Wednesday, January 13, 2021

Book Review – The Emperor of All Maladies, Siddhartha Mukherjee


My first introduction to the dreaded disease of cancer was through movies, where the hero bleeds through his nose, wraps a shawl and goes around with unshaven face, singing sad songs about his plight. My mother’s narrations about her elder sister’s traumatic experience with breast cancer and resultant mastectomy at a young age didn’t make much of an impact on me. As I grew up, there were so many characters with cancer in so many movies that the word cancer itself started to feel like those foreign locations that the lead characters go to for their duets – exotic, intriguing, yet faraway, having nothing to do with me. But as I matured into adulthood, I started seeing relatives, families of friends and colleagues bear the brunt of this ominous disease. My brief volunteering with an NGO that works for cancer patients brought me face to face with the seriousness of this scourge of humans. Young children suffering from leukemia, men in their early twenties fighting lung cancer caused by smoking, elderly people disfigured by throat cancer due to tobacco use - cancer was no longer exotic and faraway. It was close and gross.

When recently someone near and dear was diagnosed with cancer, I felt my curiosity piqued. I was looking for resources to learn more about this disease and do what I can to spread awareness. That’s how I found this book. And, what a worthy primer this turned out to be!

Cancer is not a modern illness. Its ancientness parallels that of our own. For millennia, people have suffered from and succumbed to cancer. But what makes this dreaded disease unique is its ability to evolve at the same rate as we do. Every time we find a cure and hope to kill this disease forever, cancer evolves and moves the bull’s eye. To borrow an idea from the author, imagine an Achilles whose vulnerability shifts someplace else, just as you target an arrow at his heel.

All those centuries of painstaking research has taught us one thing – this disease emerges from within. While external agents – like viruses and carcinogens - play a crucial role in waking this demon from its slumber, cancer is something internalized. It is our own body cells gone rogue, disobeying the lifecycle of birth-growth-decline. In a cruel twist of fate, our own body cells, nano-representations of our own selves, find a mutated vigor for ‘life’, start proliferating so profusely that they end up killing us, their collective image. Killing a harmful virus or bacteria has been relatively easier, because they have definite shape, purpose and, especially, are apart from us. But cancer is a part of us, our own cells, our genes, DNAs gone rogue. Not just that. Each of these mutations takes its own unique form as there are individuals. Cancer isn’t one single disease to find a cure against. It is a bunch of mutations, the perverted race of cells to proliferate and spread all over.

This book taught me those things in an intense way. Starting from the earliest mentions of this disease in history, nearly 2500 years ago, to the latest development in the field of oncology, this book tries to light up a very vast area. And, it succeeds too. The tug of war between cancer and science, the misunderstandings, poorly designed treatments, lessons learnt, sacrifices by patients as well as physicians, their tenacity in the face of adversity, emotional / physical reliefs brought by discovery of cures, relapses and remissions, egos and ebullience of the people involved, this book tells it all. If you are looking to learn what cancer is and what a devastating trail it has left all through the annals of mankind, then this is a book you must start with. The sheer effort and research that fills these pages is astounding. Dr. Mukherjee has put his heart and soul into this book.

The book is comprehensive but not complete though. For example, the book doesn’t dwell into ovarian cancer, something that I was so keen to learn about. The book doesn’t provide any advice on how to prevent cancer, if at all it is possible, or what kinds of lifestyles are prone to the risk of it. But, of course, the good doctor promptly justifies his reasons in the annexures.

This book doesn’t tell you everything that you would like to know about cancer. But it will tell you all the basics that you need to know about it. If you are pursuing the subject with curiosity, this is a good book to begin with. Not an easy read, but definitely worth the time.

As I finished reading and sat staring at the covers, I had this strange emotion – in their traits of reproducing profusely, migrating to wherever possible, reshaping the landscape of their destination (organ), and increasing ability to defy death that results in the ultimate demise of the host organism, isn’t cancer quite akin to us humans? Are cancer cells the microcosmic parallels to what we humans are to the macrocosm, i.e., the Universe?!

Who knows?! May be, we are!

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