Friday, January 04, 2013

Book 47: The Emperor of Maladies

While science lost its appeal for me during high school's AP Chemistry class, I still enjoy the occasional science book for the laymen such A Short History of Nearly Everything, The Disappearing Spoon, etc.  I like to know the ideas and the processes behind science, just don't ask me to get into the actual details.  I've also read a few books (and added others to my wishlist) related to medical history that I've enjoyed, including The Great Influenza, so this tome seemed like a natural addition to my reading pile.
It definitely did not disappoint.  Mukherjee frames the book with a patient's story, a woman who is diagnosed with an aggressive type of leukemia.  While he refers to her on occasion, he then delves deep into the history and some of the science behind cancer.  While there are references to diseases that appear to be cancer to the modern eye going as far back as the ancient Egyptians, cancer's current prevalence is rather recent, and for good reason: our life expectancy has increased quite a lot.  By eliminating (or at least reducing the occurence of) other killers, such as tuberculosis, typhoid and many other diseases, humans now have the opportunity to live long enough to develop cancer.
While the book is subtitled a "biography of cancer," it doesn't have straight time line.  Instead, he picks different topics and approaches, and discusses them in a detailed manner.  The reader can then connect the dots and be baffled by the type of treatments that were occuring while other groundbreaking research was showing how ineffective that treatment was (such as radical mastectomies not adding any more life span than a smaller surgery would have in a similar case).  The American Cancer Society was originally a small group but once certain donors became interested in the cause it became a political force.  Of course, while they did a lot to get more funding for cancer and such, Mukherjee also discusses the idea that historically, most diseases and illnesses have been eradicated due to prevention rather than treatment, and while cancer treatment is of course important, ACS's constant pushing for cures may have also diverted some people from focusing on the cause, or getting to know and understand the disease more intimately.  He talks about the history of lung cancer as one of the most obvious one as far as causes while for other cancers there is still much to be learned.  While he discusses breast cancer, I was surprised that he didn't mention Suan G. Komen - it just seems like there is so much talk about breast cancer being ignored before those types of organizations but it seems like most cancers were kind of quietly hidden and not talked about for a long period of time prior to last century.  He also discusses the idea of cancer patients being at war, and how cancer is portrayed as a battle so that in some cases the hardest thing is to simply accept that there is a point where nothing else can be done, and simply let the patient die with dignity without the patient feeling like they have somehow failed in their battle.
Overall, I thought it was an absolutely fascinating read, discussing cures and treatments that can sometimes seem worse than the disease, what research has revealed recently, and the way people's understanding as evolved over the years, and how understanding could be culturall influenced.  It was definitely worth the time, and Mukherjee never forgets the people involved, be that the scientists, the doctors, or the patients.

No comments: