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1.97k reviews for:
El Emperador de Todos Los Males / The Emperor of All Maladies: A Biography of Cancer
Siddharth Mukherjee
4.33 AVERAGE
1.97k reviews for:
El Emperador de Todos Los Males / The Emperor of All Maladies: A Biography of Cancer
Siddharth Mukherjee
4.33 AVERAGE
Bit of a slog for a layperson at times but very rewarding.
This is a great book. It's an adventure of cancer research history, a sadness story about how we have been fighting cancer for such a long time without medical cure for most of the cancer, and a hope...
I wish all of the cancer patients having a better life...
I wish all of the cancer patients having a better life...
Historical perspective on cancer and it's treatment modalities over the centuries. Slow read. Written in terms easily understood by a nonmedical individual. If the reader has a family history of cancer it helps to put a perspective on the treatments ( in time context) of family members.
challenging
hopeful
informative
medium-paced
informative
sad
tense
slow-paced
challenging
informative
inspiring
slow-paced
Learned a lot:
- Hippocrates named the disease “cancer” because he believed it looked like a crab the way the tumour had spread out with “legs”.
- Cancer was originally thought to have been linked with a black pus that needed to be released (but no one could find).
- Penicillin was so precious during WWII that it was red reacted from the urine of patients who had been treated with it.
- The concept of starving cancer cells was conceived in 1946 when folate supplements were found to accelerate cancer progression. As such, anti-folates were theorised.
- December 28, 1947: the first “chemotherapy” was used. An anti-folate that could plateau leukaemia cell proliferation.
- Radical mastectomies were common as early as the 1890s. And surgeons were competing to be the most radical. They would regularly cut out the pectoralis major and lymph nodes. An approach that was too aggressive for the early stages and not aggressive enough for those that had already metastasised.
- In contrast to the radical mastectomy, radical prostatectomies were much more meticulous (1904).
- Mustard gas’ propensity to completely eviscerate bone marrow led to its use as a cancer treatment. IV mustard was administered in 1942. Demonstrating that “all treatments are a poison in disguise”.
- Government expenditure shows where our priorities were: $231,000 USD on the Jimmy Fund (children’s cancer research). $100 million USD every month on the Manhattan Project.
- The concept of using multiple chemotherapy drugs was slammed for years for being barbaric. It wasn’t until 1959 that it was first trialled. It still took many more years before doctors would realise treatment was still required after symptoms were gone.
- Cancer staging didn’t get developed until the 1950s which is when doctors realised not all cancers were the same.
- Chemotherapy works well on cancer cells because it ceases proliferation. Because cancer cells proliferate faster than most normal cells, it affects them most.
- Identifying smoking as a powerful carcinogen was easy. It took years to convince the public, marking a significant argument between the medical community and marketing.
- Antifolates, such as Farber’s aminopterin, interrupt the metabolism of folic acid and starve all cells of a crucial nutrient required for cell division. Nitrogen mustard and cisplatin chemically react with DNA, and DNA-damaged cells cannot duplicate their genes and thus cannot divide. Vincristine, the periwinkle poison, thwarts the ability of a cell to construct the molecular “scaffold” required for all cells to divide.
Favourite quotes:
Dying, even more than death, defines the illness.
Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.
If we seek immortality, then so, too, in a rather perverse sense, does the cancer
For 3,000 years and more, this disease has been known to the medical profession. And for 3,000 years and more, humanity has been knocking at the door of the medical profession for a “cure.”
“When a doctor has to tell a patient that there is no specific remedy for his condition, [the patient] is apt to feel affronted, or to wonder whether the doctor is keeping abreast of the times.”
A patient, long before he becomes the subject of medical scrutiny, is, at first, simply a storyteller, a narrator of suffering—a traveler who has visited the kingdom of the ill.
Patients tell stories to describe illness; doctors tell stories to understand it.
- Hippocrates named the disease “cancer” because he believed it looked like a crab the way the tumour had spread out with “legs”.
- Cancer was originally thought to have been linked with a black pus that needed to be released (but no one could find).
- Penicillin was so precious during WWII that it was red reacted from the urine of patients who had been treated with it.
- The concept of starving cancer cells was conceived in 1946 when folate supplements were found to accelerate cancer progression. As such, anti-folates were theorised.
- December 28, 1947: the first “chemotherapy” was used. An anti-folate that could plateau leukaemia cell proliferation.
- Radical mastectomies were common as early as the 1890s. And surgeons were competing to be the most radical. They would regularly cut out the pectoralis major and lymph nodes. An approach that was too aggressive for the early stages and not aggressive enough for those that had already metastasised.
- In contrast to the radical mastectomy, radical prostatectomies were much more meticulous (1904).
- Mustard gas’ propensity to completely eviscerate bone marrow led to its use as a cancer treatment. IV mustard was administered in 1942. Demonstrating that “all treatments are a poison in disguise”.
- Government expenditure shows where our priorities were: $231,000 USD on the Jimmy Fund (children’s cancer research). $100 million USD every month on the Manhattan Project.
- The concept of using multiple chemotherapy drugs was slammed for years for being barbaric. It wasn’t until 1959 that it was first trialled. It still took many more years before doctors would realise treatment was still required after symptoms were gone.
- Cancer staging didn’t get developed until the 1950s which is when doctors realised not all cancers were the same.
- Chemotherapy works well on cancer cells because it ceases proliferation. Because cancer cells proliferate faster than most normal cells, it affects them most.
- Identifying smoking as a powerful carcinogen was easy. It took years to convince the public, marking a significant argument between the medical community and marketing.
- Antifolates, such as Farber’s aminopterin, interrupt the metabolism of folic acid and starve all cells of a crucial nutrient required for cell division. Nitrogen mustard and cisplatin chemically react with DNA, and DNA-damaged cells cannot duplicate their genes and thus cannot divide. Vincristine, the periwinkle poison, thwarts the ability of a cell to construct the molecular “scaffold” required for all cells to divide.
Favourite quotes:
Dying, even more than death, defines the illness.
Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.
If we seek immortality, then so, too, in a rather perverse sense, does the cancer
For 3,000 years and more, this disease has been known to the medical profession. And for 3,000 years and more, humanity has been knocking at the door of the medical profession for a “cure.”
“When a doctor has to tell a patient that there is no specific remedy for his condition, [the patient] is apt to feel affronted, or to wonder whether the doctor is keeping abreast of the times.”
A patient, long before he becomes the subject of medical scrutiny, is, at first, simply a storyteller, a narrator of suffering—a traveler who has visited the kingdom of the ill.
Patients tell stories to describe illness; doctors tell stories to understand it.
Highly enjoyable and greatly informative. I got engrossed in the chapters that talk about the history of cancer and how doctors struggled and eventually succeeded in finding cures for cancer. Got a bit bogged down in the parts that discuss the technicalities within the cell, but still enjoyable overall.
This is a thoroughly fascinating read. It is an in depth look into the history, science, and politics of medicine both as a a career and as therapy. It is a biography of our humanity through the lens or what might perhaps be the oldest disease that we have ever faced, Cancer. As such, it takes us through the fabric of who we are and what we can accomplish through tenacity, creativity, and a serendipitous confluence of seemingly disparate events.
informative
medium-paced
challenging
dark
emotional
hopeful
informative
reflective
slow-paced
I listened to this and while it took a while it definitely helped to envision the concepts discussed in the book. Overall extremely informative and felt not just a biography of Cancer, but a biography of humanity in a new lens.