The Emperor of All Maladies: A Biography of Cancer

You know the feeling that you get when you're done reading a book on the subject and realize how it changed your understanding of the field dramatically? Such as Feynman's Lectures on Physics, A Brief History of Time, or The Emperor's New Mind? This magnificent treatise on cancer is just what the subject needed - a meticulous, no-holds-barred treatment that reveals a plethora of information on cancer, and our ancient, never-ending war with it - a constantly shape-shifting enemy whose root is ourselves.
Mukherjee describes in eye-watering detail how our understanding of cancer has changed in around four thousand years, and how the landscape of the ‘War Against Cancer' has undergone multiple paradigm shifts - from the witch-doctors who thought the best cure for the then-unnamed disease was crab soup; to current efforts, which are a mixture of chemotherapy and targeted drugs, some of which can almost erase certain cancers from its roots.
Absolutely no detail is withheld from the reader - the politics, the money, the legal battles over potential cures and clinical trials, the innumerable doctors involved, the patients whose lives were altered with the onset of the disease, and how each potential drug worked (or why it stopped working).
Mukherjee also focuses on how patients embrace their sickness as the new normal, and how some patients accept death easier than doctors - his work is, above all, a testimony to the tenacity and resilience of the human spirit.
In conclusion, although this might not be the most readable book, it is definitely one of the most sobering books I have ever encountered. A must-read.

I enjoyed this book because it gives an in-depth look at cancer from the side of the patient, the oncologist, and the activist. The author breaks each bit down into a story - a story of one scientists struggle, a story of one treatment, a story of one patient - in order to build up a narrative about cancer and its treatment (or lack thereof) overtime.

Although I enjoyed the book, and I feel that I have benefitted from reading it, I did not fly through the story. I had to read it in measured bits. At points, I bored with the text as the author labored over details that weren't interesting enough to me, but perhaps would be to others. But, generally, I appreciated that the medical terminology and approaches were broken down for the reader, so I could follow along.

My advice to folks who don't have time to read the book: Still read the thought experiment of Atossa's treatment over time (pp 463-465). It shows (less poignantly than the stories in the book) that diagnosis, treatment, and outcomes of treatment of cancer has changed substantially over the last 2500 years or so for some cancers but not at all for others. Sober indeed.

I am not a medical professional, and I assume that folks with knowledge of cancer may not appreciate this book.

The book starts out rooted firmly in the human experience, told through the stories of patients, doctors, and discoverers from the ancients up through the modern era. I found these stories fascinating and often incredibly sad; I could relate to them. Around the 1960s the book shifts into a more technical vein, which makes sense because this is when so many innovations in cancer research and treatment began, but I found myself disengaging from the story. The author does a laudable job of keeping the human experience a part of the story, but this is a biography of cancer - not humans - and at some point the story becomes less about “us” and more about “it”. Or rather, “them”, because one of the most fascinating parts of the book was seeing how heterogenous cancer is in the human body. Lymphomas are completely different from breast cancer, which is completely different from sarcoma, etc. I truly had no idea.

Also fascinating was how breast cancer was the focus of cancer research for literally hundreds of years. This seems like a woman-positive situation until you discover the devastating surgeries and experiments that doctors inflicted on the female body. Would they have been so quick to carve out literal pounds of flesh if these were male bodies? Would male patients have had more authority over their own care, and been fully informed about what was about to be done to their bodies? Kudos to the author for explicitly calling out the medical industry on its historically cavalier treatment of women, and acknowledging the women of the 1970s who refused to be sidelined in their own treatment, and thus forged the patients' rights movement out of the second-wave feminist movement.

Very interesting. Kind of a downer. But it shows how much progress we as a society have made in such a short amount of time.

Sigh. I love Mukherjee's New Yorker pieces, but don't seem to be intelligent enough to appreciate his books; this one makes two for two.

I found the first half engaging despite the frequent timeline jumping: valuable history, insights into the personalities of researchers and the challenges they faced, compassionate reflection on the lives of those afflicted. I never really got the “biography of cancer” angle—it felt jarring every time he brought it up, gimmicky—but ok, whatever.

Somewhere midway, he just lost me. I found myself reading pages over and over, not understanding even a tenth of the content; deciding to press on, understanding even less on the next pages. It doesn't feel quite fair for me to assign a low rating over something that's my own stupidity... but I kept feeling like this was stuff he was really excited about, really into, and when I get into that mode I have to be especially careful to calm down and remember my audience. I think he got carried away. So, mostly me, but partly him too. Recommended only for very smart educated people.

Cancer is bad. I know that. My mom has been fighting cancer (and I mean, honestly, fighting—fighting as if she is sword fighting, fighting as if she is wrestling, fighting as if she is boxing—fighting cancer
for the past ten years).



Mukherjee shows the horror of attempting to fight cancer. It's a fearsome opponent. It can appear beaten yet suddenly it can appear again, this time stronger than ever. It causes horrific pain. It has to be fought with poison and radiation that battle the cancer by killing the body.



I liked this book a lot. I did well in following all the medical terms until I hit the chapters that spoke of c-myc genes and ras and Rb in the last quarter of the book. My head began to swivel. I read on. I could feel my brain spinning. I pushed to the end, though I wasn't terribly clear about what I was reading. Way, way over my head.



My final assessment: I wish there'd been an editor to make the last parts of the book more readable for the layman like me. Up until that point, I'd loved the book enough to wish it had been nominated for the best nonfiction of 2010.

This is by far the most comprehensive book on the history of medicine I've encountered. I was genuinely surprised to discover how inseparably oncology is woven into medical history—from the incurable breast tumor described in ancient Egypt to sarcomas found in immunosuppressed patients in the 1980s.

Siddhartha Mukherjee masterfully blends personal stories of his patients, ranging from rare but treatable Hodgkin lymphomas to the devastatingly common pancreatic cancer, making the book both touching and insightful.

It's a profound work, accessible to general readers while offering invaluable historical context for doctors—who may be familiar with treatments but not the rich history behind ‘The Emperor of All Maladies'.

PS: If I were the author, I'd have focused more on biology than history. Just a different perspective—but still, the book is a masterpiece.

A humane account of a terrible malaise

Pretty good read. Not light hearted and funny obviously, but it caught and held my attention. Not sure how it would have been to actually read it (I had the audio version from Audible), but listening to it in 30 to 45 min segments too and from work was good. I really liked the weaving of actual cancer patient stories into the narrative of the history. The most interesting part, for me, was the relationship between cancer treatment and treatment of HIV/AIDS in 1980's and how that fed back into the cancer treatments in the 1990's.

I found this supremely well written, balanced between the smooth telling of a suspense (who-done-it?) and just enough grounding in science history to keep both strands readable.
He kept the human context alive with the patients he followed and he showed humility in the way he never presumed to be more than a learner even after he became a qualified specialist.
The best science books are those that kindle the feeling of awe at life and the universe. Here there is awe at the perseverance of many to find cures and even awe at the incredible wily supreme survivor, the disease itself.
The only reason I didn't give 5-stars was because there wasn't enough of the patients perspectives, but perhaps I'm being unfair, the subtitle is “a biography of Cancer” after all.

Good narrative on history of cancer as a pathology and our reaction as species to it from ancient times to this date. Without having any background in medicine, it sounded balanced and well researched.
As some have pointed out, the literary devises sometimes felt a bit much, but I appreciated the overall effort on making it more readable for a wide audience.

Book Review: The Emperor of All Maladies: A Biography of Cancer - well deserving of its Pulitzer Prize. Long but worth it. Mukherjee did a very good job of balancing the recitation of facts with the telling of stories. The stories were used to keep interest, give a human face and provide illustration without taking over the book. There are some long passages where the science is pretty deep. But it is all well written and interesting.


You can read the full review on my blog at http://bookwi.se/cancer/

Moving, informative, and inspirational in equal measure.

Listened to this one in the car. I was hesitant to start it - concerned it would be too technical to enjoy. Boy, was I wrong. It's a fascinating book - and very well written. I looked forward to my morning commute. There's a point about 2/3rds of the way through that gets very technical (and it's necessary)- but I let the audiobook pull me along which helped me stick with it - and I did get a better understanding of that particular area the book was explaining and was glad to have hung in there. Excellent read!