Emperor of All Maladies (Book)

This book by an Indian-American oncologist (S. Mukherjee) is subtitled “A Biography of Cancer.”  But it is less a history of the disease than the history of the medical profession’s response to the disease in the 19th and 20th centuries.

Mukherjee is an excellent writer, with a strong sense of the “herd mentality” of scientific and medical research. Dr. Papanicolou developed an understanding of the stages of cervical cancer in the 1920s, but the medical profession, focused on (mostly unsuccessful) surgery as the only successful route to cancer treatment, wasn’t interested. It wasn’t until the late 1940s, when the first “chemotherapy” drugs came online, that people started to be interested in screening tests. Similarly, research on chemotherapy for breast cancer was delayed for years while people focused on bone marrow transplants (which turned out to be based on fraudulent research)

Dr. Mukherjee also has an eye for the ironic detail, and isn’t afraid to follow up on the sometimes startling stories uncovered by his research. For example:

  • The first chemotherapy drugs were developed using a fortuitous (if you can use that word) finding from mustard gas survivors. The gas was very good at selectively destroying white blood cells, which turns out to be very useful in the treatment of leukemia. Some of that research came from an “inadvertent” release of mustard gas in WWII that was previously unknown to me — a German bombardment of an American ship in the harbor of Bari Italy, which ship was, unknown probably even to the American sailors, loaded with mustard gas.


  • The “Jimmy Fund” for children’s cancer started with an emotional appearance on a national radio program (in 1948)of a child being treated for cancer in Boston. The little boy was a huge baseball fan, and the Boston Braves, and later the Boston Red Sox, became the principal supporters of this charity, which continues to this day. Chocolate sprinkles on ice cream cones in Boston are still called “jimmies” in his honor. 50 years later, someone tracked down the adult “Jimmy”, now living quietly in Maine with his wife and three children, and brought him to the hospital where he had been successfully treated, for an emotional reunion.  “Jimmy’s” real name was Einar Gustaffson.

  • The link between cigarette smoking and lung cancer was discovered independently by American and British researchers (some initially skeptical) in the early 1950s. The scientific evidence was overwhelming, and by the early 1960s there was no serious scientific debate on the issue. The tobacco companies embarked on a program of paying scientists to discuss the “controversy,” and leaning on Congressmen heavily dependent on tobacco company donations as a means of delaying significant government intervention — a method successfully copied by science denialists many times since.