In Europe, they once had a Hundred Years War. Our own War on Terror has been going on for about a decade. But the War on Cancer — well, as Siddhartha Mukherjee writes in his impressive new book, that's been going on for 4,000 years. It's been the central struggle of our species since Hippocrates named deadly tumors after the crab, with its penetrating pinchers and menacing, alien visage.
As a cancer physician, Mukherjee is perfect for this job. He has been in those cold, sterile rooms as the bad news he has delivered hangs in the air like a black hole blotting out all hope and humanity. He has felt the highs of a "miracle" cure and the lows of death coming way too soon.
He attempts a biography of a disease here, but it's an enigma. So we get a biography of cancer's enemies — researchers and doctors, patients and fundraisers. You get to meet all the warriors, from Sidney Farber to Mary Lasker. You also tour the trenches — the horrific wrong turns (radical mastectomy), the accidental discoveries (mustard gas, it was found, killed cancer cells along with soldiers) and the politics (Nixon's War on Cancer).
What The Emperor of All Maladies really stands for, however, is an appreciation of the scientific method. Millions of tiny discoveries, along with a handful of pivotal insights, have resulted in progress — incremental and frustrating, but still progress.
As Mukherjee humbly submits, there is still much we don't know. Some survivability outcomes for specific cancers are about the same as they were a century ago; others, using a mix of drugs, radiation and surgery, can be cured.
There's that pesky word: cure. As a rallying cry, a total cure is powerful. But, as Mukherjee writes, "This War on Cancer may best be 'won' by redefining victory."
Perhaps a victory over "the most elemental and magisterial disease known to our species" — one that is "stitched to our genome" — will take a little more humility and practicality. "We might as well focus on prolonging life," Mukherjee writes, "rather than eliminating death."