Monday, March 28, 2011

Excerpts: The Emperor of All Maladies

The Emperor of All Maladies

From "The Emperor of All Maladies," by Siddhartha Mukherjee:

Open quote
She imagined and concocted various causes to explain her symptoms - overwork, depression, dyspepsia, neuroses, insomnia. But in the end, something visceral arose inside her - a seventh sense - that told Carla something acute and catastrophic was brewing within her body."

After the jump, my review and more excerpts.

The Emperor of All Maladies, by Siddhartha Mukherjee, is a history of cancer research. It reads like a centuries-long scientific detective story that isn't over. Cancer has been with humanity for thousands of years, defying all attempts to cure it. Still, increasing scientific knowledge has finally led to progress in prevention and treatment. We're far from the end of the story, but at least the identity and modus operandi of the villain is coming to light. I strongly recommend this book to all.


"Cancer, we now know, is a disease caused by the uncontrolled growth of a single cell. This growth is unleashed by mutations - changes in DNA that specifically affect genes that incite unlimited cell growth."

"In most ancient societies, people didn’t live long enough to get cancer. Men and women were long consumed by tuberculosis, dropsy, cholera, smallpox, leprosy, plague, or pneumonia. ... Civilization did not cause cancer, but by extending human life spans, civilization unveiled it."

"'I’m sorry, Ms. Rosenow, but the Times cannot publish the word breast or the word cancer in its pages. Perhaps,' the editor continued, 'you could say there will be a meeting about diseases of the chest wall.'"

"The campaign against cancer, Farber learned, was much like a political campaign: it needed icons, mascots, images, slogans - the strategies of advertising as much as the tools of science."

"The leukemia ward was already being called a 'butcher shop' by others at the NCI. 'The idea of treating children with three or four highly cytotoxic drugs was considered cruel and insane,' Freireich said."

"For cancer therapeutics, the mid and late 1980s were extraordinarily cruel years, mixing promise with disappointment, and resilience with despair."

"A hundred instances of Hodgkin’s disease, even though pathologically classified as the same entity, were a hundred variants around a common theme. Cancers possessed temperaments, personalities - behaviors. And biological heterogeneity demanded therapeutic heterogeneity; the same treatment could not indiscriminately be applied to all."

"In the decade since the discovery of Gleevec, twenty-four novel drugs have been listed by the National Cancer Institute as cancer-targeted therapies. Dozens more are in development. The twenty-four drugs have been shown to be effective against lung, breast, colon, and prostate cancers, sarcomas, lymphomas, and leukemias."

"Between 1990 and 2005, the cancer-specific death rate had dropped nearly 15 percent, a decline unprecedented in the history of the disease."

"The Human Genome Project, the full sequence of the normal human genome, was completed in 2003. In its wake comes a far less publicized but vastly more complex project: fully sequencing the genomes of several human cancer cells. Once completed, this effort, called the Cancer Genome Atlas, will dwarf the Human Genome Project in its scope."

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