It’s not all that often that you see a top-tier professional in one field effortlessly able to transition to the highest strata of a completely separate field altogether – almost overnight – but that’s exactly what’s happened with medical doctor and author Siddhartha Mukherjee and his book The Emperor of All Maladies: A Biography of Cancer.
Mukherjee, both a cancer physician (a world-renowned cancer physician, at that) and lead researcher at Columbia University also shows incredible skills as a storyteller and author with this book, a book that does a deep dive into cancer throughout history – but especially how prevalent (and destructive) it is in our modern world.
Interestingly enough, the title calls itself a “biography of cancer”, with the author opening up the entire book with the first mention of this insidious disease throughout history. It occurred in ancient Egypt more than 4600 years ago, and an Egyptian physician named Imhotep was speaking about the Queen of Persia that ordered a Greek slave to cut off one of her breasts that had a tumor inside of it and how it saved her life.
With how prevalent cancer is today in our modern world, and how frequently it touches each and every one of our lives, it would be reasonable to assume that cancer has always been this prevalent, always been this widespread, and always been just a quick diagnosis away.
As you begin to dig through The Emperor of All Maladies you soon learn that nothing could be further from the truth.
In fact, the author illustrates just how incredibly rare cancer was up until right around the beginnings of the 20th century. He goes into great depth explaining the how and the why behind the explosion in cancer around this point in history, but also shows how a dramatic climb in life expectancy really propelled cancer (particularly of aging cells) to where it sits today as the second leading cause of death – a position it has had ever since the 1940s.
Incredibly, most of the action of this book covers the last century or so. The author traces back to find some of the more transformative revelations in our scientific understanding of cancer, how these big breakthroughs came about, and how they changed the way we look and think about this disease today.
Mukherjee also goes on to talk about how society has had a shifting and ever-changing view of cancer as well.
A diagnosis of cancer in the past used to be seen as nothing more than a death sentence. Once you were diagnosed with cancer you may as well have given up right then and there. Modern medicine and technology at that point in time just didn’t provide for very much hope.
Today, however, the opposite is true.
Today society takes a very different look at cancer and what it might mean. Instead of thinking of it as an undefeatable force of nature we now look at it as an evil, vile enemy that has to be beaten and bludgeoned into submission – with the help of powerful medical solutions like surgery and chemotherapy to dominate it and win back our freedom and independence.
Mukherjee also shows us how cancer has been worked into a bit of a politically fueled weapon as well, used to fund some pretty desperate research projects that have distorted what we understand about human biology and have eliminated a lot of nuance in the solutions that we are able to put forward.
Interestingly enough, Mukherjee also writes about the things we can learn from cancer and the way it operates.
In some of the most enlightening parts of the book, Mukherjee talks about how survivors and fighters in the war against cancer use many of the same tactics of this dangerous, deadly, and insidious disease to fight ferociously back.
Describing cancer as desperate, inventive, fierce, territorial, and canny Mukherjee could at the same time be describing those that have been diagnosed with cancer in the actions that they are willing to take to win the war against this disease and to earn their good health back.
Throughout the book, we meet a number of wonderful characters, some of them a little more off-color than others. We learn how the early days of cancer research unfolded, we learn about the major leaps forward that were made between 1891 and 1981 when it comes to cancer treatments, and we learn about much of the cutting-edge solutions being put forward today.
Of course, no true “biography of cancer” would be complete without talking about setbacks, stumbling blocks, and sacrifice as well. Mukherjee does not paint a rosy picture of what life fighting cancer can be, but instead shines a bright mirror against what life fighting cancer is.
It isn’t always pretty, it certainly isn’t always fun, and it’s almost always a little battle to survive that some turn into a battle to thrive.
The end of the book shows how a number of major miscalculations during the 1980s and 1990s surrounding the combination of high-dose chemotherapy and bone marrow transplantation kind of ran cancer research off the rails a little bit.
And then moves into new research that shows the major leaps forward that breast cancer solutions have made in just the last 20 years, showing how chemotherapy has overtaken surgery, radiation therapy, and hormone drugs like tamoxifen have changed the game completely again, and how new cancer experts are looking to stop the growth of cancer cells first and then moving in to wiping them out once they have been contained.
At the end of The Emperor of All Maladies, Mukherjee leaves us with thoughts of hope and validation for the perseverance so many people impacted by cancer show and have shown on a day-to-day basis.
Between 1990 and 2005 cancer mortality rates are down 15%. People are living longer and longer after a cancer diagnosis, and treatment solutions today are better than they have ever been in the past. We have better prevention, better screening, and better therapeutic solutions as well.
The war against cancer may never be won – and Mukherjee quotes the Red Queen from Alice in Wonderland near the end of the book and her famous “It takes all the running you can do just to keep in the same place” – but that doesn’t mean that it’s a war worth ignoring or surrendering to.
Fight! Fight! Fight!
Pseudo-science in the age of space travel? You better believe it!
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