The Emperor of all Maladies: A Biography of Cancer

This book by Siddhartha Mukherjee won the 2011 Pulitzer for non-fiction and was a recent choice of my book group. He is also coming to Bend to speak as part of the library's "Author! Author!" series. Mukherjee wrote his book while on an oncology fellowship at Massachusetts General Hospital. He became fascinated with the disease itself and with the history of cancer research and treatment. He takes us all the back to 2500 BC when a Persian princess ordered one of her slaves to cut off a breast that had developed lumps. Even then, people recognized the often fatal outcome of finding lumps on the body. And for centuries, cancer, in all its forms, was virtually a death sentence.
But in the 18th, 19th and 20th centuries, doctors and researchers continued to look for an effective treatment or cure. Surgery--excising the affected body parts, and often more--was the first strategy pursued. The "Halstad mastectomy" is named for the surgeon who performed radical removal of breast, muscle and even bones in his zeal to remove the root of cancer. Later, researchers began experimenting with chemicals, some of the early substances used included derivatives of textile dyes and chemical weapons (mustard gas). Eventually, as technology permitted, researchers sought a genetic explanation and discovered that the cells that begin to multiply so rapidly in cancer are actually part of our standard genetic makeup, or as Mukherjee puts it, "Cancer was intrinsically 'loaded' into our genome." What fascinated me particularly was the realization from reading this book that there is no single "cause" of cancer. Many things can either stimulate the growth genes or damage the tumor suppression genes--environmental toxins, chemicals, viruses, radiation--that is, some of the same things used to treat cancers can also initiate them. This is truly a fascinating if sometimes weighty read and I highly recommend it. Great reviews abound: The Guardian, Kirkus, The Wall Street Journal, etc. It was named one of Time Magazine's "All-Time 100 Best Non-Fiction Books," and one of the New York Times "10 Best Books" for 2010.