The Emperor of all Maladies

I have been spending my lazy holiday break days with my family, snowed in on a mountainside overlooking Bear Lake.  I've spent much time pouring over a book my older brother (a surgeon) mailed to us, "The Emperor of all Maladies" by Siddhartha Mukherjee.  It is a riveting, well written biography of cancer.  Although I am only 1/5 of the way through this 500 page textbook/novel, I feel like sharing some of the many interesting things I have learned from my readings.  I am sure that as I continue through this book, there will be more interesting things posted on this blog.

"Illness is the night-side of life, a more onerous citizenship.  Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.  Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place." --Susan Sontag


"Those who have not been trained in chemistry or medicine may not realize how difficult the problem of cancer treatment really is.  It is almost - not quite, but almost - as hard as finding some agent that will dissolve away the left ear, say, and leave the right ear unharmed.  So slight is the difference between the cancer cell and its normal ancestor." --William Woglom

History

I have always been under the impression that cancer is a modern disease, but many paleopathologists have found cancers in mummified specimens.  Bone tumors, because they form hardened and calcified tissue, are vastly more likely to survive over centuries and are best preserved.

--Abdominal cancer found in a mummy in the Dakhleh Oasis in Egypt from about 400 AD.

--2000 year old Egyptian mummy in the Alexandrian catacombs with a tumor invading the pelvic bone.

--A jawbone dating from 4000 BC found in southeastern Africa carried the signs of a peculiar form of lymphoma. 

--440 BC Atossa, the queen of Persia, had a form of breast cancer.

--March 19, 1845 John Bennett described an unusual case where a patients blood was chock full of white blood cells.  He called it "a suppuration of blood" or in other words, the blood had apparently spoiled.  This is the earliest known case of Leukemia.

"Cancer, far from being a "modern" disease, is one of the oldest diseases ever seen in a human specimen - quite possibly the oldest." --Siddhartha Mukherjee

"Thus, for 3,000 years and more, this disease has been known to the medical profession.  And for 3,000 years and more, humanity has been knocking at the door of the medical profession for a "cure." --Fortune, March 1937

"Cancer's emergence in the world is the product of a double negative: it became common only when all other killers themselves (tuberculosis, dropsy, cholera, smallpox, leprosy, plague, or pneumonia) have been killed...civilization did not cause cancer, but by extending human life spans - civilization unveiled it...The capacity to detect cancer earlier and earlier, and to attribute deaths accurately to it, has also dramatically increased in the last century." --Siddhartha Mukherjee

"Why don't we try to conquer cancer by America's 200th birthday: What a holiday that would be!" --Advertisement published in the New York Times by the Laskerites.  December 1966

Terms

-In 400 BC karkinos, from the Greek word "crab" showed up in medical literature to describe a tumor with a clutch of swollen blood vessels around it.  It reminded Hippocrates of a crab dug in the sand with its legs spread in a circle.

-Onkos was the Greek term for a mass or a load, or more commonly a burden.  Cancer was imagined as a burden carried by the body.  Onkos occasionally was used to describe tumors, from which the discipline of oncology would take its modern name.

--Weisses Blut - white blood - was the first name for leukemia.  It is a literal description of the millions of white cells seen in the blood.

--1847, "leukemia" - from the Greek word leukos, meaning "white" became the official name for Leukemia.