The Emperor of All Maladies: A Biography of Cancer (110 page)

clinical trials in,
see
protocols

clinical vs. laboratory-based,
337
,
339
,
354
–55,
375
,
402
,
404
,
455
–56

Congress and,
24
–25,
113
–14,
122
,
150
,
177
,
184
–89,
455

effect of AIDS crisis on,
319

as historically underfunded,
23
–25

“one cause, one cure” approach in,
93
,
155
,
173
,
223
,
332
–33,
342
–43,
403

relevance of past in,
466

understanding of carcinogenesis downplayed in,
304

World War II and,
26

see also specific cancers, researchers, and therapies

Cancer Research
, 254

“cancer stem cells,”
458
–59

“Cancer Undefeated” (Bailar and Gornik),
330
–32

Cancer Ward
(Solzhenitsyn),
4
,
181
,
316
,
461

Canellos, George,
159
,
162
,
163
,
164
,
207
,
220
,
312
,
313

Cantor, David,
235

Cantor, Eddie,
94

carbolic acid,
57
–58,
62

Carbone, Paul,
219
–20

Carboplatin,
403
–4

carcinogenesis,
285

Auerbach’s research on,
258
–59,
284
,
286
,
289
,
384
–85,
386

chromosomes and,
341
–42,
343
,
348
,
365
–66,
402

as downplayed by researchers,
304

epidemiology and,
276

genetic mutation as mechanism of,
6
,
39
,
176
,
278
,
357
,
362
,
364
–69,
370
,
380
–83,
384
–88,
390
–92,
403
,
406
,
449
–50,
462
,
464
–65

internal vs. external agents in,
342
,
349
,
350

molecular model of,
388
–90

premalignant stages of,
385

prevention as dependent on understanding of,
284
–85,
303

risk factors and,
44
,
276
,
303
,
349
,
445
–46,
455
–57

somatic mutation hypothesis of,
173
–74

two-hit hypothesis for,
367
–69,
376
,
377
,
380

unitary cause of,
342
,
347
,
348
,
390

Varmus/Bishop (proto-oncogene) theory of,
361
–63,
364
,
369
,
370
,
375
,
380

carcinogens:

bacterial,
281
–84,
303

chemical,
276
–77,
388
,
446

DNA as damaged by,
75
,
77
,
122
,
351
,
406
,
462

environmental,
173
–74,
176
,
238
,
349
,
388
,
446
,
456
–57

genes as,
see
oncogenes; tumor suppressor genes

genetic mutation caused by,
278
,
362
,
364

inflammations as,
281
,
284
,
303
,
340
,
388
,
456
n

mutagens as,
278
,
303
,
347
,
348
,
362
,
364
,
406
,
456

radiation as,
77
–78,
347
,
349
,
364
,
389

tobacco as,
see
tobacco-cancer link

viral,
173
,
174
–76,
278
–81,
303
,
342
–43,
349
–50,
351
–56,
357
,
362

Carey, William,
180

Carroll, Lewis,
357
,
360
,
362
,
441
,
443

Carson, Rachel,
199
–200,
456

Carter, Paul,
419
,
420
,
427

case-control studies,
245
,
246
–47,
276
,
280
,
294

Castle, William,
11

causality:

in disease,
253
–56,
290

Hill’s postulates for,
255
–56

Koch’s postulates for,
254
,
382

see also
carcinogenesis; carcinogens

Cautions against the Immoderate Use of Snuff
(Hill),
239
–40,
276

Cavenee, Webster,
376
,
377

cell death (apoptosis),
391
,
402
,
407

cell growth:

hyperplastic,
see
hyperplasia

hypertrophic,
15

neoplastic,
see
neoplasia

cell phones, glioma and,
446
–47

cells:

membranes of,
410
–11

normalcy vs. abnormalcy of,
449
,
459

cellular theory of disease,
14
–16

Centers for Disease Control (CDC),
315

cervical cancer,
381
n

Pap smears and,
288
–90,
331
,
385
,
401

premalignant stage of,
385

CGP57148,
see
Gleevec

Chabner, Bruce,
304
,
405
,
439

Chappaquiddick scandal,
179

Charlotte’s Law,
325

“chemical castration,”
213
,
215

chemicals, synthetic,
81
–86,
91
,
277

medicine and,
83
–84

chemical stains,
84
–85

Chemical Warfare Unit,
90
,
92

chemotherapy,
7
,
114
,
304
,
355
,
448

adjuvant,
219
,
220
–21,
222
,
223
,
320
,
400
,
464

bone marrow transplants in,
see
bone marrow transplants

for breast cancer,
122
–23,
162
,
232
,
306,
308
–9,
427
–28

“cancer stem cells” and,
458
–59

cure rates for,
228
,
231
;
see also
specific cancers

as cytotoxic,
43
–44,
143
n,
162
–63,
165
,
168
,
176
,
207
,
208
,
220
,
223
,
305
,
309
,
312
,
320
,
405
,
427
–28,
452

dose limits of,
309

Ehrlich and,
84
–88

fixed percentage of cells killed by,
141

high-dose multidrug regimens in,
132
–34,
135
,
140
–43,
162
,
163
,
166
,
167
,
172
,
173
,
176
–77,
204
–5,
207
–9,
216
,
232
,
305
,
306
,
308
–9,
329
,
389
,
400
,
443
,
452
;
see also
bone marrow transplants;
specific regimens

for Hodgkin’s lymphoma,
163
–66,
208
,
308
,
315
,
401

immune system compromised by,
165
,
315

indiscriminate use of,
210

for leukemia,
19
–20,
21
,
27
,
29
–30,
31
,
33
–36,
92
,
100
,
101
,
103
–4,
122
,
132
–34,
135
,
140
–42,
167
–70,
308
,
339
,
401
,
443

for lung cancer,
308
–9,
389
,
403
–4,
443

for lymphomas,
90
–91,
96
–97,
122
,
132
–34,
135
,
162
,
401
,
443

nontoxic,
439

radiation in combination with,
123
–24,
154
,
168
–70,
400

secondary cancers as outcome of,
165
,
306
,
312

side effects of,
18
,
96
,
123
,
165
,
205
–6,
209
,
226
,
305

specific affinity in,
80
–81,
84
–88,
90
–92,
433
,
434
,
439

sterility caused by,
165

surgeons’ hostility to,
219
–21

targeted,
see
targeted therapies

for tumors,
122
–23,
154
,
207
,
308
–9

as universal cure,
93

white blood cells and,
127
,
315

Chesterfield cigarettes,
268

Chiari, Hans,
62

Chicago Tribune
, 187,
189
,
235

chickens, sarcomas in,
173
,
174

child labor,
239

children:

cancer in,
123
,
331

leukemia in,
7
,
12
,
17
,
19
,
32
–36,
92
,
96
,
101
,
103
–4,
123
,
133
,
139
,
163
,
166
,
170
,
179
,
231
,
232
,
401

Children’s Cancer Research Fund,
see
Jimmy Fund

Children’s Hospital (Boston),
11
–12,
19
,
22
,
27
,
29
,
30
,
33
,
34
,
94
,
95
–96,
97
,
99
,
101
,
387

Children’s Hospital (Buffalo),
133

chimeras,
366
,
409
–10,
430
–31

Chimney Sweepers Act (1788, British),
239

chimney sweeps,
173
,
237
–39,
241

China, cigarette consumption in,
273
–74

Chiribaya mummies,
42
–43,
45

chloramphenicol,
22

cholesterol,
444

choriocarcinoma,
135
–36,
139
,
168
,
228

choriogonadotropin (hcg),
136
,
137
,
138

Christakis, Nicholas,
445

Christie, Agatha,
444

Christie Hospital,
216
–17

chromosomes,
340

in cancer cells,
341
–42,
343
,
348
,
430
–31

genes as carried on,
344

pairing of,
377

staining of,
340
,
365

translocation of,
365
–66,
402
,
409
–10,
430
–31

chronic myeloid (myelogenous) leukemia (CML),
365
–66,
430
–31,
433
,
444

bone marrow transplants and,
434
–35,
437

drug resistance in,
441
–43

Gleevec trial for,
436
–38

remissions of,
437
–39,
441
,
443
,
465

Ciba-Geigy,
431
–32,
433
–34,
436

cigarettes:

consumption of,
see
smoking

filter tips on,
263
,
268

warning label on,
264
–65,
267
,
273
,
401

see also
nicotine; tobacco; tobacco industry

Cipollone, Anthony,
268
,
270

Cipollone, Rose,
267
–72,
273
,
401

cirrhosis, chronic,
279

cisplatin (
cis-platinum
),
203
–4,
205
,
208
,
406
,
421

nausea from,
205
–6

cis-retinoic acid,
408
–9

c-kit
gene,
467
–68

Claire-King, Mary,
381

Clauson, Phyllis,
395
–96,
397

Cleland, John,
204
–5