Thanks for coming back to read more on Siddhartha Mukherjee’s Emperor of all Maladies!
On to the second theme. . . . curing breast cancer . . . . big topic, I
know.
Three
cancer types dominated this book: leukemia, breast cancer, and lung cancer. Whereas the discussion on leukemia was
quite anecdotal, and lung cancer provided the foundational example of the
importance of epidemiological studies, the story of breast cancer exemplifies
how cancer research has progressed over the last 100 years or so.
My
first reaction when the author shared the history of breast cancer treatment
was disappointment and disillusion with the progression of the cancer research
field. I always thought that we,
as cancer scientists, made great strides towards better treatment of this
disease, particularly in the last 30 years. But when Mukherjee described Halsted’s early treatment of
breast cancer through radical mastectomy, followed by Grubbe’s radiation
treatment in the early 1900’s, I began to wonder: how far have we really come?? Even 100 years later, our first line of defense against
breast cancer remains surgery and radiation. Albeit, Halsted’s surgery essentially mangled the women for the
rest of her short life (learning that by removing the breast in addition to large
amounts of the chest cavity reduced the risk of cancer recurrence) and the
nuances of the cancer-promoting properties of radiation were largely
unknown. But really, have we really
only improved upon those early treatments? What new discoveries have we made in the last 100 YEARS!?
In
my semi-depressed state, I brought up this disappointment to my
supervisor. He, being a true
academic, told me not to get too depressed and preceded to talk about the great
advancements in our breast cancer field.
Of course, he’s right (when is your boss not right?) and Mukherjee
doesn’t neglect these details either.
In addition to less toxic chemotherapies, physicians now possess several
specific targeted therapies that can distinguish cancer cell from normal cell
or benefit patients with aggressive and resistant disease. Being immersed in the breast cancer
field, I am, of course, aware of these new therapies. . . .I just needed
reminding.
We
have made progress in curing breast cancer (among a multitude of other
cancers), perhaps not as dramatic as I had imagined, but progress
nonetheless. And ultimately, I am
thankful for these advancements.
“Why, it is asked,
does the supply of new miracle drugs lag so far behind, while biology continues
to move from strength to strength?” Lewis Thomas, The Lives of a Cell, 1978
