Cancer – 2500 year journey

Recently, finished reading a book on Biography of cancer – The Emperor of All Maladies by Siddhartha Mukherjee.

Its a fixating book which travels through the history of the disease and how its transformed through the eyes of Patients, Doctors and Science itself. Its a must read to understand the evolution of the disease – though very detailed medically and requires lot of patience and time to journey through the book, but a rewarding journey.

When i first started reading this book in 2011, i could not complete as it was emotionally challenging to go through them as my dad was suffering from the same aside. Then, i kinda lost in time and reading habit. When i want to come back to resurrect the journey in 2017, i couldn’t choose any other book. But emotionally strong this time and have completed the book with so much of reminiscent of memories as distant past so near but so far.

The author did his fellowship in oncology from Massachusetts General Hospital and his extensive research is displayed in the chronological events unfolded in the history of the disease.

When i look back retrospectively, the book took me from 500BC to present day and vigorously show case how the physicians, scientists, oncologists and patients and their families suffered, resolved, zealous, sacrificed and hoped to understand and ultimately to cull the disease in all forms.

The journey starts with breast cancer observed in Persian Queen – Atossa and she cut off her breast with a greek slave. Probably the first surgery to treat cancer but looking back an act more of agony than treatment. With surgery shaping up in eighteenth century, so does the view to treat cancer. William Hasted promoting radical mastectomy which removes breast tissues profoundly and anything beneath and beyond. With surgery being a limited options for localised and non-invasive cancers, a need for other options erupted.

Sidney Farber, considered father of chemotherapy tried with anti folate drugs against leukemia in children is the first to see some remissions, even though little but paved the way for more…

Lot of scientists, physicians, chemist looking for drugs in early nineteenth century tried various options from die factory to war zones (mustard and nitrogen gas bombs). Combination drugs emerged like VAMP and STAMP to fight against cancer cells as the belief was more and multitude drugs can do better than single drugs.

Marie curie invention of Radium developed radiations therapy to treat and shrink the size of tumors. Then the combination of surgery, adjuvant chemotherapy with radiation was hybrid option often prescribed for localised cancers.

With more advanced technologies and proliferation of pharmaceutical technology companies like Gentech, new generation of target therapies evolved with the discovery of oncogenes (src, ras etc) which helped to develop drugs to kill the cancer cells than normal cells.

Now, we have myriad of options like Surgery, targeted therapy, hormone therapy, chemotherapy and radiations and combinations of them. But, still cancer outgrows and defeat us in this war of 2500 years…

Its perpetual war where the humans and the disease keep running against each other beating each other…

Hopefully, when you grow up, we might have better treatment options with paradigm shift in discoveries and inventions…

Hope is the best medicine!