Siddhartha Mukherjee

An assessment of cancer addresses both the courageous battles against the disease and the misperceptions and hubris that have compromised modern understandings, providing coverage of such topics as ancient-world surgeries and the development of present-day treatments. Reprint. Best-selling winner of the Pulitzer Prize. Includes reading-group guide.

A Biography of Cancer

The Emperor of All Maladies

Manasi Gajjalapurna

Eight thousand miles away, in the cloth mills of Bombay (owned by English traders and managed by their cutthroat local middlemen), wages had been driven to such low levels that the mill workers lived in abject poverty, malnourished and without medical care. When English physicians tested these mill workers in the 1920s to study the effects of this chronic malnutrition, they discovered that many of them, particularly women after childbirth, were severely anemic. This was yet another colonial fascination: to create the conditions of misery in a population, then subject it to social or medical experimentation.

When a disease insinuates itself so potently into the imagination of an era, it is often because it impinges on an anxiety latent within that imagination. AIDS loomed so large on the 1980s in part because this was a generation inherently haunted by its sexuality and freedom; SARS set off a panic about global spread and contagion at a time when globalism and social contagion were issues simmering nervously in the West. 

Every era casts illness in its own image. Society, like the ultimate psychosomatic patient, matches its medical afflictions to its psychological crises; when a disease touches such a visceral chord, it is often because that chord is already resonating.

Nineteenth-century doctors often linked cancer to civilization: cancer, they imagined, was caused by the rush and whirl of modern life, which somehow incited pathological growth in the body. The link was correct, but the causality was not: civilization did not cause cancer, but by extending human life spans—civilization unveiled it.

Gigi V

A must read for those of you have a cancer history in hour family. It helped me understand the cancer that caused the death of my mother. I was too young then to understand what happened to her.

Laura Mauler

The book starts out rooted firmly in the human experience, told through the stories of patients, doctors, and discoverers from the ancients up through the modern era. I found these stories fascinating and often incredibly sad; I could relate to them. Around the 1960s the book shifts into a more technical vein, which makes sense because this is when so many innovations in cancer research and treatment began, but I found myself disengaging from the story. The author does a laudable job of keeping the human experience a part of the story, but this is a biography of cancer - not humans - and at some point the story becomes less about "us" and more about "it". Or rather, "them", because one of the most fascinating parts of the book was seeing how heterogenous cancer is in the human body. Lymphomas are completely different from breast cancer, which is completely different from sarcoma, etc. I truly had no idea. 

Also fascinating was how breast cancer was the focus of cancer research for literally hundreds of years. This seems like a woman-positive situation until you discover the devastating surgeries and experiments that doctors inflicted on the female body. Would they have been so quick to carve out literal pounds of flesh if these were male bodies? Would male patients have had more authority over their own care, and been fully informed about what was about to be done to their bodies? Kudos to the author for explicitly calling out the medical industry on its historically cavalier treatment of women, and acknowledging the women of the 1970s who refused to be sidelined in their own treatment, and thus forged the patients' rights movement out of the second-wave feminist movement.

charisa

can you believe i used to read nonfiction part 2

Gavin

Here now in his triumph where all things falter,
Stretched out on the spoils that his own hand spread,
As a god self-slain on his own strange altar,
Death lies dead.


(Swinburne)

Quite lyrical but exhausting. All the way from Galen to personal oncogenetics.

The section on pre-anesthesia radical surgery was truly nauseating. A horrendous macho fad:

  Haagensen wrote in 1956: 'it is my duty to carry out as radical an operation as the... anatomy permits.'

The radical mastectomy had... edged into the “ultraradical,” an extraordinarily morbid, disfiguring procedure in which surgeons removed the breast, the pectoral muscles, the axillary nodes, the chest wall, and occasionally the ribs, parts of the sternum, the clavicle, and the lymph nodes inside the chest.

Breast cancer, [Halsted] claimed, spun out from the breast into the lymph nodes under the arm, then cartwheeled mirthlessly through the blood into the liver, lungs, and bones. A surgeon’s job was to arrest that centrifugal spread by cutting every piece of it out of the body, as if to catch and break the wheel in midspin. This meant treating early breast cancer aggressively and definitively. The more a surgeon cut, the more he cured.


The sheer amount of money and genius thrown at cancer - with merely gradual returns - is not really considered in terms of its opportunity cost, by Mukherjee of anyone - what diseases might we have cured with those hundreds of billions? What giant, clever prevention studies run? But never mind: cancer won the PR war (against apathy, against political indifference, against more cost-effective causes) very early on, with the chemo pioneer Farber and his use of Jimmy

  The campaign against cancer, Farber learned, was much like a political campaign: it needed icons, mascots, images, slogans—the strategies of advertising as much as the tools of science. For any illness to rise to political prominence, it needed to be marketed, just as a political campaign needed marketing. A disease needed to be transformed politically before it could be transformed scientifically.


and later with the powerful patient blocs.

Not sure who would benefit from reading this closely; there's too much detail. Maybe med school freshers?

Story telling imbued with history, data, and perspective. A truly enlightening read!

Matthew Serrano

Hazal Özlem

** spoiler alert **
           Bazı durumların, uygulamaların ve kabullerin yüzyıllar içinde dahi değişmediği, bazılarınınsa neredeyse anlık hızla değişebildiğini; tıbbın ve bir onkoloğun gözünden okumak heyecan verici. Kanser ile katettiğimizi sandığımız yolun bir arpa boyundan çok olmadığını ve gelecekte her iki kişiden birinin kanserle savaşacağı öğrenince korkmamak, hüzünlenmemek elde değil. Mükemmel bir kitap.

Flavia Louise

4.5 stars
I always have trouble rating nonfiction books because of my rating system being so based on how much I enjoy a book. But I did actually enjoy this and it was just VERY interesting.

Ashley Zahalan

Good read. Excellent telling of how far cancer research has come. 

ANDREW BRYK

I say I enjoy most books but this one was truly incredible. Using both research and personal stories, the author is able to tell a story that will change the way you think about disease and cancer in particular. There were definitely aspects that I did not understand as I am not in the medical field but it is a must read nonetheless

Melody Izard

I was sent right back to the 70s watching my father as we first discovered he had leukemia and then as he went though, the experimental treatment of "chemotherapy" to annihilate the mutant, prolific, white blood cells. It didn't work. His death was slow and very painful to watch. But he did enjoy a period of remission between the first diagnosis and the final stage where his hematologist just disappeared without even a word of sympathy to our family. Just enough time where my mom convinced herself the doctors were wrong and it had just been a bad infection and all would be fine.

Damn you cancer. 

The Emperor of Maladies tries to walk above this "damn you cancer" line. Which is just impossible to do. Try, try, try to be all clinical and factual about this hideous, shape-shifting disease if you dare. Nope. Not going to work.

Omar Fernandez

This offers a thorough review of our understanding of cancer over many decades. I give a lot of credit to the author for making such a complicated history palatable to the general public. It helps highlight the great difficulties faced over the years with regards to finding a cure for cancer, not just the scientific and medical complexities but also the political forces behind it. Overall, I think it's a great book, although it covers so much ground that as a reader I often wished it were more concise. As beautifully written as it was, you need a lot of patience to read through it all. 

Confession: I listened to the audio book at 3x speed to get through it.

Jade Flynn

“Cancer was not disorganised chromosomal chaos. It was organised chromosomal chaos," S. M. 

4.5/5 Thank you, Dr. Mukherjee. I am grateful.

Jeni Enjaian

I enjoyed this book much more than I thought I would. I found myself absolutely fascinated by all the topics Mukherjee mentioned. Cancer, as he describes, is not just one static disease. Both the disease-and all its forms-and the treatments take such wide varied form, it's hard to imagine how Mukherjee crammed as much as he did into this book without overwhelming the reader.

That last fact, in my opinion, was both an advantage and a disadvantage. I'll start with the negative first. It was so vast Mukherjee often had to jump back and forth in the time line as he discussed each successive advance in prevention and/or treatment. I'm sure that it would have been more obvious had I read this book in print rather than as an audiobook. Another disadvantage due to the format? Mukherjee's frequent lapses into personal anecdotes, which, while appropriate, were often disconcerting in the shift from third to first person.

Here's the advantage. Mukherjee mastered all the various themes and topics he crammed into this book without overwhelming the reader, a supremely impressive feat. The science alone could easily overwhelm the average reader. It's no wonder Mukherjee won the Pulizter.

Phil James

I found this supremely well written, balanced between the smooth telling of a suspense (who-done-it?) and just enough grounding in science history to keep both strands readable. 
He kept the human context alive with the patients he followed and he showed humility in the way he never presumed to be more than a learner even after he became a qualified specialist.
The best science books are those that kindle the feeling of awe at life and the universe. Here there is awe at the perseverance of many to find cures and even awe at the incredible wily supreme survivor, the disease itself.
The only reason I didn't give 5-stars was because there wasn't enough of the patients perspectives, but perhaps I'm being unfair, the subtitle is "a biography of Cancer" after all.

The Emperor of All Maladies A Biography of Cancer

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