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The Emperor of All Maladies: A Biography of Cancer
 
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The Emperor of All Maladies: A Biography of Cancer [Kindle Edition]

Siddhartha Mukherjee
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Produktbeschreibungen

Pressestimmen

'Sid Mukherjee's book is a pleasure to read, if that is the right word. Cancer today is widely regarded as the worst of all the diseases from which one might suffer - if only because it is fast becoming the most common. Dr. Mukherjee explains how this perception came about, how cancer has been regarded across the years and what is now being done to treat its protean forms. 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 Postwar and III Fares the Land 'Rarely have the science and poetry of illness been so elegantly braided together as they are in this erudite, engrossing, kind book. Mukherjee's clinical wisdom never erases the personal tragedies which are its occasion; indeed, he locates with meticulous clarity and profound compassion the beautiful hope buried in cancer's ravages.' Andrew Solomon, National Book Award-winning author of The Noonday Demon 'Siddhartha Mukherjee has done something that should not have been possible: he has managed, at once, to write an authoritative history of cancer for the general reader, while always keeping the experiences of cancer patients in his heart and in his narrative. 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

Pressestimmen

'Sid Mukherjee's book is a pleasure to read, if that is the right word. Cancer today is widely regarded as the worst of all the diseases from which one might suffer - if only because it is fast becoming the most common. Dr. Mukherjee explains how this perception came about, how cancer has been regarded across the years and what is now being done to treat its protean forms. 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 Postwar and III Fares the Land 'Rarely have the science and poetry of illness been so elegantly braided together as they are in this erudite, engrossing, kind book. Mukherjee's clinical wisdom never erases the personal tragedies which are its occasion; indeed, he locates with meticulous clarity and profound compassion the beautiful hope buried in cancer's ravages.' Andrew Solomon, National Book Award-winning author of The Noonday Demon 'Siddhartha Mukherjee has done something that should not have been possible: he has managed, at once, to write an authoritative history of cancer for the general reader, while always keeping the experiences of cancer patients in his heart and in his narrative. 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

Kurzbeschreibung

WINNER OF THE PULITZER PRIZE

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 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.

Synopsis

A comprehensive history of cancer -- one of the greatest enemies of medical progress -- and an insight into its effects and potential cures, by a leading expert on the illness. Cancer is one of a handful of human ailments that continue to elude us. The modern age is plagued with news of rising cancer rates, all kinds of possible man-made causes and a constant stream of potential miracle cures. In the course of his investigations into cancer, however, Siddhartha Mukherjee discovered that it is an ancient illness, which endured for centuries as a private matter, swaddled in secrecy and shame. Peering beyond the screen he saw that every generation had imagined cancer uniquely, and made its own desperately inventive attempt to find a cure. It is only over recent generations that cancer has morphed into one of the most public and politically scrutinised diseases of our era. Mukherjee delves into the larger history of cancer. How old is it? When did the battle against it begin? How have we -- as a society -- dealt with its challenge? How have we imagined the disease and what forces have we marshalled against it? Essentially: where are we in the war against cancer?What, if anything, have we won so far, and what have we lost? Cancer is a survivor: it changes, it adapts, it evolves, it grows. It is so close to us in biology that, in destroying it, we often destroy ourselves. The quest for the 'cure' for cancer has gradually transformed into a lodestone quest, the yardstick of our scientific and medical progress. This book is the story of that quest.

Synopsis

A comprehensive history of cancer -- one of the greatest enemies of medical progress -- and an insight into its effects and potential cures, by a leading expert on the illness. Cancer is one of a handful of human ailments that continue to elude us. The modern age is plagued with news of rising cancer rates, all kinds of possible man-made causes and a constant stream of potential miracle cures. In the course of his investigations into cancer, however, Siddhartha Mukherjee discovered that it is an ancient illness, which endured for centuries as a private matter, swaddled in secrecy and shame. Peering beyond the screen he saw that every generation had imagined cancer uniquely, and made its own desperately inventive attempt to find a cure. It is only over recent generations that cancer has morphed into one of the most public and politically scrutinised diseases of our era. Mukherjee delves into the larger history of cancer. How old is it? When did the battle against it begin? How have we -- as a society -- dealt with its challenge? How have we imagined the disease and what forces have we marshalled against it? Essentially: where are we in the war against cancer?What, if anything, have we won so far, and what have we lost? Cancer is a survivor: it changes, it adapts, it evolves, it grows. It is so close to us in biology that, in destroying it, we often destroy ourselves. The quest for the 'cure' for cancer has gradually transformed into a lodestone quest, the yardstick of our scientific and medical progress. This book is the story of that quest.

Über den Autor und weitere Mitwirkende

Siddhartha Mukherjee M.D., Ph.D., is a cancer physician and researcher. He is an assistant professor of medicine at Columbia University and a cancer physician at the CU/NYU Presbyterian Hospital. A Rhodes Scholar, he graduated from Stanford University, University of Oxford, and from Harvard Medical School and was a Fellow at the Dana Farber Cancer Institute and an attending physician at the Massachusetts General Hospital and Harvard Medical School. He has published articles in Nature, New England Journal of Medicine, Neuron, the Journal of Clinical Investigation, The New York Times, and The New Republic. He lives in New York with his wife and daughter.

Leseprobe. Abdruck erfolgt mit freundlicher Genehmigung der Rechteinhaber. Alle Rechte vorbehalten.

Prologue

Diseases desperate grown

By desperate appliance are relieved,

Or not at all.

—William Shakespeare,
Hamlet

Cancer begins and ends with people. In the midst of scientific abstraction, it is sometimes possible to forget this one basic fact. . . . Doctors treat diseases, but they also treat people, and this precondition of their professional existence sometimes pulls them in two directions at once.

—June Goodfield

On the morning of May 19, 2004, Carla Reed, a thirty-year-old kindergarten teacher from Ipswich, Massachusetts, a mother of three young children, woke up in bed with a headache. “Not just any headache,” she would recall later, “but a sort of numbness in my head. The kind of numbness that instantly tells you that something is terribly wrong.”

Something had been terribly wrong for nearly a month. Late in April, Carla had discovered a few bruises on her back. They had suddenly appeared one morning, like strange stigmata, then grown and vanished over the next month, leaving large map-shaped marks on her back. Almost indiscernibly, her gums had begun to turn white. By early May, Carla, a vivacious, energetic woman accustomed to spending hours in the classroom chasing down five- and six-year-olds, could barely walk up a flight of stairs. Some mornings, exhausted and unable to stand up, she crawled down the hallways of her house on all fours to get from one room to another. She slept fitfully for twelve or fourteen hours a day, then woke up feeling so overwhelmingly tired that she needed to haul herself back to the couch again to sleep.

Carla and her husband saw a general physician and a nurse twice during those four weeks, but she returned each time with no tests and without a diagnosis. Ghostly pains appeared and disappeared in her bones. The doctor fumbled about for some explanation. Perhaps it was a migraine, she suggested, and asked Carla to try some aspirin. The aspirin simply worsened the bleeding in Carla’s white gums.

Outgoing, gregarious, and ebullient, Carla was more puzzled than worried about her waxing and waning illness. She had never been seriously ill in her life. The hospital was an abstract place for her; she had never met or consulted a medical specialist, let alone an oncologist. She imagined and concocted various causes to explain her symptoms—overwork, depression, dyspepsia, neuroses, insomnia. But in the end, something visceral arose inside her—a seventh sense—that told Carla something acute and catastrophic was brewing within her body.

On the afternoon of May 19, Carla dropped her three children with a neighbor and drove herself back to the clinic, demanding to have some blood tests. Her doctor ordered a routine test to check her blood counts. As the technician drew a tube of blood from her vein, he looked closely at the blood’s color, obviously intrigued. Watery, pale, and dilute, the liquid that welled out of Carla’s veins hardly resembled blood.

Carla waited the rest of the day without any news. At a fish market the next morning, she received a call.

“We need to draw some blood again,” the nurse from the clinic said.

“When should I come?” Carla asked, planning her hectic day. She remembers looking up at the clock on the wall. A half-pound steak of salmon was warming in her shopping basket, threatening to spoil if she left it out too long.

In the end, commonplace particulars make up Carla’s memories of illness: the clock, the car pool, the children, a tube of pale blood, a missed shower, the fish in the sun, the tightening tone of a voice on the phone. Carla cannot recall much of what the nurse said, only a general sense of urgency. “Come now,” she thinks the nurse said. “Come now.”

I heard about Carla’s case at seven o’clock on the morning of May 21, on a train speeding between Kendall Square and Charles Street in Boston. The sentence that flickered on my beeper had the staccato and deadpan force of a true medical emergency: Carla Reed/New patient with leukemia/14thFloor/Please see as soon as you arrive. As the train shot out of a long, dark tunnel, the glass towers of the Massachusetts General Hospital suddenly loomed into view, and I could see the windows of the fourteenth floor rooms.

Carla, I guessed, was sitting in one of those rooms by herself, terrifyingly alone. Outside the room, a buzz of frantic activity had probably begun. Tubes of blood were shuttling between the ward and the laboratories on the second floor. Nurses were moving about with specimens, interns collecting data for morning reports, alarms beeping, pages being sent out. Somewhere in the depths of the hospital, a microscope was flickering on, with the cells in Carla’s blood coming into focus under its lens.

I can feel relatively certain about all of this because the arrival of a patient with acute leukemia still sends a shiver down the hospital’s spine—all the way from the cancer wards on its upper floors to the clinical laboratories buried deep in the basement. Leukemia is cancer of the white blood cells—cancer in one of its most explosive, violent incarnations. As one nurse on the wards often liked to remind her patients, with this disease “even a paper cut is an emergency.”

For an oncologist in training, too, leukemia represents a special incarnation of cancer. Its pace, its acuity, its breathtaking, inexorable arc of growth forces rapid, often drastic decisions; it is terrifying to experience, terrifying to observe, and terrifying to treat. The body invaded by leukemia is pushed to its brittle physiological limit—every system, heart, lung, blood, working at the knife-edge of its performance. The nurses filled me in on the gaps in the story. Blood tests performed by Carla’s doctor had revealed that her red cell count was critically low, less than a third of normal. Instead of normal white cells, her blood was packed with millions of large, malignant white cells—blasts, in the vocabulary of cancer. Her doctor, having finally stumbled upon the real diagnosis, had sent her to the Massachusetts General Hospital.

In the long, bare hall outside Carla’s room, in the antiseptic gleam of the floor just mopped with diluted bleach, I ran through the list of tests that would be needed on her blood and mentally rehearsed the conversation I would have with her. There was, I noted ruefully, something rehearsed and robotic even about my sympathy. This was the tenth month of my “fellowship” in oncology—a two-year immersive medical program to train cancer specialists—and I felt as if I had gravitated to my lowest point. In those ten indescribably poignant and difficult months, dozens of patients in my care had died. I felt I was slowly becoming inured to the deaths and the desolation—vaccinated against the constant emotional brunt.

There were seven such cancer fellows at this hospital. On paper, we seemed like a formidable force: graduates of five medical schools and four teaching hospitals, sixty-six years of medical and scientific training, and twelve postgraduate degrees among us. But none of those years or degrees could possibly have prepared us for this training program. Medical school, internship, and residency had been physically and emotionally grueling, but the first months of the fellowship flicked away those memories as if all of that had been child’s play, the kindergarten of medical training.

Cancer was an all-consuming presence in our lives. It invaded our imaginations; it occupied our memories; it infiltrated every conversation, every thought. And if we, as physicians, found ourselves...
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