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The Emperor of All Maladies: A Biography of Cancer Paperback – 29 Sep 2011
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‘Mukherjee calls this great and beautiful book a biography, rather than a history, because he wants his reader to understand his subject not just as a disease, a scientific problem or a social condition, but as a character – an antagonist with a story to tell. His intensely vivid and precise descriptions of biological processes accumulate into a character, fully developed and eerily familiar. The notion of "popular science" doesn't come close to describing this achievement. It is literature.’ Observer
‘This is a riveting book…profound, eloquent and searching’ John Carey, Sunday Times
‘”The Emperor of All Maladies” is the book that many will have been waiting for. This elegantly written overview allows us to look a once whispered-about illness squarely in the eye.’ Independent
‘So beautifully written; this is literature, not popular science. “The Emperor of Maladies” empowers us, makes it clear that we really do know this enemy, and so brings us another step closer to victory.’ Evening Standard
‘Mukherjee never condescends, yet he manages to write lucidly and tellingly about complex experimental, technological and theoretical matters’ Will Self, New Statesman
About the Author
Siddhartha Mukherjee M.D., Ph.D., is a cancer physician and researcher. He is an assistant professor of medicine at Columbia University and a cancer physician at the CU/NYU Presbyterian Hospital. A Rhodes Scholar, he graduated from Stanford University, University of Oxford, and from Harvard Medical School and was a Fellow at the Dana Farber Cancer Institute and an attending physician at the Massachusetts General Hospital and Harvard Medical School. He has published articles in Nature, New England Journal of Medicine, Neuron, the Journal of Clinical Investigation, The New York Times, and The New Republic.
He lives in New York with his wife and daughter.
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This book does an excellent job, as far as my knowledge extends, in providing a historical guide to the ways in which cancer has been treated and the growing understanding of what cancer actually is. The two have not necessarily gone hand in hand, and it is comparatively recently that the understanding of the biology of cancer has produced targeted treatments.
The flip side of that understanding, though, is that it is quite likely there will never be a magic 'cure' for cancer. In some ways, as the book explains, everyone's cancer at the genetic level is unique, though it appears there are certain genes which are likely to be drivers of cancer. But with an aging population, cancer may be, like wrinkles, a feature of old age. The good news is that cancers that affect the young have been the ones where the treatment has been most effective.
Some of the chapters in the book that deal with the biology of cancer at the chromosome level are a little hard going for a non-biologist. A diagram may have been useful in places. But, ultimately, the book is worth the effort and the information within it should help dispel some of the fear and dread that surrounds mention of the disease.
Tracing the business of cancer - a catch-all noun for a multiple disease of infinite variety but with a common origin - the progress of the malady is meticulously dissected out through anecdote, fact, history,science, quackery, coincidence, serendipity, elation, catastrophe, failure, humanity, hubris and a thousand other perspectives. Heart-wrenching tales of suffering, false trails, missed opportunities, stupidity and greed are juxtaposed with brilliant insights, fastidious labour, lucky breaks, dedication, applied logic, professional ostracization, and tenacity in the face of ruin.
The mundane reality of the horrors of early treatments and the humanity it can elicit make for astonishing reading. The excitement of giant leaps in treatment progress - Morton with aneasthesia and Lister with antisepsis, for example - are juxtaposed with reflections on the lady who having endured a mastectomy without anaesthetic rises from the table and, curtsies to the surgeons apologizing should she have disturbed their progress with any inadvertent cries during the procedure and so induces tears in the eyes of those who operated on her.
Cancer, it turns out may well be the primary disease of diseases with its basis in genetic malfunction it has been demonstrated in two million year old bones, in Egyptian mummies and ancient Peruvian graves. It is universal and its supremacy has been camouflaged by parallel diseases such as plague, tuberculosis, heart disease etc depressing longevity, for cancer is a disease that is predominantly occasioned by living to a ripe old age. The modern shift appears to be immunological challenges that disturb the equanimity of genetic replication procedures leading to malfunctions of cell reproduction cycles.
Cancer,it seems from reading Mukherjee's tale, is the ultimate survival machine. Beautiful in its mechanisms and its association with the fundamental processes of life.
Perhaps he might be persuaded to pen another volume containing what he had to leave out previously. One can only hope. There are several internet lectures/discussions in which he features if you wish to sample an appetizer for this book
Mukherjee envisages Cancer as not one disease but more a family. His is a fascination with the world of the cancer patient, one which around a half of us will inhabit at some time. There is no panacea but in a battery of treatments there is hope, such that more will die with than of the disease; this is part of a movement quashing the old equating of Cancer with Death.
One cavil: he refers to largely American research and developments, which lessens his scope somewhat. I still have read it straight though three times in the year I have had it. Brilliant.