Saturday, January 29, 2011

The Emperor of All Maladies; Siddhartha Mukherjee

 Title: The Emperor of All Maladies: A Biography of Cancer
Author: Siddhartha Mukherjee
Publication Year: 2010
Publisher: Scribner
Edition: eBook/Kindle
Source: Purchase
Date Completed: 1/27/2011
Setting: n/a
Rating: 5/5 stars
Recommend: Yes 
"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

ABOUT THE AUTHOR - 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 Republic. He lives in New York with his wife and daughters. 


  1. I have this one checked out from the library right looks so interesting, but I am thinking it is probably not a fast read.

  2. I'm not really a non-fiction reader, but this is one of the books that I would like to read this year. Thanks for the review!

  3. I'm not much of a non-fiction reader, but this one sounds like something I might like. Do you know if it is available in audio?

  4. I'm so glad I saw your review of this one...I like to read non-fiction, and had thought about picking this one up, but I was afraid that it would be too dry -- just what you say it is not :)
    Thanks so much for this informative overview!

  5. I'm about halfway through this fascinating book and agree completely with you. Tina, it's not a fast read, because of its length, but I have found myself continuing to read when I normally would have put the book down to go on to something else, so I will have plenty of time to finish before it's due back at the library. Annie

  6. A friend who is a doctor recommended this book to me recently - so I'm glad to see it gets a good review. I did add it to my Amazon wishlist, but it'll be a while before I get hold of a copy.

  7. I am glad to see you liked this one so much, Diane. I've been wondering about it and debating whether to read it myself. It's definitely a topic that interests me.

  8. Tina, it took me about 2.5 weeks to read, everyday (m-f) at lunch for about 30-40 min. I was never bored. It is the kind of info you want to read slow so it will sink in.

  9. I keep dancing around this one but you have pushed me a little closer. So much of the disease in my family that I think fear keeps me away.

  10. This really sounds fascinating! I'm hoping to read a little more non-fiction this year, so I'm on the lookout for engaging non-fiction. Sounds like this one fits the bill!

  11. I am listening to this on audio while biking right now, and I am loving it! It is the only book I have read about cancer, and I am finding that it is not as frightening as some of the other cancer books out there. I like the fact that the material is so factual and so well defined, and I am actually learning a lot. My step-father and a few close friends are dealing with cancer right now, and it is really helping me feel empowered having all this information at my disposal. I am glad you liked it so much!

  12. I didn't realize the book was quite the chunkster but I do want to read this one. I first heard about it on NPR and just thought it sounded so fascinating. Cancer has touched my family's life and I think it's one of the most scariest things I can think of. All the sadness and grief it causes so many people.

  13. I am reading this right now. Just got to the part about the "selective" poison and it is really an interesting concept. It's like trying to renovate your bathroom... using a bomb.

  14. Kay, yes this book is available in audio and I heard it is excellent in audio as well.

    Fantaghiro23, BookGirl, and Erin, even if you do not read much non fiction, I think you might enjoy this book. I believe knowledge is power, and cancer being such a scary disease, I feel like the more I know the better prepared I am should it strike my family again, (or me).

    Annie, Carin and Heather, I am glad to hear that you are enjoying this book as well. It was so fascinating IMO.

    Tracy, Wendy, Frances and Iliana, I wholeheartedly recommend trying this book. I did not find it to be the least bit intimidating, just so very informative.

  15. I have an ARC of this one...I really need to get over the length and just read it!

  16. I've heard such good things about this book ... yet part of me can't IMAGINE how it would read. I guess I just need to find out for myself.

  17. Sounds like a great book. The NY Times book podcast featured an interview with the author last week. He was fascinating and had a good sense of humor. Thanks for the review!


  18. I really want to read this one and have already had it on my list. Wow, some of those statistics are staggering!

  19. I did not find it to be the least bit intimidating, just so very informative.
    I'm not worried about being intimidated, Diane,(I read a huge number of non-fiction books, most science-based, and I read some pretty hefty tomes too - I've recently finished both Anna Karenina and Wolf Hall), it's a question of facing my fears - my dad died of cancer. And your right, the best way to conquer that fear is to be fully-informed - ignorance does no-one any good (which is partly why my medical friend recommended it to me, plus her taste in books is very similar to yours :))

  20. This book is very well written and highly informative. By the time I finished I had a much better understanding of what cancer is and why it is treated the way it is. The author does this by tracing the long history of cancer and cancer research up to the modern day. I highly recommend this book to anyone that wants to learn more about cancer or just enjoys science related books.


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