by Siddhartha Mukherjee, M.D., 2010
Fantastic book about the history of cancer. The hundreds of years of unnecessary, radical mastectomies, and the evilness of Big Tobacco stand out. Also, the futility of trying to cure cancer. There are only a few cancers for which we’ve discovered what might be termed cures: CML, Hodgkin’s, breast cancer which is positive for estrogen receptor and can be treated with tamoxifen, and/or Her-2 amplified and can be treated with Herceptin.
Here are some quotes, this first from the chapters on how smoking causes lung cancer: “It is difficult for me to convey the range and depth of devastation that I witnessed in the cancer wards that could be directly attributed to cigarette smoking….It remains an astonishing, disturbing fact that in America–a nation where nearly every new drug is subjected to rigorous scrutiny as a potential carcinogen, and even the bare hint of a substance’s link to cancer ignites a firestorm of public hysteria and media anxiety–one of the most potent and common carcinogens known to humans can be freely bought and sold at every corner store for a few dollars.”
On mammography, he quotes statistician, Donald Berry, who studies the results of mammography screenings in Malmo, Sweden: “‘Mammography, in short, was not going to be the unequivocal “savior” of all women with breast cancer. Its effects, as the statistician Donald Berry describes it, “are indisputable for a certain segment of women–but also indisputably modest in that segment.” Berry wrote, “Screening is a lottery. Any winnings are shared by the minority of women. . . . The overwhelming proportion of women experience no benefit and they pay with the time involved and the risks associated with screening. . . . The risk of not having a mammogram until after age 50 is about the same as riding a bicycle for 15 hours without a helmet.”‘ It does seem to reduce breast cancer mortality by 20 to 30 percent in women aged 55 to 70.
“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. Every last morsel of energy is spent tending the disease.”
Close to the last chapter, here is a defining quote: “Indeed, as the fraction of those affected by cancer creeps inexorably in some nations from one in four to one in three to one in two, cancer will, indeed, be the new normal–an inevitability. The question then will not be if we will encounter this immortal illness in our lives, but when.”
And Wayne quotes Joe Jackson’s song, “Everything gives you cancer; there’s no cure, there’s no answer.”
Excellent book – there were parts that I just had to skim over because my brain cannot make sense of it – the parts about chromosomes and genes – but other than those chapters, this book was very readable and very interesting.