Alternate Cover Edition ISBNISBNThe Emperor of All Maladies is a magnificent, profoundly humane biography of cancer from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence Physician, researcher, and award winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist s precision, a historian s perspective, and a biographer s passion The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with and perished from for than five thousand years The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all out war against cancer The book reads like a literary thriller with cancer as the protagonist From the Persian Queen Atossa, whose Greek slave cut off her malignant breast, to the nineteenth century recipients of primitive radiation and chemotherapy to Mukherjee s own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive and to increase our understanding of this iconic disease Riveting, urgent, and surprising, The Emperor of All Maladies provides a fascinating glimpse into the future of cancer treatments It is an illuminating book that provides hope and clarity to those seeking to demystify cancer


10 thoughts on “The Emperor of All Maladies: A Biography of Cancer

  1. David David says:

    Every year there s always one non fiction book that the entire literate world raves about and that I hate In 2009 it was Richard Holmes s The Age of Wonder , the following year it was The Emperor of All Maladies.Universally admired, winner of a Pulitzer prize, this book annoyed me so profoundly when I first read it that I ve had to wait almost a year to be able to write anything vaguely coherent about it The flaws that I found so infuriating a year ago seem less important upon a second read Every year there s always one non fiction book that the entire literate world raves about and that I hate In 2009 it was Richard Holmes s The Age of Wonder , the following year it was The Emperor of All Maladies.Universally admired, winner of a Pulitzer prize, this book annoyed me so profoundly when I first read it that I ve had to wait almost a year to be able to write anything vaguely coherent about it The flaws that I found so infuriating a year ago seem less important upon a second reading Though I still think it is a poorly conceived book, executed in a manner that lacks all restraint, it s nowhere near as terrible as I remembered As I recall, the aspects of the book that most annoyed me were a the author s anthropomorphism of cancer a stupid, unhelpful, and ineffective metaphor In general, I detest this practice of attributing personalities to diseases Perhaps it s a necessary psychological strategy for oncologists But it s particularly inappropriate in the case of cancer, as it perpetuates the incorrect belief that cancer is a single disease, as opposed to a shape shifting disease of colossal diversity For the same reason, it makes little sense to speak of a war on cancer , as if it were a sentient villain with plans for world domination, one that can somehow be vanquished if we just find the magic formula Mukherjee correctly deplores this view as simplistic and reductive, but he then proceeds to adopt it hook, line, and sinker It s a baffling and unfortunate choice, because its inherent deficiencies lead to a kind of narrative incoherence, as well as a damaging lack of clarity about the nature and scope of the book It s a symptom of Mukherjee s vagueness of purpose that he often refers to the book as a biography of cancer , as if that phrase had meaning b A complete, fatal, inability to leave anything out There is a certain type of non fiction writer who seems hellbent on inflicting everything he or she learned while researching the book on the misfortunate reader No detail is spared Everyone the author spoke to during the five years researching the book gets a mention, it would seem As do a bunch of dead folks, some of them very dead, not all clearly particularly relevant.If, by doing this, the author is trying to impress with the breadth of his research, then he fails Leaving everything in is the simple, intellectually lazy, option Where non fiction is concerned, the reader has a right to expect the author to take the trouble to shape his material into some kind of coherent whole, recognizing that while some details are critical, others are not, and pruning accordingly All too often, though, authors forget this Their enthusiasm about the subject leads them to lose perspective the reader needs the whole story and will be thirsting for all the gory details it would be criminal to leave anything out.Well, actually, NO We want you, the author, to point out to us what s important and what s not c The author includes stories of his own patients experience with cancers of various types I have nothing against this per se it s entirely sensible to do so However, it requires delicacy and finesse to report on his patients stories without seeming exploitative or emotionally manipulative Writers like Jerome Groopman and Oliver Sachs regularly navigate this terrain with grace and sensitivity Mukherjee, a much less experienced writer, repeatedly crosses the line into bathos and melodrama The language is overly dramatic one senses also that Mukherjee succumbs to the oncologist s fallacy of believing that cancer is intrinsically worse , orserious, than all other ailments Actually, I guess that s already evident from the book s title d He has a particularly unfortunate habit of prefacing each chapter with at least one literary quote , and when the book reaches a new section there are six in all , he tends to go hog wild and give us a whole page of quotes These seem like a minor distraction at first, but their cumulative effect is to leave the reader with the impression that i it is very important to the author to let the world know that he is a well read, Renaissance dude ii chances are the author is a bit of a poser The bard, the bible, St Thomas Aquinas, Sophocles, Kafka, Hegel, Voltaire, Plato, Sun Tzu, and William Blake are all mined for a portentous snippet or two about mortality and the evils that the flesh is heir to Not to mention Gertrude Stein, Jack London, Czeslaw Milosz, W.H Auden, Hilaire Belloc, D.H Lawrence, Lewis Carroll, Conan Doyle, Italo Calvino, Woody Allen, Solzhenitsyn, Akhmatova Using just the right quote to frame an argument, or introduce a topic, can be an extremely effective device, but its effectiveness diminishes rapidly with overuse One gets the distinct impression that the author ransacked some quotation website in the mistaken idea that sprinkling them copiously throughout the manuscript would magically confer some kind of gravitas I reached my eye rolling moment on page 190, introducing part three, when Doctor Mukherjee felt impelled to quote T.S Eliot I have seen the Eternal Footman hold my coat, and snicker.And in short, I was afraid e As I mentioned, I think the structure and organization of the material leaves much to be desired The writing is generally adequate, if a little verbose, though one tic of the author s drove me nuts Each of the apparently infinite number of characters in the book is introduced in Mukherjee s characteristically breezy style, then immediately fixed in amber by means of a trio of adjectives Accurate information about the personality and character of many of these historical characters being limited, one suspects that these adjective triplets may well have been chosen at random from a thesaurus This kind of thing childless, socially awkward, and notoriously reclusivewealthy, politically savvy, and well connectedwealthy, gracious, and enterprisingambitious, canny, and restlessself composed, fiery, and energeticproud, guarded, and secretiveflamboyant, hot tempered, and adventurouscool, composed, and cautiousintellectual, deliberate, and imposingcharming, soft spoken and carefuloutspoken, pugnacious, and boldimpatient, aggressive and goal drivenbrackish, ambitious, dogged, and feistysuave, personable, and sophisticated impeccably dressed in custom cut Milanese suits brilliant, brash and single mindedlaconic and secretive, with a slippery quicksilver temperObviously, Dr Mukherjee is an adherent of the Adjectives are Your Friends school of writing If this kind of tic bothers you, be warned that it really runs rampant in this book In the general scheme of things, it s a minor detail.Enough caviling What has the author accomplished in this book I think he has written an overly detailed , partially complete , suboptimally organized account of the evolution of our understanding of cancer and the development of treatment options to counteract it The result is a very readable account, though I imagine some of the second half of the book may be hard for non scientists to understand In general, he seems to get things right, though there are a few lapses most notably in his discussion of the use of mustard gas in WWI I can find no corroboration of his statement that in a single year it left hundreds of thousands dead in its wake one wonders if he may have confused casualties with fatalities His ability to explain biomedical ideas in terms a layperson can understand seems decent, though not exceptional I don t think the writing is of a caliber that deserves the Pulitzer prize, but what do I know overly detailed to give just one example, was it really necessary to devote a page and a half to reviewing Lister s introduction of antiseptics And in a book which appeared to be focused on diagnostic and therapeutic options, why devote 40 pages to the link between smoking and cancer with the emphasis firmly on the legal and regulatory aspects eye glazing detail about kinase inhibitors, but nothing about anti angiogenesis agents Avastin was approved around 2003, as I recall, so it s clearly well within the time horizon a person could get whiplash from all the zipping up and back down the historical timeline, for no obvious reason.Thank you Now that I ve got that out of my system, I feel much better


  2. Riku Sayuj Riku Sayuj says:

    Anna CancerinaWhat a masterpiece With beautiful metaphors, poignant case studies, breath taking science and delectable literary allusions, Siddhartha Mukherjee takes us on a detailed yet panoramic trip spanning centuries Probably one of the best science books I have ever read.My favorite parts in the book are the literary allusions that capture the depth and feeling of what is being described so well, such as Cancer Ward, Alice in Wonderland, Invisible Cities, Oedipus Rex and manyThe mo Anna CancerinaWhat a masterpiece With beautiful metaphors, poignant case studies, breath taking science and delectable literary allusions, Siddhartha Mukherjee takes us on a detailed yet panoramic trip spanning centuries Probably one of the best science books I have ever read.My favorite parts in the book are the literary allusions that capture the depth and feeling of what is being described so well, such as Cancer Ward, Alice in Wonderland, Invisible Cities, Oedipus Rex and manyThe most memorable of all is when he encapsulates Cancer with a play on the favorite opening lines from Anna Karenina Happy families are all alike every unhappy family is unhappy in its own way becomes Normal cells are identically normal malignant cells become unhappily malignant in unique ways This unacknowledged transmutation of the famous lines encapsulates the book for me, inways than one.For a comprehensive take on the influence of cancer as a metaphor in our daily lives and societies, go here


  3. Always Pouting Always Pouting says:

    I think this is a really good and accessible book about cancer that traces the history of our understanding of it I m not sure if it qualifies as a biography of cancer per se and I only mentioned this because I kind of feel ambivalent about the anthropomorphizing of cancer through out the book I feel like it wasn t really even anthropomorphizing really, especially not when compared to the way a lot of biologist speak of things like genes, butmetaphorical and a way of relating cancer to a I think this is a really good and accessible book about cancer that traces the history of our understanding of it I m not sure if it qualifies as a biography of cancer per se and I only mentioned this because I kind of feel ambivalent about the anthropomorphizing of cancer through out the book I feel like it wasn t really even anthropomorphizing really, especially not when compared to the way a lot of biologist speak of things like genes, butmetaphorical and a way of relating cancer to a larger cultural feeling and tone I just found Mukherjee s attention to etymology and to larger metaphorical meaning in terms of the language used and the approach taken to treating cancer a really salient part of this book I haven t decided how I feel about it though, whether I liked it or not I enjoyed reading this though and found it really informative I can see why everyone was recommending it


  4. Petra-X Petra-X says:

    This book took me over a year to read I kept it on the kitchen counter and as the left hand page pile got bigger there was me standing on the right, getting smaller It was my diet book A couple of pages and a pound or so every week What I was doing was either boiling the kettle or making my own concoction of a fat and cholesterol busting mousse that involved just holding an immersion whisk for a couple of minutes I have such a low threshold for boredom I had to do something, so I read Emper This book took me over a year to read I kept it on the kitchen counter and as the left hand page pile got bigger there was me standing on the right, getting smaller It was my diet book A couple of pages and a pound or so every week What I was doing was either boiling the kettle or making my own concoction of a fat and cholesterol busting mousse that involved just holding an immersion whisk for a couple of minutes I have such a low threshold for boredom I had to do something, so I read Emperor of All Maladies I had previously tried to read the book in the proper way but failed It is very heavy and not all of it is equally fascinating, but it all hangs together in the end and has given me a proper education in genes, dna, mutations, what cancer actually is and why it has been so impossible to find a panacea It s a bit like fighting a guerrilla war You can only defeat the insurgents where you find them and where you think they might be It might seem as if all the rogue cells have been annhilated But if you didn t find them or one is high in the hills watching, or there are reinforcements coming from abroad in the next few months, then the battle will resume as soon as numbers have built up and the enemy is attacking once again That is not to say there aren t victories, but they are victories of battles, not of the war, but the war against cancer is one from which we can never withdraw.One thing struck me that was full of hope, was Mukherjee was talking about a previously rare cancer that is now quite common It might be assumed that the cancer itself is on the upsurge, but no, it was rare because people died from it, now they live with it, so just like AIDS, it is no longer a killer but a chronic disease.7 star book 8 even it was that good


  5. Julia Hayes Julia Hayes says:

    This is personal Cancer entered my life uninvited trying to consume the body of my daughter, Aria It was January 2008 when I heard the words, We think she has leukemia She was four years old.In the prologue of The Emperor of All Maladies A Biography of Cancer by Siddartha Mukherjee, he wrote, the arrival of a patient with acute leukemia still sends a shiver down the hospital s spine all the way from the cancer wards on its upper floors to the clinical laboratories buried deep in the bas This is personal Cancer entered my life uninvited trying to consume the body of my daughter, Aria It was January 2008 when I heard the words, We think she has leukemia She was four years old.In the prologue of The Emperor of All Maladies A Biography of Cancer by Siddartha Mukherjee, he wrote, the arrival of a patient with acute leukemia still sends a shiver down the hospital s spine all the way from the cancer wards on its upper floors to the clinical laboratories buried deep in the basement Leukemia is cancer of the white blood cells cancer in one of its most explosive, violent incarnations What caught my attention was the word still Leukemia happens to be one of thesuccessful cancers in terms lengthy high quality remissions and even cure, yet still Cancer governed every facet of our lives throughout her chemotherapy treatment, which lasted 794 days followed by 90 days of continued maintenance antibiotics, antacids and anti nausea medication She was lucky Trust me, you CAN imagine my relief, my sense of humility, my inexpressible gratitude and my continued fear of its return.That fear is now what governs me and it is an awful burden to carry I have discovered many things but there are two worth mentioning I ve discovered that one can have fear and be unafraid and I have learned that cancer is indeed Death It may not always bring physical death but it always brings the death of a life once lived Deeply held convictions die The illusion of control is smothered Friendships and relationships wither Its victims are forever scarred with raw oozing reminders Pure and simple it is a scary way to have to live life.So as part of survivorship, I committed myself to figuring out how to have this fear and be unafraid No doubt about it, information is everything There was no way I would have been able to read this book during Aria s treatment and I m not certain I would have been able to read it had she died It is only upon the perch of her wellness that I can dig deep into the darkest corners of cancer and extract understanding.I hold this book, this gem, like a shield of valor as I continue to face the beast that is cancer even in remission it s there The Emperor of All Maladies has empowered and humbled me Dr Mukherjee writes with grace and elegance about a topic that strikes fear like little else and takes the reader from a horrifying history, the effects of which still linger and haunt, to the fever pitched decades of discovery, experimentation, fearlessness and compassion, to where we are now, which I am convinced is the cusp of medicine s finest hour.The early experimentation with cytotoxic therapies following WWII on young leukemia patients was particularly impressive, for obvious reasons Three of those early identified successful agents are the very ones Aria had in addition to 5 other cocktails I am indebted to those researchers I am indebted to the parents of the children whose lives hung in balance of life and death for the sake of an unknown future I m indebted to those children.It is overwhelming to consider that this exquisite and brilliant person decided to tackle medicine from its humors to the genome atlas detailing every twist and turn in between all the while tenderly weaving in the real life stories of real life people.We are on other side of cancer I would like nothingthan to tell you that I feel safe I do not Every step I take I hear the echoed voices of the thousands of children who perished in order that my daughter s life would be spared Still, it wasn t until I read the last few chapters of this book that I felt tangibly hopeful I won t lie Those chapters were hard to digest It would be easy to dismiss them criticizing Dr Mukherjee for losing steam or failing to keep non medical people engaged, but this would be a gross injustice to what I think was beautifully accomplished Namely, our understanding of cancer is at the genetic level where just a mere 100 years ago blood and its constituents were identified and understood Now we can get into those individual cells and understand and map the universe within them I am in awe of this science and I am deeply, profoundly indebted to Dr Mukherjee for explaining it to me Yes, to me I told you this was personal.He doesn t over simplify because the complexity of what we know now and continue to question and understand can t be toned down, cut away or reduced for easier swallowing in the layman s mouth Cancer in all of its presentation is almost impossible to stomach and so these last chapters require the highest degree of concentration, attention and care It is the place where anyone suffering the effects of cancer or fearing cancer can grasp a firm thread of promise.When I read the last sentence, In that haunted last night, hanging on to her life by nothan a tenuous thread, summoning all her strength and dignity as she wheeled herself to the privacy of her bathroom, it was as if she had encapsulated the essence of a four thousand year old war I closed the book, brought it to my chest and smiled This is an old battle This is a known battle This is a battle for which I was called to arms as witness to the battle my daughter fought This is a battle that continues to terrify me This is a battle that I can face with confidence despite my fear This is a battle that will remain but with weapons like the minds of Dr Mukherjee and others, this is a battle whose field will continue to shift in the favor of human well being and dignity Thank you Dr Mukherjee On behalf of my family, I bow deeply


  6. Cait Poytress Cait Poytress says:

    Cancer fucking sucks.


  7. Diane S ☔ Diane S ☔ says:

    The author is a cancer physician and researcher, I don t think anyone else could take on the challenge of writing about cancer, from the first rearing of its ugly head He gives us a sweeping look at the beginning treatments, trials, operations, and research Leukemia, breast cancer, Hodgkin s, and other cancers flit in and out throughout this book Reading about children with this horrible disease always tears at my heart, I think this was the hardest part Although it was all quite hard, but The author is a cancer physician and researcher, I don t think anyone else could take on the challenge of writing about cancer, from the first rearing of its ugly head He gives us a sweeping look at the beginning treatments, trials, operations, and research Leukemia, breast cancer, Hodgkin s, and other cancers flit in and out throughout this book Reading about children with this horrible disease always tears at my heart, I think this was the hardest part Although it was all quite hard, but so informative.How doctors think at times, when confronted with patients they are not sure they can cure There is so much included in this book, but it is done well Written well and definitely kept my interest.The narrator was Fred Sanders and he was terrific


  8. Vicki Vicki says:

    As someone with a budding interest in diseases whether chronic, acute, or intermittent I immediately purchased this book for my library as soon as it was published I anticipated a similarity to a favorite book of 2010, The Immortal Life of Henrietta Lacks, but this book dives much deeper into the history of cancer, while interweaving personal accounts of patients the author treated This biography is different from anything I have read this year poignant, lyrical, accessible and most of all As someone with a budding interest in diseases whether chronic, acute, or intermittent I immediately purchased this book for my library as soon as it was published I anticipated a similarity to a favorite book of 2010, The Immortal Life of Henrietta Lacks, but this book dives much deeper into the history of cancer, while interweaving personal accounts of patients the author treated This biography is different from anything I have read this year poignant, lyrical, accessible and most of all, real Living, and breathing along with his patients, Siddhartha Mukherjee dives deep into the dark and the light side of cancer, and explores not only how the diseases spreads within the body, but through the lives of his patients, and the doctors and scientists who strived to defeat this complicated, deadly disease Great read


  9. Warwick Warwick says:

    I ve been wanting to read this since it first appeared, but I was just too nervous Call it superstition This is far scarier than any of your Barkers, your Kings or your Koontzes there are no such things as zombies or bogeymen, but cancer is out there Waiting for us.In The Great War and Modern Memory, Paul Fussell talks a lot about the irony of the First World War Cancer, in the same way, is a deeply ironic disease As Peyton Rous said, Nature sometimes seems possessed of a sardonic humor I ve been wanting to read this since it first appeared, but I was just too nervous Call it superstition This is far scarier than any of your Barkers, your Kings or your Koontzes there are no such things as zombies or bogeymen, but cancer is out there Waiting for us.In The Great War and Modern Memory, Paul Fussell talks a lot about the irony of the First World War Cancer, in the same way, is a deeply ironic disease As Peyton Rous said, Nature sometimes seems possessed of a sardonic humor The ability cancer cells have to reproduce themselves is the same biochemical magic that normal cells use to self replicate it s the whole reason we re alive Cancer has weaponised our own life force its life is a recapitulation of the body s life, its existence a pathological mirror of our own Similarly cancer rates have gone up, in historical terms, not because there arecarcinogens but becauseirony we are living longer.Civilization did not cause cancer, but by extending human life spans civilization unveiled it.Now that so many people are surviving into their seventies and eighties, cancer has a better chance to pull off its mask like a Scooby Doo villain to reveal that it was lurking there inside us all along And I would have gotten away with it, too, if it wasn t for you pesky oncologists.So this book is frightening, and you do have to brace yourself to read endless variants on the phrase unfortunately it had metastasized inoperably into her liver and brain over and over again however, balancing this terror is the very real intellectual thrill of following the generations of doctors and scientists who have tried to understand and fight the disease.The fight has got a bitsophisticated than it used to be Not a lot, but a bit The prevailing approach for a long time was that pioneered by William Halsted, who insisted on literally radical surgery to cut out as much tissue as physically possible, in order to maximize the chances of removing all the cancerous cells One disciple, for instance, evacuated three ribs and other parts of the rib cage and amputated a shoulder and a collarbone from a woman with breast cancer Gradually, advances in biochemistry and, latterly, genetics, have allowed fortargeted non surgical solutions, although so far only really for certain specific cancers.In fact the most progress has been made not in dealing with cancer, but in avoiding it in the first place Anti smoking campaigns, lifestyle advice, along with Pap smears and other screening programmes, have been very successful at least in the West elsewhere, things are going backwards in many cases Once it actually develops, your options remain fairly limited, and the metric of success is still often how many years of remission one can hope for, rather than the chances of an outright cure Mukherjee is thorough with his story and writes pretty well, although the focus is very much on the American scene, with researchers from Europe and elsewhere sometimes dealt with in a cursory fashion at one point he even describes France and England as lying on the far peripheries of medicine He also goes a bit overboard with his literary credentials, bookending every chapter and section with multiple epigraphs from poets and other thinkers It s not clear how well he understands his sources here, though, especially when you see that he s dated Burton s Anatomy of Melancholy to 1893, when Burton had been dead for two hundred and fifty years.Still, this is overall a very rich and rewarding book, full of scientific discovery and packed with historical detail It s a thriller, it s a sci fi, it s a horror story Let s just hope that future editions have evento report in the way of progress


  10. Christina Christina says:

    Deep breath This book is elegant, extraordinarily insightful, and most of all important Despite the big words and the complicated science, Mukherjee had me riveted from start to finish I thought I had a knowledge of cancer before this book, but now I understand it, in all of its feverish complexity and horrifying beauty In the history of cancer research, there have been bright flashes of brilliance combined with truths that are stupidly rediscovered centuries too late such as the carcinogen Deep breath This book is elegant, extraordinarily insightful, and most of all important Despite the big words and the complicated science, Mukherjee had me riveted from start to finish I thought I had a knowledge of cancer before this book, but now I understand it, in all of its feverish complexity and horrifying beauty In the history of cancer research, there have been bright flashes of brilliance combined with truths that are stupidly rediscovered centuries too late such as the carcinogenic nature of tobacco, which was delineated by an amateur scientist in a pamphlet in 1761 but that was still, somehow, up for debate in the 1960s What sticks with me most is that no one in cancer research really knows what they re doing, but the strength of truly great doctors lies in knowing that, instead of assuming the arrogant position that you ve found the only way and other possibilities are laughable.I did not know that this book won the Pullitzer this year when I read it, but it deserves every piece of praise it gets I will admit it was very hard to read this book with my 29 year old sister so struck by and dying of breast cancer On every page are patients suffering through cancer and its treatments, losing their battle only a few chapters before the particular solution they needed is found Cancer is a formidable foe that, for better or worse, is tightly intertwined within our genes One of the doctors profiled in the book had a favorite aphorism about how death in old age is not something to be beaten, but death before old age is the enemy to fight That is what I hope for Not extravagant medical advances aiming for immortality just the opportunity for each of us to fully experience our mortality for a period of time that does not rob of our best years, or the chance to have children, or the chance to find love and find ourselves Sigh