‘The Emperor of all Maladies’ by Siddhartha Mukherjee

With cases of cancer rising due to various factors such as increased life expectancy and better detection techniques, it has become a major concern in today’s medical practice and for the public. As a highly recommended book, due to the extra time on my hands and because of my genuine interest in wanting to understand the origin of cancer and its progress through time, this book was an ideal read.

It was so useful to have picked up a book and fulfill my understanding of cancer through a piece whereby the author had amalgamated all the research for you; tracking the history of cancer from its humble beginnings to its recognized ‘potential’ today. Admittedly, it was avery long read, however I was able to genuinely appreciate the work of our predecessors as I gradually neared the end of the book; reading my way through the history of cancer, the research and the patients it had and still is affecting. The questions asked and the solutions found over time were certainly intriguing, however personally, the most enthralling bit for me are the questions and answers still yet to come.

Scientific advancements usually occur due to a trial and error approach, which was evident through this book. Within the chapter ‘VAMP’ Mukherjee discusses the new discovery of administering multiple drugs at once in different doses to target the cancer once and strongly. To the reader this comes across as a very invasive and insensitive approach, as what will happen to the patient who must suffer the consequences of all the treatments’ side effects? However, I guess we have to understand that, at the time, this was the only method which gave doctors/scientists an idea as to what the right dose to target cancer is. As Mukherjee highlights through the use of Voltaire’s quote – ‘Doctors are men (and women) who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing’

At the beginning of the book, you could see the approach researchers took, which usually involved trying to target the issue directly without any background to the mechanism of the problem. However, during the progression of the book you could see that this approach altered and in fact if was Sidney Farber, a paediatric pathologist, when trying to figure out how red blood cells were formed before figuring out how to block their abnormal growth in leukemia, who wanted to ‘…approach the disease from normal to abnormal – to confront cancer in reverse’. Personally, this is a technique that I believe would fare well if implemented in every situation that we handle. Through retracking the routes of the issue, you not only find answers which would help address the dilemma at hand but it may also present an opportunity to find other solutions which may just as beneficial.

‘A patient, long before he becomes the subject of medical scrutiny, is, at first, simply a storyteller, a narrator of suffering – a traveller who has visited the kingdom of ill’ – I personally love this quote, as it is a very accurate description of the position a patient is in, vulnerable and lost in unfamiliar territory, especially when confronting a life-changing disease. It conveys that it is up to us, the wisdom of the ill, that can guide them through different treatment options and experiences to make them feel safe. The metaphor certainly encapsulates what it means to be a patient and it helps define the core of the doctor-patient relationship.

After reading this book, it has definitely made me realize how sceptical many of us can be of change and new ideas. With every discovery made there was always considerable backlash from others in the same profession, the government or the media. However, I learnt that it was those that stood by their revelations, backed with adequate evidence, that created history and somewhat brought us one step closer to finding ‘cures’.

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