From Al-Zahrawi’s Kitab Al-Tasrif to modern oncology: enduring principles of surgical cancer management

Introduction: Cancer has been recognized as a disease since antiquity, with references documented across multiple civilizations. While the most effective advances in diagnosis and treatment have emerged in recent decades, fundamental principles – particularly the role of surgical excision – were already described and practiced by earlier physicians. Among the most prominent was Abū al-Qāsim Al-Zahrawi (Albucasis, 936–1013 CE), whose encyclopedic treatise Kitab al-Tasrif outlined surgical approaches to cancer that reflect enduring principles in oncologic care. This review analyzes Al-Zahrawi’s descriptions of cancer management in Kitab al-Tasrif and evaluates their relevance to modern principles of surgical oncology. Methods: A historical-comparative review of Al-Zahrawi’s descriptions of cancer surgery was undertaken, focusing on his rationale, operative techniques, and cautions. These were compared with contemporary surgical oncology principles to identify continuities and distinctions. Al-Zahrawi advocated complete surgical excision with surrounding healthy tissue, acknowledged the risk of recurrence, emphasized the importance of early diagnosis, and recommended caution in advanced or deeply hidden disease. These insights parallel enduring principles of surgical oncology. Despite the limitations of medieval resources, his writings demonstrate a sophisticated anticipation of doctrines that underpin modern cancer surgery. Conclusions: Al-Zahrawi’s Kitab al-Tasrif illustrates how medieval physicians developed an advanced understanding of cancer surgery. His teachings highlight both the continuity of surgical principles across centuries and the enduring legacy of medieval medical thoughts in shaping modern oncologic practice.