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The Emperor of All Maladies: A Biography of…
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The Emperor of All Maladies: A Biography of Cancer (2010)

by Siddhartha Mukherjee

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1,978983,421 (4.33)1 / 186
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English (95)  Italian (1)  German (1)  Dutch (1)  All languages (98)
Showing 1-5 of 95 (next | show all)
An impressively detailed - but sometimes dry - story of the dreaded disease, from its first recorded discoveries to the present day. It's filled with twists and turns, false starts and breathtaking breakthroughs - and thankfully, in the end it's a book filled with hope for the future. ( )
  alexrichman | Nov 30, 2014 |
Siddhartha Mukherjee is an oncologist, and The Emperor of All Maladies is part his reflection on his work with cancer patients, part a history of how people have thought of and treated cancer, and part an explanation of modern scientific understandings of cancer. Mukherjee has a real gift for explaining complex scientific ideas in prose that's lucid but not dumbed down, though there were some parts of the presentation of the book that irked me a little. The marketing of it as a "biography of cancer" is reductive, anthropomorphising, and largely meaningless. (We cannot, as Mukherjee writes at one point, "enter the mind of this immortal illness, to understand its personality." That's to reinforce the idea of cancer as the discrete, malevolent force that Mukherjee otherwise works so hard to dispel.) It's still an engrossing book, though perhaps one not to read in public—the details of the various treatments and experiments undergone by patients and researchers made me pull some horrified faces during my morning commute. ( )
  siriaeve | Nov 13, 2014 |
I've been wanting to read this since it first appeared, but I was just too nervous. Call it superstition. This is far scarier than any of your Barkers, your Kings or your Koontzes: there are no such things as zombies or bogeymen, but cancer is out there. Waiting for us.

In The Great War and Modern Memory, Paul Fussell talks a lot about the irony of the First World War. Cancer, in the same way, is a deeply ironic disease. As Peyton Rous said, ‘Nature sometimes seems possessed of a sardonic humor.’

The ability cancer cells have to reproduce themselves is the same biochemical magic that normal cells use to self-replicate; it's the whole reason we're alive. Cancer has weaponised our own life force; its ‘life is a recapitulation of the body's life, its existence a pathological mirror of our own.’

Similarly cancer rates have gone up, in historical terms, not because there are more carcinogens but because (more irony) we are living longer.

Civilization did not cause cancer, but by extending human life spans – civilization unveiled it.

Now that so many people are surviving into their seventies and eighties, cancer has a better chance to pull off its mask – like a Scooby-Doo villain – to reveal that it was lurking there inside us all along. And I would have gotten away with it, too, if it wasn't for you pesky oncologists.

So this book is frightening, and you do have to brace yourself to read endless variants on the phrase ‘unfortunately it had metastasized inoperably into her liver and brain’ over and over again; however, balancing this terror is the very real intellectual thrill of following the generations of doctors and scientists who have tried to understand and fight the disease.

The fight has got a bit more sophisticated than it used to be. Not a lot, but a bit. The prevailing approach for a long time was that pioneered by William Halsted, who insisted on (literally) ‘radical’ surgery to cut out as much tissue as physically possible, in order to maximize the chances of removing all the cancerous cells. One disciple, for instance, ‘evacuated three ribs and other parts of the rib cage and amputated a shoulder and a collarbone from a woman with breast cancer’. Gradually, advances in biochemistry and, latterly, genetics, have allowed for more targeted non-surgical solutions, although so far only really for certain specific cancers.

In fact the most progress has been made not in dealing with cancer, but in avoiding it in the first place. Anti-smoking campaigns, lifestyle advice, along with Pap smears and other screening programmes, have been very successful at least in the West (elsewhere, things are going backwards in many cases). Once it actually develops, your options remain fairly limited, and the metric of success is still often how many years of remission one can hope for, rather than the chances of an outright ‘cure’.

Mukherjee is thorough with his story and writes pretty well, although the focus is very much on the American scene, with researchers from Europe and elsewhere sometimes dealt with in a cursory fashion; at one point he even describes France and England as lying on the ‘far peripheries’ of medicine! He also goes a bit overboard with his literary credentials, bookending every chapter and section with multiple epigraphs from poets and other thinkers. It's not clear how well he understands his sources here, though, especially when you see that he's dated Burton's Anatomy of Melancholy to 1893, when Burton had been dead for two hundred and fifty years.

Still, this is overall a very rich and rewarding book, full of scientific discovery and packed with historical detail. It's a thriller, it's a sci-fi, it's a horror story. Let's just hope that future editions have even more to report in the way of progress. ( )
  Widsith | Nov 5, 2014 |
A recommended gift for a student contemplating a research career, since it leaves out most of the negative biographical gossip about its cast of scientists and practitioners, unlike political and literary collective biographies. Fascinating read; if you like Sherwin Nuland's books you'll enjoy this one. It's a little troubling that so many lay readers find the section on genetics to be a big stumbling block since work in that area has been such an important breakthrough in our understanding of the disease(s). Commendable too that the author addresses the political aspects of scientific and medical research, especially the need to balance the immediate and understandable desire of patients to get the most advanced treatment possible and the need for dispassionate testing to determine whether a protocol actually works. For practical reasons, a new protocol won't be manufactured and widely distributed, and covered by insurance, until it's been validated empirically, so in a sense the needs of current patients are in contention with the needs of
future patients. Both researchers and patients are caught between a rock and a hard place, and it may be that researchers are better off not having the average amount of human empathy. ( )
  featherbear | Sep 24, 2014 |
Siddhartha displays an excellent understanding of cancer and is able to describe it in understandable terms. This book covers the history of cancer and discusses advances, problems, and causes in cancer. Although I have worked in the field for years, I learned quite a bit. Thanks go to Siddhartha for putting this book together. ( )
  GlennBell | Jul 30, 2014 |
Showing 1-5 of 95 (next | show all)
It's time to welcome a new star in the constellation of great doctor-writers. With this fat, enthralling, juicy, scholarly, wonderfully written history of cancer, Siddhartha Mukherjee - a cancer physician and researcher at Columbia University - vaults into that exalted company ...
 
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Epigraph
Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell. to identify ourselves as citizens of that other place. --Susan Sontag
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To Robert Sandler (1945-1948), and to those who came before and after him.
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(Prologue) On the morning of May 19, 2004, Carla Reed, a thirty-year-old kindergarten teacher from Ipswich, Massachusets, a mother of three young children, woke up in bed with a headache.
In a damp fourteen-by-twenty-foot laboratory in Boston on a December morning in 1947, a man named Sidney Farber waited impatiently for the arrival of a parcel from New York.
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In solving a problem of this sort, the grand thing is to be able to reason backwards. That is a very useful accomplishment, and a very easy one, but people do not practice it much.- Sherlock Holmes, in Sir Arthur Conan Doyle's A Study in Scarlet
Physicians of the utmost fame Were called at once; but when they came They answered, as they took their Fees, "There is no Cure for this Disease." - Hilaire Belloc
Its palliation is a daily task, its cure a fervent hope. - William Castle, describing leukemia in 1950
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A magnificently written "biography" of cancer--from its origins to the epic battle to cure, control, and conquer it.

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