BJS Bookshelf: The Emperor of All Maladies: A Biography of Cancer.

“The Emperor of All Maladies: A Biography of Cancer” by Siddhartha Mukherjee (New York based oncologist and cancer researcher at Columbia university and the New York Presbyterian Hospital) offers a compelling and profound history of cancer. The book traverses the landscape of human understanding of cancer, from its first documented appearances thousands of years ago in ancient Egypt to the upcoming of radical oncological surgery, the discovery of the first chemotherapeutic agents as well as modern genetic and molecular discoveries and therapies. Mukherjee blends historical anecdotes, medical case studies, and his own experiences as a clinical oncologist to present a comprehensive picture of cancer. It is an enlightening journey through centuries of research and treatment advances which also examines the psychological and societal impact of this devastating disease. The powerful narrative intertwines multiple storylines covering science, history, and personal stories. On the one hand, it captures the endurance of patients as well as the dedication of physicians, whilst on the other, it highlights the intricacies of medical politics and the challenge of balancing hope and realism. Overall, it is a riveting saga of a ‘relentless and multifaceted menace,’ a testament to human resilience and scientific tenacity, for which the author was awarded the Pulitzer Prize in 2011.

This book is a crucial read for surgeons for multiple reasons. First of all, it provides a comprehensive historical and scientific understanding of cancer, a disease surgeons frequently encounter. While surgery is important in the fight against cancer and remains the cornerstone of curative treatment, understanding the history and development of chemo-, radio- and targeted therapy allows readers to better appreciate a multidisciplinary approach. This provides surgeons with a broader context for their work, allowing them to view their role within a larger narrative of medicine and science. The book delves into the breakthroughs in cancer research and treatments, including surgical advancements that have shaped modern oncological treatment. The sections on the development of surgical oncology and its principles, which focus on Halsted, the radical mastectomy and certain erratic paths that surgery has taken during history, are essential knowledge for every surgeon. Unfortunately, this is seldom taught in medical school and residency.

Second, the book explores the experiences of patients, providing surgeons with profound insights into the emotional and psychological aspects of dealing with cancer. It presents a holistic and empathetic view that goes beyond the operating room and the short perioperative period where surgeons normally accompany their patients. By revealing the patient perspective of the complex journey from diagnosis to treatment and often death, it enables surgeons to better understand the comprehensive effects of a cancer diagnosis on a patient’s life.

In essence, “The Emperor of All Maladies” is not just a history of a disease but rather serves as a reminder of the resilience of the human spirit, the crucial role surgeons play in the ongoing battle against cancer and an affirmation of the noble pursuit that is the medical profession.