I heard about The Emperor of All Maladies: A Biography of Cancer years ago, I’m not sure from whom or where. But this Pulitzer Prizing winning non-fiction book made its way onto my reading list and I eventually obtained a copy after a long hold with the Calgary Public Library. Even after nearly a decade in print, the hold list surpassed 33 requests.
Long and detailed, this book recounts the history of cancer and its treatment. For me, it offered an in-depth look at cancer from the human side of medicine. I was surprised however, coming from a veterinary perspective, that there was relatively little mention of comparative oncology. Our veterinary patents develop spontaneous cancers all the time and it is one major reasons pets are euthanized these days. Because of the high rates of cancer among animals, there is growing interest in exploring animal cancers as a way to better understand cancer biology and treatment. Bone cancer in dogs (canine osteosarcoma) arises frequently as a specific example where comparative oncology may benefit humans and dogs alike.
The book also describes the rising cancer rates among people but comparatively little is written about the increase in life expectancy. A similar phenomenon occurs in veterinary medicine where pets often live to old age. Many attribute this “rise in cancer” to the fact that animals are living longer and not dying to major infectious diseases and accidents. I suspect a similar effect is true for people. With the increase in life expectancy, there is more time to accumulate the DNA damage necessary for cancer to develop.
Mukherjee also includes a shout out to the legendary scientific paper, “The Hallmarks of Cancer” by Douglas Hanahan and Robert A. Weinberg. This was one of the key papers I read while studying for the notorious American College of Veterinary Pathology board certification exam. To date, the paper has been cited more than 30,000 times, a remarkable achievement. This paper and Mukherjee’s interpretation of it provides an elegant, unifying description of our understanding of cancer biology. Indeed, the paper forms the foundation of the chapter in Robbins and Cotran Pathologic Basis of Disease, the key general pathology textbook that veterinary and physician pathologists alike study to understand the fundamental nature of disease and how it develops.
Overall, Emperor is a marvelous example of how a scientific writer can weave the personal experience into the broader picture. Mukherjee shares personal anecdotes from his time training as an oncology specialist then blends this with the history and science of cancer to create a fascinating read. I recommend this book for anyone interested in cancer, biology and health.
