The Emperor of All Maladies: A Biography of Cancer by Siddharta Mukherjee

There are some books that quietly demand one’s attention. I read an article on The Emperor of Maladies late last year in The New Yorker, which focused on a case study of a 30-year old woman, the mother of three young children, who woke up one morning with a headache, ‘Not just any headache but a sort of numbness in my head. The kind of numbness that instantly tells you that something is terribly wrong.’ It was included as one of the *New York Times *Notable Books of 2010. In spite of a misguided attempt at medicine in my late teens, I am not naturally curious about medical conditions, but I was deeply curious about Mukherjee’s project. How does one write a biography of cancer?

Mukherjee is a young oncologist from Boston, who had initially conceived of writing a journal of his year spent training at the Dana-Farber Cancer Institute and Massachusetts General Hospital, but quickly readjusted the scale of his project, which became a history of cancer.

The first record of cancer was discovered on a papyrus, from the seventeenth century BC, where an Egyptian physician, Imhotep, describes a mass on a breast – ‘Therapy, there is none.’ This is an eloquent history of medicine that reminds me of Roy Porter’s wonderful book* Greatest Benefit to Mankind *and incorporates and explains all of the developments that have enhanced our understanding of cancer to date. The study of chemistry, for example, arose out of the dye and textile industry in the nineteenth century. There are remarkable descriptions of early surgery, including the origins of a radical mastectomy.

*The Emperor of All Maladies *also attempts to elucidate the cultural and political dimensions of a disease that is set to overtake heart disease as the most common cause of death. An exponential rise in cases of cancer began last century, as the pulmonary diseases of the nineteenth century were slowly eliminated. The incidence of tuberculosis, the ‘white plague’, halved between 1910 and 1940. The most critical factor was the dramatic increase in longevity, because cancer is a disease that generally develops as people get older, ‘The life expectancy of Americans rose from forty seven to sixty eight in half a century, a greater leap in longevity than had been achieved over several previous centuries.’

Many of the breakthroughs in cancer treatment have arisen out of research into leukemia, a cancer that more commonly affects children. Sidney Farber is just one of the many personalities behind cancer research: the godfather of chemotherapy, who experimented on young children without their parents’ knowledge, let alone permission. In spite of his dubious ethics, he combined forces with New York socialite Mary Lasker to campaign for cancer research.

I found this an utterly compelling read, helped along by Mukherjee’s effortless style. It is also delightfully literary, with quotes ranging from Susan Sontag to Sherlock Holmes; in that regard the only other book I could compare it to would be Armand Marie Leroi’s highly original Mutants.

Justine Douglas is manager of Readings Port Melbourne