Book Review: Physician traces history of cancer

“The Emperor of All Maladies: A Biography of Cancer” (Scribner, $30), by Siddhartha Mukherjee

In the second century A.D., the Greek physician Claudius Galen proposed that cancer was an excess of an oily liquid called black bile. His view of cancer as a hopeless, systemic disease prevailed for centuries until physicians, unable to find the thick ooze, began to base medicine on what they observed in the microscope and the human body.

In “The Emperor of All Maladies,” cancer physician and researcher Siddhartha Mukherjee mentions Galen in the course of tracing the history of cancer from its earliest mention in ancient Egypt about 2500 B.C. to the modern labs where researchers are today racing to unlock the genetic code of cancer cells.

Mukherjee weaves cases from his own clinical work into historical chapters about the Big Three of cancer treatment — surgery, radiation and chemotherapy — as well as the rise of the 20th-century cancer lobby, the critically important anti-tobacco campaign and the development of hospice care.

Certain sections of the book read like a thriller as Mukherjee details researchers’ obsessive quest for the elusive scientific breakthroughs that may end up changing the course of medical history.

His account of the first clinical trial of Herceptin, the blockbuster drug that targets a genetic abnormality in certain breast cancer tumors, is a tour de force, told from the perspective of the only woman in the initial treatment group who had a visible tumor.

“On the morning of the first intravenous infusion,” he writes, “all the women came up to feel the lump, one by one, running their hands across (her) collarbone. ... Two weeks after the first dose ... the change was incontrovertible. (The) tumor had visibly shrunk.” She survives, but many others do not. Throughout, Mukherjee writes movingly of the pain and suffering of patients.

Though he has styled the book as a “biography,” the end of cancer cannot be written because, of course, it isn’t known. He offers a great deal of hope about the potential of medical research, tempered by the circumspection of a scientist acutely aware of how the “shape-shifting” illness has outwitted humans for 4,000 years.

In 2010, one in three women and one in two men in the U.S. will develop cancer in their lifetime. For that reason alone, it is worth reading this brilliant and riveting account of our shared destiny.

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