Chapter 3: Breast cancer treatment: Are we there yet?

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

Chapter 2: Follow Your Intuition

The transition from cancer biologist to blogger dictated that I start with a book that envelops both worlds.  Siddhartha Mukherjee’s Emperor of all Maladies fills this category perfectly.  Thank goodness for the subtitle “A Biography of Cancer”, since the actual title is somewhat obscure.  At least now we know what we’re getting into!  My parents gave me this book for Christmas last year.  In their defense, I asked for it . .  . and started reading it soon after (it’s a long one!).

            Written by a physician, this history of cancer research combines the scientific details that I spend my days poring over with some poignant personal ancedotes.  I would highly recommend this book for anyone wanting to know more about how the field of cancer research has progressed over the last 100 + years, including the science and the non-science inclined. Many parts of this book incited my inner academic as well as my emotional subconscious.  True to form and my rambling sort of meanderings, there are way more subjects to discuss than can fit into one blog entry.  So, for both our sakes, I’ll break these up over the next couple of entries . . . to keep you coming back for more and to give me time to finish my next book (TBA). . . . hehe.

            The first concept that became quickly apparent is how long ago we, as a human race, acknowledged the existence of cancer.  Considering that we only knew about such fundamental concepts as the structure of DNA in 1953, the fact that people back in 400 BC (that’s right folks, more than 2400 years ago) had a word for this large overgrowth seems astonishing.   Of course, although they knew of the existence of this karkinos, the chemists and biologists understood very little of the underlying basis of cancer or had any effective way to treat this disease. 

            Interestingly, a lot of the physicians’ recommendations for the origin and treatment of cancer were actually somewhat intuitive, albeit extremely misguided.  For example, Galen, around 100 AD, postulated the first theory on the origin of cancer, explaining that cancer was a result of “black bile” that accumulated in the body, ultimately resulting in a mass.  Because this “black bile” permeated throughout the entire body, it was extremely difficult to treat (they tried blood-letting . . you guessed it, without success).  Sounds preposterous, yes?  However, take a closer look and you might realize that perhaps they were on to something.  If you think about how large and advanced a tumor would have to be before it could be detected back in the day, it most surely would have metastasized, or traveled, to distant sites within the body.  Galen’s theory of cancer flowing through the body doesn’t sound so far-fetched after all.  Coincidentally, it also saved the patients from undergoing excruciating surgery before the invention of anesthesia (phew!).  

            Of course the scientific community long ago put Galen’s theory on a shelf and identified cancer as a disease of uncontrolled cell growth.   But, perhaps we can learn from this and the multitude of other examples where men and women followed their gut feelings and ended up making great discoveries.  The moral of this story: Follow your intuition!

"Intuition will tell the thinking mind where to look next.

Jonas Salk

Chapter 1: She Writes

Welcome!  Let me give you some background on my new endeavor . . . aka this blog.

My unconscious desire to blog has resided within the back of my mind for quite some time now . . . perhaps even a decade.  I’ve always enjoyed writing (and reading) but I always found excuses not to actually write anything for myself.  Perhaps it was lack of time, lack of motivation, lack of ideas, or maybe even fear that whatever I wrote wouldn’t be important enough to permeate the internet waves.  However, recently, I’ve been inspired in two ways.  Not only have several friends started their own blogs and encouraged me to do the same, but my mother-in-law also inspires me when she talks about the 52 books/year she reads (averaging a book a week – WOW).   So what do you get when you put reading and writing together?  A blog about books, of course!  So I’m taking the plunge, putting on my brave face, and sending out my words for the world to read.

I am, as the title of my blog suggests, an academic.  To be more precise, the scientific kind of academic, the kind that studies the intricate details of the cancer cell.  This kind of study is incredibly fascinating, particularly when one thinks about how such tiny cells can contain so much complexity.  If I were to describe my academic experience, I might compare it to a roller coaster, filled with highs, lows, and even the loop-de-loops where seemingly nothing is accomplished.   Now, with the PhD behind me and the postdoctoral experience before me, I’m allowing myself to re-indulge in those things that I loved before graduate school consumed me.

And that brings me back to this blog.  I love books, both as the object and in the stories within.  I’ll pretty much read anything. . . from non-fiction to fiction, classic to bestsellers.  While I generally thoroughly enjoy all that I read, I have a tendency to forget all those great details.   With this new endeavor, I can share my random meanderings on those books, record the history of my reading, and convey my love of books.   

Enjoy!