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The First Cell: And the Human Costs of Pursuing Cancer to the Last

4.10  ·  Rating details ·  689 ratings  ·  131 reviews
With the fascinating scholarship of The Emperor of All Maladies and the deeply personal experience of When Breath Becomes Air, a world-class oncologist examines the current state of cancer and its devastating impact on the individuals it affects -- including herself.
In The First Cell, Azra Raza offers a searing account of how both medicine and our society (mis)treats cance
Hardcover, 368 pages
Published October 15th 2019 by Basic Books
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Aamir Jafarey
Aug 07, 2019 rated it it was amazing
Aamir Jafarey, Karachi Pakistan
I found the reading of “The First Cell” unnervingly disturbing, to the point that I had to put the book down periodically to let myself ‘recover’. I cannot even imagine what Azra Raza must have gone through personally in putting to paper her own extremely private thoughts, and those of the contributors, who found the courage to share their immense pain with unknown readers through this narrative.
While Raza has a clear mission, that of advocating a fresh approach t
Syed T.
Aug 06, 2019 rated it it was amazing
In her remarkable book “The First Cell,” Azra has been brutally honest at every level. President Nixon declared “War on Cancer” in 1972, but as shown in this book there has been little improvement in the prognosis of most cancers. The only decline in the death rates from cancer we have seen are due to early diagnosis from routine screening and the ability to treat cancers at such an early stage. Yet we hear of new miracle cures, transformational new drugs and so on frequently, followed by the sa ...more
Mrs. Danvers
This book reflects some very important thinking about the deficiencies in the way that cancer drug research is performed in this country and recommendations for a different protocol, and I totally buy what she says.

Unfortunately, it also is very detailed about the molecular mechanisms in a way that is difficult for the layman to follow. The more powerful statement is the simple one, the one she tells in stories about her patients. Here, too, though, it is sometimes hard to connect the human sto
Debbie Notkin
Apr 25, 2020 rated it it was amazing
This is not ordinarily a book I would read during the plague days, but it was first on my nonfiction list when I agreed to pick up chairing the Otherwise Award jury late in 2019, and one of my closest frineds recommended it very highly.

Raza is an oncologist specializing in certain leukemias, has intense personal history with cancer deaths, and has a radical take on how we treat cancer, and how we could do much better. Especially now, I don’t want to go into detail about this book, but I will sa
Marcos Malumbres
Jan 11, 2020 rated it did not like it
Do you want to read a shortlist of major problems in cancer therapy? This is your book.

Do you want to hear how difficult is to cure cancer patients? This is your book.

Have you or your relatives suffered from cancer and have no one to blame? This is your book.

Do you want to hear a few dramatic cancer stories (including the writer’s husband's) mixed with some poetry? This is your book.

Are you willing to hear that medical oncologists that suffer with cancer patients are the heroes, whereas molecula
Michelle Hopkins
Oct 19, 2019 rated it liked it
I enjoyed the first half very much. It got repetitive, I thought, in the second half, confusing in spots, a little syrupy for my taste (everyone was her dearest friend) and a little too strident in tone. I guess she wrote that part more for the people she has seen as opponents since 1984. Still, highly illuminating and I am highly sympathetic to the views she expresses, especially how nominally many people benefit from radiation and chemo, yet how tortured they are physically and financially.
Syed Mohammad
Aug 07, 2019 rated it it was amazing
Cancer has impacted everyone on this planet in some way, and this book offers hope while also reflecting how medicine needs to reevaluate how it tackles this disease. Through this book, it is clear that the author deeply cares about her patients, and it is an inspiring and sobering read at the same time.
Nolan ביטי
Jan 11, 2020 rated it did not like it
As a cancer biology PhD student, I’ll be the first to say that these are all known facts in the field. Like not only known but well understood across every scientific field. Dr. Raza doesn’t share one original idea or anything close to novel. She rants the majority of the book without offering any clear solutions. And these rants didn’t originate from her. Yes, Dr. Raza, we know animal models are artificial so what’s your solution? She reveals her extraordinary bias of her own research which has ...more
Feb 08, 2020 rated it it was amazing
Dr. Azra Raza is a trail blazer. She would not take no for an answer. She is a warier. She will fight cancer cells at their origin. She is a champion for developing new approach of early detection of pre-cancerous cell at the first mutation toward immortality. As a person, a researcher and a physician she earn my respect and admiration. She explained her ideas very clearly in her book. That said, there were a lot of repetitions through the book to the level that more than once, I question myself ...more
Maureen Grigsby
Dec 11, 2019 rated it it was amazing
Dr. Azra Raza, a medical researcher, makes a very compelling argument that there needs to be a paradigm shift in cancer research so that we are looking for very early signs of cancer and finding the first cells, rather than our pretty unsuccessful approach of trying to eradicate the last remaining cell after cancer is pretty advanced. A very thought provoking book.
Nov 30, 2019 rated it it was amazing  ·  review of another edition
Something is seriously wrong with the way cancer research is being done today. Dr. Raza, a prominent oncologist, has written a devastating critique of the way cancer care is being researched and practiced and she is calling for a revolutionary new treatment paradigm. Currently, cancer research is centered on the end stages of care, and the drugs approved through that research, at almost inconceivable expense and excruciatingly long years of research, are producing drugs that, according to Dr. Ra ...more
Cindy Lauren
Sep 09, 2019 rated it it was amazing
Love this book, truly. Wasn't sure what to expect and did also love Emperor of All Maladies.This gives a new, exciting, if painful, perspective on the whole cancer landscape. From her own first professional, then intensely personal experience with the relentlessness of the disease, the author is exemplary is her discussions.

Her detailed knowledge of the process of disease, diagnosis and treatment mirrors the clusterfuck having cancer in this day and age really is. From the pursuit of a cure - s
Leigh Anne
Jun 05, 2020 rated it really liked it
CW/TW: frank descriptions of cancer treatments

Cancer: we're doing it wrong.

Raza would know: she's spent her entire career treating a very rare type of cancer, and the book she's written is the literary equivalent of throwing your hands up in the air and saying, "Look, we just don't fucking know, okay?"

Well, we know a few things: we know that the treatments we currently have are the same treatments we've been using for decades. The great leaps and bounds in cancer treatments we've been promised
Graeme Roberts
Aug 16, 2020 rated it it was amazing
Azra Raza stands alone in the depth of her clinical experience as an oncologist, her scientific knowledge and commitment to evidence, her intellectual depth and literary knowledge, her passion and emotional intensity, and her willingness to challenge convention. I am agog that such an astonishing human being exists.

Her most important message is that too much money and effort is being devoted to the predominantly failing efforts to offer small extensions of life to cancer patients in the later st
Pedro Pinto
Sep 19, 2020 rated it really liked it  ·  review of another edition
Decided to read this book after listening to the Author on an Econtalk podcast.

There was something on how Azra Raza explained the key message of the book and the humanity conveyed in such discussion that immediately "magnated" me into reading it.

A disturbing book about cancer, its impact on the lives of those who have to deal with it (on the first person or related family and friends), that more than once made me stop, take a deep breath and reflect, before i could continue.

The key message pres
Ashwini Shenoy
Aug 23, 2020 rated it liked it
A good chronicle of cancer but not exactly a piece of research

Came across a podcast with Dr Raza's interview by Peter Attia. She is an acclaimed oncologist with a novel concept at approaching cancer at 'The First Cell' , to catch and stop it at its origin. Has critiqued the 'burn-posion-slash' approach to malignancy as archaic. This in particular is bold of her and , being a part of an oncology team myself, caught my interest. Is there a radical new way that we are missing¿ I think she is on the
Derek Emerson
Nov 28, 2019 rated it really liked it
Shelves: 2019-books-read
Azra Raza makes a bold claim in this book and backs it up. "The art of medicine, once based purely on experience and observation, a hostage to tradition, gradually evolved into a practice increasingly driven by scientific evidence. More recently, it has undergone an unexpected transition by morphing into a monstrous business enterprise" (144). Raza is not against funding for cancer research as she has made this profession and knows the personal costs as her husband died because of cancer.

Her fru
Jan 27, 2020 rated it it was ok
Physicians are not scientists and their play science efforts are part of the problem this book rails against. This smug intro is written as though her family is the only one to have had the miserable experience with cancer - after treating patients for years now she finally gets to reflect. Her enormous ego let her write this book as though she presents anything new or creative. Nope, in fact, limitations in research design and the understanding that prevention and early detection are the best d ...more
Ellie Weeks
Jul 16, 2020 rated it really liked it
I saw the author speak in Chicago last year, and was so compelled by her views and story that I’d wanted to read her book since then. I listened to the audiobook, narrated by her daughter. It was really good, and the author’s pleas are important and very clear. I did think the book was going to be a lot more ethnographic than it was, focused more on the stories of her patients — and even though the author was extremely empathetic and humanized the fight against cancer, the stories still very muc ...more
Curt Worden
Aug 07, 2019 rated it it was amazing
After reading The First Cell, I realized how I’ve misunderstood the misguided war on cancer. Dr. Azra Raza has written a powerful and insightful book drawing from the passion for her work, and being a firsthand witness to the human impact of this disease. A range of emotions are present; from the stories of patients and their families who show extraordinary strength and determination, to the frustration of the unjust realities present in the “business” of cancer.

Beautifully written with unbridle
Dec 22, 2019 rated it really liked it
I am giving this four stars because it is an important book on cancer by an oncologist working in the US, Azra Raza, who lost her own husband (another oncologist) to cancer. Raza wants to convey her concern that "cancer cures" have been oversold, and that much of the research is misguided. But be warned: she holds back nothing about the misery of failed treatments. I do NOT recommend this book for anyone undergoing cancer treatment or with a loved one suffering from cancer. As I am in the first ...more
Logan Daul
was good
Sep 06, 2020 rated it liked it
This is a very well written book. In some ways, it's a 5 star book. In other ways, it's not.

It's hard to understand who is audience for this book. It seems Azra Raza feels regular people (people not in the field of oncology) are the intended audience, but it is written in such a way that it would really be very hard for someone not in oncology to fully understand. It's very detailed and treatments and disease processes she mentions or discusses are not always explained. Yet, it does not seem th
Jennifer Bentley
Nov 06, 2019 rated it liked it
How much do you not want to die? Author Azra Reza challenges us to think deeply about what the cost of an extra six weeks or six rounds of treatment would really mean. Is it worth putting your family's financial security on the line to extend your life, if only for a few weeks? I guess this could be a depressing thought, but she philosophizes on death and life... James Baldwin (one of my favorite authors) is quoted heavily and I loved her initial chapters about how the west views death (by avoid ...more
Henry David
Feb 24, 2020 rated it it was amazing
I'd give it 6 stars if I could...
Couldn't have said it better than Nature Book Reviewer, Barbara Kiser:

"Each year, the United States spends US$150 billion on treating cancer. Yet as oncologist Azra Raza notes in this incisive critique-cum-memoir, the treatments remain largely the same. Raza wants to see change: eliminating the first cancer cell rather than “chasing after the last”, which is doable with current technologies. Meanwhile, she braids often-harrowing stories of patients, including he
Amera Raza
Aug 07, 2019 rated it it was amazing
Recommends it for: everyone
It is a beautifully written, easily understandable, emotionally stirring, and yet soundly- supplemented -with -scientific -data, book. One gets a lot of basic information about cancer as a disease, how it develops and affects its victims, it’s current and past treatment strategies and challenges and best of all select patients’ and their care givers’ personal accounts of how they feel, face and handle this harrowing disease. Azra’s main thrust is of course on how some of the cancer treatment and ...more
Ginger Hudock
Oct 19, 2019 rated it really liked it
Raza is an oncologist who has had a first-hand look at cancer through the eyes of both her patients and her husband, who died of cancer. She has seen death up close through these patients and recounts the stories of a number of them. This book is a personal memoir but is also a great discussion of the history of cancer research and treatment. Raza sees that most research funding has not been very well spent. Drugs have been developed that cost huge amounts of money, have many negative side effec ...more
Canadian Reader
Azra Raza is a professor of medicine at Columbia University and a practising oncologist. She specializes in and researches myelodysplastic syndromes (MDS), which the Canadian Cancer Society describes as “a group of diseases in which the bone marrow doesn’t make enough healthy mature blood cells.” Immature blood cells—blasts—don’t function properly, and they build up in the bone marrow and blood. Healthy red blood cells, white blood cells, and platelets are crowded out; there are fewer of them to ...more
Ronald J.
Apr 02, 2020 rated it it was amazing  ·  review of another edition
We had the great honor of interviewing Dr. Azra Raza on our radio show: The Soul of Enterprise: Business in the Knowledge Economy. You can listen to the entire 1 hour interview here:

Here are the questions I and my co-host Ed Kless asked Azra:
Ron’s Questions
Welcome to TSOE, Azra. It is such an honor to get to speak with you. Before we get into your book, during this COVID crisis, how are you holding up, personally?

Do you still have to see some patients for
Mar 05, 2020 rated it really liked it
This book caught my eye, with comparisons to The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee and When Breath Becomes Air by Paul Kalanithi. I’d read and adored both of these books: the former a fascinating treatise on the history and science of cancer and the latter a poetic, moving account of a young physician dying of cancer. I listened to The First Cell, loved the narrator, and only afterward, realized the narrator was the author’s daughter, Sheherazad Raza Priesler ...more
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