"The Emperor of All Maladies: A Biography of Cancer" is a medical masterpiece written by oncologist Siddhartha Mukherjee, a researcher and clinician who describes in Pulitzer Prize-winning detail the history of cancer from its earliest recognition thousands of years ago to the present.
There was a widespread belief in the second half of the 20th century that cures for all cancers were a possibility. This occurred thanks to the remarkable ingenuity and bravery of basic scientists and clinicians.
The advent of anesthesia made radical surgery to totally remove cancer from the body possible. The discoveries that poisonous compounds were able to kill cancer cells made medical treatment a reality.
And while irradiation and excessive X-rays led to death and suffering, appropriate harnessing of this powerful tool created yet another approach to directly target and kill cancer cells. Early efforts at treating leukemia in children and Hodgkin's disease led to the disappearance of the cancer and eventual cures for some patients.
Spurred by these early successes, savvy and astute scientists, entrepreneurs and philanthropists formed the American Cancer Society.
The organization used marketing and lobbying skills to increase public awareness of cancer, creating hope that a cure for all cancers was possible and persuading Congress to declare a war on this disease by investing huge sums of money focused on eradicating cancer once and for all.
This frontal attack led to great advances in our understanding of cancer and medical treatments. However, this knowledge has come at a price. Many patients suffered greatly when exposed to surgical and medical treatments that were truly brutal and often futile.
For a long time, there was a strong belief that the only way to cure common cancers (lung, colon and breast) was to become even more aggressive therapeutically. More and more drugs were given that led to total destruction of bone marrow, severe infections, bleeding, nausea and numerous other symptoms.
Death was prevented by keeping patients in totally sterile environments and by bone marrow transplants that eventually allowed the patient to recover.
During this time, desperate patients demanded ever more aggressive treatment in the hope for a cure. A whole industry developed around this approach to care, and sadly, the effort was fueled by the rare but unscrupulous clinical scientist who reported amazing results that later turned out to be false.
The most egregious was by a South African clinician who falsely reported that aggressive treatment cured most women with widespread breast cancer. For most cancers, this approach failed, but for others (leukemia, lymphoma, multiple myeloma) the benefits are significant.
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