Wednesday 27 January 2016

The Emperor of all Maladies


Wow, what can I say.  This book has been a phenomenal read. I have been engrossed in it every night now for over 2 weeks and it has been an unbelievable experience. It has been , and you might not believe this, a true pleasure to read. 
Yes, parts have been incredibly moving and sad, other bits have been uplifting and joyous and other bits have been like reading a detective novel. Every page I have found out something interesting and thought provoking and I'm kinda sad  it's finished now.
One thing is for sure, this doctor knows his stuff!  He has complete reverence for his patients, a great deal of historical knowledge about cancer and amazingly he is an EXCELLENT writer, who can make complicated science understandable whilst at the same time writing such beautiful sentences.
It sounds a bit sick but this book has smashed my serious scary fears I had about cancer because this guy has just laid everything bare and written down the  history of how humans have been fighting this disease to the best of their abilities over the last 4000 years. Reading about the best endeavours of focussed, almost obsessed, doctors and scientists  willing themselves to cure such a complicated disease ,whilst balancing these scientific advancements against the psychological needs of the patients themselves has been fascinating. 
My favourite parts were 

 when Victorian British doctors suddenly realised that chimney sweep boys were getting lots of scrotal cancer and that soot must be some kind of carcinogen.

How Mr Doll came up with the link between smoking and lung cancer, and was fought all the way by the tobacco companies. 

How the nonorganic dyes produced in the industrial revolution could be used so successfully to stain cells and see them so clearly. 

The power of X Rays to both see inside the body and also give you cancer.

How mustard gas and the periwinkle flowers were discovered to be great chemotherapy drugs because they are two of the best targeted cell poisons. ( Mustard gas killing off all white blood cells in healthy bone marrow was a side affect detected in dead soldiers and civilians in the First World War.)

How you shouldn't give marmite to someone with leukaemia because it speeds up the cancer cell replication. Marmite is full of folates and leukaemia sufferers need anti-folates.

How viruses, genetics, hormones, carcinogens and random mutations all play a part in the game called cancer and how scientists through the ages came to these conclusions. 

How a cancer only found in chickens helped scientists prove that cancer structurally changes our DNA.

How important mice have been for testing on and how some scientists just tested certain drugs on themselves because they were so desperate for human guinea pigs.

How a mad scientist studying the reproductive cycle of  real guinea pigs suddenly came up with the idea of the smear as a preventative test for cervical cancer.

How random trials should be carried out on humans to prove a drugs worth.  This part was fascinating for me because doctors are biased by the very nature of being human.  Putting pure mathematical and statistical data into practice when people's lives are in the balance is a tough balancing act.

The importance of screening programmes to save lives before the cancer even takes a hold. The first breast cancer screening trials in the 70s were a disaster because they were not random enough. It was a small Swedish village which produced the data that breast screening is only worthwhile in society for women over 50. 

Fund raising and awareness raising in the community, especially in 1950s America when you couldn't say the words breast, cancer or prostate on TV or radio and the absolute dedication of high society people to raise funds for children's cancer wards. Things were/are funded so differently here in the UK! 

Interviewing a woman in her 60s, who was one of the first children to be cured of childhood leukaemia through chemotherapy. This was incredibly moving. 

How new drugs target rogue genes and proteins in certain cancer cells and turn off their desire to talk to each other and replicate. How cell biologists spent such long hours finding about how these switches on genes worked and then often didn't communicate their findings so well to oncologists.  The lack of communication was often horrifying as well as the pitfalls of getting drug companies to fund trials on humans. 

How cancer touches everybody, rich and poor, old and young. How it is a disease which is a mutant copy of ourselves, a disease which has managed to gain immortality.  A disease which we will never beat completely, but one that we can control, live with and often cure. A disease which as a society ages becomes more and more prevalent.  A disease which many of us will live under the shadow of but luckily these days kills fewer and fewer children.

This book is a true testament to everything good about humans and a true testament to the author's passion and dedication to his chosen career of helping people understand and fight this terrible disease. 





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