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Emperor of All Maladies: A Biography of…
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Emperor of All Maladies: A Biography of Cancer (original 2010; edition 2011)

by Siddhartha Mukherjee (Author)

MembersReviewsPopularityAverage ratingConversations / Mentions
5,0121962,171 (4.3)1 / 340
Depending on where you live, if you're in the western world chances are you're looking at a pretty high chance of getting cancer in your lifetime. In the UK it's now 1 in 2, and my nearest geographical neighbour - Ireland - has the third highest rate of cancer per 100,000 people in the world (behind Australia at #1 and NZ at #2). We all know people who have survived it and people who have died from it, and sadly that's often just within our own immediate families. Given that there's no getting away from it I was interested in learning more about it, and this Pulitzer prizewinner from 2011 seemed as good a place to start as any.

It does what it says on the tin, taking us from the earliest known examples of cancer (breast) in BC times to savage surgery in the 1800s, the first use of radiation in the early 1900s, the introduction of the first chemotherapy in the 1940s (nitrogen mustard) and the critical discovery of the first identified oncogene in the 1980s and pursuant biological and clinical strategies in the fight against the disease.

Mukherjee is thorough in relaying this history to us. Although some patient stories are included that area was a lighter touch than expected, but in retrospect I appreciate that. This book is not an emotive, personal account of cancer (although it's clear that patients are front and centre in Mukherjee's mind during his day job as an oncologist) but rather a biological and clinical focus (with the emphasis on the former). It's a complicated subject area, and although a book for the layman Mukherjee doesn't overly dumb it down so some chapters are harder going than others. Overall, however, it was a hugely informative read, and my big takeaway was a much better understanding of the complexity of the cancer war, with not only stark differences between cancer types but also hugely different personal cell mutations even within the same cancer type.

Given that there are so many different types of cancer, this book concentrates especially on leukaemia, breast cancer and lung cancer, where perhaps there have been most marked changes in survival rates over time.

Would I recommend this if you're currently dealing with cancer, either personally or with a close family member? I'm not sure. It's not a depressing read and mostly is a chronological account of development in surgical and biological advancements, but there is the odd line here and there that's pretty sobering. This isn't a book like Atul Gawande's Being Mortal - I don't think there's anything in here that would hugely influence any decisions you'd make around treatment.

Not being from a medical background this book did raise a number of questions in my head. There seemed to be quite a chasm of missed opportunity between biologists and clinicians at various points in this history of cancer, and I wonder if this is still true today (sadly I expect it is). Also, given the advancements that were made in treatment at the cost of early patients' lives, I wondered in this modern day of medical governance and ethics just how free today's oncologists are to try out new ideas with patients, or if the fear of litigation hampers that.

My main gripe with the book was that it's very much an American biography of cancer. Yes, Mukherjee touches on advancements from other countries when it's relevant to the narrative in the States, but it's definitely very much an American political, biological and clinical journey of cancer.

All in all a dense but interesting read. Sorry to be the one to deliver a spoiler, but it appears that the notion of a magic bullet for cancer is the stuff of fairytales, and the best we can hope for are personal therapies that adjust throughout our lifetimes as personal cancer mutations change trajectory.

4 stars - a fascinating journey through what is indeed the emperor of all maladies. ( )
  AlisonY | Aug 1, 2021 |
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4.5 stars ( )
  EllieBhurrut | Jan 24, 2024 |
You know the feeling that you get when you're done reading a book on the subject and realize how it changed your understanding of the field dramatically? Such as Feynman's Lectures on Physics, A Brief History of Time, or The Emperor's New Mind? This magnificent treatise on cancer is just what the subject needed - a meticulous, no-holds-barred treatment that reveals a plethora of information on cancer, and our ancient, never-ending war with it - a constantly shape-shifting enemy whose root is ourselves.
Mukherjee describes in eye-watering detail how our understanding of cancer has changed in around four thousand years, and how the landscape of the 'War Against Cancer' has undergone multiple paradigm shifts - from the witch-doctors who thought the best cure for the then-unnamed disease was crab soup; to current efforts, which are a mixture of chemotherapy and targeted drugs, some of which can almost erase certain cancers from its roots.
Absolutely no detail is withheld from the reader - the politics, the money, the legal battles over potential cures and clinical trials, the innumerable doctors involved, the patients whose lives were altered with the onset of the disease, and how each potential drug worked (or why it stopped working).
Mukherjee also focuses on how patients embrace their sickness as the new normal, and how some patients accept death easier than doctors - his work is, above all, a testimony to the tenacity and resilience of the human spirit.
In conclusion, although this might not be the most readable book, it is definitely one of the most sobering books I have ever encountered. A must-read. ( )
  SidKhanooja | Sep 1, 2023 |
Great book. It's very helpful for anyone who is a caregiver or is afflicted with Cancer. It gave me a new perspective as a caregiver/ It is very detailed and requires some work to read and understand. ( )
  Michael_Lilly | Aug 7, 2023 |
The book starts out rooted firmly in the human experience, told through the stories of patients, doctors, and discoverers from the ancients up through the modern era. I found these stories fascinating and often incredibly sad; I could relate to them. Around the 1960s the book shifts into a more technical vein, which makes sense because this is when so many innovations in cancer research and treatment began, but I found myself disengaging from the story. The author does a laudable job of keeping the human experience a part of the story, but this is a biography of cancer - not humans - and at some point the story becomes less about "us" and more about "it". Or rather, "them", because one of the most fascinating parts of the book was seeing how heterogenous cancer is in the human body. Lymphomas are completely different from breast cancer, which is completely different from sarcoma, etc. I truly had no idea.

Also fascinating was how breast cancer was the focus of cancer research for literally hundreds of years. This seems like a woman-positive situation until you discover the devastating surgeries and experiments that doctors inflicted on the female body. Would they have been so quick to carve out literal pounds of flesh if these were male bodies? Would male patients have had more authority over their own care, and been fully informed about what was about to be done to their bodies? Kudos to the author for explicitly calling out the medical industry on its historically cavalier treatment of women, and acknowledging the women of the 1970s who refused to be sidelined in their own treatment, and thus forged the patients' rights movement out of the second-wave feminist movement. ( )
  blueskygreentrees | Jul 30, 2023 |
Me tomó varios meses leer este libro, varios de ellos mientras convivía con una persona muy cercana, enferma de cáncer. Entonces, me costó mucho trabajo, tanto que tuve que dejarlo en espera un par de meses.

Ahora que he vuelto a él, lo encuentro un libro súper intenso por los casos de estudio, por las metáforas, por las explicaciones y la información científica (que además es bastante accesible a un lector sin conocimiento de medicina, biología, química o todas las disciplinas que se unen para luchar contra esta enfermedad).

Me quedo con un fragmento casi al final del libro que creo resume esta lectura: "La mejor manera de 'ganar' la guerra contra el cáncer consiste, quizás, en redefinir la victoria". ( )
  uvejota | Jul 26, 2023 |
This Pulitzer prize winning expansive history of the disease(s) known as cancer is a pretty epic reading challenge, but well worth the effort. Mukherjee dives into his subject chronologically (from ancient and medieval treatises on the disease up through current genetic discoveries), thematically (by treatment -- surgery, radiation, chemotherapy, targeted agents; political advocacy and funding; research and clinical trials; prevention -- particularly in the context of anti-smoking campaigns), and personally with stories of his own medical training and experiences with cancer patients. The scope is so broad that you would think the approach would feel scattered, but Mukherjee has an ability to control the many threads of his narrative and dig deep into the background of individual researchers, discoveries, and treatments which grounds the reader in a narrative foundation and keeps the whole thing from running off the rails. As a breast cancer patient I was particularly fascinated with the history of the embrace and then rejection of ever more radical mastectomy surgeries, the dashed promise of scorched-earth chemo followed by a bone marrow transplant as a treatment for metastatic breast cancer, and the fascinating history of patient advocacy clashing (and then cooperating) with the pharmaceutical industry in the development of Herceptin, a wildly successful targeted treatment for Her-2 positive breast cancer. The book also helped me get my head around how clinical trials are designed and how the medical profession approaches oncology. And he FINALLY explained what kinases are and how they work in a way that clicked with my brain (as a person on her second flavor of a cyclin-dependent kinase inhibitor, this is news I could use). While his prose can sometimes be a bit florid and I didn't love every one of his patient characterizations, this was still a great read and I am very interested in reading his new book, The Song of the Cell. Human bodies are so complicated, and cancer uniquely harnesses this complexity to do its thing. Mukherjee really brings this all home in an understandable and comprehensive way. ( )
  kristykay22 | Jul 15, 2023 |
An absolutely fascinating book full of both heroes and villains. All the cancer patients are of course heroes. But what is surprising is that some doctors and researchers would have to be considered villains. All to often the feelings and the overall good of the patients patients were overlooked in the need to find a cure at any cost, no matter how much suffering the patients were put through. At least the doctors were trying to do some good. What infuriated me while reading this book was the absolute greed displayed by the the tobacco and pharmaceutical companies. The one any only thing they are interested in is the almighty dollar. Thankfully the author Mukherjee focused more on the good the doctors and researches accomplished making this both an informative and very inspirational read. ( )
  kevinkevbo | Jul 14, 2023 |
I've had this on my tbr since before my 3 year old was diagnosed with cancer. I'm glad I waited to read this till I was on the other side of her treatment.
This is an immense chronicle of what we know of cancer and how it's been treated over the decades. It's crazy that we haven't improved cancer treatment in any meaningful way since chemotherapy regimens were first discovered. The cocktail of drugs they started with is largely what was used in 2020.
I hate that new drugs targeting more specific cancers aren't funded because they aren't profitable. We experienced a shortage of a vital drug due to it not remaining profitable during her treatment. For profit healthcare is evil.
Despite pediatric cancer receiving very little funding, it was a large focus of this book. I am thankful for all the oncologists and patients who have come before. As the Green brothers have just said, this is the best time in history to be diagnosed with cancer. Though a year from now would be better. (John & Hank Green). ( )
  KallieGrace | Jun 8, 2023 |
من المفترض ان يكون هذا الكتاب علميا بحتا لكن ما ان تبدأ بالقراءة تحس بانك تغوص في رواية اسطورية وملحمة ادبية ابطالها الخارقين ما هم الا علماء واطباء ومرضى حقيقيون , كم هي غريبة ومشوقة قصة العلم وتفاصيل جسدنا التي كانت خافية عنا, . التجربة والخطأ , المحاولة تلو المحاولة ملاحظة التفاصيل الدقيفة, الارادة والعزيمة التي يتمتع بها العلماء, مقارعة الاعراف والتقاليد والسائد , حكاية الانسان الذي صعد الى السماء وغاص في اعماق جزيئات جيناته, هذه الملحمة للطبيب الفذ سيدهارتا موخرجي تجعلك تؤمن بجمال المعرفة وعظمة العلم ( )
  Amjed.Oudah | Jul 26, 2022 |
Much more a history of cancer treatment than of cancer. Not heavy on the science.
  FKarr | May 21, 2022 |
Great medical history of the disease of our times ... except, of course, it isn't. Cancer has been traced back to the ancient Egyptians. Mukherjee relays the trials and triumphs in the pursuit of this killer in a way that reads like a medical thriller. Did I understand all of the medicine? No. Will I remember the details of successful drugs and treatments? No. Does it matter? No. My take-away is that we are making progress against a very complicated enemy whose weapons include altering our very DNA and reacting to certain chemicals in our environment ("carcinogens"). ( )
  mjspear | Apr 9, 2022 |
Excellent book! I worked in a cancer research clinic for some years, and this book was really enlightening. ( )
  dmrabson-7 | Feb 3, 2022 |
This is worth all 472 pages. It was easy to follow, very educational, and it made me appreciate how far cancer treatment has come and the lives that contributed to this progress. Cancer is the world's oldest disease, but it wasn't until vaccines and civic improvements raised the life expectancy that cancer was finally studied. Early attempts at treatment included x-rays, radical surgery and even mustard gas, but until the 1950s it was an unspoken death sentence.

Sydney Farber, a researcher in Boston, decided to tackle leukemia. Why? Leukemia, as a blood disease, can be measured without surgery. Farber performed several unsuccessful tests with antifolates on (unconsenting) children. Eventually his research attracted the attention of the Variety Club of Boston and Mary Lasker, a driven socialite and philanthropist. With Farber in tow, the Variety Club finds a poster child, Einar Gustafson, to exploit for funding. Meanwhile, Lasker runs a much more successful campaign through Reader's Digest, balls and benefits creating the American Cancer Society. But Dr. Min Chiu Li, a Korean immigrant, was the first to cure a cancer with antifolates. He dosed an adult choriocarcinoma patient even after visible symptoms had vanished. A high dose 4-drug combo for leukemia was finally launched in 1961 followed by a series of toxic chemo cocktails of the 1970s, i.e. MOMP for Hodgkin's Disease. It wasn't until the 1980s that the whole system was turned on its head, with the idea of "prevention" being the cure, rather than treatment. Radical surgeries became unnecessary, DNA is tested for mutations, anti-smoking campaigns are run and occupational diseases are finally investigated.

There's so much to unpack for a small review, but it's 5/5 and I've recommended to friends and coworkers as well! ( )
  asukamaxwell | Feb 3, 2022 |
I was pleasantly surprised by how good this book was. Not sure how I came up on it, might have been the Freakonomic MD Podcast that I listen to by Dr Bapu Jena. I like some many have had close family members taken by Cancer and wanted to learn more about its history and this book does a great job of relating mostly in chronological fashion the developments through the years of the battle against cancer from the earliest references all the way till the 80s/90s. Yes is has a primarily pan American view point and yes it does seem repetitive at times but overall one comes away feeling inspired by how far we have come and also knowing the realities of the situation right now how far we still have to go. It is really interesting to read and learn about the different players over the years and how they have contributed to the body of knowledge surrounding cancer as well as how the political, fund raising and marketing aspects of the organizations that were setup. The stories of the patients involved was a great counterpoint to all the technical information shared in the story. Read the book you will not forget it. ( )
  thanesh | Oct 15, 2021 |
Hmm. My friend told me earlier today that I wasn't gonna like Don Delillo because he was "more style than substance," or something like that. I can honestly say that I took one star off this book because it was more substance than style.

What I mean is, I liked this book a whole lot. Information frothed over the top of pages like high tide; I learned so much. I understood almost everything. The humanity of it all really burst through. But I also zoned out some parts of the book, mostly because the writing was so clear, so straightforward, that I just got lost in the history and the science and couldn’t help but gaze down at the page numbers, flip through to see when the next chapter was coming up, then return wearily to the passage I’d found a tad tiresome.

The writing was so clear. It was too clear. The author (who I must say is some divine all-powerful creature, regardless of my momentary criticism) took the tons of research he’d complied and fitted it into a writing canvas that riveted at times, but also seemed repetitive at others. I can’t really blame him that much though, because the history of cancer IS quite repetitive: Scientist sees cancer, scientist studies cancer, scientist thinks of solution, scientist experiments with solution, solution becomes universal, etc. Obviously with some exceptions.

I loved the human anecdotes sprayed throughout. I loved the ending. I loved the tone. This book is so important. I’m basically bound to get cancer someday, I think, with my family history, my perpetual sunburns, my Ashkenazi Jewness. I remember I used to fret about the disease back in middle school ever since this boy a grade above me died from brain cancer. The thought of it haunted me for a while, and there was a period where I’d just walk up to my mom and tell her I felt scared. At least now I know that cancer is not entirely a mystery, and that we’re on the road to uncover the part that remains so.
( )
  Gadi_Cohen | Sep 22, 2021 |
Depending on where you live, if you're in the western world chances are you're looking at a pretty high chance of getting cancer in your lifetime. In the UK it's now 1 in 2, and my nearest geographical neighbour - Ireland - has the third highest rate of cancer per 100,000 people in the world (behind Australia at #1 and NZ at #2). We all know people who have survived it and people who have died from it, and sadly that's often just within our own immediate families. Given that there's no getting away from it I was interested in learning more about it, and this Pulitzer prizewinner from 2011 seemed as good a place to start as any.

It does what it says on the tin, taking us from the earliest known examples of cancer (breast) in BC times to savage surgery in the 1800s, the first use of radiation in the early 1900s, the introduction of the first chemotherapy in the 1940s (nitrogen mustard) and the critical discovery of the first identified oncogene in the 1980s and pursuant biological and clinical strategies in the fight against the disease.

Mukherjee is thorough in relaying this history to us. Although some patient stories are included that area was a lighter touch than expected, but in retrospect I appreciate that. This book is not an emotive, personal account of cancer (although it's clear that patients are front and centre in Mukherjee's mind during his day job as an oncologist) but rather a biological and clinical focus (with the emphasis on the former). It's a complicated subject area, and although a book for the layman Mukherjee doesn't overly dumb it down so some chapters are harder going than others. Overall, however, it was a hugely informative read, and my big takeaway was a much better understanding of the complexity of the cancer war, with not only stark differences between cancer types but also hugely different personal cell mutations even within the same cancer type.

Given that there are so many different types of cancer, this book concentrates especially on leukaemia, breast cancer and lung cancer, where perhaps there have been most marked changes in survival rates over time.

Would I recommend this if you're currently dealing with cancer, either personally or with a close family member? I'm not sure. It's not a depressing read and mostly is a chronological account of development in surgical and biological advancements, but there is the odd line here and there that's pretty sobering. This isn't a book like Atul Gawande's Being Mortal - I don't think there's anything in here that would hugely influence any decisions you'd make around treatment.

Not being from a medical background this book did raise a number of questions in my head. There seemed to be quite a chasm of missed opportunity between biologists and clinicians at various points in this history of cancer, and I wonder if this is still true today (sadly I expect it is). Also, given the advancements that were made in treatment at the cost of early patients' lives, I wondered in this modern day of medical governance and ethics just how free today's oncologists are to try out new ideas with patients, or if the fear of litigation hampers that.

My main gripe with the book was that it's very much an American biography of cancer. Yes, Mukherjee touches on advancements from other countries when it's relevant to the narrative in the States, but it's definitely very much an American political, biological and clinical journey of cancer.

All in all a dense but interesting read. Sorry to be the one to deliver a spoiler, but it appears that the notion of a magic bullet for cancer is the stuff of fairytales, and the best we can hope for are personal therapies that adjust throughout our lifetimes as personal cancer mutations change trajectory.

4 stars - a fascinating journey through what is indeed the emperor of all maladies. ( )
  AlisonY | Aug 1, 2021 |
Cancer is prevalent in our society, so a book covering our knowledge of the disease, its complexities, and it's history is extremely relevant. The ongoing research programs, treatment and prevention techniques, and the history behind them was very informative. It explains a lot about treatment recommendations, including recent changes in mamograph recommendations. Mukharjee did an excellent job in enlightening me on this important subject, and did in a very readable format. ( )
  rsutto22 | Jul 15, 2021 |
nonfiction/medical science. a fascinating comprehensive history of oncology that treats cancer not as a discrete medical phenomenon but as a human condition that touches so many of us personally. ( )
  reader1009 | Jul 3, 2021 |
An excellent blend of history, science and social observations. I enjoy the way the book reads like a story, tracing our understanding of cancer through the ages. It is definitely for people who like their history more topic-focused, rather than centered around a specific person. ( )
  Nommie | May 5, 2021 |
An excellent read if you have ever wondered about causes, treatments, and understanding how cancer takes over a body or you have someone close to you that has suffered through this nightmare. This book is written in more of a biography style since as the writer puts it, Cancer acts more like a biological being that can adapt to it's surroundings. It also explains the technological advances that have occurred over the past 100 years and how there is hope for future treatments in the future. The war on cancer may never be won, but science and medicine are slowly winning the battles with new treatments. DEFINITELY recommended reading! ( )
  sjh4255 | May 4, 2021 |
The author covers the history of cancer. Well detailed, and for the most part, very readable. ( )
  addunn3 | Apr 13, 2021 |
I learned so much! A few parts of the newer, genetic science were a bit beyond me, but the author did a good job with analogies and examples to help the non-scientist reader. His research is comprehensive and the story is fascinating.

My biggest take-away from this book is the sense of gratitude and awe I have for the researchers who never give up. The kind of people who search tirelessly for cures or treatments and the kind of people whose sense of curiosity and love of knowledge give us the basic research which others can apply. ( )
  LynnB | Apr 13, 2021 |
Loved this book, which was not quite what I expected. Where were these great men of science when my father was dying? Where are they now? I know they exist, but most of us only have access to those physicians, like my late father's, who treat their cancer patient using standard protocol: "Here's a list, let's check everything off, watch the patient die, then say we did what we could and get home in time for dinner and the evening news.." The real physicians are like those who appear in this book -- driven to cure this horrible disease. I was inspired and awed by these men and fascinated by the world of cancer research. Although the author did not pull punches when it came to the greed of the pharmaceutical industry, it was never the diatribe it could have been. This wasn't a book about where the blame lies, but about those who have worked hard and brought us far in such a relatively short time. ( )
1 vote GiGiGo | Feb 5, 2021 |
Truly excellent. Mukherjee makes you feel like a trusted colleague or a favorite student, explaining everything clearly and precisely, but never makes you feel like you're struggling to keep up and never loses sight of the human cost of cancer. One of the best nonfiction books I've read in ages. ( )
  skolastic | Feb 2, 2021 |
I don't quite buy the conceit that this is a "biography" rather than a more prosaic work of history. But it's very informative and not difficult to read, at least once one gets past the hypochondria-inducing initial chapters. Captures both the thrill of scientific discovery and the agony as each discovery ends up proving inadequate. ( )
  dhmontgomery | Dec 13, 2020 |
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