The Emperor of All Maladies (英語) ペーパーバック – 2011/9/29
‘Mukherjee calls this great and beautiful book a biography, rather than a history, because he wants his reader to understand his subject not just as a disease, a scientific problem or a social condition, but as a character – an antagonist with a story to tell. His intensely vivid and precise descriptions of biological processes accumulate into a character, fully developed and eerily familiar. The notion of "popular science" doesn't come close to describing this achievement. It is literature.’ Observer
‘This is a riveting book…profound, eloquent and searching’ John Carey, Sunday Times
‘”The Emperor of All Maladies” is the book that many will have been waiting for. This elegantly written overview allows us to look a once whispered-about illness squarely in the eye.’ Independent
‘So beautifully written; this is literature, not popular science. “The Emperor of Maladies” empowers us, makes it clear that we really do know this enemy, and so brings us another step closer to victory.’ Evening Standard
‘Mukherjee never condescends, yet he manages to write lucidly and tellingly about complex experimental, technological and theoretical matters’ Will Self, New Statesman
Siddhartha Mukherjee M.D., Ph.D., is a cancer physician and researcher. He is an assistant professor of medicine at Columbia University and a cancer physician at the CU/NYU Presbyterian Hospital. He has published articles in Nature, New England Journal of Medicine, Neuron, the Journal of Clinical Investigation, The New York Times, and The New Republic. He lives in New York with his wife and daughter.
- ASIN : 0007250924
- 出版社 : Fourth Estate Ltd (2011/9/29)
- 発売日 : 2011/9/29
- 言語 : 英語
- ペーパーバック : 400ページ
- ISBN-10 : 9780007250929
- ISBN-13 : 978-0007250929
- 寸法 : 14.1 x 3.91 x 21.06 cm
- Amazon 売れ筋ランキング: - 20,173位洋書 (の売れ筋ランキングを見る洋書)
And the overall message: 150 years of cancer treatment hasn’t much changed – slash, burn, poison – but understanding of cancer certainly has. In some ways that’s frustrating for medics (and patients!). But perhaps it also means doctors don’t have, and never did have, all the answers. However many prizes they win.
This book also reveals how brutal some doctors need to be in the modern health industry. The author is aware that he is one of these doctors and shows occasional sympathy with nurses dealing, for example, with vomit. But as a cancer patient myself I thought: Yes, but how about the vomiting person? Maybe you need to be thick-skinned to be a sane medic. Yes, and maybe that’s why about ½ million American women had unnecessary butchery to their breasts not so long ago.
Also I wonder about short quotes on the back of books. For example: “‘Feels like a thriller more than anything else’ Will Self.” OK, but was Will Self’s next phrase: ‘a genre unsuited for telling this story or showing human kindness.’
For example, (pages 144-145), when doctors have treated children with the ‘four-drug chemo regimen’ VAMP, having ‘wiped out all the normal cells’ (presumably not ALL cells in the body), children were ‘slumped into near coma and hooked to respirators’. Finding nothing useful to do, doctors, ‘nurtured’, tried to provide ‘comfort’, ‘caregiving and support’, all written as if these four things were extraneous to the work of a proper go-ahead prize-winning medic.
Patients in ‘Emperor’ are typically children or women (‘desperate patients lurch toward last-ditch efforts to save their lives’ page 218), but doctors and researchers mainly men, described in 3-adjective combinations such as: ‘Brilliant, brash and single-minded’ (p. 353), and ‘Outspoken, pugnacious, and bold’ (p. 166).
And I noticed researchers John Bailer and Elaine Smith are soon reduced to ‘Bailer’ and ‘Bailer’s analysis’ (several times) as if Ms Smith were less important (p. 229-234).
I was amused to read of Joseph Lister’s work in Glasgow and ‘the neighbouring town of Carlisle’ (p. 57). OK, I understand this means nothing for readers in Toronto’s neighbouring town of New York.
There’s confused British geography on page 81 and confused time on page 239, where chimney-sweep events in 1851 cause law changes in 1788. It’s fine to be slap-dash and derogatory about Britain (so much to be derogatory about!) but if there are errors in things I already knew, what is the possibility there are errors in things I didn’t know? High, I guess.
The book is good on mistakes that have been made in assigning the causes of cancer: personality, viruses, and, perhaps, genes. Good on the mood of rivalry and competition among ambitious hospital physicians. Very good at showing how doctors have a strong bias against any experiment that may disprove the benefit of their untested beliefs and practices. Good at explaining drug trials and experiments. Good on the difficulties of statistics and confusion caused by different ways of measuring outcomes, for example time from diagnosis to death. Early testing may cause early diagnosis, and with no change at all in treatment, lead to longer diagnosis-to-death results without increasing lifespan or life quality.
And the book is very good at explaining oncogenes and anti-oncogenes. That is, genes promoting the growth of cancer cells, and genes damaging or destroying cancer cells. They are called ‘jammed accelerators’ and ‘missing brakes’ on page 381. Excellent, vivid metaphor, particularly for people in societies where car driving is normal.
Finally, I was strongly reminded of the dangers of kidney failure and took this message: before any new treatment, drink more water! Once you start pooing or spewing it may be too late.
So, my advice to cancer patients hoping to heal: don’t read this book, drink a glass of water.
This book does an excellent job, as far as my knowledge extends, in providing a historical guide to the ways in which cancer has been treated and the growing understanding of what cancer actually is. The two have not necessarily gone hand in hand, and it is comparatively recently that the understanding of the biology of cancer has produced targeted treatments.
The flip side of that understanding, though, is that it is quite likely there will never be a magic 'cure' for cancer. In some ways, as the book explains, everyone's cancer at the genetic level is unique, though it appears there are certain genes which are likely to be drivers of cancer. But with an aging population, cancer may be, like wrinkles, a feature of old age. The good news is that cancers that affect the young have been the ones where the treatment has been most effective.
Some of the chapters in the book that deal with the biology of cancer at the chromosome level are a little hard going for a non-biologist. A diagram may have been useful in places. But, ultimately, the book is worth the effort and the information within it should help dispel some of the fear and dread that surrounds mention of the disease.
Many words or adjectives come to mind after reading this book, including detailed, long, very intense, upsetting, disturbing, depressing yet informative. I think the most accurate description would be highly informative. Author has filled the pages with years of experience and his complete knowledge of the subject. Reading this book ensures a better understanding of cancer and how it has affected the journey of medicine in treatment of cancer.
From the beginning of the story Author dives into history of cancer and the way it is portrayed as the story goes, it seems more like an actual person and not an illness. More like a super powerful villain who is here for human extinction or advancement of human race. It’s literally do or die situation for human race against cancer.
“In writing this book, I started off by imagining my project as a “history” of cancer. But it felt, inescapably, as if I were writing not about something but about someone. My subject daily morphed into something that resembled an individual—an enigmatic, if somewhat deranged, image in a mirror. This was not so much a medical history of an illness, but something more personal, more visceral: its biography.” –Siddhartha Mukherjee
Author reveals how cancer has been around much longer than we thought by showing examples of exhumed corpses from ancient Egypt and other archeological sites. Once mankind realized how aggressive and fast growing cancer is, the historical treatments were equally zealous and intense with the goal to find a cure and get rid of the cancerous tissue as soon as they can.
Cancer is an expansionist disease; it invades through tissues, sets up colonies in hostile landscapes, seeking “sanctuary” in one organ and then immigrating to another. It lives desperately, inventively, fiercely, territorially, cannily, and defensively—at times, as if teaching us how to survive. To confront cancer is to encounter a parallel species, one perhaps more adapted to survival than even we are.―Siddhartha Mukherjee
The emperor of Maladies – the title captures ones interest and this no doubt has proven to a book which sticks with you even after you finish reading it. To conclude, the book sheds new light on the future of war on cancer, Medicine and science has come a long way in the past decades and new treatments continue to be discovered and tested. The war on cancer is far from over, however based on the knowledge from this history; we surely are equipped to face it head on.
"We are so close to a cure for cancer. We lack only the will and the kind of money and comprehensive planning that went into putting a man on the moon" -Dr. Sidney Farber
Tracing the business of cancer - a catch-all noun for a multiple disease of infinite variety but with a common origin - the progress of the malady is meticulously dissected out through anecdote, fact, history,science, quackery, coincidence, serendipity, elation, catastrophe, failure, humanity, hubris and a thousand other perspectives. Heart-wrenching tales of suffering, false trails, missed opportunities, stupidity and greed are juxtaposed with brilliant insights, fastidious labour, lucky breaks, dedication, applied logic, professional ostracization, and tenacity in the face of ruin.
The mundane reality of the horrors of early treatments and the humanity it can elicit make for astonishing reading. The excitement of giant leaps in treatment progress - Morton with aneasthesia and Lister with antisepsis, for example - are juxtaposed with reflections on the lady who having endured a mastectomy without anaesthetic rises from the table and, curtsies to the surgeons apologizing should she have disturbed their progress with any inadvertent cries during the procedure and so induces tears in the eyes of those who operated on her.
Cancer, it turns out may well be the primary disease of diseases with its basis in genetic malfunction it has been demonstrated in two million year old bones, in Egyptian mummies and ancient Peruvian graves. It is universal and its supremacy has been camouflaged by parallel diseases such as plague, tuberculosis, heart disease etc depressing longevity, for cancer is a disease that is predominantly occasioned by living to a ripe old age. The modern shift appears to be immunological challenges that disturb the equanimity of genetic replication procedures leading to malfunctions of cell reproduction cycles.
Cancer,it seems from reading Mukherjee's tale, is the ultimate survival machine. Beautiful in its mechanisms and its association with the fundamental processes of life.
Perhaps he might be persuaded to pen another volume containing what he had to leave out previously. One can only hope. There are several internet lectures/discussions in which he features if you wish to sample an appetizer for this book