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First Person

A disease dissected

Cancer's 4,000-year history

Siddhartha Mukherjee
By Kathleen Burge
November 28, 2010

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Oncologist Siddhartha Mukherjee, 40, will read from "The Emperor of All Maladies: A Biography of Cancer" at Harvard Bookstore on Thursday.

Why call this a biography of cancer? I felt I was writing not about something, but about someone. We write biographies in order to understand, to decipher the psyche, to enter the personality. In a sense, we’ve been trying to do this with cancer for nearly 4,000 years.

Did the book grow out of your fellowship at Dana-Farber in Boston? It was a combined fellowship between Dana-Farber and Mass. General. I was keeping a journal at that time. But, of course, cancer’s so enveloping that one can’t just write a journal. It becomes a much larger intellectual project. Susan Sontag wrote this about AIDS in the 1980s. She said AIDS is no longer just a biological illness, it’s almost a cultural category. And it seems to me that, in the 21st century, it’s cancer – a cultural category, replete with story and metaphor and a history and a future.

You dedicate the book to Robert Sandler. Who was he? A 2 1/2-year-old boy from Dorchester who was diagnosed with leukemia. He came to [Dr. Sidney] Farber’s clinic and had a brief, very tantalizing response to chemotherapy, and then relapsed and died. It was one of the first chemotherapy trials in leukemia.

When does cancer first appear in written history? There are veiled references to things that might have been cancer that go back to about 2500 BC. There’s a much debated reference in Herodotus’s writings to Queen Atossa, who may have had breast cancer; we know it was treated. And surgeons – particularly in the 19th century – were convinced this was breast cancer treated with a primitive mastectomy. One of the people I interviewed is a pathologist whose job is to find diseases in mummies. He was one of the first discoverers of what was probably a bone cancer in a 1,000-year-old mummy from Peru.

You write that maybe we should think more about extending life than eradicating cancer. What it means to win the war on cancer is not to eradicate cancer from our lives, but rather to imagine extending what I call this cat-and-mouse game with cancer as far as possible while retaining as much dignity of patients as possible.

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