The Emperor of All Maladies: A Biography of Cancer

by Siddhartha Mukherjee

The conversation ran for nearly an hour. In his hands, information was something live and molten, ready to freeze into a hard shape at any moment, something crystalline yet negotiable; he nudged and shaped it like glass in the hands of a glassblower.

Ars longa, vita brevis.

In an essay titled A View from the Front Line, Jencks described her experience with cancer as like being woken up midflight on a jumbo jet and then thrown out with a parachute into a foreign landscape without a map: “There you are, the future patient, quietly progressing with other passengers toward a distant destination when, astonishingly (Why me?) a large hole opens in the floor next to you. People in white coats appear, help you into a parachute and—no time to think—out you go. “You descend. You hit the ground.… But where is the enemy? What is the enemy? What is it up to?… No road. No compass. No map. No training. Is there something you should know and don’t? “The white coats are far, far away, strapping others into their parachutes. Occasionally they wave but, even if you ask them, they don’t know the answers. They are up there in the Jumbo, involved with parachutes, not map-making.” The image captured the desolation and desperation of the era. Obsessed with radical and aggressive therapies, oncologists were devising newer and newer parachutes, but with no systematic maps of the quagmire to guide patients and doctors. The War on Cancer was “lost”—in both senses of the word.

This seminal transition from descriptive biology to the functional biology of cancer will provoke three new directions for cancer medicine.