People in the past tended to die of other diseases (and in poorer countries, still do), but as our longevity increases so does the incidence of cancer. As we extend our lives, Mukherjee writes, ‘we inevitably unleash malignant growth’. But what is cancer, how can we understand and treat it?
In this book, which I first read a couple of years ago, Siddhartha Mukherjee writes of the first documented appearances of cancer thousands of years ago, of the Persian Queen Atossa (550-475 BCE) who has surgery for a bleeding lump in her breast (as recorded by Herodotus in ‘The Histories’), of primitive radiation and chemotherapy treatments in the nineteenth century, of the new treatments available to patients now.
In addition to discussing treatments (and some of us will remember those who had endured the Halsted radical mastectomy for breast cancer) Dr Mukherjee examines the aetiology and pathology of cancer, and some of those who’ve been involved in the quest for understanding and answers. Our co-existence with cancer over the past five thousand years or so has not been passive: physicians, surgeons and scientists have all sought to understand and hoped to conquer the disease. Dr Mukherjee recounts discoveries and setbacks, deaths and victories. Understanding the journey brings the reader in contact with both the best and worst of humanity: dedicated and obsessive; ingenious and resilient; hubristic and inflexible; arrogant and detached.
‘Cancer, we have discovered, is stitched into our genome.’
Although the topic of cancer is uncomfortable and difficult, Dr Mukherjee has presented a very readable history of the disease and of progress in combatting it. Some of this progress is too late for family and friends who’ve already succumbed to death as a consequence of cancer, but is helping many people now and will (presumably) help more in the future. There’s hope in this book: that a better understanding of disease processes will lead to better health outcomes.
If there is a war against cancer, what will be our measure of victory? What constitutes a cure?
‘This war on cancer may best be ‘won’ by redefining victory.’
Both my parents and a number of friends have died of cancer in the past four years, and other friends are fighting their own battles. I’ve revisited this book recently, to remind myself that there has been great progress, and there is hope.