The Emperor of All Maladies: Cancer

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In 2010, about six hundred thousand Americans, and more than 7 million humans around the world, died of cancer. In the United States, one in three women and one in two men will develop cancer during their lifetime. A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer. In some nations, cancer will surpass heart disease to become the most common cause of death.

With this sobering statistic, physician and researcher Siddhartha Mukherjee begins his comprehensive and eloquent “biography” of one of the most virulent diseases of our time. An exhaustive account of cancer’s origins, The Emperor of All Maladies illustrates how modern treatments — multi-pronged chemotherapy, radiation, and surgery, as well as preventative care — came into existence. Thanks to a century’s worth of research, trials, and small, essential breakthroughs around the globe.

This book is composed of six parts that deal with the cenotaphic events according to the historical progress in the screening, diagnosis, treatment, and prevention of cancer. In the first part, the author mentioned the first description of leukemia as “a suppuration of blood” by Dr. John Bennett and subsequent renaming to “leukemia” by Dr. Rudolf Virchow in 1847. The author introduces Dr. Sidney Farber as the father of modern chemotherapy, who accidentally discovered aminopterin as a powerful anti-cancer chemical leading to the dramatic remission of leukemia. In addition, he describes the development of surgery and anesthesia as well as the concept of radicality in the removal of the tumor. In the following parts, this book covers several landmarks in the development of the treatment of cancer including combination chemotherapy and molecular targeted agents. Another part depicts the exploration history of cancer causes which includes the discovery of cancer-causing viruses such as Rous sarcoma virus and two-hit hypothesis, that is, activated proto-oncogenes (jammed accelerators) and inactivated tumor suppressor genes (missing brakes).  Dong Hoon Suh; Book Review

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I found this book really interesting and insightful. It is kinda a textbook as well as a thriller type of genre in the style of writing. It is written entirely for a layperson to understand but Siddhartha, the author also wanted to threat this audience with the utmost seriousness. He mentioned that this book is an attempt to answer question asked by one of his patients which had been treated with chemotherapy and had relapsed and been treated again. She said: “I’m willing to go on, but i need to know what it is i’m battling.”

As medical students, reading all these stories about real life patients struggling with cancer really struck my heart. I gained a deeper understanding not only about cancer history and revolution, but also a deeper understanding of medical humanities involved in treating this deadly diseases, to really listen to what the patients have to say. Anyone who has spent time in the oncology clinic will definitely understand that it can be a very depressing place. Thus it really enquire one to deploy everything in the battle: be it emotion, mental and physical strength.

Also, this book touched on the different research on potential treatments on various cancer from genetic regulation in cancer cells, cancer metabolism, microenvironment of cancer cells to immunological aspects. This really raise hope to the public as cancer really is a disease of old-age and as the global life expectancy continue to raise, more and more cancers will be diagnosed. Cancer, in fact is an uncontrolled growth of our own cells. This magnificent study of cancer suggests that, for all medicine’s advances, we cannot beat a disease that is a distorted version of ourselves. We will always have cancer, among us and within us. The ultimate purpose of this book is not just to understand the past of cancer but to raise a question: is it possible to eradicate this disease from our bodies and societies forever?

This book is a must read for all future doctors – fascinating and powerful!

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