The Emperor of All Maladies: A Biography of Cancer

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The Emperor of All Maladies: A Biography of Cancer

4.24 of 5 stars 4.24 · rating details · 16,602 ratings · 2,276 reviews

The Emperor of All Maladies is a magnificent, profoundly humane “biography” of cancer—from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence. Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with...more

ebook, 592 pages

Published November 16th 2010 by Scribner (first published January 1st 2010)

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Mar 01, 2012 Riku Sayuj rated it 5 of 5 stars · review of another edition

Recommended to Riku by: Rohini Nair

Shelves: favorites, reviews

Anna Cancerina

What a masterpiece. With beautiful metaphors, poignant case studies, breath-taking science and delectable literary allusions, Siddhartha Mukherjee takes us on a detailed yet panoramic trip spanning centuries. Probably one of the best science books I have ever read.

My favorite parts in the book are the literary allusions that capture the depth and feeling of what is being described so well, such as Cancer Ward, Alice in Wonderland, Invisible Cities, Oedipus Rex and many more.

The mo...more

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Nov 27, 2012 Petra X rated it 5 of 5 stars

Shelves: medicine-science

This book took me over a year to read. I kept it on the kitchen counter and as the left-hand page pile got bigger there was me standing on the right, getting smaller. It was my diet book. A couple of pages and a pound or so every week. What I was doing was either boiling the kettle or making my own concoction of a fat and cholesterol-busting mousse* that involved just holding an immersion whisk for a couple of minutes. I have such a low threshold for boredom I had to do something, so I read Empe...more This book took me over a year to read. I kept it on the kitchen counter and as the left-hand page pile got bigger there was me standing on the right, getting smaller. It was my diet book. A couple of pages and a pound or so every week. What I was doing was either boiling the kettle or making my own concoction of a fat and cholesterol-busting mousse* that involved just holding an immersion whisk for a couple of minutes. I have such a low threshold for boredom I had to do something, so I read Emperor of All Maladies.

I had previously tried to read the book in the proper way but failed. It is very heavy and not all of it is equally fascinating, but it all hangs together in the end and has given me a proper education in genes, dna, mutations, what cancer actually is and why it has been so impossible to find a panacea.

It's a bit like fighting a guerrilla war. You can only defeat the insurgents where you find them and where you think they might be. It might seem as if all the rogue cells have been annhilated. But if you didn't find them or one is high in the hills watching, or there are reinforcements coming from abroad in the next few months, then the battle will resume as soon as numbers have built up and the enemy is attacking once again. That is not to say there aren't victories, but they are victories of battles, not of the war, but the war against cancer is one from which we can never withdraw.

One thing struck me that was full of hope, was Mukherjee was talking about a previously rare cancer that is now quite common. It might be assumed that the cancer itself is on the upsurge, but no, it was rare because people died from it, now they live with it, so just like AIDS, it is no longer a killer but a chronic disease.

7-star book. 8 even... it was that good.

*Recipe (view spoiler)

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May 26, 2011 Cee rated it 4 of 5 stars

Informative. The first hundred pages trace cancer's history, even way back to the Egyptian civilization. The next two hundred pages are about the long struggles in surgery, radiation and chemotherapy to fight cancer. Then the last two hundred pages launch into prevention, genetics and more pharmacology.

With the scientific terminology toned down and explained as best as the author could, I felt I was reading a quasi-textbook. Before the topic would become monotonous there were breaks in form of s...more

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Jul 13, 2011 Jessica rated it 4 of 5 stars · review of another edition

Recommended to Jessica by: my brilliant scientist friend emily, who i hope cures cancer before i get it

Shelves: kind-of-depressing

I am a big blubbery crybaby when I'm reading a book, but I'm gonna have to get over that if I'm going to get through The Emperor of All Maladies. I almost bailed at page five because it was obvious that reading this would involve an intolerable amount of weeping on public transit, but then I realized that what I must do is master myself.

I'm too old to be crying all the time! It's ridiculous! I'm going to read this book and I'm going to put a wrench to the waterworks! I'm gonna save my tears for...more

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May 18, 2011 Andy Perdue rated it 5 of 5 stars · review of another edition

Shelves: cancer

This was a mammoth undertaking of research and writing. As a survivor/thriver, I found the book fascinating - and glad I live in the age I do. I think those who read this should also read "Anticancer: A New Way of Life" by Dr. David Servan-Shreiber. He's a two-time survivor who uses science to show how we can avoid/mitigate cancer, and it shows a side of the disease that isn't covered in this outstanding work.

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Oct 07, 2011 Victorious rated it 5 of 5 stars · review of another edition

Shelves: favorites, made-me-smarter

As someone with a budding interest in diseases- whether chronic, acute, or intermittent- I immediately purchased this book for my library as soon as it was published. I anticipated a similarity to a favorite book of 2010, The Immortal Life of Henrietta Lacks, but this book dives much deeper into the history of cancer, while interweaving personal accounts of patients the author treated. This biography is different from anything I have read this year; poignant, lyrical, accessible- and most of all...more

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Jul 04, 2012 Meetu rated it 5 of 5 stars · review of another edition

I first heard about this book a year back and was sure I would never read it. Medical non-fiction is not something I want to wrap my head around. So finally when I did pick it up from the library it was because a young acquaintance was undergoing chemotherapy and I thought it was perhaps "important" to understand cancer.

I am surprised at what a gripping read the book turned out to be. I ran through the initial 100 or so pages that chronicle the first instances of cancer in history. Mukherjee's...more I first heard about this book a year back and was sure I would never read it. Medical non-fiction is not something I want to wrap my head around. So finally when I did pick it up from the library it was because a young acquaintance was undergoing chemotherapy and I thought it was perhaps "important" to understand cancer.

I am surprised at what a gripping read the book turned out to be. I ran through the initial 100 or so pages that chronicle the first instances of cancer in history. Mukherjee's ability with words is obvious from the very first page. He makes the whole guided tour of cancer a fascinating one. At the same time, there is an emotional undertone to the whole story. There is the evil enemy cancer and there are the good guys........a mixed bunch of chemists, biologists and doctors who are fighting valiantly against a seemingly undefeatable evil. The personality of each of these contributors to the fight against cancer, is charmingly analysed by the writer and is one of the things I especially liked about the book.But after a fortnight and with more than half the book left, I realised I was losing the thread because of the numerous people and events that had been explained. So I actually (and geekily) made notes at the back of the book in pencil so that the basic developments would be clear to me. It still took me another month or so to complete the book. I cried, felt triumphant and figuratively bit my nails as I waited for some sort of denoument. The cure of course was never coming but I still felt there SHOULD be something. Mukherjee makes this whole labyrinthine journey seem like some Greek adventure. In the end, a basic understanding of the disease was all that decades of research arrived at. However, with an opponent as formidable as that described by the writer, this was as good a climax as those I have come across in any good thriller.
The book reads like a dedication to all those who lost their lives to the disease and to those who made it their live's purpose to vanquish it. There is a strong "personal" sense to the writing that elevates the book. It is definitely among the most significant books that I have ever read.

quotes from the book:
"I explained the situation as best as I could.......And it is - I paused here for emphasis, lifting my eyes up - often curable. Curable. Carla nodded at that word, her eyes sharpening..........We spoke for an hour, perhaps longer. It was now nine thirty in the morning. The city below us had stirred fully awake. The door shut behind me as I left, and a whoosh of air blew me outward and sealed Carla in."

"Nature," Rouss wrote in 1966 "sometimes seems possessed of a sardonic humour." And the final lesson of Rous sarcoma virus had been its most sardonic by far. For nearly six decades, the Rous virus had seduced biologists - Spiegelman most sadly among them - down a false path. Yet the false path had ultimately circled back to the right destination - from viral src toward cellular src and to the notion of internal proto-oncogenes sitting omnipresently in the normal cell's genome.
In Lewis Carroll's poem, when the hunters finally capture the deceptive snark, it reveals itself, not to be a foreign beast, but one of the human hunters sent to trap it. And so it turned out with cancer. Cancer genes came from within the human genome. Indeed the Greeks had been peculiarly prescient yet again in their use of the term oncos. Cancer was intrinsically "loaded" in our genome, awaiting activation.We were destined to carry this fatal burden in our genes - our own genetic "oncos".

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Nov 25, 2010 Nick Black rated it 4 of 5 stars · review of another edition

Recommended to Nick by: Steven Shapin (The New Yorker)

Shelves: important, likely-reread, snap-crackle-pop-science

http://www.newyorker.com/arts/critics...

Hyperliterate, scientifically savvy, a hot-boiled detective novel spinning along axes of surgery, chemical and radiative therapy, molecular biology, bioinformatics, immunology, epidemiology and supercomputing -- there's a little bit here for every NT (and if you aren't NT*, then to hell with ya!). Suffers noticeably from a lack of editorial quality control -- several passages are repeated almost word-for-word (why does this happen so often in high-grade po...more http://www.newyorker.com/arts/critics...

Hyperliterate, scientifically savvy, a hot-boiled detective novel spinning along axes of surgery, chemical and radiative therapy, molecular biology, bioinformatics, immunology, epidemiology and supercomputing -- there's a little bit here for every NT (and if you aren't NT*, then to hell with ya!). Suffers noticeably from a lack of editorial quality control -- several passages are repeated almost word-for-word (why does this happen so often in high-grade pop science? what's up with the lack of good, scientifically-literate editors?), and insufficient detail -- the book would have benefited from entire extra chapters detailing pathway-based drug discovery, the physics and mathematics of random mutation (a quick nod is paid to Schrodinger's What is Life, of which I fully approve), the use of statistical and combinatorial analyses in drug discovery, etc. Then again, less technically-minded readers are probably thankful for these lacunae. Overall, I'd have appreciated more focus on the past 20 years of oncological research, rooted as they are more deeply in the hard sciences of molecular biology and targeted pharmocology; cancer treatment has, until quite recently, been a story of observation-driven research, which (no matter how complete the collection or analysis of data points) is (and must remain) both fundamentally less effective and less interesting than the ineluctable march of theory.

Then again, one of Mukherjee's major points is that "cancer" is a collection of protean, complex, multifaceted things, evolution in situ possessing its own elegance and beauty, a noble and almost clever opponent. So often thought hovering on the brink of defeat, it has always managed to elude its pursuers, and perhaps the proliferation of pathways hints that protein folding and recombinance will form no more a panacea than did adjuvant radiotherapy forty years ago.

warning, the following are personal conjectures of a precocious computer scientist: The evolution, for instance, of repressed metastasis suppressors or disabled anti-oncogenes coding for "undruggable" proteins -- those lacking differentiated bonding sites along the cell membrane (see breast and ovarian cancer's infamous HER2/neu, so efficaciously targeted by Herceptin, for a counterexample), or deeply interwoven with non-renewable, inaccessible host material (eg meningioma, gliosarcoma) -- would require wholly new avenues of treatment (hence the sprezzaturic gamma knife -- "from the rain of the cobalt, O Lord, deliver us". Hence the radiolabeled polyethylene glycol-coated hexadecylcyanoacrylate nanospheres, in all their evanescent busting of the blood-brain barrier -- and in all their depositive despair). Cancer's accelerated evolution suggests convergence of mortality toward such rough beasts. Pathway-oriented research is critical.

Anyway! This is a pretty goddamn good book. I recommend it.

* Extreme ENTP here, of course.(less)

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May 16, 2011 Christina rated it 5 of 5 stars · review of another edition Recommends it for: Everyone

Shelves: favorites, nonfiction, science

Deep breath. This book is elegant, extraordinarily insightful, and most of all important. Despite the big words and the complicated science, Mukherjee had me riveted from start to finish. I thought I had a knowledge of cancer before this book, but now I understand it, in all of its feverish complexity and horrifying beauty. In the history of cancer research, there have been bright flashes of brilliance combined with truths that are stupidly rediscovered centuries too late (such as the carcinogen...more

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Feb 02, 2013 David rated it 5 of 5 stars · review of another edition

Shelves: non-fiction, science

Written as a narrative, this book takes on two challenges: outlining the history of cancer as perceived and treated by humans; explaining the science and scientific method behind not only the disease, but also the various forms of therapy and industries that have affected oncology.
Ambitious in scope, The Emperor of All Maladies not only effectively communicates the scientific and socio-economic events involving cancer - no small feat in themselves - it also employs a "human" component to the nar...more Written as a narrative, this book takes on two challenges: outlining the history of cancer as perceived and treated by humans; explaining the science and scientific method behind not only the disease, but also the various forms of therapy and industries that have affected oncology.
Ambitious in scope, The Emperor of All Maladies not only effectively communicates the scientific and socio-economic events involving cancer - no small feat in themselves - it also employs a "human" component to the narrative.

People involved in both the treatment and suffering of cancer are taken into account. They are not portrayed as mindless agents in science's steady march for enlightenment (like programmed cells with predictable behaviour), they are individuals with differing characters, emotions, and drives. One finds him/herself emoting with these individuals.

The Emperor of All Maladies is a reminder that science is not a cold subject, especially when it comes to the medical sciences. It is as enlightening as it is emotional.

That said, I have found it extremely distressing when I read about past scientists/doctors avoiding questions and putting their pride above the possibility of more effective treatment. The determination driving Halstedian mastectomies has been especially disturbing. If nothing else, however, reporting these disagreements may be the most accurate portrayal of scientific "progress" and might help the public understand how the world of science works.

Dedicating a chapter to the relationship between cancer and smoking, Mukherjee takes us on an epistemological journey central to the history of cancer. How do we know what we know about cancer and smoking? What were the underlying politics that led us to where we are now? It did seem that there was an obvious metaphor that was missed (maybe purposefully omitted): after all the fighting against smoking, not only has smoking not disappeared from society, but it is also growing in popularity again; much like the sudden, explosive relapse of a particularly stubborn cancer.(less)

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Feb 23, 2011 Cait rated it 4 of 5 stars · review of another edition

Shelves: non-fiction, science, read-in-2011, titles-i-love, ucked-fay-up-way, owned, pulitzer

Cancer fucking sucks.

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Jan 27, 2013 Astrid rated it 5 of 5 stars · review of another edition

Shelves: 2013-reading-challenge

This is a biography of an unlikely subject: cancer. I have a particular interest in this topic as one of my sons is pursuing a PhD in molecular biology and genetics to become a cancer research scientist. This book helped me understand his field. To be perfectly honest, I had to overcome many generations of familial hypochondria to read this book and once I shoved those fears aside, I found the history of the diseases that make up cancer, its treatments and discoveries very interesting. The autho...more

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Mar 04, 2011 Anna Balasi rated it 5 of 5 stars · review of another edition

So far, I'm completely enthralled/moved/disturbed! I never realized that a book about the history of Cancer could keep me reading on. I'm not a doctor or a nurse, though I've had a close member of the family pass away from Cancer, and perhaps that's what keeps me going, since I've been morbidly fascinated and terrified of the disease since.

The chapters I've read have been so hard to get through (it has so far covered childhood Lukemia (lord, the tears!), mastectomies, surgery without anesthesia,...more So far, I'm completely enthralled/moved/disturbed! I never realized that a book about the history of Cancer could keep me reading on. I'm not a doctor or a nurse, though I've had a close member of the family pass away from Cancer, and perhaps that's what keeps me going, since I've been morbidly fascinated and terrified of the disease since.

The chapters I've read have been so hard to get through (it has so far covered childhood Lukemia (lord, the tears!), mastectomies, surgery without anesthesia, disfigurement, tumors erupting from the bone and through the skin, surgeons with over-sized egos, and other such terrible things) but I'm still reading, and I'm still enthralled/moved/disturbed.

Cancer is a terrible, terrible disease, and this book captures the essence of how it has changed history, medicine, and our lives as we know it.

More to come...

On edit:
And so I finished this book about a month ago and I still couldn't wrap my head around how epic is is. There is a lot of information to get through, but I have learned more about cancer in the hours I've had with this book than I ever did in a lifetime--not even as I watched my own loved-one die of the disease. Cancer, the phantom, has now become cancer, the complex, amazing, all-consuming, aggressive, immortal, microscopic, biological, genetic disease. I don't understand everything about it, but it has become real and tangible--no longer the abstract "concept" that it once was to me. This book has, in fact, helped me quit smoking better than any fad psychobabble. I quit smoking half-way through the book. I had been smoking for over a decade, and while there was a two-year interval somewhere when I quit because I was pregnant and then because I wanted to take care of my child, I "relapsed" into my habits and my addiction. The entire time I *wasn't* smoking, I just wanted to smoke. Now it's different. Now all I can remember when I think about smoking is THE EMPEROR OF ALL MALADIES and how it moves me to understand in a split second why I don't want to smoke anymore. This book has truly made an impact on me. (less)

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Jan 10, 2011 Laura rated it 4 of 5 stars · review of another edition

In the beginning this book felt like a three: I could tell it was well researched and written but I was interested rather than fascinated. By the end I was fascinated. I have never had any personal experiences with cancer, but I feel like if I did now I would have a million questions in addition to an emotional response. One of the many things I learned from this book is that lumping (no pun intended) all cancers together is like lumping all vehicles together. Even lumping all breast cancer toge...more

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Jul 26, 2011 Osho rated it 3 of 5 stars · review of another edition

Shelves: 2011

A good mix of history, research, descriptive material, and anecdote about cancer. Mukherjee illustrates the move toward naming and talking about cancer over time in U.S. culture (as did Sontag). The sections on the discrepancies between the states of research and practice were particularly interesting and thought-provoking. As in any discussion about medical treatment in the era of AIDS, issues of access to treatment, and the balance between providing experimental treatments and safeguarding vul...more

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Mar 25, 2013 Melissa Jarmel rated it 5 of 5 stars

I know I started this book many times and took breaks from it even more, but it is a work of beauty. Part of what took me so long to complete this book was going off on tangents that were directly suggested or inspired by the stories told here (i.e. Susan Sontag's Illness as Metaphor and Bob Weinberg's One Renegade Cell, both fantastic!). I recommend this to everyone because all will inevitably come into a personal run-in with cancer. This is the story of what it is, what we've done to understan...more

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Sep 06, 2012 Carol rated it 3 of 5 stars · review of another edition

Finally, I'm on page 461!
This is a thorough study of the history of cancer treatment and research. I have been reading and reading and reading and am still not quite finished with this book. I would love to read a shorter version, without all the meandering. The material is overall great, but there is a bit too much of it.

The "Emperor of All Maladies" is a history of cancer, both in general and in treatment and research. The history encompasses everything from the early observations of cancer ov...more

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Sep 20, 2012 Phil James rated it 4 of 5 stars · review of another edition

Shelves: american

I found this supremely well written, balanced between the smooth telling of a suspense (who-done-it?) and just enough grounding in science history to keep both strands readable.
He kept the human context alive with the patients he followed and he showed humility in the way he never presumed to be more than a learner even after he became a qualified specialist.
The best science books are those that kindle the feeling of awe at life and the universe. Here there is awe at the perseverance of many to...more

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Jul 02, 2012 McKenzie rated it 5 of 5 stars · review of another edition

Mukherjee presents a true biography of cancer in The Emperor of All Maladies, tracing the history of the disease from ancient Egypt up to the present, in an engaging and very readable narrative. The only portion of the book that I (an admittedly non-science person) found difficult to follow was on the genetic discoveries of the last few decades, but Mukherjee does a good job of keeping such science-specific discussions relevant by explaining their greater significance. His writing, beyond being...more

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Dec 24, 2011 Vanessa rated it 5 of 5 stars · review of another edition

Shelves: non-fiction, science

It is a story of the biggest irony of human race: after generations of human chasing the pipe dream of living forever, we finally realized it was when one of the very building block of the human bodies, our cells, reached its immorality, we met our own demise. Life gets to live when cell dies; life comes to end when cell won’t die - “ nature satanic humor”.

This is a biography of a disease that at least is 4000 years old: the first medical description of cancer was written in 2500 BC, since the...more It is a story of the biggest irony of human race: after generations of human chasing the pipe dream of living forever, we finally realized it was when one of the very building block of the human bodies, our cells, reached its immorality, we met our own demise. Life gets to live when cell dies; life comes to end when cell won’t die - “ nature satanic humor”.
　　
　　This is a biography of a disease that at least is 4000 years old: the first medical description of cancer was written in 2500 BC, since then many theories have been proposed to explain this disease and even more methods have been introduced to trying to cure it, methods of which always resulted with disappointments.
　　Before 1900, the only resolve to cancer was surgery, which culminated in 1890s when William Stewart Halsted devised the radical mastectomy; however, radical as it was, it extirpated patient’s breast entirely but not patient’s cancer entirely - mastectomy turned out to be futile for already metastasized cancer, many women died with despair hearts and disfigured bodies.
　　Hope descended but soon aroused with the discovery of radium, high doses of which could killed tumors even the metastasized one; but radiation was soon found out to be carcinogenic itself, and its discoverers- Marie and Pierre Curie - over exposing themselves to X-ray, died from leukemia.
　　The next treatment of cancer is hardly less intrusive than its predecessors: chemotherapy - the most widely used cancer treatment nowadays - didn’t come into existence until World War II. Sidney Farber, the pioneer of chemotherapy, was the most mentioned medical hero in this book. He specialized in leukemia from which he discovered a folic acid analog that killed rapidly dividing cells in the bone marrow. This folic acid could help patients obtain remissions for a brief period. The concept of remission changed the doctor’s perception of cancer treatment; after all if we couldn’t cure cancer entirely maybe we could make cancer be lived with at peace. However chemotherapy is anything but peaceful, the chemical that kills cancer cells also kills normal cells, making patients vomit, lose hairs and enervate.
　　Cancer treatments were that intrusive and painful, and patients needed to solider up for the procedures, those who couldn’t started to turn to palliative care. Being considered as the antimatter of cancer therapy, the popularity of palliative care seemed to symbolize an admission of failure to the battle against cancer. The world was longing for a less intrusive treatment with high efficacy and it was about to appear, but before that happen, something has to be changed.
　　Cancer had been a mystical disease that kept defying all the logic. Scientists and clinicians needed to know the cause of a disease before they can seek the cure, but for cancer, the cause and cure, for a long time, “ having feasted and been feted together, separate taxis off into the night.” The cause and cure of cancer finally came into confluence at the age of genetics. With the help of knowledge of genes, cancer was decoded to be a genetic defection which was caused by an activated proto-oncogene and a dis-activated anti-oncogene. Different cancers has different corresponding proto-oncogenes and anti-oncogenes, a discovery that crashed the generations’ dream of “an universal cure” for cancer, but born the new hope of oncogene-targeted drug - the latest weaponry against cancers. Again, being higly effective, this targeted drug is hardly an elixir of cancer. Cancer with an indefatigable power keeps evolve and develop to resist the drug and scientists need to develop new drugs to subside the new version of cancer - a battle between cancer and the ingenuity of human being.
　　
　　The ingenuity of human being wasn’t only displayed in the medical field. As a disease that kills millions people per year, cancer is also a social and political issue: in 1970, a full-page advertisement "Mr. Nixon: You can cure cancer" appeared in the New York Times, showing the zeal of the public to defeat cancer. The campaign of “ War on Cancer” championed by Farber and Lasker (a legendary entrepreneur, socialite and the fairy godmother of cancer research), had been going on for decades. But a political cure didn’t lead to a medical cure; scientific discoveries were too serendipitous to follow a blue print. The only consolation was, although the gigantic campaign didn’t produce an end to cancer, it produced many clinics and organizations both of which became the foundations of latter cancer researches, also the campaign produced a new way of combating public issue that inspired generations of advocates. Action does not always bring success, yet it often brings progress.
　　
　　Dr.Siddhartha Mukherjee, a cancer physician and researcher, wrote his debut book when he was doing his residency in an oncology department of a general hospital. He said cancer is caused by uncontrolled growth of a single sell, hence it is a distorted version of our self. Cancer indeed is so much like a human being: it too exploits the genetic instability to evolve itself, and human species as well as cancer ironically are the ultimate products of Darwinian selection. I believe this similarity between cancer and human was the reason Dr.Mukherjee called this book a biography rather than a history. And I also believe it was the plenty personal touches in this book made this book more of a biography than history.
　　The stories in this book captured patients’ overwhelming despair, pain and confusion. One story articulated the last emotion: Dr.Mukherjee paid a visit to a patient, Ella, who was the only survivor of a trial treatment for childhood leukemia back in the 50s. All of children she knew during the trial succumbed to the disease, only she survives, standing and smiling, at the age of fifty-six. “ I don’t know why I deserved the illness in the first place, but then I don’t know why I deserved to be cured,” Ella said, looking at the album of the days during the medical trial. Once again cancer showed us how it defy our logic, being alive become the the underved. This kind of psychological suffering wasn’t only reserved to patients; it also haunted family, friends, nurse and doctors. At the very beginning of book, Dr. Mukherjee talked about his glumness when he was driving to work, concerning whether his patient, with whom he talked 3 hours yesterday would develop a fatal complication; in the middle of the book, he talked about when he was finishing his residency he and his colleagues had to decide to work at laboratory or at the clinic, they had this impromptu memorial service at which they read a list of the names of their passed away patients followed short eulogies respectively; latter he talked about the dreadfulness he felt when he saw a pile of death certificates waiting for his signature sitting on his desk… The battle against cancer is a battle fought by patients, patients ‘love ones and professionals that surrounding the patients, all of who are soldier in tears facing this immortal enemy.
　　
　　The book ended with the story of Germaine, one of the patients of Dr.Mukherjee. She was diagnosed with a rare kind of gastrointestinal cancer and when she was diagnosed her cancer already metastasized with no chemotherapy could help. When her hope was drained, a miracle happened, an oncogene-targeted drug specific target her cancer was developed. The new drug saved her life when she was about to be defeated. Unfortunately after four years of subsidence, her cancer developed a resistance to the drug, reappeared with a mass metastasis. Couldn’t wait for another miracle, she died to the death she had expected five years ago.
　　It is hard to tell whether it was a happy ending: Germaine did live five more years and the longevity as well as the survivor rate of cancer is extended across the board; yet these cold statics can’t give us any comfort. We’re still dread at the image of death, and seeing this battle with so many fatalities, how can anyone have any comfort?
　　We hoped, disappointed, thrilled, and despaired and then hope again, at the end of the day the most consistent feeling is sadness, sadness for the transience and vulnerability of life itself. (less)

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Sep 15, 2012 M. Salahuddin rated it 5 of 5 stars · review of another edition

Fantastic! Rarely have I encountered an author with such a capacity for engaging eloquent prose. Add to this the daunting nature of the subject and it makes Mr. Mukherjee's achievement all the more remarkable. With the deftness of a fiction writer, this book grips all but the most moribund of minds in its beautiful, often poignant, never dull descriptions of mankind's enduring struggle with the fearsome illnesses we collectively call cancer. Frequently dealing with scientific concepts and the se...more

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Apr 14, 2012 Karen rated it 5 of 5 stars · review of another edition

Shelves: death-and-dying, nonfiction, science, aging

This book won the Pulitzer for best nonfiction in 2010, and I can see why. Mukherjee shadows researchers in their Ahab-like quest to find the origins and the cure for cancer. We learn about the early developments for the cancer treatments of surgery, radiology and chemotherapy and the subsequent refinements for each. Mukherjee does an excellent job portraying the character of several cancer researchers, showing how science is dynamic, interested and perspectival. Much of the book traces the hist...more This book won the Pulitzer for best nonfiction in 2010, and I can see why. Mukherjee shadows researchers in their Ahab-like quest to find the origins and the cure for cancer. We learn about the early developments for the cancer treatments of surgery, radiology and chemotherapy and the subsequent refinements for each. Mukherjee does an excellent job portraying the character of several cancer researchers, showing how science is dynamic, interested and perspectival. Much of the book traces the history and development of cancer research; however, the author at times switches gears from describing a complex puzzle to highlighting the impact cancer has on the people struggling to combat this unrelenting disease. He also balances the scientific detail with epigraphs from literature and history and with references to works such as Susan Sontag's Illness as Metaphor.

What I found interesting is how cancer research over the centuries reflects humankind's worldview. During the centuries where Galen's theories of the four humors prevailed, people thought cancer was an excess of bile and rejected surgery because they thought the bile would spread. Then during the early 20th Century, people used war metaphors to describe cancer treatment. Now the focus is on the cellular level, using genetics as the most influential discipline. Although Mukherjee doesn't state this overtly, I see today's genetic-based research and treatment as using analogies from computer programming. As a society, we have to discover the specific way cancer is encoded so we can learn how to reprogram cancer in order to save the patient.

The book can be demanding because of its length and its technical detail, so if you only have time and the constitution to read two passages, read these: On p. 391, the author has a 6 point description of cancer's characteristics, which focuses on cellular processes of growth gone wild. His more succinct commentary is contained in a single sentence from p. 388: "Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves."

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Jul 12, 2011 Cheryl rated it 4 of 5 stars · review of another edition

Shelves: non-fiction

The cancer researcher and oncologist Dr. Siddhartha Mukherjee has written THE EMPEROR OF ALL MALADIES: A BIOGRAPHY OF CANCER from a question asked by his patients, "What is it that I am battleing?".

The purpose of the book, then, is to write the history of the disease from 2500 BCE to the present with a prognosis of the malady that has evaded understanding and cure, intersecting science and humanity in a deadly way.

The arc of the story is two or three tales: Dr. Mukherjee's coming of age as an on...more

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Oct 30, 2011 Maureen rated it 4 of 5 stars · review of another edition

Shelves: 2011, nf_health

The Emperor of All Maladies is a sweeping history of the medical profession's interactions with and study of cancer. It was a very dry read, and I was grateful to have an audio version from the library to help me get through it. This is not recommended reading for the average reader. I would think only those with an extreme interest in cancer or a devotee of medical literature would be interested in this book. However, it was very thorough and, as a cancer patient, I found it fascinating.

The fi...more The Emperor of All Maladies is a sweeping history of the medical profession's interactions with and study of cancer. It was a very dry read, and I was grateful to have an audio version from the library to help me get through it. This is not recommended reading for the average reader. I would think only those with an extreme interest in cancer or a devotee of medical literature would be interested in this book. However, it was very thorough and, as a cancer patient, I found it fascinating.

The first half of the book was plodding; a travel back through cancer in history to its earliest mentions, and then traveling forward in time as medical science wrestled with overcoming the disease. It certainly makes one glad to be a cancer patient in this period of time, and I was surprised to realize how very recent most scientific and medical advances in cancer have been. Chemotherapy really only came about in the 60s and 70s, and most progress in treating cancer happened after the 1980s.

The latter half of the book brings us into modern times from the 1960s and beyond, through the development of adjuvant treatments of chemo and radiation and on through the discoveries of the Human Genome Project and the development of the Cancer Genome Atlas to the development of targeted cancer therapies - those designed to target specific cancer cells, rather than the more generic chemotherapy, which targets all rapidly dividing cells, both cancerous and healthy normal cells.

This part of the book was very interesting and explained the behavior of cancer at the genetic level, down to proteins and cellular pathways. It was the first cancer book that I have read that truly explained what happens inside a cell that causes it to turn cancerous. Most cancer books only mention that cancer cells divide uncontrollably. This book explains how that process starts and covers the 2 ways that it can happen on the cellular level - either by accelerated and uncontrolled growth (akin to a stuck gas pedal on a car) or the absence of the cellular equivalent to a brake pedal to suppress cell growth.

I must say, it was an eye-opener about how cancer really works, but I was left with the feeling that cancer is and will continue to be a formidable foe to mankind. I'm not sure that science and medicine will really ever be able to cure cancer - maybe just be able to keep it at bay. I was left with the feeling that cancer is almost a natural bodily function to carry out the process of aging and death.(less)

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Jan 29, 2011 Diane rated it 5 of 5 stars · review of another edition

Shelves: ebooks

"Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings whom they know nothing" --Voltaire

The Emperor of All Maladies: A Biography of Cancer, is a fascinating book about the history of cancer, a disease that would kill 600,000 people in the United States, and 7 million people worldwide in 2010 alone. The author, an Oncologist, researcher, and professor of medicine began this book when he was a resident at Dana Farber Cancer In...more "Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings whom they know nothing" --Voltaire

The Emperor of All Maladies: A Biography of Cancer, is a fascinating book about the history of cancer, a disease that would kill 600,000 people in the United States, and 7 million people worldwide in 2010 alone. The author, an Oncologist, researcher, and professor of medicine began this book when he was a resident at Dana Farber Cancer Institute, and an Oncologist at Mass General Hospital in 2005.

Most of the information learned about cancer in this novel takes is from the early 1900's to the present, however, in 440bc, a Greek Historian named Herodotus recorded the story of Atossa, Queen of Persia, who has a "bleeding lump in her breast. Her breast was removed, however, it is uncertain as to whether the cancer had returned when she died. There is also on record a 1,000 year old bone cancer preserved in a mummy that was a member of the Chiribaya Tribe. So it appears that cancer was present in the distant past, but that it was somewhat rare, probably because as the author writes. "people didn't live long enough to get cancer". Today since people are living longer and longer, it makes sense that more of us will die of this disease unless a cure is found, as "mutations in cancer genes increase with age".

Today however, although significant advances have been made, the war on cancer has not been won by any means. The book is loaded with interesting information, but a difficult book to review, so I thought I would share a combination of statistics, advances in treatment and quotes, that I found interesting:

"Killing a cancer cell in a test tube is easy. The trouble lies in finding a selective poison - a drug that will kill cancer without annihilating the patient"

* Between 1970-1994, lung cancer was the #1 killer. Lung cancer with women over age 55 increased by 400%.
* Between 1990-2005, mortality declined by about 1% each year for, lung, breast, colon and prostate cancer --despite this, a half million Americans died of cancer in 2005 alone.
* 1/400 - 39 year old women will develop breast cancer
* 1/9 - 70 year old women will develop breast cancer
* As of 1981, radical mastectomy is rarely performed today
* Prostate cancer and breast cancer are hormone dependent cancers
* Breast cancer and ovarian cancer have been found to be connected

In 1962, the drug Tamoxifen was developed for birth control, but was found to have the reverse effects, actually shutting off the estrogen signal to tissues. In 1973, V. Craig Jordan, a bio-chemist from a little known lab in Central Massachusetts found estrogen receptors were highly responsive to Tamoxifen which choke the cells growth, so a trial drug program was designed for women with advanced metastatic breast cancer, which seemed to cut the cancer's recurrence by 50% in women over 50. It lengthened survival, however, many patients eventually relapsed.

The book is full of fascinating insights of the discoveries, advances and outcomes made by cutting edge scientists of the past and present, like the discovery of radium oncology in the early 1900s, mammography, PAP tests, and so much more. From the primitive surgeries of the past to the politics of battling insurance companies who deny treatments here today, this book is never dry or dull. The book is like a medical drama of the past and present. There are interesting photos, advertisements and articles as well. The book was easy to read and understand, even if you are someone who does not have a background in science. Don't let the 590+ pages discourage you from reading this wonderful book, as at least 20% of that are sources used for researching this book. HIGHLY RECOMMENDED(less)

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Nov 28, 2011 Mama Kaye rated it 5 of 5 stars · review of another edition

It's not hard to see why The Emperor of All Maladies was awarded the 2011 Pulitzer Prize for General Nonfiction. It is an engrossing and powerful history of cancer and a fascinating journey through the development of modern medicine. I learned so much from this book and feel like I have a much better understanding of the nature of cancer and the importance of its role in modern life.

This book is so jam-packed with interesting stories and information, it's hard to know where to begin. I will jus...more It's not hard to see why The Emperor of All Maladies was awarded the 2011 Pulitzer Prize for General Nonfiction. It is an engrossing and powerful history of cancer and a fascinating journey through the development of modern medicine. I learned so much from this book and feel like I have a much better understanding of the nature of cancer and the importance of its role in modern life.

This book is so jam-packed with interesting stories and information, it's hard to know where to begin. I will just mention a few key portions of the book that I found to be especially interesting. First, I was fascinated to learn that doctors and researchers developed various cancer therapies over a period of more than a century (surgery, radiation, chemotherapy) without having even a rudimentary understanding of the basic way that cancer works in the cell. Second, I was shocked by the story of the radical mastectomy, especially since my grandmother had this operation performed on her. Third, I was intrigued by the important relationship between the AIDS epidemic, cancer research, and the birth of the patient advocacy movement.

Fourth, I really enjoyed learning about the development of modern medical research tools such as the randomized clinical trial -- these types of research tools are much more complicated than I ever imagined. Fifth, I was very interested by the long and agonizing tale of the medical establishment's growing understanding of the relationship between cigarette smoking and cancer and the political and corporate resistance to enacting public health measures to warn consumers of the dangers.

In fact, I found the information about the slow and evolving understanding by doctors and researchers of cancer's environmental causes to be extremely interesting and somewhat surprising. And of course, in recent years, our understanding of cancer has become even more refined as we now know that cancer is basically a genetic disease (or actually, many genetic diseases). I found the section in the book on genetics to be the most difficult to understand, but I definitely came away with a better understanding of the complexities of treating cancer.

I listened to this book as an audiobook. My only complaint -- and it's a minor one -- is that I didn't care for the reader's voice very much. He was not terrible, and it wouldn't keep me from recommending it, but he certainly wasn't one of my favorite audiobook readers. (His reading style was rather stiff and formal.)

This is a fabulous book and I highly recommend it to anyone who would like to learn more about this important disease and how it has impacted human society and medical science. (less)

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Mar 18, 2013 charlie rated it 5 of 5 stars · review of another edition

The biography of cancer. An epic accomplishment.

There are many types of science writers: propeller heads who can't communicate to the plebe readers like me, journalists who write as outsiders looking in.

I read this book with my jaw dropped page by page. From page one you love the author. From page to page, he takes the time to explain complex science in a way that even a thick head like me can understand. With a passion and emotion that is charming and engaging. Trust me, it's all complex scie...more

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Feb 12, 2013 Simone rated it 3 of 5 stars · review of another edition

Shelves: non-fiction, 2013

I was drawn to the book because the subject matter is undeniably compelling. Just off the top of my head, I can think of SEVEN people in my life that are/were impacted by cancer in varying degrees of intensity: my mother, my maternal-grandfather, my paternal-grandmother, my cousin-in-law, my mother-in-law and 2 colleagues on my team.

I kept describing this book as “a sentence of interesting lost in a paragraph of boring” but that’s not entirely fair; it’s just that my interest in the subject matt...more

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Mar 23, 2013 Johanna Kirk rated it 4 of 5 stars · review of another edition

Writing beautifully about cancer is an impressive feat. Learning about the disease, the research and the changing treatments has been so interesting. The chapters about smoking were especially troubling (how can they still get away with selling this poison?). The aha moments are too many to count, it's such a worth-while read.
The sad fact is that most of us have been affected by cancer, directly or indirectly. There may not ever be a magic bullet per se but I still see a lot of hope for treatme...more

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Jun 08, 2011 Kate rated it 5 of 5 stars · review of another edition Recommends it for: Ed

Shelves: new-in-2010, book-club, doorstops, medicine, health-care, history, work, the-stacks, pulitzer-prize

I don't have time to write a full review at the moment, but I must say that The Emperor of All Maladies is an absolute must read for anyone who works in cancer research, prevention or treatment and anyone who is or has a family member being treated for cancer. In fact, I recommend it for everyone. This is an incredibly honest accounting of where we've come from in cancer treatment and where we stand now while also succeeding in a feat rare to such works: Mukharjee capably demonstrates compassion...more

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About Siddhartha Mukherjee

Siddhartha Mukherjee is a cancer physician and researcher. He is an assistant professor of medicine at Columbia University and a staff cancer physician at Columbia University Medical Center. A Rhodes scholar, he graduated from Stanford University, University of Oxford, Harvard Medical School. He has published articles in Nature, The New England Journal of Medicine, The New York Times, and The New...more

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“It remains an astonishing, disturbing fact that in America - a nation where nearly every new drug is subjected to rigorous scrutiny as a potential carcinogen, and even the bare hint of a substance's link to cancer ignites a firestorm of public hysteria and media anxiety - one of the most potent and common carcinogens known to humans can be freely bought and sold at every corner store for a few dollars.” — 23 people liked it

“The art of medicine is long, Hippocrates tells us, "and life is short; opportunity fleeting; the experiment perilous; judgment flawed.” — 18 people liked it

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