"The Emperor of All Maladies" by Siddhaartha Mukherjee

One of my daughter's close friends recommended "The Emperor of All Maladies". Admittedly, I had somehow or other missed the notoriety of a first time author being awarded the Pulitzer Prize. The achievement is spectacular. It is even more amazing that a relatively young research physician could somehow or other manage this feat while maintaing a lab and, maybe, some clinical responsibilities (plus somehow or other, having time for a wife and two small children). In itself, the task deserves a prize, but the actual product was more than worthy of being distinguished by the Pulitzer.

The basic objective of the book was to transverse the long history of cancer, "the emperor of all maladies". Granted references to relatively ancient reports of what we now to be cancer are minor since so little was known and, in fact, many people did not live long enough to know that they were plagued by the onslaught of cells no longer regulated by the usual cycle of the birth and death of cells. The author does take the reader through the 19th and 20th century of history of the medical approach to cancer. With their knowledge, they could see no more than surgery, thinking that the only hope was carving out the bad cells, and then, later, the use of radiation. Most of the book deals with the relatively recent focus, initiated by Sidney Farber, on the possible use of chemicals to thwart the "natural" progression of cancer.

I am no scientist nor am I trained in biology, chemistry, or medicine. Yet, this author was able to relate this fantastic history, even into very recent times, without losing me on the way! I may still not really understand chromosomes and genes. I may not grasp the mutations that occur to initiate cancer, but I did understand that these mutations can occur in multiple ways, that the process involves either the "positive" thrust of genes that cannot stop dividing or the "negative" phenomenon of genes that do not know how to stop their usual process of healthy destruction of cells. An oncogene is now a familiar term, referencing the enormous variety of mutations that actually can be narrowed down to a relatively small number of mutations that generate the most damage, albeit with a plethora of pathways that complicate the creation of the now famous targeted drugs.

The author, then, provided me an educational experience that I enjoyed.

Moreover, I was intrigued that someone with as much scientific and technical expertise could write in a narrative form that borders on the traditional form of a story. He was able to blend technical information with the human history of both the clinician/researcher with the patient.

It was an incredible experience to have read the book. I am thankful to Suneet for the recommendation.