Personal Review of “Emperor of All Maladies” by Siddhartha Mukherjee
Wow what a book…it took me several months to finish the behemoth of content laced in this book but was it well worth it! I think what really slowed the reading down for me was my school schedule, applications, and other life events that left me stumbled throughout late Summer and all of Autumn, but once Winter Break came around, I knew I had to finish this book! And I only finished it yesterday, which shows the thoroughness that the author accomplishes in providing a convenient and educational approach to learning about the history of cancer.
Well…it is not only about the history of cancer, even thought the author takes us on a sort of chronological journey through how the knowledge of cancer has progressed over generations. However, even the book does not illustrate how “old” cancer really is, as alluded to in the following link:
Usually, when thinking about medicine, we always strive to discuss the experiments, the updated research, the growing knowledge base that leaves experts talking at length at conferences for days, weeks, and months. However, this book illuminated one overlooked aspect of cancer, in its historical incidence of the phenomenon. Maybe we should strive to archaeologically inspect historical fossils, bones, and even other animals to illuminate even more research on how cancer may sprout? How did cancer spread about, was it concomitant with life’s origination? Over evolutionary processes that have protected even us across vast amounts of time, how come evolution has not selected against cancer over the years and wiped it clean from our existence? Is cancer immutable?
Recollecting all of the information in Siddhartha’s book, which can almost be read as an encyclopedia that may be referenced with time (and probably is at this point honestly) would be nearly impossible. As such, it probably is best to buy the book outright than to borrow it from a library. But almost everything in the book is useful knowledge to anyone; pinpointing some risk factors, intriguing stories about scientific discoveries, and the cellular genesis of such pathology leads one to an unnerving truth that plagues many patients that must endure this malady. Many times, during the review of this book was I shaking my head, wincing at the horrors that one may go through if one ever has the misfortune for contracting such a condition.
Ultimately, the message is sound and clear. As a physician, the main takeaway for how we should approach cancer pathology is three-fold: Screening, prevention, and treatment:
Screening allows one to see if there is growth, and early detection is the best way for us to prevent or set up treatment methods to hopefully come up with a complete cure, or to extend a patient’s remission. As such, take screening seriously. Mammograms are recommended for women above 40 (and maybe prior), colonoscopies are recommended almost every 10 years, and the usual X-rays or CT scans can provide important information about abnormal bone growth or progenitor tumors. Hopefully, screening methods will be improved in the coming years to not only pinpoint the earliest potential tumor growth that is occurring, but also to provide even more enhanced resolution and even predictive models to follow metastases or dimensional values.
Prevention, as popularly described on current cigarette packs now, provides one the opportunity to decrease the amount of potential risk from environmental carcinogens. HIV, another cancer-causing agent, may be reduced by practicing safe-sex or by not sharing needles that could be contaminated by someone else’s blood. More examples are present, and surely more are to follow with time.
As for treatment, admittedly the most intriguing aspect of cancer for me, the book details the history from Imhotep describing what may have been one of the first ever conscriptions detailing breast cancer that led to mastectomy to current methods of chemotherapy, radiation therapy, and/or combination drugs. However, I had no idea how many trials of combination therapies was attempted to cure one ailment, for example. Many conditions require more than one single medication, or more than just a zap of radiation therapy to the affected area. The book homes in on all the trials, the years, and in some cases decades, to only stave off remission for afflicted patients that can even range to as young as toddlers. Not knowing much about ALL (Acute lymphoid leukemia), which implicates young patients that have dysfunctional bone marrows that can lead to abnormal blood cells. The explanation of the mechanism in the book of how ALL manifests is as dreary as one would expect. Many do not make it past the treatment stage, and if they do, not without the side effects that come with the treatments and the lost amount of time from their lives. That will resonate with me personally more than many other things, as this provides some purpose for continuing to study subjects such as these.
Accordingly, this has also elucidated many of the failures that have preceded successes. While inevitable, this may serve as a hallmark for further hopes to improve the oncological field. There is no “one size fits all approach,” every pathological condition manifests seemingly randomly, quickly, and tragically. Frankly, I feel lucky to have come across this book, as it really does make one fearful of such a malady. I suggest it to those who are willing to stomach some of the potential phenomena that one may contract, due to increased understanding and awareness of the importance of screening and prevention, as well as the respect given towards those that may be struggling with such a despairing situation.