Overview
Mukherjee's 2010 biography of cancer traces the disease from ancient Egyptian tumour records through the birth of chemotherapy, the war on cancer, and the genomic revolution. The book won the Pulitzer Prize for General Nonfiction in 2011.
Mukherjee is an oncologist at Columbia who wrote the book over six years while treating patients. The book opens with a patient, Carla Reed, whose treatment he runs through as a frame for the historical narrative. Published in 2010, it has shaped a generation of science writers and has been adapted by Ken Burns into a PBS documentary series.
Key Ideas
Cancer as civilisational history
Humans have known about cancer for millennia, but the idea of curing it is almost entirely a twentieth-century project.
The chemotherapy gamble
Early cancer drug development was essentially trial-and-error poisoning, and many of its pioneers were treated as cranks.
The war on cancer
Nixon's 1971 declaration was a political act built on premature science, and we are still managing its consequences.
Targeted therapy
The shift from poisoning cells broadly to disrupting specific molecular pathways marks the real turning point.
Prevention is the frontier
Most durable victories against cancer — tobacco, HPV vaccines — have come from prevention rather than treatment.
Who should read this
Readers who want one of the great works of contemporary science writing. Also essential for anyone who has been touched by cancer personally — the book is clinical without being cold, and Mukherjee is unusually humane in how he discusses patients.
Who might skip it
Skip if you want current-state-of-the-art oncology; the book is historical up to 2010 and much has changed since, particularly in immunotherapy. Also skip if very clinical descriptions of illness would distress you right now.
The verdict
One of the best science books I have read — not only on cancer but on the structure of scientific progress itself. Mukherjee writes as both a physician and a historian, and the book's refusal to oversimplify either role is its greatest strength. The chapters on Sidney Farber's first chemotherapy trials are some of the most moving writing about medicine I know.
Cancer is not simply a disease; it is a disease of our age. It is a product of our longevity.
— Siddhartha Mukherjee, The Emperor of All Maladies
If you liked this
The Gene for Mukherjee's follow-up on genetics. The Song of the Cell for his most recent book.