''The Emperor of All Maladies: A Biography of Cancer'' is a book written by
Siddhartha Mukherjee
Siddhartha Mukherjee (born 21 July 1970) is an Indian-American physician, biologist, and author. He is best known for his 2010 book, '' The Emperor of All Maladies: A Biography of Cancer'', that won notable literary prizes including the 2011 Pu ...
, an Indian-born American physician and
oncologist
Oncology is a branch of medicine that deals with the study, treatment, diagnosis and prevention of cancer. A medical professional who practices oncology is an ''oncologist''. The name's etymological origin is the Greek word ὄγκος (''ó ...
. Published on 16 November 2010 by
Scribner, it won the 2011
Pulitzer Prize for General Non-Fiction
The Pulitzer Prize for General Nonfiction is one of the seven American Pulitzer Prizes that are awarded annually for the "Letters, Drama, and Music" category. The award is given to a nonfiction book written by an American author and published duri ...
: the jury called it "an elegant inquiry, at once clinical and personal".
''
The Guardian
''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
'' wrote that "Mukherjee manages to convey not only a forensically precise picture of what he sees, but a shiver too, of what he feels."
Title
The book explains its title in its
author's note:
Content
The book weaves together Mukherjee's experiences as a
hematology
Hematology ( always spelled haematology in British English) is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood. It involves treating diseases that affect the produc ...
/
oncology
Oncology is a branch of medicine that deals with the study, treatment, diagnosis and prevention of cancer. A medical professional who practices oncology is an ''oncologist''. The name's etymological origin is the Greek word ὄγκος (''ó ...
fellow
A fellow is a concept whose exact meaning depends on context.
In learned or professional societies, it refers to a privileged member who is specially elected in recognition of their work and achievements.
Within the context of higher education ...
at
Massachusetts General Hospital
Massachusetts General Hospital (Mass General or MGH) is the original and largest teaching hospital of Harvard Medical School located in the West End neighborhood of Boston, Massachusetts. It is the third oldest general hospital in the United Stat ...
as well as the history of cancer treatment and research.
Mukherjee gives the history of cancer from its first identification 4,600 years ago by the Egyptian physician
Imhotep
, other_names = Asclepius (name in Greek) Imouthes (also name in Greek)
, burial_place = Saqqara (probable)
, occupation = chancellor to the Pharaoh Djoser and High Priest of Ra
, years_active =
, known_for ...
. The Greeks had no understanding of cells, but they were familiar with hydraulics.
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
thus considered illness to be an imbalance of four cardinal fluids: blood, black bile, yellow bile, phlegm.
Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
applied this idea to
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
, believing it to be an imbalance of black bile. In 440 BCE, the Greek historian
Herodotus
Herodotus ( ; grc, , }; BC) was an ancient Greek historian and geographer from the Greek city of Halicarnassus, part of the Persian Empire (now Bodrum, Turkey) and a later citizen of Thurii in modern Calabria ( Italy). He is known f ...
recorded the first breast tumor excision of
Atossa
Atossa (Old Persian: ''Utauθa'', or Old Iranian: ''Hutauθa''; 550–475 BC) was an Achaemenid empress. She was a daughter of Cyrus the Great, and a wife of Darius I.
Name
The name "Atossa" (or "Atusa") means "bestowing very richly" or "well ...
, the queen of
Persia
Iran, officially the Islamic Republic of Iran, and also called Persia, is a country located in Western Asia. It is bordered by Iraq and Turkey to the west, by Azerbaijan and Armenia to the northwest, by the Caspian Sea and Turkmeni ...
and the daughter of
Cyrus
Cyrus ( Persian: کوروش) is a male given name. It is the given name of a number of Persian kings. Most notably it refers to Cyrus the Great ( BC). Cyrus is also the name of Cyrus I of Anshan ( BC), King of Persia and the grandfather of Cyrus ...
, by a Greek slave named
Democedes
Democedes of Croton (; el, Δημοκήδης), described in ''The Histories of Herodotus'' as "the most skillful physician of his time".
Democedes's background
Democedes was a Greek physician and a member of the court of Darius I. He was born ...
. The procedure was believed to have been successful temporarily. Galen's theory was later challenged by the work of
Andreas Vaselius and
Matthew Baille, whose dissections of human bodies failed to reveal black bile.
In the 19th century,
surgeons
In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
devised various approaches to remove tumors, like
William Halsted
William Stewart Halsted, M.D. (September 23, 1852 – September 7, 1922) was an American surgeon who emphasized strict aseptic technique during surgical procedures, was an early champion of newly discovered anesthetics, and introduced several ...
and the
radical mastectomy
Radical mastectomy is a surgical procedure involving the removal of breast, underlying chest muscle (including pectoralis major and pectoralis minor), and lymph nodes of the axilla as a treatment for breast cancer. Breast cancer is the most comm ...
. Additionally,
Emil Grubbe
Émil Herman Grubbé (1 January 1875 — 26 March 1960) was possibly the first American to use x-rays as a treatment for cancer (versus detection) but this is disputed and no reliable contemporary source of this claim exists. He was born in Ch ...
used
X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
s to treat cancer, thus identifying another treatment modality.
Rudolph Virchow
Rudolf Ludwig Carl Virchow (; or ; 13 October 18215 September 1902) was a German physician, anthropologist, pathologist, prehistorian, biologist, writer, editor, and politician. He is known as "the father of modern pathology" and as the founde ...
first observed
leukemia
Leukemia ( also spelled leukaemia and pronounced ) is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or ' ...
, and
Franz Ernst Christian Neumann localized the pathology to the bone marrow.
In the 20th century, cancer became the second most common cause of death after heart disease in the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
.
Sidney Farber
Sidney Farber (September 30, 1903 – March 30, 1973) was an American pediatric pathologist. He is regarded as the father of modern chemotherapy for his work using folic acid antagonists to combat leukemia, which led to the development of other c ...
induced temporary remission in pediatric leukemia using
antifolates
Antifolates are a class of antimetabolite medications that antagonise (that is, block) the actions of folic acid (vitamin B9). Folic acid's primary function in the body is as a cofactor to various methyltransferases involved in serine, methionine ...
developed by
Yellapragada Subbarow
Yellapragada Subba Rao (12 January 1895 – 8 August 1948) was a pioneering Indian biochemist who discovered the function of adenosine triphosphate (ATP) as an energy source in the cell, developed methotrexate for the treatment of cancer a ...
.
Louis Goodman and
Alfred Gilman also used
nitrogen mustard
Nitrogen mustards are cytotoxic organic compounds with the chloroethylamine (Cl(CH2)2NR2) functional group. Although originally produced as chemical warfare agents, they were the first chemotherapeutic agents for treatment of cancer. Nitrogen m ...
to treat
lymphoma
Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). In current usage the name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlar ...
. The
National Cancer Institute
The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
(NCI) introduced
clinical trials
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
to test the efficacy of
chemotherapy
Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemotherap ...
. Recognizing the possibility for a cure, Farber sought funding for his efforts through
The Jimmy Fund
The Jimmy Fund, established in Boston in 1948, is made up of community-based fundraising events and other programs that benefit Dana-Farber Cancer Institute. Since 1948, millions of people have given money to the Jimmy Fund to help save lives an ...
and
Mary Lasker
Mary Woodard Lasker (November 30, 1900February 21, 1994) was an American health activist and philanthropist. She worked to raise funds for medical research and founded the Lasker Foundation.
Early life
Mary Woodard was born in Watertown, Wisconsi ...
. Inspired by the
Space Race
The Space Race was a 20th-century competition between two Cold War rivals, the United States and the Soviet Union, to achieve superior spaceflight capability. It had its origins in the ballistic missile-based nuclear arms race between the tw ...
, Farber and Lasker appealed to the nation and
President Nixon
Richard Milhous Nixon (January 9, 1913April 22, 1994) was the 37th president of the United States, serving from 1969 to 1974. A member of the Republican Party, he previously served as a representative and senator from California and was t ...
to enact legislation for the
War on Cancer
The "war on cancer" is the effort to find a cure for cancer by increased research to improve the understanding of cancer biology and the development of more effective cancer treatments, such as targeted drug therapies. The aim of such efforts is t ...
, resulting in the passage of the National Cancer Act of 1971 and increased funding for the NCI.
The book also reviews the origins of
hospice
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by ...
and
palliative medicine
In 2006, ''hospice and palliative medicine'' was officially recognized by the American Board of Medical Specialties, and is ''co-sponsored'' by the American Boards of
* Internal Medicine
* Anesthesiology
* Family Medicine
* Physical Medicine ...
and
cancer screening
Cancer screening aims to detect cancer before symptoms appear. This may involve blood tests, urine tests, DNA tests, other tests, or medical imaging. The benefits of screening in terms of cancer prevention, early detection and subsequent treatme ...
.
According to Mukherjee, the book was a response to the demand of a patient: "I’m willing to go on fighting, but I need to know what it is that I’m battling."
Mukherjee states that two of his influences for the book were
Randy Shilts
Randy Shilts (August 8, 1951February 17, 1994) was an American journalist and author. After studying journalism at the University of Oregon, Shilts began working as a reporter for both '' The Advocate'' and the ''San Francisco Chronicle'', as wel ...
' ''
And the Band Played On
''And the Band Played On: Politics, People, and the AIDS Epidemic'' is a 1987 book by ''San Francisco Chronicle'' journalist Randy Shilts. The book chronicles the discovery and spread of the human immunodeficiency virus (HIV) and acquired immun ...
'' and
Richard Rhodes
Richard Lee Rhodes (born July 4, 1937) is an American historian, journalist, and author of both fiction and non-fiction, including the Pulitzer Prize-winning ''The Making of the Atomic Bomb'' (1986), and most recently, ''Energy: A Human Histor ...
' ''
The Making of the Atomic Bomb
''The Making of the Atomic Bomb'' is a contemporary history book written by the American journalist and historian Richard Rhodes, first published by Simon & Schuster in 1987. It won the Pulitzer Prize for General Non-Fiction, the National Book ...
'', but the defining moment for him was "when he conceived of his book as a biography".
It was described, by the magazine
''TIME'', as one of the 100 most influential books of the last 100 years, and by ''
The New York Times
''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'' magazine as among the 100 best works of non-fiction.
Chapters
# OF BLACKE CHOLOR, WITHOUT BOYLING: Early understandings of cancer
# AN IMPATIENT WAR: Chemotherapy and other modern (20th century) forms of treatment
# WILL YOU TURN ME OUT IF I CAN'T GET BETTER: Failures of treatments and dominant theories; paradigm shifts in the 1970s
# PREVENTION IS THE CURE: Preventive medicine applied to cancer in the United States
# A DISTORTED VERSION OF OUR NORMAL SELVES: The cellular nature of cancer
# THE FRUITS OF LONG ENDEAVORS: A review on the contemporary state-of-the-art and the victories from a long line of research
The epilogue, "Atossa's War", discusses prognosis and the ultimate goals of cancer treatment.
Awards and honours
* 2011:
Pulitzer Prize for General Nonfiction
The Pulitzer Prize for General Nonfiction is one of the seven American Pulitzer Prizes that are awarded annually for the "Letters, Drama, and Music" category. The award is given to a nonfiction book written by an American author and published duri ...
, winner
* 2011:
PEN/E. O. Wilson Literary Science Writing Award, winner (inaugural)
* 2011:
Guardian First Book Award
The Guardian First Book Award was a literary award presented by ''The Guardian'' newspaper. It annually recognised one book by a new writer. It was established in 1999, replacing the Guardian Fiction Award or Guardian Fiction Prize that the newspap ...
, winner
* 2011:
Wellcome Trust Book Prize, shortlist
* 2010:
New York Times Best Books of the Year
''The New York Times Book Review'' (''NYTBR'') is a weekly paper-magazine supplement to the Sunday edition of ''The New York Times'' in which current non-fiction and fiction books are reviewed. It is one of the most influential and widely rea ...
* 2010:
New York Times Notable Book of the Year
''The New York Times Book Review'' (''NYTBR'') is a weekly paper-magazine supplement to the Sunday edition of ''The New York Times'' in which current non-fiction and fiction books are reviewed. It is one of the most influential and widely rea ...
* 2010:
New York Times Bestseller
''The New York Times'' Best Seller list is widely considered the preeminent list of best-selling books in the United States. John Bear, ''The #1 New York Times Best Seller: intriguing facts about the 484 books that have been #1 New York Times ...
* 2010: TIME Magazine's Best Books of the Year
* 2010:
National Book Critics Circle Award
The National Book Critics Circle Awards are a set of annual American literary awards by the National Book Critics Circle (NBCC) to promote "the finest books and reviews published in English".[Los Angeles Times Book Prize
Since 1980, the ''Los Angeles Times'' has awarded a set of annual book prizes. The Prizes currently have nine categories: biography, current interest, fiction, first fiction (the Art Seidenbaum Award added in 1991), history, mystery/thriller ( ...]
, finalist
Translations
* 2011: Italian: ''L' imperatore del male. Una biografia del cancro'', Neri Pozza ().
* 2011: Korean: ''암 : 만병의 황제의 역사'', 이한음 ().
* 2012: Turkish: ''Tüm Hastalıkların Şahı'', Zeynep Arık Tozar ().
* 2012: German: ''Der König aller Krankheiten'', Barbara Schaden ().
* 2012: Lithuanian: ''Visų ligų karalius: vėžio biografija'', leidykla "Versus aureus" ().
* 2012: Portuguese: ''O Imperador de Todos os Males. Uma biografia do cancro'', Bertrand Editora ()
* 2012: Spanish: "El emperador de todos los males: Una biografia del Cancer" editorial Taurus ()
* 2013: French: ''L'empereur de toutes les maladies. Une biographie du cancer'', Éditions Flammarion ().
* 2013: Dutch: ''De keizer aller ziektes, een biografie van kanker'', de Bezige Bij ().
* 2013: Russian: ''Царь всех болезней. Биография рака'', АСТ, .
* 2013: Ukrainian: ''Імператор усіх хвороб: біографія раку'', Київ, видавництво Жупанського ().
* 2013: Polish: ''Cesarz wszech chorób: Biografia raka'', Wydawnictwo Czarne ()
* 2013: Bulgarian: ''Императорът на всички болести: Биография на рака'', Изток - Запад ()
* 2013: Hungarian: ''Betegségek betegsége: mindent a rákról'', Libri ()
* 2013: Arabic: ''إمبراطور الأمراض: سيرة ذاتية للسرطان'', Tariq Olayan ()
* 2014: Swedish: ''Lidandets konung: Historien om cancer'', Albert Bonniers Förlag ().
* 2014: Thai: ''จักรพรรดิแห่งโรคร้าย ชีวประวัติโรคมะเร็ง : The Emperor of All Maladies : A Biography of Cancer'', สุนันทา วรรณสินธ์ เบล แปล, สำนักพิมพ์มติชน ().
* 2015: Persian: "سرطان امپراطور بیماریها", The House of Biology ().
* 2015: Icelandic: "Meistari allra meina: Ævisaga krabbameins", Forlagið ().
* 2015: Czech: "Vládkyně všech nemocí", Masarykova univerzita ().
* 2017: Persian: «
پادشاه همۀ امراض», Salekan ().
See also
*
''Cancer'' (2015 PBS film)
*
History of cancer
The history of cancer describes the development of the field of oncology and its role in the history of medicine.
Early diagnosis
The earliest known descriptions of cancer appear in several papyri from Ancient Egypt. The Edwin Smith Papyrus was ...
*
History of cancer chemotherapy
The era of cancer chemotherapy began in the 1940s with the first use of nitrogen mustards and folic acid antagonist drugs. The targeted therapy revolution has arrived, but many of the principles and limitations of chemotherapy discovered by the ...
Notes and references
Further reading
* Mukherjee's ''New York Times Magazine'' article based on his book.
External links
*
Discussion of ''The Emperor of All Maladies'' with Mukherjee, February 18, 2011at
C-SPAN
Cable-Satellite Public Affairs Network (C-SPAN ) is an American cable and satellite television network that was created in 1979 by the cable television industry as a nonprofit public service. It televises many proceedings of the United States ...
Discussion of ''The Emperor of All Maladies'' with Mukherjee, September 25, 2011at
C-SPAN
Cable-Satellite Public Affairs Network (C-SPAN ) is an American cable and satellite television network that was created in 1979 by the cable television industry as a nonprofit public service. It televises many proceedings of the United States ...
{{DEFAULTSORT:Emperor Of All Maladies
Pulitzer Prize for General Non-Fiction-winning works
2010 non-fiction books
Books about cancer