Book Review - The Emperor of All Maladies: A Biography of Cancer

The Emperor of All Maladies: A Biography of Cancer

by Siddartha Mukherjee 

Fourth Estate: £9.99

Review by Dr Anne Parfitt-Rogers, FY1 doctor at Crosshouse Hospital, Kilmarnock

IN 2010, an estimated seven million people died of cancer worldwide, with countless more affected by the disease. As oncologist and professor Siddhartha Mukherjee writes, this is “a story that has to be told”.

The book opens with Carla Reed, a Massachusetts kindergarten teacher who, aged 30, is struck by an aggressive form of leukaemia. The story of her gruelling treatment is interwoven with an account of the complex history of the disease itself. From the Persian Queen Atossa, who ordered a servant to excise her breast tumour with a knife, the book describes advances in the understanding and treatment of cancer over the past 4,000 years.

Central to this history is the pioneering work of Dr Sidney Farber, who developed antifolate chemotherapy in the 1950s, and his collaboration with Mary Lasker, a philanthropic American who was instrumental in the creation of the National Cancer Institute. It also describes advances such as Doll and Hill’s landmark smoking study, the advent of mammography and the use of bone marrow transplantation to keep pace with an everevolving disease.

No book about cancer can dodge that big question – when will we find a cure? While no one can know for sure, Mukherjee is hopeful for the future, citing recent developments including gene therapy and vast improvements in multidisciplinary care.

An interview with the author gives a fascinating insight into the highs and lows of oncology, including the value of communication and the heartbreak of breaking bad news. Mukherjee describes the impact on his own life, from fitting the writing around evenings with family, to harvesting his daughter’s umbilical cells as a resource for leukaemia research.

And what of Carla’s story? In 1999, Mukherjee drove to her house with a bouquet of flowers to celebrate five years since her diagnosis – in oncology, almost tantamount to a cure – and asks how she survived the ordeal. “There was no choice,” she explains. “For someone who is sick, this is their new normal”.

This is a compelling, elegantly-written book which holds the reader’s attention and leaves you better informed about a wide variety of aspects within oncology. Primarily aimed at patients, it is easily readable, while still providing a significant amount of depth. For doctors, it will enhance your treatment of patients and enrich your view of medicine.