcinoma

The case history
of Walter H.

“Radiation enthu­siasm”

Early in the 20th cen­tury, physi­cians, physi­cists, elec­tri­cal techni­cians and engi­neers across the western world fo­cus­ed their efforts on ra­dia­tion the­ra­py.

Pro­ce­du­res and medi­cal machi­nes were re­fin­ed to pene­tra­te the body more pre­cise­ly, pre­serv­ing as much healthy tissue as possible.

By the 1920s, ra­dia­tion was already con­sider­ed a cen­tral ele­ment of can­cer thera­py. Hos­pi­tals built their own ra­dia­tion de­part­ments and radio­logy became well-establish­ed as an inde­pen­dent discipline.

Two illustrated advertisements for new irradiation devices from 1921

Fig. 1/6 Adver­tise­ments for new ir­radia­tion devices, 1921

Were the inno­vative treat­ment methods adopted prematurely?

In the case of 52-year-old Walter H., this may have been true. In 1921, the ad­ver­tise­ment copy­writer felt an itch­ing sen­sa­tion on his geni­tals and notic­ed a nodule un­der his fore­skin. When his symp­toms didn’t go away on their own, he went to see a der­mato­lo­gist.

After several un­suc­cess­ful at­tempts at treat­ment, he was sent to the hos­pi­tal for fur­ther testing.

There, the doctors diag­nos­ed Walter H. with a rare type of cancer: penile carcinoma.

Black and white Photograph: Surgical University Hospital of the Charité

Fig. 2/6 Surgical Uni­ver­sity Hospital of the Charité

The sur­geons were very hesitant to operate on Walter H.

Penile ampu­tation would be severely traumatic.

So, after consult­ing with radio­lo­gists and like­ly with Walter H. him­self, the doc­tors felt that X-ray ra­dia­tion was the best way forward.

They were en­courag­ed by the work of their col­lea­gues, who had suc­cess­ful­ly treat­ed simi­lar skin can­cers using this method.

Black and white Photograph: Radiologist in the 1920s

Fig. 3/6 Radio­logist in the 1920s

Due to the expen­sive radio­active sub­stan­ces, the therapy was costly.

In 1921, the statutory health insurers paid 2,000 Reichsmarks for six rounds of irradiation.

People who did not have health insurance, like many higher-up offi­cials and the self-employ­ed, often could not af­ford the therapy.

Being that he self-employed, Walter H. was not cover­ed by a statutory health in­surance fund. How­ever, he was vo­lun­tari­ly insur­ed by a private fund, which cover­ed the costs of his ra­dia­tion therapy.

Black and white Photograph: Irradiation technique, around 1925

Fig. 4/6 Irradia­tion technique “Wintz-Kanone”, ca. 1925

A high-tech radia­tion device was used to target the tumor.

At first, the therapy con­sider­ably reduc­ed the tumor’s size, but after two weeks the shrink­age plateaued.

As a side effect, Walter H. developed an “X-ray hang­over.” This left him ex­haust­ed, vomit­ing fre­quent­ly, and suf­fer­ing from both severe diar­rhea and the con­stant urge to uri­nate. Urinat­ing became more and more pain­ful. Ad­di­tional­ly, the tumor began decay­ing as it ac­cumu­lat­ed bac­te­ria, pro­duc­ing a foul odor.

Finally, his doc­tors de­cid­ed it was time to ope­rate. Not long after his ope­ration, the father of four died in the hospital.

Black and white Photograph: X-ray irradiation, around 1931

Fig. 5/6 X-ray irradiation, ca. 1931

Looking back, the doctors recognized that they had made the wrong decision.

The attending radio­logist later wrote in an article that an im­medi­ate ope­ra­tion fol­lowed by a stron­ger dose of ra­dia­tion would likely have been more suc­cess­ful.

Unfor­tu­nately, he explained, very little in­forma­tion about ra­dia­tion dosages was avail­able to them at the time.

Such regret­ful ex­pres­sions of self-cri­tic­ism are rarely found in medi­cal publi­ca­tions from the 1920s. Failed treatments were typi­cally framed as an oppor­tun­ity for learn­ing and a pre­requi­site for the opti­mi­zation of cancer therapies.

Page from Hans Hartoch, About the Peniscarcinoma, 1923

Fig. 6/6 Hans Hartoch, Über das Peniscarcinom, 1923

Page from Hans Hartoch, About the Peniscarcinoma, 1923

Breast cancer
relapse therapy

The case history
of Minna N.

In October of 1932, Minna N. under­went an ope­ra­tion in the Beeskow hospital.

Doctors had dis­cover­ed a malig­nant tumor about the size of a wal­nut in her left breast.

To save Minna N., who was 46 years old, they de­cid­ed to per­form a radi­cal ope­ra­tion, as was the stan­dard pro­ce­dure at the time.

She had a mastec­tomy, which in­volv­ed the re­moval of her mam­mary gland, skin and nipple.

Picture postcard from Beeskow, around 1900

Fig. 1/5 Picture postcard from Beeskow, ca. 1900

Four years later, her cancer relapsed.

In 1936, by which time Ger­many was under Na­tio­nal So­cial­ist rule, Minna N. went to see her fami­ly doctor.

There had been swell­ing in her left arm for a while. When mas­sa­ges and heat the­ra­py didn’t re­lie­ve her symp­toms, her wor­ried doc­tor re­ferr­ed her to the Sur­gi­cal Uni­ver­sity Clinic in Berlin.

There, his sus­pi­cions were con­firm­ed: A new tumor had form­ed in Minna N.’s chest wall and there was evi­dence of metas­ta­sis in her tho­rax (chest cavity). The cancer had pro­gress­ed from local to syste­mic, which meant that it was no longer curable.

Picture of a Referral to the Charité in Berlin, 1937

Fig. 2/5 Referral to the Charité in Berlin, 1937

There is a possibi­lity that Minna N. was in­form­ed of her diagnosis.

The philosophy that pa­tients should be in­form­ed “truth­fully” and “fac­tual­ly” of their ter­mi­nal ill­ness gained popu­lar­ity under Na­tio­nal Socialism.

People now believ­ed more often that “gent­ly lying” in order to calm fears of death and dying should no lon­ger be prac­tic­ed by doctors.

They con­sider­ed dying to be a Ger­man’s “final test of strength”. This shouldn’t be taken away from them through the de­liber­ate omis­sion of in­forma­tion. Fol­low­ing this logic, some even con­sider­ed it wrong to give pa­tients painkillers.

Invitation to a meeting during which the psychiatrist F. Künkel expressed this point of view.

Fig. 3/5 Psychiatrist F. Künkel ex­press­ed this view at the meeting.

Radiation the­ra­py was be­liev­ed to slow the pro­gres­sion cancer.

So, Minna N. went through radio­the­ra­py at the X-Ray and Radium Insti­tute in the uni­ver­sity’s sur­gi­cal clinic.

In her pa­tient file, the doc­tors re­cord­ed mini­mal side ef­fects: “no nau­sea, no vomit­ing, un­dis­turb­ed ap­pe­tite and sleep.” Red­den­ing of the skin in the tar­get area was the only nega­tive aftereffect.

A note taken some time later, how­ever, reveals that Minna N. didn’t come in for a follow-up ap­point­ment in June of 1938, “because she was sup­posed­ly away on a rehabilitative trip.”

Irradiation protocol from patient file, 1937

Fig. 4/5 Ir­radia­tion pro­tocol from pa­tient file, 1937

Irradiation protocol from patient file, 1937

Minna N. died on March 2nd, 1940.

How the patient far­ed be­tween the miss­ed check­up in June 1938 and her death can­not be in­ferr­ed from her medi­cal file.

Overall, the qua­lity of care avail­able to pa­tients of ter­mi­nal cancer dete­rio­rat­ed drama­ti­cally under Na­tio­nal Socialism.

One reason for this de­velop­ment was the con­vic­tion that only heal­thy “Volks­ge­nos­sen” were valua­ble. What’s more, people who were im­por­tant to the war ef­fort were given prio­ri­ty for medi­cal care from 1939 on.

Black and white photograph: Ceremony at the Berlin University Women's Hospital, 1941

Fig. 5/5 Ceremony at the Berlin Uni­ver­sity Women’s Hospital, 1941

A relative describ­ed his experience in the criti­cal care ward of the Charité in 1940:

“Even the entrance must hor­rify the pa­tient, through which he is brought to this dungeon. (…)

The toilet in the men’s ward can only be reach­ed through the bath­room, which is shar­ed be­tween all sexes. In front of this bath­room is the only util­ity and storage room, where those who have fallen vic­tim to their ill­ness must be hous­ed until they are taken away. (…)

The most modest re­crea­tion room is miss­ing, (…) as is any at­tempt to (…) offer the sick (…) some com­fort and courtesy.”


Cervical cancer

The case history of Hilde W.

A cry for help was heard in the Czerny Hospital.

In May of 1953, the renown­ed Heidel­berg Hos­pi­tal for Radio­the­rapy re­ceiv­ed a let­ter from the daugh­ter of cancer patient Hilde W., who wrote that family could no lon­ger care for her mother at home.

She asked for per­mis­sion to bring her seri­ous­ly ill mother back to the cli­nic where she had been treat­ed pre­viously.

Like most fami­lies who liv­ed in cramp­ed quar­ters and could not afford a nur­se, Hilde W.’s fami­ly was over­whelm­ed by the care she required.

Daughter’s letter to the hospital, May 1953

Fig. 1/6 Daughter’s letter to the hospi­tal, May 1953

Daughter’s letter to the hospital, May 1953

Just a year earlier, there were no indi­ca­tions that Hilde W. was ill.

In February 1952, at 41 years old, she dis­cover­ed that she was pre­gnant; she was any­thing but hap­py about it.

Her hus­band had been un­employ­ed for months and of her ten chil­dren, five were still of school age.

Hilde W. con­sider­ed ter­mi­nat­ing the pre­gnan­cy, but it would have been a crime. Women who de­cid­ed to have an abor­tion could face as many as five years in prison.

Black and white photograph: Social housing construction, Federal Republic of Germany, 1950s

Fig. 2/6 Social housing con­struc­tion, FRG, 1950s

Her pre­gnan­cy con­tinu­ed with­out complications.

Hilde W. paid no atten­tion to her light, on­going bleeding.

On No­vem­ber 22nd, 1952 she went into labor and began bleed­ing more heavi­ly. She went di­rect­ly to the munici­pal hospi­tal in Pirma­sens, Pala­ti­nate thinking that she was about to give birth.

Her labor dragged on. Final­ly, the doc­tors de­cid­ed to per­form a C-section.

Black and white photograph: Delivery and operating room, around 1960

Fig. 3/6 Delivery room, operat­ing room, ca. 1960

During the oper­ation, the sur­geon rea­liz­ed why the birth had stalled.

Hilde W. had cer­vi­cal can­cer. The can­cer had already spread to the neigh­bor­ing organs and was hin­der­ing the birth.

The doc­tors de­liver­ed the child, a viable girl, and remov­ed part of the tumor. That was all they could do for the pa­tient.

Hilde W. was re­ferr­ed to the Czerny Hospital for Ra­dia­tion Treat­ment for follow-up ra­dia­tion, al­though she wasn’t aware that she had can­cer. At that time in the Fede­ral Repu­blic of Ger­many, it was nor­mal to leave pa­tients un­in­form­ed of their can­cer diagnosis.

Black and white photograph: Samaritan House in Czerny Hospital, built in 1905

Fig. 4/6 Samaritan House in Czerny Hospital, built in 1905

The tumor was irra­diat­ed using X-rays.

In addition, Hilde W. had radio­active cobalt in­sert­ed into her va­gina and bladder.

In the 1920s, it was al­ready com­mon prac­tice to com­bine inter­nal and ex­ter­nal ra­dia­tion. The goal was to ef­fec­tive­ly de­stroy the can­cer cells while spar­ing as much healthy tis­sue as possible.

Just a few years later, doc­tors at­tempt­ed to achieve the same effect by us­ing new radia­tion devices: the beta­tron, the cyclo­tron or gammatron.

Black and white photograph: Betatron presentation, X-ray Congress, London, 1950

Fig. 5/6 Betatron presen­tation, X-ray Con­gress, London, 1950

Hilde W. was not re­ad­mitt­ed to the Heidelberg hospital.

Instead, her family took her to the muni­ci­pal hos­pi­tal in Pirma­sens, where she died at 42 years old.

Unlike the GDR, in the 1950s the Fede­ral Repu­blic of Ger­many didn’t pro­vide any nurs­ing homes to care for the seri­ous­ly ill and dying.

In the FRG, people were meant to be car­ed for at home by (female) re­la­tives if they were sick or near­ing the end of their life. This ex­pec­ta­tion was re­in­forc­ed early in the 1960s through legis­la­tion and state sup­port payments.

Note to Czerny Hospital, May 1958

Fig. 6/6 Note to Czerny Hospital, May 1958


The case history of Walter H.


Fig. 1/6 Two ad­vertise­ments for irradia­tion devi­ses, from: Strah­len­thera­pie. Mit­tei­lun­gen aus dem Geb­iete der Behand­lung mit Rönt­gen­strah­len, Licht und radio­akti­ven Sub­stan­zen, zu­gleich Zentral­organ für Krebs- und Lupus­behand­lung, Bd. XXI, 1921, Berlin/­Wien: Verlag Urban & Schwarzenberg.

Staats­bibliothek zu Berlin

Fig. 2/6 Former sur­gical uni­ver­sity hospi­tal of the Charité in Ziegel­straße, undated.

Charité, Fleischbein-Brinkschulte, Bild-Nr. 002968

Fig. 3/6 Guido Holzknecht (1872-1931), Austrian physi­cian, pioneer of radio­logy, Vienna Uni­ver­sity Hospital, 1920s.

Charité, In­sti­tut für Ge­schichte der Medi­zin und Ethik in der Medi­zin, Bild-Nr. 020054

Fig. 4/6 Ir­radia­tion “Wintz gun” and first de­vi­ces of radia­tion pro­tec­tion, ca. 1925.

Nach­kommen des Verlags­in­habers Krüger/­Uni­ver­si­täts­archiv Erlangen, Sig. E5,3 Nr. 142

Fig. 5/6 X-rays, photo­graph from the exhi­bi­tion „Kampf dem Krebs“ (Fighting Cancer), ca. 1931.

Deutsches Hygiene-Museum Dresden, Inv.-Nr. DHMD 2001/247.135

Fig. 6/6 Hans Hartoch, Über das Penis­carci­nom mit be­sonde­rer Be­rück­sich­ti­gung der Strah­len­thera­pie, Köln: Kerschgens 1923.

Staatsbibliothek zu Berlin

The case history of Minna N.


Fig. 1/5 1/5 Picture postcard from Beeskow (Brandenburg), ca. 1900.

Berliner Medizinhistorisches Museum der Charité

Fig. 2/5 Referral to the Berlin Charité, document from a patient file, Geschwulstklinik (Ulcer Clinic), 1937.

Charité, Institut für Geschichte der Medizin und Ethik in der Medizin, Berlin

Fig. 3/5 Invitation to the meeting of the working group between physicians and clergy on 2.9.1937.

Landesarchiv Berlin, A Rep. 003-04-03, Nr. 55

Fig. 4/5 Ir­radia­tion proto­col from a pa­tient re­cord at the Ge­schwulst­kli­nik (Ulcer Clinic), 1937.

Charité, Institut für Ge­schich­te der Medi­zin und Ethik in der Medi­zin, Berlin

Fig. 5/5 Cere­monial act at the Berlin Uni­ver­sity Women’s Hospi­tal on the oc­casion of the 70th birth­day of the gyne­co­logist Walter Stoeckel (1871-1961), 1941.

Charité, Institut für Ge­schichte der Medi­zin und Ethik in der Me­dizin

The case history of Hilde W.


Fig. 1/6 Letter to Czerny Hos­pi­tal for Radia­tion Thera­py, dated 10.5.1953.

Uni­ver­si­täts­­archiv Heidel­berg, Acc. 14/02, Nr. 17342

Fig. 2/6 Münster-City, Blumen­straße re­con­struc­tion com­muni­ty, ma­nag­ed by GAGFAH - Gemein­nüt­zige Aktien­gesell­schaft für An­ge­stell­ten-Heim­stät­ten, ca. 1955.

Sammlung LVA Westfalen: Woh­nungs­not und Wohn­bau­för­de­rung in den 1920er-1950er Jahre, Archiv-Nr. 03_3865

Fig. 3/6 Univer­sity Women’s Hospi­tal Berlin, de­live­ry room - ope­rat­ing room with exami­nation couch, 1960.

Charité, Thiele, Bild-Nr. 001884

Fig. 4/6 “Samariter­haus” (Samaritan House) in Czerny Hospital, built in 1905/06.

Uni­ver­si­täts­archiv Heidel­berg / Bild­archiv Pos I 03761

Fig. 5/6 Queen Elizabeth (Queen Mum) looks at the beta­tron at the Inter­natio­nal Con­gress of Radiol­ogy in London, 1950.

Siemens Healthi­neers Histo­ri­cal Insti­tute, A 54_13

Fig. 6/6 Notice from a regis­trar of the pa­tient’s death to the Czerny Hospital for Radia­tion Treat­ment, dated 5.9.1958.

Uni­ver­si­täts­archiv Heidel­berg, Acc. 14/02, Nr. 17342

Fotografie, schwarz-weiß, von 1991: Das Foto zeigt einen, in einem Krankenhausbett liegenden Mann, der den Kopf nach rechts geneigt hat. Rechts steht eine Frau im weißem Kittel, die eine Infusion einstellt.


As early as 1900, physi­cians began search­ing for drugs that could fight can­cer. Ins­pir­ed by the spec­ta­cu­lar suc­ces­ses of bac­terio­lo­gy, they ex­peri­ment­ed with va­rious the­ra­peu­tic sub­stan­ces to com­bat can­cer cells. It was not until ob­serv­ing the ef­fects of che­mi­cal wea­pons used during the First and Second World Wars that their at­ten­tion turn­ed to sub­stan­ces that could at­tack and inhi­bit the growth of human cells rather than patho­gens. After 1945, large-scale pro­grams in the USA con­tinu­ed re­search in this di­rec­tion and va­rious groups of sub­stan­ces were suc­cess­ful­ly test­ed for their anti-cancer effects.

Chemotherapeutic agents were ini­tial­ly investi­gated in rela­tion to the treat­ment of leu­ke­mia and lym­phoma. In the 1950s, there was no pro­spect of a cure for leu­ke­mia, and it was known that nei­ther type of can­cer could be treated locally. There­fore, high hopes were pinn­ed on the new systemic can­cer drugs. In the 1960s and 70s these drugs were only able to delay death for can­cer patients. How­ever, in the fol­low­ing decades, the new drugs signi­fi­cantly improved their chances of being cured. For the patients, the novel treat­ment re­pre­sent­ed hope for a cure, but also con­sider­able pain with most people suf­fer­ing a drama­tic physi­cal deterio­ra­tion at the onset of treatment.

Breast cancer
Lung cancer


Please Click

Leukemia becomes

The medical history
of four-year-old Regina

Regina was a care­free child.

She was born in 1966 and later de­ve­lop­ed into a bright, live­ly girl. She en­joy­ed kinder­gar­ten and almost never got sick.

When Regina was just shy of five years old, she began to com­plain more and more of fati­gue and joint pain. She lost her desire to play as well as her appe­tite.

Her parents brought her to the fami­ly doc­tor, who immedi­ately sent her for tests at the local child­ren’s clinic.

Black and white photography: Mother with children, 1963

Fig. 1/6 Mother with children, 1963

The doc­tors at the cli­nic dis­cover­ed that Regina was suf­fer­ing from blood cancer.

She had a form of acute leu­ke­mia, a can­cer af­fect­ing the de­velop­ment of blood cells with­in bone marrow.

Her diag­no­sis was ex­plai­ned to her parents, but it was diffi­cult for them to under­stand and they didn’t want to ask too many questions.

They had never heard of this new can­cer treat­ment, which was the first one that could delay the pro­gres­sion of the di­sea­se and, in rare cases, might even be a cure.

Black and white photography: Children’s hospital, 1969

Fig. 2/6 Children’s hospital, 1969

Regina had to stay in the hospi­tal for six weeks.

She went through ag­gres­sive chemo­the­ra­py, re­quir­ing a com­bi­na­tion of drugs.

The side ef­fects were seri­ous: the four-year-old vomit­ed con­stant­ly, suf­fer­ed seve­re diar­rhea, did not want to eat, and con­tract­ed a life-threa­ten­ing infection.

During this time, her pa­rents didn’t visit her. The doc­tor had ad­vis­ed against visits so as not to up­set the child and her pa­rents fol­low­ed his advice.

Black and white photography: Pediatric clinic, hospital room, undated

Fig. 3/6 Pediatric clinic, hospital room, undated

For the four-year-old, it was her first time being away from her parents.

She was home­sick and be­came in­creas­ing­ly quiet. She be­friend­ed a boy who was also suf­fer­ing from leu­ke­mia, but when he died, she didn’t want to play with any other chil­dren in the clinic.

When her pa­rents pick­ed her up from the hospi­tal after the suc­cess­ful treat­ment, they hard­ly re­cog­niz­ed her:

Her body and face were bloat­ed, and her hair had fal­len out. The girl, who used to be so cheer­ful, had become solemn. She couldn’t be left alone, and she would scream in her sleep.

Black and white photography: Children’s hospital, day room, undated

Fig. 4/6 Children’s hospi­tal, day room, un­dated

After her hospi­tal stay, the out­patient ap­point­ments began.

For two years, Regina’s mother took her to the hos­pi­tal every six weeks for check-ups.

At every ap­point­ment, they per­form­ed a bone marrow punc­ture to check for signs of a re­lapse. To ease the pain of the punc­ture, Regina was meant to in­hale an anesthetic.

Each time, she resisted the face mask with all her might because the anes­the­tic made her feel like she was fal­ling into a deep, dark lake.

Experience report of a 10-year-old about the follow-up examinations, detail view

Fig. 5/6 A 10-year-old describes follow-up examination

Experience report of a 10-year-old about the follow-up examinations

The anes­the­sio­logist cri­ti­ciz­ed Regina’s mother for her child’s behavior:

She could sense her mother’s angst and in­se­cu­rity, caus­ing her fear­ful pro­tests.

According to the doc­tor, it was up to the parents to pre­pare the chil­dren well, then they would be ready to endure the pro­cedure.

Neither the child nor the pa­rents were of­fer­ed psycho­lo­gi­cal sup­port, although medi­cal lite­ra­ture had al­ready noted its impor­tance to the treat­ment’s success.

Black and white photography: Entrance of a children’s hospital

Fig. 6/6 Entrance of a chil­dren’s hospital

Regina’s leuke­mia didn’t return.

She was one of the 1-2 % of chil­dren who were cur­ed of their acute leu­ke­mia in the early 1970s with the help of the new chemo­thera­peu­tic drugs.

For 98-99% of children, how­ever, the new drugs could only les­sen their symp­toms and delay their death.

In the de­cades that fol­low­ed, more and more children were cur­ed. None­the­less, “cured” did not always mean healthy. Many sur­vi­vors suf­fer­ed long-term side ef­fects of their treat­ment into adult­hood, such as meta­bo­lic dis­orders, organ damage, in­fer­ti­li­ty or anxiety.


A drug trial in the GDR

The medical history of Karin S.

Karin S. had run out of patience.

She had been endur­ing her ill­ness for so long. In Sep­tember of 1986, doc­tors at the East Berlin Women’s Clinic of the Charité Hos­pi­tal gave her the news that they found a mali­gnant tumor (mam­mary car­ci­no­ma) in her right breast.

She had a com­plete mas­tec­tomy. After her wounds healed, Karin S. re­ceiv­ed radia­tion treatment.

In July of 1987, the doc­tors ad­vised her to under­go chemo­thera­py after dis­cover­ing metas­tasis in her liver.

Black and white photography: University Women’s Clinic East Berlin, around 1980

Fig. 1/5 Univer­sity Women’s Clinic East Berlin, ca. 1980

Once a week, Karin S. had to be “put on a drip”.

Each time, she watch­ed as the cytos­ta­tic drug flow­ed from the syrin­ge into the veins in her arm. The drug is sup­pos­ed to kill the ra­pid­ly di­vid­ing cells.

Although the “poison” ex­haust­ed her, she couldn’t sleep. She lost her abi­li­ty to con­cen­trate and could hard­ly read. After the in­fu­sions, she vomit­ed repeatedly.

She felt like the drug also ex­tingu­ish­ed her cou­rage, her vital­ity, and her happiness.

Black and white photograph: Infusion bottle and stand for chemotherapy at the Central Institute for Cancer Research in East Berlin, 1991

Fig. 2/5 Chemo­ther­apy (ZIK, East Berlin)

The early mor­ning hours were the worst.

She was awoken from her dreams and fear swell­ed in­side her. No one, she was sure, could ever under­stand the horror if they hadn’t expe­rienc­ed it themselves.

In front of her family, she main­tain­ed a peace­ful façade, but she saw the way her hus­band would oc­ca­sio­nal­ly strug­gle to hold back tears.

She was dis­turb­ed by people who avoid­ed her gaze or who pro­phe­siz­ed that every­thing would be all right if only she be­liev­ed it would be.

Black and white photograph: University Women’s Hospital, hospital corridor, around 1980

Fig. 3/5 Univ. Women’s Hospital, hos­pital corri­dor, ca. 1980

The medicine used to treat Karin S. came from the West.

A doctor had asked her if she would be will­ing to take part in a cli­ni­cal drug trial.

The study aim­ed to test the the­ra­peu­tic ef­fica­cy and toler­abi­li­ty of a cytos­ta­tic drug from the Fede­ral Repu­blic that had not yet been ap­prov­ed for treatment.

The doctors in­form­ed her of the pos­sible side ef­fects and com­pli­cations. Regard­less, she agreed im­medi­ate­ly, hop­ing that the new drug would be a break­through in her the­ra­py. It wasn’t a cure, but it pro­long­ed her life by several months.

Black and white photograph: University Women’s Hospital, consulting room, around 1985

Fig. 4/5 Univ. Women’s Hospital, consult­ing room, ca. 1985

Western Companies commission­ed a series of drug studies within the GDR.

In the field of onco­logy, 44 stu­dies were veri­fi­ably con­duct­ed be­tween 1961 and 1990. The GDR’s cen­tra­liz­ed system was desir­able to drug com­pa­nies as it ac­cele­rat­ed the im­ple­men­ta­tion and eva­lua­tion of the studies.

The GDR govern­ment came into Western cur­rency through the com­mis­sions, as it receiv­ed all the study fees, not the in­volv­ed pa­tients and doc­tors.

Doctors were able to travel to con­fe­ren­ces in the West, given western trial drugs free of charge and some­times grant­ed ac­cess to medi­cal techno­logy un­avail­able in the GDR.

Black and white photograph: Central Institute for Cancer Research, East-Berlin, 1991

Fig. 5/5 Central Institute for Cancer Research (ZIK)


Lung cancer

The medical history
of Axel T.

Axel T. anxiously waited in the corridor of the university hospital in June of 1990.

The 64-year-old was waiting for his ap­poin­tment with the onco­logist.

His fear tor­ment­ed him and his stomach was in knots. He felt like a guil­ty man wait­ing to re­ceive a sentence.

Axel T. told him­self to stay calm. In a moment he would have to focus in order to under­stand every­thing cor­rect­ly. He might also be asked to make an im­por­tant decision.

Color photography: Corridor with waiting room

Fig. 1/6 Corridor with wait­ing room

Prior to this con­ver­sation, he had gone through several diag­nos­tic tests:

In ad­di­tion to the con­ven­tio­nal x-ray exa­mi­nation, doctors ordered a com­pu­ter tomo­graphy - a new imag­ing pro­ce­dure that made visi­ble the spatial dimen­sions of the tumor.

Additionally, they per­form­ed a micro­sco­pic exa­mi­nation of the lung mucosa cells as well as a broncho­scopy (lung endo­scopy), in which tis­sue samples were taken from the lung for fur­ther analysis.

Finally, they did a media­stino­scopy to deter­mine the extent to which the lung cancer had spread.

Color photography: Computer tomograph, around 1988

Fig. 2/6 Computer tomo­graph: SOMATOM Plus, ca. 1988

The oncologist diag­nos­ed Axel T. with small cell lung cancer.

She explain­ed that lung can­cer has be­come one of the most com­mon can­cers found in in­dustria­liz­ed countries.

According to cur­rent re­search, in­creas­ing ciga­rette con­sump­tion, en­viron­men­tal toxins, expo­sure to cer­tain chemi­cals and mine­rals, as well as nu­tri­tion and gene­tic fac­tors all con­tri­bute to the in­creas­ed cases of lung cancer.

She told him matter-of-factly: The fast-grow­ing can­cer is cha­rac­te­riz­ed by a high rate of cell di­vi­sion, leav­ing little hope for a cure. However, there are thera­pies that can pro­long one’s life.

Lung cancer, CT scan of a 67-year-old man, undated

Fig. 3/6 Lung cancer, CT scan of a 67-year-old man, undated

In light of his diag­no­sis, the doc­tors recom­mend­ed a com­bi­na­tion of treatments.

Axel T. was treat­ed with four dif­fe­rent anti-cancer drugs in three cycles.

Immediate­ly after the first in­fu­sion, he was felt eupho­ric. He suf­fer­ed almost no side ef­fects. They would come later, as his hos­pi­tal room neigh­bor warn­ed, and he was right.

Diarrhea and stomach pain like he had never felt before, an in­flam­ed oral mu­cosa, ex­treme fati­gue, weak­ness and burn­ing veins be­came common­place for Axel T.

Color photography: Charité pharmacy, drug production, 1995

Fig. 4/6 Charité pharmacy, drug production, 1995

Between treat­ments and dur­ing breaks in his treatment he often felt relief from the side effects.

He didn’t want to wait any lon­ger to ful­fill his desires.

He travell­ed to Greece once again with his wife, he was happy when the chil­dren and grand­chil­dren came to visit and tri­ed not to miss any chances to see his child­hood friends.

When the weather was nice, he went to the park to feel the sun and the breeze on his skin. There, he was amus­ed by the spar­rows and often ate his favor­ite kind of ice cream.

Picture postcard, Acropolis, Greece

Fig. 5/6 Picture postcard, Acro­polis, Temple of Pallas Athena

A psycho­logist from the cli­nic ad­vis­ed him to live in the moment.

The philosophy behind this was that seri­ous­ly ill people must have hope. If their hope to be cur­ed is fu­tile, then their hope can in­stead be di­rect­ed to­wards the litt­le things, like go­ing to the sea once again.

In the early 1990s, it was popu­lar to think that hope­ful thoughts could po­si­tive­ly in­fluen­ce the im­mune system and, thus, the course of the disease.

Seriously ill people now in­creas­ing­ly found them­sel­ves call­ed upon to have hope - an ex­pec­ta­tion that could some­times also be a burden.

Color Photograph: Older man in a park

Fig. 6/6 Older man in a park


The medical history of four-year-old Regina


Fig. 1/6 Mother with two children, Zurich-Oerlikon, corner Schaff­hauser­strasse and Wallisellenstrasse, 1963.

ETH-Bibliothek Zürich, Bildarchiv / Fotograf: Comet Photo AG (Zürich) / Com_L12-0072-0008-0038 / CC BY-SA 4.0

Fig. 2/6 Children’s Hospital, Zurich, 1969.

Baugeschicht­liches Archiv Zürich/­Wolf-Bender’s Erben, Bildcode BAZ_118508

Fig. 3/6 Children’s Hospital Wed­ding, hospital room: nurses apply­ing a leg bandage, child patient with head bandage, undated.

Charité, Institut für Geschich­te der Medi­zin und Ethik in der Medi­zin, Bild-Nr. 009158

Fig. 4/6 Children’s Hospital Wedding, day room: nurse play­ing with sever­al chil­dren, undated.

Charité, ZFA, Bild-Nr. 008948

Fig. 5/6 A ten-year-old describes a follow-up exa­mina­tion, from: Petra Kelly (Hg.), Viel Liebe gegen Schmer­zen. Krebs bei Kin­dern, Reinbek: Rowohlt-Taschen­buch-Verl. 1986.

Staats­biblio­thek zu Berlin

Fig. 6/6 Entrance of a chil­dren’s hospi­tal, Zurich, built in 1939.

Bau­geschicht­liches Archiv Zürich/­Wolf-Bender’s Erben, Bildcode BAZ_118569

The medical history of Karin S.


Fig. 1/5 Entrance to the Uni­ver­sity Women’s Clinic in East Berlin, ca. 1980.

Charité, Institut für Ge­schichte der Medi­zin und Ethik in der Medi­zin, Berlin, Bild-Nr. 001428

Fig. 2/5 „Pharma­ceu­ti­cal indu­stry test­ed drugs on pa­tients in the GDR“, here: Drug tests in the ex-GDR, chemo­thera­py pa­tient at the Cen­tral Insti­tute for Can­cer Research during infusion, 11.1.1991 (picture detail).

Berlin, Bundes­stif­tung zur Auf­arbei­tung der SED-Diktatur/­Klaus Mehner, Inv.-Nr.: 91_0111_GES_MedTest_21

Fig. 3/5 Univer­sity Women’s Clinic, corridor, ca. 1980.

Charité, Thiele, Bild-Nr. 001656

Fig. 4/5 Univ. Women’s Hospital, con­sul­tation room, ca. 1985.

Charité, Thiele, Bild-Nr. 001916Z

Fig. 5/5 „Pharma­ceuti­cal indu­stry test­ed drugs on pa­tients in the GDR“, Cen­tral Insti­tute for Can­cer Re­search/­Aca­demy of Scien­ces of the GDR, 11.1.1991.

Berlin, Bundes­stif­tung zur Auf­arbei­tung der SED-Dik­tatur/­Klaus Mehner, Inv.-Nr.: 91_0111_GES_MedTest_23

The medical history of Axel T.


Fig. 1/6 „In a corridor there is a wait­ing room“, 3.2.2016.

Marcel Derweduwen/­Alamy Stock Photo, Bild ID FGJWHW

Fig. 2/6 Computer tomo­graph: SOMATOM Plus, ca. 1988.

Siemens Healthineers His­tori­cal In­sti­tute, Bild-Nr. 3122 abx

Fig. 3/6 Lung cancer, CT scan of a 67-year-old man, undated.

Rajaaisya / Science Photo Library / Alamy Stock Fotos, Bild ID 2GYNGY

Fig. 4/6 Pharmacy of the Charité, pro­duc­tion of medi­cines, from: Antje Müller-Schubert, Susanne Rehm, Caroline Hake, Sara Harten, Charité. Foto­grafi­scher Rund­gang durch ein Kran­ken­haus, be.bra Verlag: Berlin 1996.

Charité, Institut für Ge­schichte der Medi­zin und Ethik in der Medi­zin, Berlin

Fig. 5/6 Picture post­card, Athènes, Le Parthe­non, Post­card stamp 12.4.1951.

ETH-Bibliothek Zürich, Bild­archiv / Fotograf: Unbe­kannt / Fel_052590-RE / Public Domain Mark

Fig. 6/6 Older man in a park, 2.4.2013.

Jürgen Ritterbach/Alamy Stock Foto, Bild-ID D5GDKE

Fotografie, schwarz-weiß, von 2022: Das Foto zeigt einen leeren schwarzen Raum. Im Vordergrund sieht man links ein Mikrophon zur Tonaufnahme und rechts einen leeren Stuhl.
Fotografie, schwarz-weiß, von 2022: Das Foto zeigt einen leeren schwarzen Raum. Im Vordergrund sieht man links ein Mikrophon zur Tonaufnahme und rechts einen leeren Stuhl.
Fotografie, schwarz-weiß, von 2022: Das Foto zeigt einen leeren schwarzen Raum. Im Vordergrund sieht man links ein Mikrophon zur Tonaufnahme und rechts einen leeren Stuhl.


Being cured of cancer

Living with cancer

Dying of cancer

Even in the 21st century, medical care for people suffer­ing from cancer con­tinues to evolve. In addi­tion to the classic thera­pies - surgery, radia­tion, and chemo­therapy - there are now promi­sing new forms of treat­ment, such as immuno­therapy or mole­cu­larly tar­geted thera­pies. With these inno­vations, our under­stand­ing of cancer and the way we handle the disease have changed. The follow­ing twelve inter­views reflect this change from diffe­rent perspectives.