The Emperor of all Maladies: A Biography of Cancer (2010) by Siddhartha Mukherjee

It may seem like an odd idea to write a biography of cancer when biographies are usually written about famous people.  But, in fact, this reads much like the story of a famous person–complete with subplots of  the main players, milestones in its life, and its long chronology.  Yes, it feels almost human.  And much like its cells that divide and live on nearly forever, this disease has been around nearly forever, and unfortunately, there is no end in sight.

As a two and a half year survivor of this disease, this book was at times difficult to read, especially stories of just how virulent cancer cells can be.  Yet, the book is a fascinating mix of history, biology, chemistry, social activism, medicine, and politics.  And–it’s so well written that I often felt I was in the hands of a great novelist rather than an oncologist.  How Mukherjee had time to conduct exhaustive research (70 pages of end notes and a bibliography) while at the same time finishing an oncology fellowship with a full patient load AND being a husband and father is beyond me.

 

Some of the more fascinating aspects of this book: tracing what could be a description of  a breast tumor to an Egyptian doctor practicing in 2500 BC, and also to Atossa, Queen of Persia two thousand years later; the beginnings of “magic bullet” drugs that target a specific human disease; the origin of “Jimmy” of the famous Jimmy Fund; the first uses of chemotherapy; Sydney Farber’s contribution and commitment to chemotherapy and cancer research; the origin of the American Cancer Society and its socialite fundraiser, Mary Laksar; the influence and damage of the tobacco industry. But what stood out most was how we have so often mistaken cancer as a single disease (as in a “war on cancer”) rather than what it really is: a “shape shifting disease of colossal diversity.” More than anything, it clarified that this disease won’t be cured—or prevented—anytime soon.  That’s a depressing concept, but somehow it doesn’t take away from the fascinating nature of the book.  And yet, it’s hopeful as well.  Smart people are doing amazing research–we just need more of them to continue chipping away at answers.  And we need a lot more information about prevention—but that’s even more complex than finding cures.  After all, we live in a toxic world where toxic products make a lot of money.  We now know the evils of tobacco.  And we’re finally learning the potential evils of hundreds of other products in our environment on our grocery store shelves.  I suspect we’ll one day find that many of them are more directly linked to cancer than we’ve been led to believe. Until then, we’ll need to rely on researchers and doctors, and ultimately to accept that cancer is sewn into our genes.  It is a fact of life. (nonfiction)

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