The Emperor of all maladies by Siddhartha Mukherjee

Siddhartha Mukherjee has to be the best chronicler of our times. The poignancy and the precision with which he tells this incredible ‘biography’ of cancer is something to die for. The only alter ego of cancer was verily seen to be only death. Either people died of the disease or its cure! Cancer made both doctors and patients lose their patience. This book is a silent tribute to all the people who have contributed their share (and in some cases their lives) in the human race’s fight against cancer. Cytologists, epidemiologists, oncologists, scientists, philanthropists, anthropologists, lobbyists, socialites et al.
Cancer is a vague term given to contain a disease which has manifested itself in innumerable facets. There are hardly any organs or parts of the human body which remain not at risk of cancer. It is but pathological mitosis. A mutated cell (and hence abnormal) giving rise to a volley of other mutated cells which gives rise to more mutated cells ad infinitum. Is it some virus? Is it some external chemical? Or is it some agent in the cell? These might turn out to be mere descriptions given by scientists from a long time. Blinded by incomplete knowledge, they were trying to describe the same elephant! And boy did it take time to understand the true chemical and genetic nature of cancer.
Cancer has come a long way. From a disease which was not at all known to humankind to the most dreaded malaise. Cancer is, in no simpler terms to describe, the emperor of all maladies. Great philanthropists and lobbyists have time and again set a crusade against it, taking the governments and the medicine world by storm. The amount of work and frustration which social workers and lobbyists had to go thru just to gather the right amount of money and support to spread awareness against cancer and start a crusade against it is humongous.
I am reminded of the first attempts where awareness ads against breast cancer were turned down as they could not print both the words ‘breast’ and ‘cancer’. Radical Mastectomy or the surgical removal of breasts (and indeed the lymph nodes till the rib cage as was earlier done) was the sole desperate attempt to eliminate breast cancer initially. Not to mention, after a century of this ‘treatment’, the medical world finally concluded that radical mastectomy was but futile! Exasperation at its best!
Talking about exasperation, we still have carcinogens so easily accessible that it’s not surprising if we still hear of lung cancer- Cigarettes and their nicotine! There was a time when an average American person (irrespective of gender) smoked up to 12 cigarettes a day. Thanks to cigarette barons trying to flood the psyche of the public with ads of smoking and hence making it a part of the milieu. The consumers just couldn’t see how smoking, which was so much a part of their lives, could be a stealthy cause to a life taking condition. What was a pass time or a habit was going to turn around as a vice, right under their noses. It took a mammoth task for social workers and litigators to finally get a hold on the cigarette ads and bring down the consumption of the most fashionable carcinogen in the history of the world.
At the start, research wise, cancer was seen as a manifestation of ‘black bile’. Then came a time when scientists and doctors started to ‘backtrack’ starting from the cancer to its possible cause and as a corollary to the remote probability of a cure. After a century of maneuvering thru dark alleys which offered very few possibilities, light was seen at the end of the tunnel. Central dogma of molecular biology!
The biography of cancer is incomplete without a mention of chemotherapy! The first chemicals which were used in medical experiments were but dyes. It took many a failed experiments and a sea of serendipities for dyes to be recognized and used as drugs in treatment for diseases. With the possibility of a drug (or a concoction of several of them) being used as a sure cure for cancer, several patients were used as guinea pigs for a hosts of drugs. I can’t forget the vivid images of patients who, under the adverse effects of the experimental drugs, walked the corridors of the hospitals as zombies at night. Radiotherapy came to be used with or without chemotherapy too. It is to be remembered here that X-rays themselves are carcinogenic. Madam Curie who discovered Radium, herself, died of leukemia! So even if cancer didn’t kill you, the ‘treatment’ might as well. In all these uncertainty, there came (and very aptly) the need of a place for the terminally ill. A hospice where the condition of the patients are respected and they are provided palliative treatment and care.
The crusade against cancer is incomplete without a mention of its victims! These are also the people who have lent their support in the many formal and informal studies and experiments conducted by scientists and doctors under tremendous pressure. Indeed, here is a story of people and their families and loved ones; their resilience, perseverance and the human will to survive.