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The Philadelphia Chromosome: A Mutant Gene…
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The Philadelphia Chromosome: A Mutant Gene and the Quest to Cure Cancer at…

by Jessica Wapner

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This is a very good companion piece to Siddhartha Mukherjee's, The Emperor of All Maladies: A Biography of Cancer. It could easily serve as a welcome and more detailed look at the last portions of Mukherjee's book. While there is plenty of depth to both books, not all participants in the battle against cancer over the many years come out looking very saintly. The Emperor of All Maladies has a rather jaundiced view of a number of cancer physicians, and The Philadelphia Chromosome author points out many of the shortcomings of drug companies. Nevertheless, this author does make a solid effort to share the drug companies' public relations position papers with a straight face. Having read Mukherjee's book before this one, it is quite difficult to say how much I would have appreciated this one without the knowledge of the first one. My gut tells me I would have enjoyed the book anyway, but that I have a more extensive and accurate assessment of where we are with our battle with cancer because of reading both. Frankly, I can't imagine facing a possible cancer diagnosis without the knowledge I now have. ( )
  larryerick | Apr 26, 2018 |
The major topic of The Philadelphia Chromosome, the discovery of a cancer causing genetic mutation known as chronic myeloid leukemia (CML), was actually touched on briefly in The Emperor of All Maladies. However, Jessica Wapner uses the entirety of her book to focus on the connections between genetics and cancer, from the late 1950's through a series of breakthroughs that have allowed thousands to survive what would have once been a fatal diagnosis.

The Philadelphia Chromosome works well because of its balance. It never reads like an overly technical textbook, nor does it fall into a wordy history or weepy biography. Wapner uses the personal stories of patients who were able to survive by taking a daily pill to piece together the history of genetic cancer research. While the science behind the success is described, it is broken down in a way that readers unfamiliar with the details of genetics can easily understand.

Though parts of the book did read rather similar to The Emperor of All Maladies, I didn't necessarily feel like I was reading the same information over again. In fact, I would recommend reading it prior to reading The Philadelphia Chromosome, since it provides readers with a good groundwork in the history of cancer research that Wapner's book can easily build on. ( )
  rivercityreading | Aug 10, 2015 |
As someone who has a pre-cancer that may or may not turn into cancer I am overjoyed by this book, The Philadelphia Chromosome by Jessica Wapner. The author writes for many publications but I know her for her articles in Cure, a patient focused magazine for who have cancer. In this book, she writes a history of the search for a very effective treatment for Chronic Myeloid Leukemia.

This cancer is considered rare because only 70,000 people a year are diagnosed with it. Being rare that makes it much more difficult to persuade a drug company to invest in research, trials, and development. It simply would not pay to invest the tremendous amounts of money necessary and expect to recoup only a small fraction of it back. That is only one of the huge road blocks to finding a medicine that would work. There many more discussed in the book. Sometimes knowledge earned has to wait until someone knows what to do with it.

This book is written in easy to understand language and there was even a glossary in the back with the medical and research terms, an index and color photos of the cancer pioneers and microscope photos. It is so fascinating that I did not want to lay it down.

I never felt lost while reading this book. I will admit that I have had a head start on the vocabulary because of be familiar with the terms of another blood cancer disease. I now have an even deeper appreciation of the hard work, patience and intelligence that over many years led to a very effective pill for this cancer. This book is a mystery of history, science and clinical care. Dr. Brian Drucker is now one of my heroes. Without his persistence and love for his patients, I doubt that this important medicine would have been developed. Some of the major contributors were motivated by pure curiosity, others wanted to advance our knowledge of how cancer works and how can it be stopped.

This disease used to be always terminal always but slowly growing. Now people can have an extension of life as long as the pill keeps working for them. I really appreciate Jessica Wapner’s careful writing and probably endless interviews. She was very careful to get her facts start and has a tremendous respect for the cancer pioneers.

I highly recommend this book to anyone who has cancer or pre-cancer or is interested in medicine.

I selected this book from Amazon Vine but receiving it free did not influence my review in any way. ( )
  Carolee888 | Jan 12, 2014 |
As is usually the case, I received this book free. Unfortunately, I'm unable to determine the source of that freeness but suffice to say it came in the mail specifically for my review.

Typically, I review books based on qualitative properties, but in this case it's not really necessary. The book is sharp, thorough, professional and detailed. There's no real need to go into specifics about that. The more important thing to say may be to discuss exactly what this book is.

Topically, the book is a fairly even split between science and history. The author goes into a surprisingly great depth about the science involved and readers are encouraged to take notes along the way to make sure they keep up properly. This is no pop-science read; it expects readers to be as sharp and keep up. New terms are defined when used but typically just once and there's no fear in the writer about delving into technicalities.

On the historical side, the dozens of professionals involved are described in terms of their specific contributions and once those are complete, they step aside and are never heard from again. While there is a strong biographical component, it's really a biography of a disease rather than any of the people involved.

In summary, a painstakingly thorough treatment of an important topic but not for the faint of heart with reams of detailed technical information ( )
1 vote slavenrm | Jun 15, 2013 |
In 1959 two Philadelphia researchers, David Hungerford, a scientist at the Fox Chase Cancer Center, and Peter Newell, a physician studying cancer at the University of Pennsylvania School of Medicine, made a momentous discovery that revolutionized the understanding of cancer. Hungerford, who specialized in studying and photographing chromosomes from a variety of species, looked at a slide of the cancerous cells from a patient with chronic myelogenous leukemia (CML), using a technique of halting chromosomes during division that was designed by Newell. To his great surprise, Hungerford noticed that one of the chromosomes was significantly shorter than it should have been. He took a photograph of the shortened chromosome and showed it to Newell, who subsequently prepared slides of cancerous cells from several other people with CML. Each of these patients had the same abnormal chromosome. The two published their findings in a three paragraph article in Science the following year. The study was largely ignored, as the study of genetics was in its infancy, and essentially no one suspected that cancer could be caused by chromosomal abnormalities.

Over a decade later Janet Rowley, a geneticist at the University of Chicago, studied these same cells from CML patients, using staining and visualization techniques that weren't available to Hungerford and Newell. She found the same shortened chromosome, which was by then determined to be chromosome 22, but she also found that chromosome 9 was also abnormal, being longer than it should have been. Through meticulous study of these chromosomes she correctly determined that a portion of chromosome 22 had migrated to chromosome 9, while a similar portion of chromosome 9 appeared on chromosome 22, in a process that is known as chromosomal translocation.

This translocation led to the creation of a fusion gene, made up of a portion of the abl gene of chromosome 9 and the bcr gene of chromosome 22. The bcr-abl gene, known as an oncogene, led to the production of a protein that allowed the affected cell to rapidly multiply without the normal controls exhibited by other cell types. Similar to the famous Trouble with Tribbles episode of Star Trek, the cancerous cells, which are derived from immature white blood cells, overtake the bone marrow, leading to decreased production of the normal bone marrow cells: red blood cells, normal white blood cells and platelets. Initially this causes anemia, leukopenia and thrombocytopenia, or decreased red blood cells, white blood cells and platelets in the circulatory system, respectively. As the cancerous cells continue to multiply they escape from the bone marrow and make their way into the bloodstream in large numbers, which causes profound leukocytosis, or an excessive number of white blood cells in the circulatory system. Leukemia is often diagnosed at this stage, when the blood is filled with abnormally large white blood cells.

Without any treatment to block the uncontrolled multiplication of these leukemic cells they migrate to other organs, which leads to organ dysfunction and ultimately death.

In The Philadelphia Chromosome, Jessica Wapner brilliantly describes the painstaking research by scientists and clinicians to elucidate the mechanisms on a genetic and molecular level that lead to cancer, including the study of cancer causing viruses such as Rous sarcoma virus and Moloney virus, and the discovery of tyrosine kinase and other protein kinases, which are essential to normal function and growth in healthy cells but can cause unregulated division in cancerous cells. The bcr-abl in CML cells was discovered to code for an abnormal tyrosine kinase, and a collaboration between academia and the pharmaceutical industry led to the eventual development of the first tyrosine kinase inhibitor, imatinib mesylate, which is also known as Gleevec in the US and Glivec in most of the rest of the world. The use of this and subsequent tyrosine kinase inhibitors has allowed people with CML to live near normal lives by taking one pill a day, with minimal side effects; until the 1980s CML was a universally fatal disease. Other kinase inhibitors and similar compounds are under development, which have not yet been as successful in treating other malignancies but hold promise that cancer can be successfully controlled, if not cured, in our lifetimes.

The Philadelphia Chromosome is a carefully researched and very well written book, given the complexity of the techniques used in molecular biology and genetics, which also reads like a suspense novel as Wapner describes the hurdles that the discoverers of the first tyrosine kinase inhibitor faced in getting Novartis, its manufacturer, to approve the drug for clinical trials and make it available to the general public. It is a very important and timely book, which I would recommend to all readers, although it may prove to be a bit of a challenge for those readers without a basic science background. It is nearly as good as Siddharta Mukherjee's Pulitzer Prize winning book The Emperor of All Maladies: The Biography of Cancer, and it would be a perfect next step for those wishing to learn more detail about cancer research after reading that book. ( )
12 vote kidzdoc | Jun 9, 2013 |
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This work focuses on what is widely viewed as the 'poster child' of rational drug development in the cancer research world. The history of the founding of a genetic mutant chromosome in the indication of Chronic myeloid leukemia disease, and the subsequent development of "Gleevec," is the keynote of this astounding publication.… (more)

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