Friday, December 17, 2010

Day 17: The Emperor of All Maladies

It's Day 17 in our 24 Days of Books. Only one week til Christmas Eve -- egad! The book for Day 17 is The Emperor of All Maladies: A Biography of Cancer, by Dr. Siddhartha Mukherjee. Sadly, cancer has been with us for a long time -- the oldest surviving description of cancer is written on a papyrus from about 1600 BC -- and it continues to bring pain, sadness, and a lot of questions. It will kill about 600,000 Americans by the end of this year, and more than seven million people around the planet. Mukherjee, a physician, researcher, and award-winning science writer, examines cancer with a cellular biologist's precision, a historian's perspective, and a biographer's passion.

Mukherjee calls his book a biography because he is attempting to enter "the mind" of this illness, to understand its personality and demystify its behavior. The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers,

One of the constants in oncology, says the author, is the "queasy pivoting between defeatism and hope." One of the hopeful aspects he talks about concerns the work of Dr. Brian J. Druker, an oncologist at Oregon Health and Sciences University and a Howard Hughes Medical Investigator. Last year Druker was one of three winners of the Lasker-DeBakey Clinical Medical Research Award, often called the “American Nobel Prize,” for the development of "molecularly targeted treatments for chronic myeloid leukemia, converting a fatal cancer into a manageable chronic condition.” Another aspect of the disease Mukherjee covers is the infrequency of communication between the doctors treating people with cancer and the researchers studying it in the lab. “The two conversations seemed to be occurring in sealed and separate universes.”

Here's an astonishing fact: Back in 1953, the average adult American smoked 3,500 cigarettes a year, or about 10 a day. Almost half of all Americans smoked. Yet, as one epidemiologist wrote, “asking about a connection between tobacco and cancer was like asking about an association between sitting and cancer.”

The New York Times review of Mukherjee's book called it "an epic story that he seems compelled to tell, the way a passionate young priest might attempt a biography of Satan." Last Sunday the NYT named The Emperor of All Maladies one of the Top Five Nonfiction Books of 2010 (along with Apollo's Angels, Cleopatra, Finishing the Hat, and the Warmth of Other Suns).

Mukherjee is an assistant professor of medicine at Columbia University and a staff cancer physician at Columbia University Medical Center. A Rhodes scholar, he graduated from Stanford University, University of Oxford, Harvard Medical School. He has published articles in Nature, The New England Journal of Medicine, The New York Times, and The New Republic. He lives in New York with his wife and daughters.

Here is a short video clip of the author discussing the book and a couple of the major players in his story about cancer research. 

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