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History of Cancer

December 13, 2015

While shopping for Christmas presents in the bargain section of a local book store, I came across something that interested me instead.  It was The Emperor of all Maladies: A Biography of Cancer, by Siddhartha Mukkherjee.  I bought this book, as well as two for gifts to other people.

It’s supposed to be a history of cancer, but that history does not go back very far.  Diagnosis only goes back a couple of hundred years, probably because the early physicians had no way to see inside the human body where most of the cancer resides.  Treatments go back less than a hundred years, starting with ones that had no real benefit.  Effective treatments only began to be developed recently, with the most effective being discovered as the book was in preparation.  Still, it’s an interesting story, and quite exciting in places.

The book describes several high-profile events in detail.  One of these is cancer treatment by radical surgery.  Doctors believed that their surgery was effective.  Patients agitated for the most radical forms.  It was only carefully-conducted trials that determined radical surgery had no benefit.  This was similar to another treatment: extreme chemo-therapy with bone marrow transplants.  Again, doctors and patients believed in the therapy.  Again, statistical analysis damped the excitement by showing that the treatment had no benefit.

The War on Cancer was a major event, with billions of dollars spent, and institutions devoted to finding a cure for cancer.  They did make some advances, of course, but many key discoveries were made outside of these institutions and in other countries.  Their targeted research often did not work because they didn’t know where to start looking for a cure.  As well, the causes of cancer turned out to be much more complicated than what scientists initially believed.

Tobacco smoking soon appeared to be a major cause.  What a flap that turned out to be, with many legal battles, before the companies even admitted that smoking was a cause.  It was amazing for me to find out how little power the US government had to regulate any industry.  It was really the change in public attitudes that finally led to a massive decrease in smoking.

It was only recently that researchers discovered the ultimate cause of cancer, the mechanism by which ordinary cells change into cancer cells.  Not everything is known, of course, but what is known has led to new treatments and to prevention methods.  These discoveries have also redirected a great deal of cancer research into areas of treatment that appear promising.

Along with the history of cancer, the author also tells his own story as an oncologist and cancer researcher.  He also tells the story of patients who have undergone various treatments.  Both of these types of stories have added elements of humanity and compassion to the book.

This book was quite long: 470 pages.  Many of the small discoveries seemed similar to me in how they were described.  No doubt the author felt they were important and deserved to be covered.  Nevertheless, they made the reading more tedious than necessary.  Still, I found the book interesting, exciting in some places, and heartwarming in others.  The author does have an engaging style.  I’m certainly glad that I bought this book.

 

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