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The Cancer Chronicles: Unlocking Medicine's Deepest Mystery

The Cancer Chronicles: Unlocking Medicine's Deepest Mystery [Kindle Edition]

George Johnson
3.0 out of 5 stars  See all reviews (3 customer reviews)

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"Rich and sweeping...this is a book for anyone whose life has been touched by cancer, which is just about everyone" -- Barbara Ehrenreich "Compact, elegant...gripping... Everyone who is concerned about cancer - that is every thinking adult - should read The Cancer Chronicles" -- Charles C. Mann "A highly captivating book that meticulously explains the current scientific understanding of cancer" Times Literary Supplement "A fascinating compilation of selected discoveries in cancer research that helped shape his deeper understanding of the disease process" -- Mary L. Disis Science "Johnson elegantly tells a fascinating chronological tale of cancer" British Journal of General Practice

Book Description

A vibrantly informative and provocative look at the war against cancer - from the age of dinosaurs through to today and beyond.

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3.0 out of 5 stars
3.0 out of 5 stars
Most Helpful Customer Reviews
4 of 4 people found the following review helpful
3.0 out of 5 stars Chaotic and kaleidoscopic. 20 Oct 2013
I had high hopes for this book. It got some good reviews in the heavier weeklies, and the subject deserves a new, wide ranging treatment. All we get in the media are pharma press releases and their attendant post code lottery stories. Nice, I thought, to get an overview.

And the book does give some very deep insights about origins:

Cancer isn't a disease - it's natural, and a condition which all multicellular organisms can experience, way back to the dinosaurs. "The price of evolution"
It results from a combination of cell mutation and cell division; there are a lot of similarities to the way bacteria behave when they're faced with a stress agent like an antibiotic.

Apart from the chemicals in tobacco or marijuana smoke, there is very little evidence to support the assertion that chemicals in food or the environment cause cancer: one exception is alcohol and cancers of the mouth or throat. Similarly there isn't a good link between radiation and cancer, except for very high doses which have a local effect. All these things may cause increased mutation, but mutation on its own doesn't lead to cancer.

A cancerous growth has a very difficult time establishing itself in a body: it benefits if we encourage it.

Cancer can be encouraged by factors which enhance cell growth: hormones especially oestrogen; insulin (which is why obesity and diabetes lead to higher incidences.

The statistics suggest that the incidence of cancer is not increasing unusually. We just don't die of other causes.

There's other good stuff, too. I really enjoyed the description of large science conferences: the poster sessions resemble the souks of Marrakesh, long interwoven corridors of goodies, and students waitng to pounce to tell you about them.
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1 of 1 people found the following review helpful
From prehistoric times to current developments, Johnson surveys the phenomenon of cancer, all along blending personal anecdote with cutting-edge research. The popular science writer started his journey into cancer when his wife, Nancy, was diagnosed with a rare uterine variety. He took it as an opportunity not just for personal soul-searching (why her? why now?), but also for a wide-ranging odyssey into research about what causes cancer and how long it has been with us.

Johnson successfully balances (auto)biographical information and hard science, though some may struggle with the level of detail about cell biology and medical trials. Nancy's story reveals the harsh reality of cancer treatment – especially in America, where bureaucracy and astronomical medical bills exacerbate an already horrible experience. 'How quickly the unthinkable becomes routine,' Johnson reflects. The book ends on a sad note – though not with Nancy's death, one hastens to add. If only Johnson could have chosen to find more hope; instead he concludes, "With our tools and intelligence, we can strike small victories and hold off death for a while. But it is the tide that will eventually prevail." Ultimately, Siddhartha Mukherjee's Pulitzer Prize-winning The Emperor of All Maladies is the more comprehensive and optimistic study of cancer, but Johnson's is shorter and highly readable.

We have reached a point where no one is unaffected by cancer, directly or indirectly. That is to say, there is no one to whom this book will not be relevant. Some might be put off by both the weighty scientific subject and the pessimistic tone. However, I encourage reluctant readers to give it a try. You will learn more than you might expect, and explode many myths along the way.

(My full review is available at The Bookbag:
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1 of 4 people found the following review helpful
2.0 out of 5 stars Hard to get into! 18 Oct 2013
Format:Hardcover|Verified Purchase
I started reading this book with much enthusiasm as part of it has been serialised in the Daily Mail which I enjoyed reading.
Unfortunately this was the only part that I enjoyed as the rest of the book was difficult to read and unclear!
The style also didn't suit me.
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Most Helpful Customer Reviews on (beta) 4.3 out of 5 stars  81 reviews
25 of 26 people found the following review helpful
4.0 out of 5 stars Three words you never want to hear 17 July 2013
By J. Green - Published on
Format:Hardcover|Vine Customer Review of Free Product (What's this?)
Science-writer George Johnson and his wife heard three words that changed their lives - "you've got cancer" - when she was diagnosed with a metastatic uterine form of the disease. As a result, Johnson embarked on a quest to learn everything he could about cancer and has written an interesting overview of what is known, which turns out to be less than you might hope. Cancer is not one disease but many and has been around a long time, and evidence of different cancers have even been found in dinosaur fossils. In fact, it has been with mankind as long as we've been around, but if it seems to be increasing it's only because we're living longer. With some cruel exceptions, cancer is mostly a disease of older people but, beyond age, the only other reliable factors that can be said to cause cancer are smoking and obesity.

If you're looking for a positive, upbeat, "let's beat Cancer!" kind of book, this probably isn't it. Johnson says that while we've made significant strides, our understanding of why it happens and how to treat it still has a long way to go. He points out that studies are frequently flawed and inconclusive, and recommendations that eating fruits and vegetables or any particular food will help prevent cancer do not hold up under more rigorous testing. There is some correlation that exercise and maintaining a healthy body and diet helps, but the benefits are often small and disputed. And as he discusses the effects of drinking water tainted with chemical pollutants he illustrates very well why it is so difficult to *prove* causation. Even if a specific chemical or activity can be linked to a 30% increase in cancer (which sounds very dramatic), if your odds were only 1.2% in the beginning it only translates to new odds of 1.56%, which is still within normal and random variations. (See Toms River: A Story of Science and Salvation for an excellent account of why it is so difficult to conclusively link environmental concerns with cancer.) Even exposure to radiation isn't as cut and dried as you might think.

This is an informative book but often the information is thrown at the reader in a rapid-fire listing of facts and figures that make it hard to absorb. As one who is not overly familiar with the different types of cancers, I frequently felt like I was in a whirlwind of data and trying to make sense of too much random information. Still, it's a sobering overview of the current status of cancer research and isn't a bad introduction (I plan to move on to Siddhartha Mukherjee's book soon).
93 of 114 people found the following review helpful
3.0 out of 5 stars A cancer surgeon's review....Nothing new, just repackaged information. 27 Aug 2013
By Sinohey - Published on
I was eager to read this book because, as a surgeon, I am always searching for new information,fresh ideas and innovative techniques in the management of cancer.

I read the 280+ pages of The Cancer Chronicles hoping maybe to discover a new treatment, or a novel approach or cutting edge therapy to combat this vicious disease that has plagued all living creatures since life began on earth. Tumors have been found in fossils of dinosaurs.
Sadly I found nothing new; the promised "explosive new ideas" touted by the publicity hype were neither new nor explosive, but just fizzled. Most of it was common routine knowledge in the medical field. On page 17, I learned that "mammals appear to get more cancer than reptiles or fish. Domesticated animals seem to get more cancer than their cousins in the wild. And people get the most cancer of all." It is a great piece of information with which to stomp your friends at trivia.
Even some information was inaccurate; the author confuses the function of free radicals with antioxidants.

The book touches on the genesis of cancer, mostly unknown except for a few causative relationships such as smoking and environmental hazards (Eg. asbestos) associated with mainly with lung cancers. It correctly challenges the myths of unproven causal links between cancer, the environment or diet. Many studies are inconclusive, flawed or biased.
Screening tests like mammograms, PSA and CA 125 are not specific or sensitive enough for an absolute diagnosis and often result in a false positive, leading to unnecessary, often radical, treatment. Ideally, early diagnosis and treatment lead to cure; best examples of screening are Pap smears and colonoscopy that can detect pre-cancerous lesions and allow early therapy.
Robust research is being conducted on genetics, obesity, inflammation and aging as triggers of malignant cellular metamorphosis and cancer. The quest for biomarkers is a giant step forward in the search for an accurate screening test. In my opinion, the answer shall be unlocked in the study of the human genome.

Surgical interventions, preceded or followed by radiotherapy and/or chemotherapy remain the standard of care in the treatment of cancer. These therapies are being constantly refined to minimize collateral damage to nearby tissues and to mitigate general side effects and complications. The "one size fits all" approach is slowly being replaced by custom designed treatments for each individual and their specific cancer.

Johnson did an in-depth research of the subject when his wife was diagnosed with an advanced stage gynecological cancer. He interviewed researchers and visited their labs, attended conferences and read the literature, and all the while trying to relate his findings to his unfortunate wife's condition and management. The stories are related in parallel and are intertwined, which gives a disjointed sequence of chapters that are neither organized thematically nor chronologically. Johnson peppers his account with stories of cancer in hamsters, Tasmanian devil and accidental self-contamination from a needle poke. Even the some Italian nuns are not spared from conjecture. No theory, however far fetched, is ignored; Gould's theory of "punctuated equilibrium" is mentioned and left hanging (it refers to an evolutionary process in two stages, rapid cell development and death in one and stasis in the other). Wienberg's work on oncogenes (cancer-causing genes), mitosis and entropy is explained to its conclusion "If we lived long enough...we all would eventually get cancer."
He tends to drone on about his interface with researchers, conferences and history mixed in with results of studies, and to cram in numerous facts, figures and anecdotes; causing confusion in the lay reader and loss of interest in the medical professional.
Johnson seems oblivious of the SEER (Surveillance, Epidemiology and End Results Program) and EPIC (European Prospective Investigation into Cancer and Nutrition) that prove the importance of diet in the prevention and treatment of malignancies. A vegetarian food regimen or Mediterranean diet stand out as the best choices.

The culmination of all Johnson's efforts is his eureka moment "whether any one person gets cancer or does not will always remain mostly random". I had to read 203 pages to get to that conclusion? This is after he already quoted Elio Riboli (epidemiologist) half way in the book, "as much as 50% to 60% of cancer, we didn't have the slightest idea of where it comes from". Yeah, I got it the first time; it's a crapshoot. Cancer is unpredictable. We are also reminded that cancer is not just one but myriad diseases "with no cure in sight."

Towards the end of the book Johnson chronicles his brother Joe's courageous encounter with cancer of the head & neck and his untimely demise. This adds to the poignancy and fatalism of the work, for what he calls "The Immortal Demon" no permanent cure is presently available.

It is a well-written book in the style of investigative journalism and a good overview of the state-of-the-art in the diagnosis and treatment of cancer, for the interested layman. The poignant account of Johnson's wife's battle with cancer, encompassing about a quarter of the book, adds emotion and sympathy to, what would otherwise be, a minor textbook of facts and figures, and of little interest to the academic or medical professional.
Overall the book is a good introduction to what is available today for the management of cancer in general and a good place to start to begin to understand the complexity of the disease and the intricacies of its treatment.
Interested readers should add "The Emperor of All Maladies", "The Truth in Small Doses" and "The Philadelphia Chromosome" to their reading list to get a more complete picture on the subject.

I noticed that all the "vine" reviewers have given the book 4 & 5 stars. I shall be an outlier, but I cannot give it more than 3 stars for, in my opinion, it did not deliver any "new explosive ideas" as promised.
12 of 13 people found the following review helpful
4.0 out of 5 stars Very informative. 10 July 2013
By J. FELLA - Published on
Format:Hardcover|Vine Customer Review of Free Product (What's this?)
Having had cancer myself when I was 21, I've been devouring every bit of info on health, nutrition, and cancer since then. This book certainly tackles things fairly comprehensively and brings up issues and viewpoints I never thought of, or heard. He talks about why many previous studies were flawed or nearly useless, and how new studies will remedy those errors.

Ironically, the chapter on metabolism and cancer was the one I was looking forward to the most, but turned out to be the most disappointing. He does mention Gary Taubes' excellent book "Good Calories, Bad Calories" and some of the statistics he uncovered involving hunter-gatherer societies and their low-carb diets allowing those cultures to live without many western diseases. He says it makes sense, but then doesn't go into ANY examination or review of any studies, statistics, etc. He only says that, at this point, fat-storage, diabetes, and insulin levels are one of the few significant dietary factors we have to go on.

He also makes a very strange comment about free radicals. He says people would never want to completely get rid of free radicals, because they are actually a good thing. He says they are the bodies garbage collector and keep toxins from building up. It sounds like he's describing anti-oxidants, not free radicals. I have never, in my years of reading about this subject, ever heard anyone say free radicals were in any way positive.

Still, this book has some surprising revelations and I can almost guarantee you will be thinking differently about cancer when you're finished.
4 of 4 people found the following review helpful
5.0 out of 5 stars Terror Cells 5 Oct 2013
By Melanie Gilbert - Published on
Format:Hardcover|Vine Customer Review of Free Product (What's this?)
Cancer, what is it good for? Absolutely nothing. (to parphrase Edwin Starr's song, "War.").

Author George Johnson writes a damning argument on the futility of the War on Cancer. Despite having a ringside seat - due to his wife's metastatic adenocarcinoma - this isn't a cancer memoir. Yet, that personal experience motivates him to research the cancer universe and document its scientific terrain in layman language without prejudice or agenda.

It's grim reading. Johnson describes a disease that operates like a terrorist organization. It doesn't acknowledge boundaries, conventions, or consequences. It advances without regard to human suffering or collateral damage. It evades detection and defeats defenses through stealth and cunning by hijacking local networks. It's on a suicide mission. It recruits converts. And it does all this by feeding off and weakening the system in which it exists.

It is a ruthless, relentless and resilient enemy that has not retreated despite medical advances. What makes cancer all the more dangerous is that it is also capricious and random.

I've read the survivor and spiritual, the academic and scientific, the genetic and medical, the historical and evolutionary, the diagnostic and surgical, the financial and legal, and the governmental and political books on cancer. But this is the most ominous book I've read on the disease.

Practically speaking, says Johnson, we have no earthly idea what we're dealing with or how to prevent or treat it. "We rage," he says, "against the machine." This book is a terrifying reality check that challenges our notion of who - or what - is "winning the war on cancer."
3 of 3 people found the following review helpful
5.0 out of 5 stars The Immortal Demon 11 Sep 2013
By James Henderson - Published on
George Johnson opens his book, on the page preceding chapter one, with an epigraph from Reynolds Price's memoir about his own struggle with cancer that left him in a paraplegic state. I mention this because I was moved by my reading of Price's book almost two decades ago and, while it was an eloquent expression of the experience of cancer it did not, as I remember, inform me significantly about the nature of the disease itself. With The Cancer Chronicles George Johnson, a writer whose book Fire in the Mind impressed me several years ago, shares both the history and nature of the disease called Cancer and a memoir of his wife's own battle with that disease.
The history of cancer begins very far back in prehistoric times for it seems that scientists have found that the disease was already present in the age of Dinosaurs. This revelation along with others made the book both informative and interesting to read. His chronicle of the history of the science of cancer explores the realms of epidemiology. clinical trials, laboratory experiments while sharing information from evolutionary biology and other sciences. Even the economics of the Cancer research juggernaut is described -- an industry that has grown to an immense size in the search for an elusive "cure" for cancer.
Cancer the disease is at the core of the book and permeates the narrative, but the chronicles reveal what is in reality multiple different diseases. Each cancer affects different parts of the body and different groups of humans in unique ways. This is an important part of the story and represents some of the basis for many of the obstacles scientists continue to face in analyzing how to stop or prevent the disease.
Johnson capably personalizes the story with interludes where he shares his wife's struggle with Cancer. In doing this he reveals a view of the disease from the point of view of the everyday person who must deal with the practicalities of diagnoses and treatments and hospital stays. For those of us who have family or close friends who have had the experience of this disease the narrative is a moving personal story. I also appreciated the literary allusions whether explicit, like the reference to Solzhenitsyn's masterpiece Cancer Ward, or implicit. The author is eloquent both in his telling analysis of the disease and in his personal memoir; he demonstrates an ability to convey scientific concepts lucidly enough for the layman to understand. These characteristics and the fascination that the author shares for scientific discovery make this a great book full of insights into the deep mysteries of some of the most complex areas of modern medicine.
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