The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee

Mukherjee is a cancer physician and interlaces his own experiences with patients with the history of cancer.  He does a thorough job tracing back its earliest diagnosis and follows doctors through the ages as they learn to identify and name this Emperor of All Maladies.  His descriptions of the different cases and attempts at doctors to save people from cancer read like a suspense novel.

One becomes drawn into the lives that these doctors try to save.  Some interesting facts emerge:  at first physicians did not understand that there could be environmental reasons for cancer and that cancers come from the development of lesions in the body.  

Doctors started to understand this in the 19th century when young boys hired as chimney sweeps in England began developing lesions on their bodies, particularly their scrotal sacks after they hit puberty.  The parts of the body infected were the parts that developed sores from the constant rubbing from traveling up and down chimneys and then became infected with soot.

It took a particularly long time for people to connect smoking with lung cancer.  This seems common sense to us today, but  back then they hardly knew what cancer was and practically everyone smoked, but not everyone developed cancer, so the cause and effect was not immediately obvious.

Mukherjee devotes a large portion of his book giving us the history of the battle between tobacco companies and victims of lung cancer.  It seems the big bad company against the little person is a safe target to vilify.  Too bad he wasn't as forthright about the connection between Sexually Transmitted Diseases and cervical cancer or that HPV is closely associated with anal cancer.  He gives those facts barely a nod while not even including the growing evidence suggesting that abortion increases risk of breast cancer.  I guess we need to make sure we only attack the people it's fashionable to attack rather than informing the populace about  unpopular preventative health measures.  He is, after all, trying to sell a book.

What was most informative was how cancer develops in the body.  The body is amazingly resilient to foreign bodies and even has a back up system when a lesion develops.  He gives an example of someone who inhaled asbestos in their youth.  This would cause a lesion in the lung, but not cancer because the immune system with its back up would only lose one "fighter"against the lesion.  (there's a medical term but I'll say fighter for convenience) 

But say the person also smoked for many years.  This would produce another lesion and attack the back up defense.  Now the body is out of fighters, hence the development of rapidly growing radicals because there is now nothing to stop it.

Mukherjee takes us along with the doctors who, through hit and miss, and countless trials finally came up with the idea of chemical warfare against free radicals as well as radiation.  He describes how these various procedures work.  This is a huge improvement from the radical surgery that doctors employed at the turn of the last century.  Surgeons would cut away almost half a person's body in order to eradicate the cancer.

What they found out was that surgery actually caused the cancer to spread by creating more lesions.

The entire book, while being non fiction, is written in a highly engaging style and is a fascinating look at a malady that has surely affected every one of us at one time or another.