The Emperor of All Maladies: A Biography of Cancer (90 page)

Inspired by the early victories of chemotherapy, cancer advocates, led by Lasker and Farber, urged the nation to launch a War on Cancer. In 1970, the Laskerites published a full-page advertisement in the New York Times, coaxing Nixon to support their war.

Many scientists criticized the War on Cancer as premature, arguing that a political cure would not lead to a medical cure.

Lasker’s use of canny advertising and potent imagery still inspires generations of advocates, including Greenpeace.

In 1775, the London surgeon Percivall Pott observed that scrotal cancer occurred disproportionately in adolescent chimney sweeps, and proposed a link between soot and scrotal cancer, launching the hunt for preventable carcinogens in the environment.

Innovative studies in the 1950s established the link between cigarette smoking and lung cancer. Yet early warning labels affixed on packages in the 1960s avoided the word “cancer.” Explicit warning labels were not required until decades later.

Although smoking rates have fallen in most developed nations, active marketing and bold political lobbying allows the tobacco industry to flourish in others, creating a new generation of smokers (and of future cancer victims).

Harold Varmus and J. Michael Bishop discovered that cancer is caused not by exogenous viruses, but by the activation of endogenous precursor genes that exist in all normal cells. Cancer, Varmus wrote, is a “distorted version” of our normal selves.

Working with collaborators across the globe, Robert Weinberg, of MIT, discovered distorted genes in mouse and human cancer cells.

Scientists have sequenced the entire genome (all 23,000 genes), making it possible to document every genetic change (relative to normal genes). Dots represent mutations in genes found in colon cancer, with commonly mutated genes becoming “hills” and then “mountains.”

In the 1990s, Barbara Bradfield was among the first women to be treated with a drug, Herceptin, that specifically attacks breast cancer cells. She is the longest survivor of that treatment, with no hint of her cancer remaining.

I have many people to thank. My wife, Sarah Sze, whose unfailing faith, love, and patience sustained this book. My daughters Leela and Aria, for whom this book was often a rival sibling; who fell asleep on many nights to the mechanical lullaby of my furious typing and then woke the next morning to find me typing again. My agent Sarah Chalfant, who read and annotated draft upon draft of my proposals; my editor Nan Graham, with whom I began to communicate with “mental telepathy” and whose thoughts are stitched into every page. My early readers: Nell Breyer, Amy Waldman, Neel Mukherjee, Ashok Rai, Kim Gutschow, David Seo, Robert Brustein, Prasant Atluri, Erez Kalir, Yariv Houvras, Mitzi Angel, Diana Beinart, Daniel Menaker, and many mentors and interviewees, particularly Robert Mayer, who were crucial in the development of this book. My parents, Sibeswar and Chandana Mukherjee and my sister, Ranu Bhattacharyya and her family, who found vacations and family gatherings swallowed up by an interminable manuscript and Chia-Ming and Judy Sze who provided sustenance and help during my frequent visits to Boston.

As with any such book, this work also rests on the prior work of others: Susan Sontag’s masterful and moving
Illness as Metaphor
, Richard Rhodes’s
The Making of the Atomic Bomb
, Richard Rettig’s
Cancer Crusade
, Barron Lerner’s
The Breast Cancer Wars
, Natalie Angier’s
Natural Obsessions
, Lewis Thomas’s
The Lives of a Cell
, George Crile’s
The Way It Was
, Adam Wishart’s
One in Three
, Aleksandr Solzhenitsyn’s
Cancer Ward
, David Rieff’s devastating memoir
Swimming in a Sea of Death
, Robert Bazell’s
Her-2
, Robert Weinberg’s
Racing to the Beginning of the Road
, Harold Varmus’s
The Art and Politics of Science
, Michael Bishop’s
How to Win the Nobel Prize
, David Nathan’s
The
Cancer Treatment Revolution
, James Patterson’s
The Dread Disease
, and Tony Judt’s
Postwar
. Many archives and libraries were accessed as primary sources for the book: Mary Lasker’s papers, Benno Schmidt’s papers, George Papanicolaou’s papers, Arthur Aufderheide’s papers and specimen collection, William Halsted’s papers, Rose Kushner’s papers, the tobacco documents at UCSF, Evarts Graham’s papers, Richard Doll’s papers, Joshua Lederberg’s papers, Harold Varmus’s
papers, the Boston Public Library, the Countway Library of Medicine, Columbia University libraries, and Sidney Farber’s personal photographs and correspondence, shared by several sources, including Thomas Farber, his son. The manuscript was also read by Robert Mayer, George Canellos, Donald Berry, Emil Freireich, Al Knudson, Harold Varmus, Dennis Slamon, Brian Druker, Thomas Lynch, Charles Sawyers, Bert Vogelstein, Robert Weinberg, and Ed Gelmann, who provided corrections and alterations to the text.