Monday, February 27, 2012

The Emperor of All Maladies

It's something that has touched every single one or us in one way or another. It's the dreaded "C" word, something whispered about in families in the early centuries. It's been the focus of decades of highly specialized research and public outcry. It's cancer, the emperor of all maladies. I haven't posted much this past week because I've been lost in a good book. I've been lost in a world of clinical trials, aggressive treatment, genetics, surgery, and research. A week or so ago my dad lent me The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee and I haven't been able to put it down. For such a depressing topic, Mukherjee really makes the topic fascinating. I haven't wanted to leave the book.

This "biography" looks at the history of the disease and the treatments and research that has been done to find the cure for cancer. It includes Imhotep's first mention of cancer (breast cancer) all the way to the most recent research being done on different types of cancer. And it's an incredible history. Galen (A Greek in AD 160 Rome) believed that cancer came from black bile building up in the body which would have to be drained. Not surprisingly this was disproved. In the mid 1800s Dr. Halsted believed that radical surgery was the only way to "cure" breast cancer. These surgeries would often remove whole sections of the chest cavity. Again this was proved false...after a couple hundred years. In the 1970s and 80s the cure was radical chemotherapy a practice of killing off any cell in the body that divided, cancerous or healthy, and then injecting healthy cells back in. All of these have been stepping stones in the War against Cancer. And all of them have changed medicine for the good or the bad.

If it had just been a history of the treatment and research I would have found the book interesting, but Mukerjee intersperses stories of patients who he has treated. He talks about the psychological effects of cancer, on both patients and doctors. He delves into cancer activism to see its effects on the national dialogue. And he discusses which cancers are being treated and which we are still looking to find some sort of solution for. He discusses the national obsession with a "cure for cancer" and the humility, hubris, hope, and despair that has gone alone with that search. He talks about doctors who can't see past their own arrogance and doctors who risk everything to find a medication that will work. He details the stories of drugs created, clinical trials failed, and every step on the road to where we have finally arrived.

There is now miracle drug at the end of this book. Mukherjee is quick to point out that cancer, is not simply one disease, so there can't be only one cure. But he condenses and distills centuries of history into a complete look at how we have failed and succeeded in finding treatments for the various different types of cancer. From the earliest treatment from Leukemia to the protein targeted drugs of today, this was simply riveting. I don't remember the last time I read something this technical, this detailed, and still found it both informative and entertaining. A great read. And a great history.

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