Science
by Siddhartha Mukherjee
What exactly is cancer?
Siddhartha Mukherjee was training as a cancer doctor when a patient told him she needed to know what she was up against. This book, which he calls a biography of cancer, is his answer. It follows the disease from ancient Egypt to the genes inside our cells.
Hear a sample · read by Laura
In the 1890s the surgeon William Halsted popularised the radical mastectomy, removing the breast with the chest muscles and nearby lymph nodes. He believed wider surgery meant more cures. It stayed standard for decades, until a trial led by Bernard Fisher in the 1970s found smaller operations did as well.
Farber teamed up with Mary Lasker, a wealthy New York campaigner, to press Washington for money. Their push helped win the National Cancer Act, signed by President Nixon in 1971. Supporters hoped for a cure within a few years. Progress was far slower, because cancer is many diseases.
In 1775 the London surgeon Percivall Pott noticed that chimney sweeps, sent up chimneys as boys, often got a cancer rare in other men. He blamed the soot. In 1950 Richard Doll and Austin Bradford Hill tied lung cancer to smoking. Prevention became a second line of attack.
From the 1970s, scientists showed cancer begins with damage to our own genes, often ones that tell a cell when to divide. In chronic myeloid leukaemia, a blood cancer, a single faulty gene drives the disease. A drug built to block its protein, imatinib (Gleevec), was approved in 2001.
Old enemy
Cancer is ancient. Doctors in Egypt described it thousands of years ago.
Our own cells
Cancer is our own cells growing out of control, which is why it's so hard to kill.
Radical surgery
Halsted's surgeons cut away more and more, but that didn't save more lives.
First drugs
Sidney Farber's drugs pushed back childhood leukaemia for a while and started modern chemotherapy.
Tobacco
Proving that smoking causes lung cancer turned prevention into a real weapon.
A story from the book
In 1947 the Boston pathologist Sidney Farber tried a new drug, aminopterin, on children with leukaemia. It blocked folic acid, which the cancer cells needed to multiply. Some children improved for months before the disease returned. Those short remissions showed a drug could hold cancer back.
Hot take · true or myth?
The biggest possible dose of chemotherapy always works best.
Myth. In the 1990s thousands of women with breast cancer had huge doses of chemotherapy, then a bone marrow transplant. Careful trials found no benefit, and the one glowing study had been faked.
One thing to try
This week, choose one treatment or test you've heard of, such as radiotherapy or the Pap smear, and read a short history of it. Find out who first tried it and how long it took to show it worked. Mukherjee's history is full of ideas that took decades to settle.
Knotd has the key ideas from 250+ non-fiction books, each in a few minutes, in plain words. The Emperor of All Maladies comes with a Hot Take round to make it stick.
Get the whole book on KnotdOpen in the appWhat exactly is cancer? Siddhartha Mukherjee was training as a cancer doctor when a patient told him she needed to know what she was up against. This book, which he calls a biography of cancer, is his answer. It follows the disease from ancient Egypt to the genes inside our cells.
Cutting wider and deeper; The war on cancer; Stopping it before it starts; Aiming at the broken gene.
This week, choose one treatment or test you've heard of, such as radiotherapy or the Pap smear, and read a short history of it. Find out who first tried it and how long it took to show it worked. Mukherjee's history is full of ideas that took decades to settle.
Yes. Knotd has the key ideas from The Emperor of All Maladies in a few minutes, in plain words, plus a Hot Take round to test them. It's one of 250+ non-fiction books in the app.
