Volume 52, Issue 5, May 2023

Book review: The emperor of all maladies

Nagalaxmi Iyengar   
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The emperor of all maladies: A biography of cancer
Author: Siddhartha Mukherjee
New York, NY: Scribner, 2010
Paperback ISBN 9781439181713

One in two Australian men and women will be diagnosed with cancer by the age of 85 years. A diagnosis of cancer is all encompassing and can feel insurmountable. Cancer unleashes its wrath when least expected and without forewarning, destroying the benevolent and treacherous, the elite and destitute, the learned and ignorant alike. With its omnipotent cellular artillery, cancer continues to defy biochemical warfare and evade death. Pulitzer Prize winner, Siddhartha Mukherjee, eloquently explores the history and biography of cancer in The emperor of all maladies, a live entity within a living vulnerable host in an age-old battle for survival that is ultimately dependant on chance.

What is most remarkable about this book is its readability. Mukherjee sets the scene by reflecting upon his personal experiences as an oncology trainee being awestruck by the manner in which cancer consumes his patients. Driven by curiosity and a compulsion to better understand this disease, he presents a historical account of cancer, the biological basis of cellular dysregulation in cancer and grapples in cancer genetics, while continuing to engage the reader. The origins of chemotherapy are also described so vividly; the imagery purposefully takes the reader to Sidney Farber’s laboratory, down the lens of his microscope as he observes malignant transformation of cells and as he injects an elixir of toxins to combat this diabolical disease. Mukherjee’s finesse as a scientific communicator is flawless; he presents human suffering using narrative inquiry to illustrate the lived experiences of cancer patients, and dovetails this with scientific discovery and medical advancements to enlighten the reader.

Oncology and the breadth of cancer treatments are continuing to expand at an exponential rate. With the prolific advances in cancer screening and advances in life expectancy, our cancer patient cohort will likewise expand. Although published in 2010, this story is relevant and provides a comprehensive understanding of cancer cell biology to a general practitioner with a critical mind to better appreciate and demystify The emperor of all maladies.

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Book reviewMedical educationVocational training

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