Book Review #38
Over the past 2 months, I read a very serious book on Cancer titled "The Emperor of All Maladies". Siddhartha Mukherjee attempts to answer questions like How old is cancer? Where are we in our war on cancer? Can this war even be won? Here are my learnings from this mammoth volume
- Cancer is not a modern disease. Autopsies on 1000 year old mummified bodies have shown bone tumor (osteosarcoma) and 2 million year old jaw bones show signs of lymphoma.
- Cancer comes from 'karkinos', the Greek word for “crab.” The tumor, with its swollen blood vessels around it reminded Hippocrates of a crab. 'Onkos' or tumor means a mass or a load - oncology comes from this word.
- Cancer is an age-related disease. Civilization did not cause cancer, but by extending human life spans—civilization unveiled it.
- Cancer is caused by uncontrolled growth of a single cell unleashed by mutations/changes in DNA . 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. Mutations in cancer genes accumulate with aging; cancer is thus intrinsically related to age.
- The foundational work on cancer was done by German pathologist Rudolf Virchow. He stumbled upon pathological hyperplasia—cancer, uncontrolled growth of cells, looking at cancerous growths through his microscope. Uncontrolled cell division created masses of tissue (tumors) that invaded organs and destroyed normal tissues. Tumors also spread from one site to another—metastasing—in distant sites, like the bones, brain, or lungs.
- Sidney Farber is the father of modern chemotherapy and in 1947 he used aminopterin discovered by Yellapragada Subbarow to induce remissions among children with leukemia. Before chemotherapy, doctors had only two strategies: excising the tumor surgically or incinerating it with radiation (Curie's radium). Just imagine antisepsis and anesthesia were only discovered around 1846.
- Mary Lasker and her group of activists (Laskerites) started the war against cancer, lobbied to get the 1971 US National Cancer Act passed. This has led us to a better understanding of cancer in the next 4 decades. Proto-oncogenes and tumor suppressors are the molecular pivots of the cell. They are the gatekeepers of cell division. Gene by gene, pathway by pathway, we now understand the biology of cancer. Complete maps of mutations in many tumor types will soon be complete, and the core pathways fully defined
- Early detection and Prevention are also major strategies in the war against cancer
- Even the discovery of major oncology drugs like Herceptin, Gleevec were providential and went through major activism and overcoming internal challenges before their commercial success. The war on cancer is far from over but we have made huge strides.
The book is an essential read for anyone wanting to understand this killer disease
#bookreview #oncology
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