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The Emperor of All Maladies
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The Emperor of All Maladies (2010) (edit title/settings)

A Biography of Cancer

by Siddhartha Mukherjee (Author) (edit contributors)

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The Emperor of All Maladies is a magnificently written "biography" of cancer--from its origins to the epic battle to cure, control, and conquer it.

Summary edit see section history

This book tells the story of cancer through advances in therapies. It provides poignant accounts of various cancer-related events and portraits of the people involved in them. The book begins with how cancer was identified as a disease and our understanding of the disease in an era when we... read more (warning: may contain spoilers)

This book tells the story of cancer through advances in therapies. It provides poignant accounts of various cancer-related events and portraits of the people involved in them. The book begins with how cancer was identified as a disease and our understanding of the disease in an era when we knew so little about the workings of the body. As the story of cancer develops, we also learn about curious advances in other aspects of science and society. It is interesting to follow how seemingly irrelevant discoveries are linked to cancer research. With advances in medicine, the book describes how some of the currently used cancer therapeutics were discovered and how they affect cancer in simple to understand terms. Throughout the book, the author grabs the readers' attention by portraying the passion of cancer researcher to find a cure and the struggles of cancer patients.

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  • “Cell division allows us as organisms to grow, to adapt, to recover, to repair—to live.”
  • “It was a project born of frustration. Virchow entered medicine in the early 1840s, when nearly every disease was attributed to the workings of some invisible force: miasmas, neuroses, bad humors, and hysterias.”
  • “Science begins with counting. To understand a phenomenon, a scientist must first describe it; to describe it objectively, he must first measure it.”
  • “Single-celled organisms such as bacteria would reveal the workings of massive, multicellular animals such as humans. What is true for E. coli <a microscopic bacterium>, the French biochemist Jacques Monod would grandly declare in 1954, must also be true for elephants.”
  • “Cancer is an expansionist disease; it invades through tissues, sets up colonies in hostile landscapes, seeking “sanctuary” in one organ and then immigrating to another. It lives desperately, inventively, fiercely, territorially, cannily, and defensively—at times, as if teaching us how to survive.”
  • “Perhaps there is only one cardinal sin: impatience. Because of impatience we were driven out of Paradise, because of impatience we cannot return.”
    Franz Kafka
  • “Basic research is the pacemaker of technological progress. In the nineteenth century, Yankee mechanical ingenuity, building largely upon the basic discoveries of European scientists, could greatly advance the technical arts. Now the situation is different. A nation which depends upon others for its new basic scientific knowledge will be slow in its industrial progress and weak in its competitive position in world trade, regardless of its mechanical skill.””
  • “A model is a lie that helps you see the truth.”
    Howard Skipper
  • “She lost sleep, her hair, and her appetite and then something more important and ineffable—her animus, her drive, her will.”
  • “Religious movements and cults are often founded on a tetrad of elements: a prophet, a prophecy, a book, and a revelation.”
  • “How many of us have asked the question, ‘If this great country of ours can put a man on the moon why can’t we find a cure for cancer?’””
  • “In science, ideology tends to corrupt; absolute ideology, <corrupts> absolutely.”
  • “To enter the ward was to acquire automatic citizenship—as Susan Sontag might have put it—into the kingdom of the ill.”
    Susan Sontag
  • “It is said that if you know your enemies and know yourself, you will not be imperiled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your enemies nor yourself, you will be imperiled in every single battle.”
    Sun-Tzu
  • “As Cairns had already pointed out, the only intervention ever known to reduce the aggregate mortality for a disease—any disease—at a population level was prevention.”
    Cairns
  • “Terry had thus spent his childhood in the penumbra of tobacco and his academic life in the penumbra of cancer.”
  • ““Multinational cigarette companies act as a vector that spreads disease and death throughout the world. This is largely because the tobacco industry uses its wealth to influence politicians to create a favourable environment to promote smoking. The industry does so by minimising restrictions on advertising and promotion and by preventing effective public policies for tobacco control such as high taxes, strong graphic warning labels on packets, smoke-free workplaces and public places, aggressive countermarketing media campaigns, and advertising bans. Unlike mosquitoes, another vector of worldwide disease, the tobacco companies quickly transfer the information and strategies they learn in one part of the world to others.””
  • “Cancer therapy is like beating the dog with a stick to get rid of his fleas. —, Let Me Down Easy”
    Anna Deavere Smith
  • “I do not wish to achieve immortality through my works. I wish to achieve immortality by not dying.”
    Woody Allen
  • “Cancer is not a concentration camp, but it shares the quality of annihilation: it negates the possibility of life outside and beyond itself; it subsumes all living. The daily life of a patient becomes so intensely preoccupied with his or her illness that the world fades away.”
  • ““Death in old age is inevitable, but death before old age is not.””
  • ““There are far more good historians than there are good prophets,””
  • “"Incremental advances can add up to transformative changes."”
  • “"Src thus forcibly induced a cell to change its state from nondividing to dividing, ultimately inducing accelerated mitosis, the hallmark of cancer." pg. 359”
  • “"In genetic terms, our cells were not sitting on the edge of of the abyss of cancer. They were dragged toward that abyss in graded, discrete steps." pg. 386.”
  • “"Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of our ourselves." pg. 388”
  • “This strategy—which cost Min Chiu Li his job—resulted in the first chemotherapeutic cure of cancer in adults.”
  • Popular Highlights from Kindle Customers
  • civilization did not cause cancer, but by extending human life spans—civilization unveiled it.
    Highlighted by 201 Kindle customers
  • Cancer, we now know, is a disease caused by the uncontrolled growth of a single cell. This growth is unleashed by mutations—changes in DNA that specifically affect genes that incite unlimited cell growth. In a normal cell, powerful genetic circuits regulate cell division and cell death. In a cancer cell, these circuits have been broken, unleashing a cell that cannot stop growing.
    Highlighted by 180 Kindle customers
  • Cancer cells grow faster, adapt better. They are more perfect versions of ourselves.
    Highlighted by 156 Kindle customers
  • Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves.
    Highlighted by 153 Kindle customers
  • Cancer is an expansionist disease; it invades through tissues, sets up colonies in hostile landscapes, seeking “sanctuary” in one organ and then immigrating to another. It lives desperately, inventively, fiercely, territorially, cannily, and defensively—at times, as if teaching us how to survive. To confront cancer is to encounter a parallel species, one perhaps more adapted to survival than even we are.
    Highlighted by 125 Kindle customers
  • Cancer thus exploits the fundamental logic of evolution unlike any other illness. If we, as a species, are the ultimate product of Darwinian selection, then so, too, is this incredible disease that lurks inside us.
    Highlighted by 117 Kindle customers
  • 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. —Voltaire
    Highlighted by 114 Kindle customers
  • “In God we trust,” he brusquely told a journalist. “All others [must] have data.”
    Highlighted by 106 Kindle customers
  • Cancer is built into our genomes: the genes that unmoor normal cell division are not foreign to our bodies, but rather mutated, distorted versions of the very genes that perform vital cellular functions. And cancer is imprinted in our society: as we extend our life span as a species, we inevitably unleash malignant growth (mutations in cancer genes accumulate with aging; cancer is thus intrinsically related to age). If we seek immortality, then so, too, in a rather perverse sense, does the cancer cell.
    Highlighted by 88 Kindle customers
  • This second version of the disease, called acute leukemia, came in two further subtypes, based on the type of cancer cell involved. Normal white cells in the blood can be broadly divided into two types of cells—myeloid cells or lymphoid cells. Acute myeloid leukemia (AML) was a cancer of the myeloid cells. Acute lymphoblastic leukemia (ALL) was cancer of immature lymphoid cells. (Cancers of more mature lymphoid cells are called lymphomas.)
    Highlighted by 84 Kindle customers
Show all 37 quotes from this book

First Sentence edit see section history

This book is a history of cancer.

Table of Contents edit see section history

Author's Note

Prologue

Part One: "Of blacke cholor, without boyling"
Part Two: An Impatient War
Part Three: "Will you turn me out if I don't get better?"
Part Four: Prevention is the Cure
Part Five: "A Distorted Version of Our Normal Selves"
Part Six: The Fruits of Long Endeavors
Atossa's War

Acknowledgements
Notes
Glossary
Selected Bibliography
Photograph Credits
Index

Glossary edit see section history

  • Acute lymphoblastic leukemia: a variant of white blood cell cancer that affects the lymphoid lineage of blood cells
  • Acute myeloid leukemia: a variant of white blood cell cancer that affects the myeloid lineage of blood cells
  • Apoptosis: the regulated process of cell death hat occurs in most cells, involving specific cascades of genes and proteins
  • Carcinogen: a cancer-causing or cancer-inducing agent
  • Chimeric gene: A gene created by the mixing together of two genes. A chimeric gene might be the product of a natural translocation, or might be engineered in the lab.
  • Chromosome: a structure within a cell comprised of DNA and proteins that stores genetic information
  • Cytotoxic: Cell-killing. Usually refers to chemotherapy that works by killing cells, particularly rapidly dividing cells.
  • DNA: Deoxyribonucleic acid, a chemical that carries genetic information in all cellular organisms. It is usually present in the cell as two paired, complementary strands. Each strand is a chemical chain made up of four chemical units - abbreviated A, C, T, and G. Genes are carried in the form of a genetic "code" in the strand and the sequence is converted (transcribed) into RNA and then translated into proteins.
  • Enzyme: a protein that accelerates a biochemical reaction
  • Gene: a unit of inheritance, normally comprised of a stretch of DNA that codes for a protein or for an RNA chain (in special cases, genes might be carried in the RNA form)
  • Genetic engineering: the capacity to manipulate genes in organisms to create new genes, or introduce genes into heterologous organisms (e.g. a human gene in a bacterial cell)
  • Genome: the full complement of all genes within the organism
  • Incidence: In epidemiology, the number (or fraction) of patients who are diagnosed with a disease in a given period of time. It differs from prevalence because incidence reflects the rate of new diagnosis.
  • Kinase: a protein enzyme that attaches phosphate groups to other proteins
  • Metastatic: cancer that has spread beyond its local site of origin
  • Mitosis: the division of one cell to from two cells that occurs in most adult tissues of the body (as opposed to meiosis, which generates germ cells in the ovary and the testes)
  • Mutation: An alteration in the chemical structure of DNA. Mutations can be silent - i.e., the change might not affect any function of the organism - or can result in a change in the function or structure of an organism.
  • Neoplasm, neoplasia: an alternative name for cancer
  • Oncogene: A cancer-causing or cancer-promoting gene. Activation or overexpression of a proto-oncogene (see below) promotes the transformation of a cell from normal to a cancer cell.
  • Prevalence: in epidemiology, the number (or fraction) of affected patients in any given period of time.
  • Primary prevention: prevention aimed at avoiding the development of a disease, typically by attacking the cause of the disease.
  • Prospective trial: a trial in which a cohort of patients is followed forward in time (as opposed as retrospective, in which a cohort of patients is followed backward).
  • Protein: A chemical comprised, at its core, of a chain of amino acids that is created when a gene is translated. Proteins carry out the bulk of cellular functions, including relaying signals, providing structural support, and accelerating biochemical reactions. Genes usually "work" by providing the blueprint for proteins (see DNA). Proteins can be modified chemically by the addition of small chemicals such as phosphates or sugars or lipids.
  • Proto-oncogene: A precursor to an oncogene. Typically, proto-oncogenes are normal cellular genes that, when activated by mutation or overexpression, promote cancer. Proto-oncogenes typically code for proteins that are associated with cell growth and differentiation. Examples of proto-oncogenes include ras and myc.
  • Randomized trial: a trial in which treatment and control groups are randomly assigned.
  • Retrovirus: an RNA virus that keeps its genes in the form of RNA and is capable, by virtue of an enzyme, reverse transcriptase, to convert its genes from the RNA form into a DNA form.
  • Reverse transcriptase: An enzyme that converts a chain of RNA into a chain of DNA. Reverse transcription is a property of retroviruses.
  • RNA: Ribonucleic acid, a chemical that performs several functions in the cells, including acting as an "intermediate" message for a gene to become a protein. Certain viruses also use RNA, not DNA, to maintain their genes (see Retrovirus, above).
  • Secondary prevention: Prevention strategies that are aimed at early detection of a disease, typically by screening asymptomatic men and women. Typically, secondary prevention strategies attack early, pre-symptomatic stages of the disease.
  • Transfection: the introduction of DNA into a cell.
  • Transgenic mice: mice in which a genetic change has been artificially introduced.
  • Translocation (of a gene): the physical reattachment of a gene from one chromosome to another.
  • Tumor suppressor gene (also called anti-oncogene): A gene that, when inactivated fully, promotes the progression of a cell into a cancer cell. Tumor suppressors usually protect a cell from one step on the progression toward cancer. When this gene is mutated to cause a loss or reduction in its function, the cell can progress to cancer. Typically, this occurs in combination with other genetic changes.
  • Two-hit hypothesis: the notion that for tumor suppressor genes, both functionally intact copies of the gene must be inactivated in order for a cell to progress toward cancer.
  • Virus: A microorganism that is incapable of reproducing by itself, but capable of creating progeny once it has infected a cell. Viruses come in diverse forms, including DNA viruses and RNA viruses. Viruses possess a core of either DNA or RNA, coated with proteins, and can be bound by an outer membrane made of lipids and proteins.
Show all 35 glossary entries

Series & Lists edit see section history

This book is in New York Times 10 Best Books of 2010. (authoritative list)
This book is in TIME Magazine's All-TIME 100 Best Nonfiction Books. (authoritative list)
This book is in Time Magazine's Top 10 Nonfiction Books of 2010. (authoritative list)

Authors & Contributors edit see section history

  1. Siddhartha Mukherjee (Author)

First Edition edit see section history

Original Language: English
Publisher: Scribner (Simon & Schuster)
Country: United States of America
Publication Date: November 16, 2010
ISBN: 978-1439107959
Page Count: 592

Awards edit see section history

Classification edit see section history

Notes for Parents edit see section history

Reading Level: Young Adults

Contains vivid descriptions of diseases and deaths.

Links to Supplemental Material edit see section history

More Books Like This edit see section history

   
  • A Brief History of Disease, Science and Medicine
  • Blood and Guts: A History of Surgery

Books with Additional Background Information edit see section history

   
  • Illness as Metaphor and AIDS and Its Metaphors
  • The Making of the Atomic Bomb
  • Cancer Crusade: The Story of the National Cancer Act of 1971
  • The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America
  • Natural Obsessions
  • The Lives of a Cell
  • The Way It Was: Sex, Surgery, Treasure, and Travel, 1907-1987
  • ONE IN THREE: A SON'S JOURNEY INTO THE SCIENCE AND HISTORY OF CANCER
  • Cancer Ward
  • Swimming in a Sea of Death: A Son's Memoir

Books Cited by This Book edit see section history

   
  • Cancer Ward
  • The Lives of a Cell
  • Illness as Metaphor
  • Hamlet
  • Siege of Cancer
  • The Hunting of the Snark
  • The Histories
  • A Study in Scarlet
  • Cautionary Tales for Children
  • In Sickness and in Wealth: American Hospitals in the Twentieth Century
  • Illness as Metaphor and AIDS and Its Metaphors
  • Full House
  • The Bible (King James Version)
  • The Anatomy of Melancholy
  • Beowulf
  • Invisible Cities
  • The Making of the Atomic Bomb
  • Cancer Crusade: The Story of the National Cancer Act of 1971
  • The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America
  • Natural Obsessions
  • The Way It Was: Sex, Surgery, Treasure, and Travel, 1907-1987
  • One in Three: A Son's Journey into the History and Science of Cancer
  • Swimming in a Sea of Death: A Son's Memoir
  • Her-2: The Making of Herceptin, a Revolutionary Treatment for Breast Cancer
  • Racing To The Beginning Of The Road: The Search for the Origin of Cancer
  • The Art and Politics of Science
  • How to Win the Nobel Prize: An Unexpected Life in Science (The Jerusalem-Harvard Lectures)
  • The Cancer Treatment Revolution: How Smart Drugs and Other New Therapies are Renewing Our Hope and Changing the Face of Medicine
  • The Dread Disease
  • Postwar

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