Raghu's Reviews > The Emperor of All Maladies

The Emperor of All Maladies by Siddhartha Mukherjee
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's review
Mar 09, 12

Read from January 22 to February 24, 2012

This is a monumental piece of work by Dr.Mukherjee, chronicling the history and biology of cancer for the layman. The prose is easily understandable and the narrative is arresting. Though it is pretty lengthy, the author keeps us engaged and interested all the way as he follows the disease from its early recorded days of 2500 BC to the twenty-first century. It is truly a biography of cancer. As the author himself says in the introduction, ' ...this book is an attempt to enter the 'mind' of cancer, understand its 'personality' and demystify its behavior'. He also uses a military metaphor in describing man's fight with cancer. Cancer is portrayed as a formidable adversary against whom victories have been won as well as defeats tasted. The various attempts by scientists and researchers to find solutions are treated as campaigns and as the author says, '..there are inevitably the wounded and the dead.'. All in all, when I finished the book, I was overwhelmed by the multiple talents of the author in presenting this biography. He is an excellent writer of popular science, has the transcending perspective of a historian and is able to talk about his subject by using apt metaphors.

The most important things that I learnt from this book are as follows:
Though cancer is simply the abnormal growth of cells, it is a disease that is intrinsically stitched into our genome. Oncogenes arise from mutations in essential genes that regulate the growth of cells. Mutations accumulate in these genes in one of two ways. One way is when DNA is damaged by carcinogens and the other way is by random errors in copying genes when cells divide. The DNA damage may be preventable but the random errors in copying is endogenous to us. So, in this sense, we can say that Nature has created us with this flaw being deeply embedded in us.
So, what does this mean to us in so far as eradicating cancer from this world just as we did smallpox? Well, Dr.Mukherjee says that the secret to battling cancer is to find means to prevent these mutations from occurring in susceptible cells or to find means to eliminate these mutated cells without compromising normal growth. But malignant growth and normal growth are so genetically intertwined that upbraiding the two might be one of the most significant challenges faced by our species. We can rid ourselves of cancer only as much as we can rid ourselves of the processes in our physiology which depend on growth - i.e, ageing, regeneration, healing and reproduction. As our cells divide and our bodies age, and as mutations accumulate inexorably upon mutations, cancer might well be the final terminus in our development as organisms.

No review of the book would be complete without mention of the two towering figures who carried on the struggle against cancer in the US. The first is Dr.Sidney Farber who was the father of modern chemotherapy and waged a relentless battle against cancer on the medical front. The other was a Manhattan socialite named Mary lasker, who raised social and political awareness in the fight against cancer showing exemplary grit, optimism and tireless effort. The author has done full justice to their herculean efforts.

In short, the book is a fantastic read and it made me want to learn more on the subject hereon.
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