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The Emperor of All Maladies: A Biography of Cancer Paperback – Aug. 9 2011

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• ISBN-10 1439170916
• ISBN-13 978-1439170915
• Edition Reprint
• Publication date Aug. 9 2011
• Language English
• Dimensions 15.56 x 4.32 x 23.5 cm
• Print length 608 pages
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The emperor of all maladies.

A Biography of Cancer

By siddhartha mukherjee..

Winner of the Pulitzer Prize, and now a documentary from Ken Burns on PBS, The Emperor of All Maladies is a magnificent, profoundly humane “biography” of cancer—from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence.

Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist’s precision, a historian’s perspective, and a biographer’s passion. The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with—and perished from—for more than five thousand years

Siddhartha Mukherjee

Siddhartha Mukherjee is the author of The Emperor of All Maladies: A Biography of Cancer, winner of the 2011 Pulitzer Prize in general nonfiction, and The Laws of Medicine. He is the editor of Best Science Writing 2013. Mukherjee is an assistant professor of medicine at Columbia University and a cancer physician and researcher. A Rhodes scholar, he graduated from Stanford University, University of Oxford, and Harvard Medical School. He has published articles in Nature, The New England Journal of Medicine, The New York Times, and Cell. He lives in New York with his wife and daughters.

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About the author, excerpt. © reprinted by permission. all rights reserved., product details.

• Publisher ‏ : ‎ Scribner; Reprint edition (Aug. 9 2011)
• Language ‏ : ‎ English
• Paperback ‏ : ‎ 608 pages
• ISBN-10 ‏ : ‎ 1439170916
• ISBN-13 ‏ : ‎ 978-1439170915
• Item weight ‏ : ‎ 1.05 kg
• Dimensions ‏ : ‎ 15.56 x 4.32 x 23.5 cm
• #3 in History of Medicine Textbooks
• #3 in Oncology Textbooks
• #19 in Internal Medicine Oncology

About the author

Siddhartha Mukherjee is a cancer physician and researcher. He is an assistant professor of medicine at Columbia University and a staff cancer physician at the CU/NYU Presbytarian Hospital. A former Rhodes scholar, he graduated from Stanford University, University of Oxford (where he received a PhD studying cancer-causing viruses) and from Harvard Medical School. His laboratory focuses on discovering new cancer drugs using innovative biological methods. Mukherjee trained in cancer medicine at the Dana Farber Cancer Institute of Harvard Medical School and was on the staff at the Massachusetts General Hospital. He has published articles and commentary in such journals as Nature, New England Journal of Medicine, Neuron and the Journal of Clinical Investigation and in publications such as the New York Times and the New Republic. His work was nominated for Best American Science Writing, 2000 (edited by James Gleick). He lives in Boston and New York with his wife, Sarah Sze, an artist, and with his daughter, Leela.

His author website is www.siddharthamukherjee.me

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The Emperor of All Maladies

A biography of cancer.

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About The Author

Siddhartha Mukherjee is the author of  The Gene: An Intimate History,  a #1  New York Times  bestseller;  The Emperor of All Maladies: A Biography of Cancer , winner of the 2011 Pulitzer Prize in general nonfiction; and  The Laws of Medicine . He is the editor of Best Science Writing 2013 . Mukherjee is an associate professor of medicine at Columbia University and a cancer physician and researcher. A Rhodes scholar, he graduated from Stanford University, University of Oxford, and Harvard Medical School. In 2023, he was elected as a new member of the National Academy of Medicine. He has published articles in many journals, including  Nature ,  The New England Journal of Medicine ,  Cell , The New York Times Magazine , and The New Yorker . He lives in New York with his wife and daughters. Visit his website at: SiddharthaMukherjee.com.

Product Details

• Publisher: Scribner (August 9, 2011)
• Length: 608 pages
• ISBN13: 9781439170915
• Lexile ® 1240L The Lexile reading levels have been certified by the Lexile developer, MetaMetrics®

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Raves and Reviews

“Mukherjee brings an impressive balance of empathy and dispassion to this instantly essential piece of medical journalism.” — Time “A meticulously researched, panoramic history . . . What makes Mukherjee’s narrative so remarkable is that he imbues decades of painstaking laboratory investigation with the suspense of a mystery novel and urgency of a thriller. . . . He possesses a striking gift for carving some of science’s most abstruse concepts into forms as easily understood and reconfigured as a child’s wooden blocks.” — The Boston Globe “Riveting and powerful . . . Mukherjee’s extraordinary book might stimulate a wider discussion of how to wisely allocate our precious health care resources.” — San Francisco Chronicle “Remarkable . . . The reader devours this fascinating book . . . Mukherjee is a clear and determined writer. . . . An unusually humble, insightful book.” — Los Angeles Times “Extraordinary . . . So often physician writers attempt the delicacy of using their patients as a mirror to their own humanity. Mukherjee does the opposite. His book is not built to show us the good doctor struggling with tough decisions, but ourselves.” —John Freeman, NPR “Now and then a writer comes along who helps us fathom both the intricacies of a scientific specialty and its human meaning. Lewis Thomas, Sherwin Nuland, and Oliver Sacks come to mind. Add to their company Siddhartha Mukherjee.” — Elle “Rich and engrossing . . . With the perceptiveness and patience of a true scientist, [Mukherjee] begins to weave these individual threads into a coherent and engrossing narrative.” — The Economist “A brilliant, riveting history of the disease . . . Threaded throughout, and propelling the narrative forward, are the affecting tales of Mukherjee’s own patients.” — Entertainment Weekly “Ambitious . . . Mukherjee has a storyteller’s flair and a gift for translating complex medical concepts into simple language.” — The Wall Street Journal “Cancer has never been as fully explored as in Dr. Siddhartha Mukherjee’s fascinating and moving history.” — The Daily Beast “With epic scope and passionate pen, The Emperor of All Maladies boldly addresses, then breaks down the monolith of disease.” — The Onion A.V. Club “Informative, elegant, comprehensive, and lucid.” — Pittsburgh Post-Gazette “Mukherjee’s elegant prose animates the science.” —Bloomberg News “Brilliant and riveting.” —Associated Press “[A] brilliant book.” —Larry King “A magnificent book.” —Sanjay Gupta, M.D., CNN “An ambitious scientific, political, and cultural history.” —Slate.com “Intensely readable.” — New York Post “Impressive.” — The Philadelphia Inquirer “Mukherjee . . . writes with supreme authority.” — The Seattle Times “Mukherjee makes us understand that along with our terrible losses, great gains have been made.” — Newsday “Eminently readable . . . A surprisingly accessible and encouraging narrative.” — Booklist (starred review) “A beautifully written account of the ingenuity, hubris, courage, and utter confusion humankind has brought to its attempts to grapple with cancer.” — Maclean’s “Future biographers and historians of the disease will labor from deep with the long shadow cast by Siddhartha Mukherjee’s remarkable The Emperor of All Maladies . . . . A vivid and profoundly engaging read.” — BookPage “Sweeping . . . Mukherjee’s formidable intelligence and compassion produce a stunning account.” — Publishers Weekly (starred review) “Siddhartha Mukherjee’s The Emperor of All Maladies left me shaken, fascinated, and not depressed, because he gives a face to our old enemy, cancer.” —Emma Donoghue, author of Room “Sid Mukherjee’s book is a pleasure to read, if that is the right word. . . . His book is the clearest account I have read on this subject. With The Emperor of All Maladies, he joins that small fraternity of practicing doctors who cannot just talk about their profession but write about it.” —Tony Judt, author of The Memory Chalet “Rarely have the science and poetry of illness been so elegantly braided together as they are in this erudite, engrossing, kind book.” —Andrew Solomon, National Book Award–winning author of The Noonday Demon “At once learned and skeptical, unsentimental and humane, The Emperor of All Maladies is that rarest of things—a noble book.” —David Rieff, author of Swimming in a Sea of Death “A magisterial, wise, and deeply human piece of writing.” —Adam Hochschild, author of King Leopold’s Ghost and Bury the Chains “ The Emperor of All Maladies beautifully describes the nature of cancer from a patient’s perspective and how basic research has opened the door to understanding this disease.” —Bert Vogelstein, director, Ludwig Center at Johns Hopkins University “A labor of love . . . as comprehensive as possible.” —George Canellos, M.D., William Rosenberg Professor of Medicine, Harvard Medical School “An elegant . . . tour de force. The Emperor of All Maladies reads like a novel . . . but it deals with real people and real successes, as well as with the many false notions and false leads. Not only will the book bring cancer research and cancer biology to the lay public, it will help attract young researchers to a field that is at once exciting and heart wrenching . . . and important.” —Donald Berry, Ph.D., MD Anderson Cancer Center, University of Texas

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The Emperor of All Maladies: A Biography of Cancer

The Emperor of All Maladies is a magnificent, profoundly humane "biography" of cancer—from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence. Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist's precision, a historian's perspective, and a biographer's passion. The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with—and perished from—for more than five thousand years.

The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all-out "war against cancer." The book reads like a literary thriller with cancer as the protagonist.

From the Persian Queen Atossa, whose Greek slave cut off her malignant breast, to the nineteenth-century recipients of primitive radiation and chemotherapy to Mukherjee's own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive—and to increase our understanding of this iconic disease.

Riveting, urgent, and surprising, The Emperor of All Maladies provides a fascinating glimpse into the future of cancer treatments. It is an illuminating book that provides hope and clarity to those seeking to demystify cancer.

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The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee – review

T hree quarters of the way through his "biography" of cancer, the New York-based oncologist Siddhartha Mukherjee pauses to set the scene in his laboratory, a beehive of esoteric activity and impenetrable jargon. In lesser hands, such a passage would leave non-specialist readers bewildered and bored. But then he describes himself in the simplest of scientific poses, looking into a microscope. And what he gazes at is one of the more sinister mysteries of human – or anti-human – life. The leukaemia cells he is examining came from a woman who has been dead for 30 years. Unlike their discarded host, these cells are "immortal".

In this small but typical moment, Mukherjee manages to convey not only a forensically precise picture of what he sees, but a shiver, too, of what he feels. "The cells look bloated and grotesque, with a dilated nucleus and a thin rim of cytoplasm, the sign of a cell whose very soul has been co-opted to divide and to keep dividing with pathological, monomaniacal purpose."

The yoking of scientific expertise to narrative talent is rare enough, but the literary echoes of The Emperor of All Maladies suggest a desire to go further even than fine, accessible explanation. "Normal cells are identically normal; malignant cells become unhappily malignant in unique ways."

It takes some nerve to echo the first line of Anna Karenina and infer that the story of a disease is capable of bearing a Tolstoyan treatment. But that is, breathtakingly, what Mukherjee pulls off. He calls this great and beautiful book a biography, rather than a history, because he wants his reader to understand his subject not just as a disease, a scientific problem or a social condition, but as a character – an antagonist with a story to tell through its eerie relationships to the wider biological and animal world that is also, inexorably, our story.

Though it has many historical antecedents, the epic medical quest to understand and treat cancer only really took shape as it emerged as a defining disease of modernity. This is the case not just in the metaphorical sense that it speaks potently to our industrialised terrors, but in the direct sense that cancer only became a leading cause of death in the world when we began to live long enough to get it.

People in the past tended to die of other diseases – as they still do in poorer countries today. Cancer now ranks just below heart disease as a cause of death in the US, but in low-income countries with shorter life expectancies, it doesn't even make the top 10. At the beginning of the 20th century, life expectancy at birth in America was 47.3 years. Now, the median age at diagnosis for breast cancer is 61; for prostate cancer, 67. As we extend our lives, Mukherjee writes, "we inevitably unleash malignant growth".

Thus the scene is set for a monumental scientific, political and human struggle. Mukherjee assembles a teeming cast of characters: from ancients such as Atossa, the Persian queen who in 500BC self-prescribed the first recorded mastectomy, to Mukherjee's own patients. There are tales of grizzly surgical techniques and astonishing medical discoveries. But, as with any epic narrative, the central drama marches towards a war.

The full-blown campaign against cancer began with the meeting in the 1940s of an American socialite, Mary Lasker, in search of a great medical cause, and the driven cancer researcher, Sidney Farber, one of the creators of chemotherapy. Mukherjee describes it as the coming together of two travellers, "each carrying one half of a map". The battlefield at the middle of the map was Washington DC and the political alliance that Lasker and Farber eventually formed was with Richard Nixon. The passing in 1971 of the National Cancer Act enshrined the idea of cancer as sovereign among diseases and bequeathed it the language of a world war.

But as Mukherjee's narrative unearths his central character , and our understanding of cancer accumulates depth and complexity, the notion of a war becomes ever more threadbare. Its combatants had been configuring the enemy they needed to fight the war they wanted. Yet the story of science, Mukherjee observes, is not just one of discovery, but of the discovery of failure. The practitioners of surgery, radiation and chemotherapy had proceeded to treat cancer without understanding its fundamental mechanisms.

Crusaders for a magic bullet, including Farber, were scornful of calls to wait on the development of genetic research, or to emphasise prevention, or to appreciate the need for care as much as "cure". To many who had worked on the front lines, relentlessly pushing patients to the brink of death to save them, such calls seemed academic. And then the academics called time out.

In 1986, in The New England Journal of Medicine , John Bailar and Elaine Smith published a cold assessment of comparative trends in cancer mortality over the years. This revealed what they called a "qualified failure". Between 1962 and 1985, though duration of survival had improved in certain areas, the war on cancer had not only failed to show overall progress, but deaths from cancer had actually increased by 8.7%. Even accounting for the postwar boom in smoking-related lung cancer, Mukherjee writes, this "shook the world of oncology by its roots".

It is from here, as he reaches for the final act in his historical drama, that it becomes clear that Mukherjee is doing more than providing an account of medical developments, scientific discovery and human suffering. The underlying structural dynamic of his book turns out to be the riddle of progress itself, the application of reason and science to chaos and disease – the uber-project of modernity that, even if it has achieved too much to be called a failure, can never finally succeed.

As he turns inwards, to questions of the basic biology of the cancer cell, Mukherjee modifies his assessment of the war on cancer, from qualified failure to qualified success. There may have been no movement of the front lines of death, but if the aims could change, from utopian notions of eradicating death to more modest ambitions for the extension of life, then the result for medical science is a "dynamic" equilibrium rather than a "static" one.

He returns to the cell itself, as genetic knowledge began to offer results that could be applied clinically – the search for causes finally coming together with the search for cures. By the end of the 1990s, the development of Gleevec as a genetics-based drug treatment for chronic myeloid leukaemia had, as one researcher put it, proved a principle: "It demonstrates that highly specific, non-toxic therapy is possible."

The cellular composition of cancer is Mukherjee's own field, but he is under no illusions that the new era will leave history behind, or that gene-based therapies will lead us out of the cancer age. Harold Varmus, accepting his Nobel prize for the cellular origin of retroviral oncogenes in 1989, turned to Beowulf : "We have only seen our monster more clearly and described his scales and fangs in new ways – ways that reveal a cancer cell to be, like Grendel, a distorted version of our normal selves."

The idea that cancer cells are copies of who we are is, Mukherjee emphasises, not a metaphor. "We can rid ourselves of cancer," he concludes, "only as much as we can rid ourselves of the processes in our physiology that depend on growth – ageing, regeneration, healing, reproduction."

And so his intensely vivid and precise descriptions of biological processes accumulate into a character, fully developed and eerily familiar. The notion of "popular science" doesn't come close to describing this achievement. It is literature.

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The Mind of a Disease

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By Jonathan Weiner

• Nov. 12, 2010

All patients begin as storytellers, the oncologist Siddhartha Mukherjee observes near the start of this powerful and ambitious first book. Long before they see a doctor, they become narrators of suffering, as Mukherjee puts it — travelers who have visited the “kingdom of the ill.”

Many doctors become storytellers too, and Mukherjee has undertaken one of the most extraordinary stories in medicine: a history of cancer, which will kill about 600,000 Americans by the end of this year, and more than seven million people around the planet. He frames it as a biography, “an attempt to enter the mind of this immortal illness, to understand its personality, to demystify its behavior.” It is an epic story that he seems compelled to tell, the way a passionate young priest might attempt a biography of Satan.

Mukherjee started on the road to this book when he began advanced training in cancer medicine at the Dana-Farber Cancer Institute in Boston in the summer of 2003. During his first week, a colleague who’d just completed the program took him aside. “It’s called an immersive training program. But by immersive, they really mean drowning,” he said, lowering his voice the way many of us do when we speak of cancer itself. “Have a life outside the hospital,” the doctor warned him. “You’ll need it, or you’ll get swallowed.”

“But it was impossible not to be swallowed,” Mukherjee writes. At the end of every evening he found himself stunned and speechless in the neon floodlights of the hospital parking lot, compulsively trying to reconstruct the day’s decisions and prescriptions, almost as consumed as his patients by the dreadful rounds of chemotherapy and the tongue-twisting names of the drugs, “Cyclophosphamide, cytarabine, prednisone, asparaginase. . . .”

Eventually he started this book so as not to drown.

The oldest surviving description of cancer is written on a papyrus from about 1600 B.C. The hieroglyphics record a probable case of breast cancer: “a bulging tumor . . . like touching a ball of wrappings.” Under “treatment,” the scribe concludes: “none.”

For more than 2,000 years afterward, there is virtually nothing about cancer in the medical literature (“or in any other literature,” Mukherjee adds.) The modern understanding of the disease originated with the recognition, in the first half of the 19th century, that all plants and animals are made of cells, and that all cells arise from other cells. The German researcher Rudolph Virchow put that in Latin: omnis cellula e cellula.

Cancer is a disease that begins when a single cell, among all the trillions in a human body, begins to grow out of control. Lymphomas, leukemias, malignant melanomas, sarcomas all begin with that microscopic accident, a mutation in one cell: omnis cellula e cellula e cellula. Cell growth is the secret of living, the source of our ability to build, adapt, repair ourselves; and cancer cells are rebels among our own cells that outrace the rest. “If we seek immortality,” Mukherjee writes, “then so, too, in a rather perverse sense, does the cancer cell.”

Mukherjee opens his book with the story of one of the founders of the hospital where he trained — Sidney Farber, a specialist in children’s diseases who began as a pathologist. In 1947, Farber worked in a tiny, dank laboratory in Boston, dissecting specimens and performing autopsies. He was fascinated by a sharklike species of cancer called acute lymphoblastic leukemia, which can move so fast that it kills an apparently healthy child within only a few days. A patient would be “brought to the hospital in a flurry of excitement, discussed on medical rounds with professorial grandiosity” and then sent home to die.

In the summer of 1947, a 2-year-old boy, the child of a Boston shipyard worker, fell sick. Examining a drop of the baby’s blood through the microscope, Farber saw the telltale signs of acute lymphoblastic leukemia, billions of malignant white cells “dividing in frenzy, their chromosomes condensing and uncondensing, like tiny clenched and unclenched fists.” By December, the boy was near death. In the last days of the year, Farber injected his patient with an experimental drug, aminopterin, and within two weeks he was walking, talking and eating again. It wasn’t a cure, only a remission; but for Farber it was the beginning of a dream of cures, of what one researcher called “a penicillin for cancer.”

The next year, Farber helped start a research fund drive around a boy who suffered from a lymphoma in his intestines, a disease that killed 90 percent of its victims. The boy was cherubic and blond, an enormous fan of the Boston Braves, and his name was Einar Gustafson. For the sake of publicity, Farber rechristened him Jimmy. That May, the host of the radio show “Truth or Consequences” interrupted his usual broadcast to bring his listeners into Jimmy’s hospital room to listen in as players on the Braves marched into Jimmy’s room and sang “Take Me Out to the Ball Game.”

By the summer of 1952, Farber had built an imposing new hospital, Jimmy’s Clinic. Soon, he was working on an even grander scale, with the help of an extraordinary socialite and medical philanthropist, Mary Lasker. (“I am opposed to heart attacks and cancer,” she once told a reporter, “the way one is opposed to sin.”) Mary and her husband, Albert, an advertising executive, joined forces with Farber. They wanted, as Mukherjee writes, “a Manhattan Project for cancer.” Together, through masterly advertising, fund-raising and passion for their common cause (“The iron is hot and this is the time to pound without cessation,” Farber wrote to Mary Lasker), they maneuvered the United States into what would become known as the war on cancer. Richard Nixon signed it into law with the National Cancer Act in 1971, authorizing the spending of $1.5 billion of research funds over the next three years.

In political terms, the war was well timed, coming at a time when America’s collective nightmares were no longer “It Came From Outer Space” or “The Man From Planet X,” but “The Exorcist” and “They Came from Within.” Mary Lasker called the war on cancer the country’s next moon shot, the conquest of inner space.

In scientific terms, however, the war was disastrously premature. The moon race had been based on rocket science. But in the early 1970s, there really wasn’t a science of cancer. Researchers still did not understand what makes cells turn malignant. Now that they were so much in the spotlight, and in the money, they fell into bickering, demoralized, warring factions. The “iconic battleground” of the time was the chemotherapy ward, Mukherjee writes, “a sanitized vision of hell.” Typically it was a kind of limbo, almost a jail, in which absolutely no one spoke the word “cancer,” the inmates’ faces had an orange tinge from the drugs they were given, and windows were covered with heavy wire mesh to keep them from committing suicide. “The artifice of manufactured cheer (a requirement for soldiers in battle) made the wards even more poignantly desolate,” Mukherjee writes.

“The Emperor of All Maladies” is a history of eureka moments and decades of despair. Mukherjee describes vividly the horrors of the radical mastectomy, which got more and more radical, until it arrived at “an extraordinarily morbid, disfiguring procedure in which surgeons removed the breast, the pectoral muscles, the axillary nodes, the chest wall and occasionally the ribs, parts of the sternum, the clavicle and the lymph nodes inside the chest.” Cancer surgeons thought, mistakenly, that each radicalization of the procedure was progress. “Pumped up with self-confidence, bristling with conceit and hypnotized by the potency of medicine, oncologists pushed their patients — and their discipline — to the brink of disaster,” Mukherjee writes. In this army, “lumpectomy” was originally a term of abuse.

Meanwhile, more Americans were dying of cancer than ever, mainly because of smoking. Back in 1953, the average adult American smoked 3,500 cigarettes a year, or about 10 a day. Almost half of all Americans smoked. By the early 1940s, as one epidemiologist wrote, “asking about a connection between tobacco and cancer was like asking about an association between sitting and cancer.” In the decade and a half after Nixon declared his war on cancer, lung cancer deaths among older women increased by 400 percent. That epidemic is still playing itself out.

Mukherjee is good on the propaganda campaign waged by the tobacco companies, “the proverbial combination of smoke and mirrors.” As one internal industry report noted in 1969, “Doubt is our product, since it is the best means of competing with the ‘body of fact.’ ” This episode makes particularly interesting reading to anyone following the current propaganda campaigns against the science of climate change.

Meanwhile, those who studied the causes of cancer in the laboratories and those who treated it in the clinics were not always talking to each other. As Mukherjee puts it, “The two conversations seemed to be occurring in sealed and separate universes.” The disease was hard to understand either intellectually, in the lab, or emotionally, in the clinic. In the lab, because it is so heterogeneous in its genetics and its migrations in the body. In the hospital, because its course is horrible and so often slow, drawn out. When it comes to cancer, Mukherjee writes, “ dying , even more than death, defines the illness.”

Mukherjee stitches stories of his own patients into this history, not always smoothly. But they are very strong, well-written and unsparing of himself: “Walking across the hospital in the morning to draw yet another bone-marrow biopsy, with the wintry light crosshatching the rooms, I felt a certain dread descend on me, a heaviness that bordered on sympathy but never quite achieved it.”

The heroes of the last few decades of this epic history are Robert Weinberg, Harold Varmus, Bert Vogelstein and the other extraordinary laboratory scientists who have finally worked out the genetics of cancer, and traced the molecular sequence of jammed accelerators and missing brakes that release those first rebel cells. As James Watson wrote not long ago, “Beating cancer now is a realistic ambition because, at long last, we largely know its true genetic and chemical characteristics.” We may finally be ready for war.

As a clinician, Mukherjee is only guardedly optimistic. One of the constants in oncology, as he says, is “the queasy pivoting between defeatism and hope.” Cancer is and may always be part of the burden we carry with us — the Greek word onkos means “mass” or “burden.” As Mukherjee writes, “Cancer is indeed the load built into our genome, the leaden counterweight to our aspirations for immortality.” But onkos comes from the ancient Indo-European nek, meaning to carry the burden: the spirit “so inextricably human, to outwit, to outlive and survive.” Mukherjee has now seen many patients voyage into the night. “But surely,” he writes, “it was the most sublime moment of my clinical life to have watched that voyage in reverse, to encounter men and women returning from that strange country— to see them so very close, ­clambering back.”

THE EMPEROR OF ALL MALADIES

A biography of cancer.

By Siddhartha Mukherjee

Illustrated. 571 pp. Scribner. $30

Jonathan Weiner is the Maxwell M. Geffen professor of medical and scientific journalism at Columbia University. His latest book is “Long for This World: The Strange Science of Immortality.”

The Emperor of All Maladies: A Biography of Cancer

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Siddhartha Mukherjee

The Emperor of All Maladies

Winner of the Pulitzer Prize, and now a documentary from Ken Burns on PBS, The Emperor of All Maladies by Siddhartha Mukherjee is a magnificent, profoundly humane “biography” of cancer—from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence.

Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist’s precision, a historian’s perspective, and a biographer’s passion. The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with—and perished from—for more than five thousand years.

The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all-out “war against cancer.” The book reads like a literary thriller with cancer as the protagonist.

From the Persian Queen Atossa, whose Greek slave may have cut off her diseased breast, to the nineteenth-century recipients of primitive radiation and chemotherapy to Mukherjee’s own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive—and to increase our understanding of this iconic disease.

Riveting, urgent, and surprising, The Emperor of All Maladies provides a fascinating glimpse into the future of cancer treatments. It is an illuminating book that provides hope and clarity to those seeking to demystify cancer.

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Author Interviews

An oncologist writes 'a biography of cancer'.

A woman prepares to undergo radiation therapy for an invasive cancer. Dr. Siddhartha Mukherjee writes about the discovery of radiation therapy as a treatment option in his biography of cancer. National Cancer Institute hide caption

A woman prepares to undergo radiation therapy for an invasive cancer. Dr. Siddhartha Mukherjee writes about the discovery of radiation therapy as a treatment option in his biography of cancer.

The Emperor of All Maladies: A Biography of Cancer By Siddhartha Mukherjee Hardcover, 592 pages Scribner List price: $30.00

Oncologist Siddhartha Mukherjee was treating one of his patients, a woman with advanced abdominal cancer who had relapsed multiple times, when she asked him what seemed like a simple question.

"She said, 'I'm willing to go on, but before I go on, I need to know what it is I'm battling,' " Mukherjee tells NPR's Terry Gross.

But, as Mukherjee explains, describing his patient's illness wasn't so simple. Defining cancer, he says, is something doctors and scientists have been struggling to do since the disease's first documented appearance thousands of years ago.

"Cancer is not just a dividing cell," he says. "It's a complex disease: It invades, it metastasizes, it evades the immune system. So there are many, many other stages of [defining] cancer which are still in their infancy."

Mukherjee's new book, The Emperor of All Maladies: A Biography of Cancer , grew out of his desire to better understand the disease he treats, through examining the way cancer has been described and treated throughout history. He chronicles the ways therapies evolved, particularly in the 20th century, as more treatment options became available and scientists worked to understand the underlying genetic mutations that caused the disease.

"If there's a seminal discovery in oncology in the last 20 years, it's that idea that cancer genes are often mutated versions of normal genes," he says. "And the arrival of that moment really sent a chill down the spine of cancer biologists. Because here we were hoping that cancer would turn out to be some kind of exogenous event — a virus or something that could then be removed from our environment and our bodies and we could be rid of it — but [it turns out] that cancer genes are sitting inside of each and every one of our chromosomes, waiting to be corrupted or activated."

Siddhartha Mukherjee is a staff oncologist at Columbia University Medical Center. Deborah Feingold via Scribner hide caption

Siddhartha Mukherjee is a staff oncologist at Columbia University Medical Center.

As the genetic understanding of cancer evolves, Mukherjee says, oncologists will be able to integrate that knowledge to develop more targeted treatment options — particularly as they find commonalities between different types of cancer.

"A breast cancer might turn out to have a close resemblance to a gastric cancer," he says. "And this kind of reorganization of cancer in terms of its internal genetic anatomy has really changed the way we treat and approach cancer in general."

Dr. Siddhartha Mukherjee is an assistant professor of medicine at Columbia University and a staff cancer oncologist at Columbia University Medical Center. His articles have been published in Nature , The New England Journal of Medicine , and The New York Times .

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The emperor of all maladies: a biography of cancer audible audiobook – unabridged.

A magnificent, beautifully written "biography" of cancer - from its first documented appearances thousands of years ago through the epic battles to cure, control, and conquer it to a radical new understanding of its essence.

The Emperor of All Maladies reveals the many faces of an iconic, shape-shifting disease that is the defining plague of our generation. The story of cancer is a story of human ingenuity, resilience, and perseverance but also of hubris, arrogance, paternalism, and misperception, all leveraged against a disease that, just three decades ago, was thought to be easily vanquished in an all-out "war against cancer". Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary. The audiobook is like a literary thriller with cancer as the central character.

From the Persian Queen Atossa, whose Greek slave may have cut off her diseased breast, to the 19th-century recipients of primitive radiation and chemotherapy to Mukherjee's own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through toxic, bruising, and draining regimens in order to survive - and to increase the store of human knowledge.

• Listening Length 22 hours and 18 minutes
• Author Siddhartha Mukherjee
• Narrator Fred Sanders
• Audible release date December 15, 2015
• Language English
• Publisher Simon & Schuster Audio
• ASIN B017DQSQD6
• Version Unabridged
• Program Type Audiobook
• See all details

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