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Washington: Indian
American cancer specialist Siddhartha Mukherjee, whose very first
book has become a runaway success, advocates a strong anti-smoking
campaign and breast cancer screening to battle the growing
incidence of the disease in India.
Less than a month after publication, Mukherjee's book, "The
Emperor of All Maladies: A Biography of Cancer", on the history of
the disease, features among "The 10 Best Books of 2010" in the New
York Times Book Reviews Sunday, a rare feat for a work of
non-fiction.
"Cancer is growing dramatically in certain parts of South Asia,"
New Delhi-born Mukherjee told IANS on phone from New York where he
practises, blaming increase in tobacco smoking as "clearly one
culprit among young men and women".
"But there are other culprits too," he says. "As the population
ages and other diseases are slowly eliminated, cancer begins to
come about."
"Cancer rises in the double negative only when all the other
killers have been killed. So I think that's beginning to occur in
some parts of South Asia."
To those who wonder if it is relevant to a country like India as
"cancer treatment can be so expensive and such a vast enterprise,
his answer is "absolutely, at all levels."
"A strong prevention campaign against smoking is not all that
expensive and is highly relevant to the future of our health in
India," said Mukherjee, assistant clinical professor at the
oncology department at Columbia University, New York.
Similarly, screening for breast cancer in the appropriate age
group and its treatment with hormonal therapy "and certainly
treatment of childhood cancers which are often curable are highly
relevant to a country like India," Mukherjee said.
Mukherjee, 40, who grew up in New Delhi's Safdarjung Enclave,
"immersed in reading and books" at home and at St. Columba's
School, says he "came into oncology in a sort of reverse, in the
sense that I first trained as a cellular biologist when I was in
Oxford as a Rhodes scholar".
"So I really came from the cell into medicine. Many people first
train in medicine, then eventually get fascinated by cells."
Mukherjee says he wrote this book because when he was a fellow in
training in Boston, "I kept coming over this question again and
again: what is the history of cancer, what's happening next and
where are we going?"
In particular, a woman he was treating told him: "I am willing to
go on with my chemotherapy, but I need to know what it is that I
am battling."
"Answering that question was the genesis of the book," he said.
The somewhat intriguing title "was found handwritten on an
antiquarian book on cancer - emperor of all maladies and king of
all terrorists".
Mukherjee said he chose to subtitle it a "biography" after a lot
of thought. "A successful biography allows you to enter the
interior of the mind or the personality of someone. So as I was
writing the book, I really felt I was drawing a portrait of cancer
through time, acknowledging the fact that cancer was not one
disease, but many diseases."
"Nonetheless, there is a sentence in the book which says, 'every
era casts illness in its own image and certainly every era has
cast cancer in its own image'. So I felt that this project could
only be described as a biography," he said.
The book isn't meant for the medical profession alone. "The target
is everyone. The point of this book was to make this world of
medicine and science and culture accessible to anyone who is
interested," Mukherjee told IANS.
"This is a disease that has developed in our times in a very
poignant way. So I intend this book to be read by anyone who
wishes to find out about it: patients and people whose loved ones
are affected by cancer or any person interested in its history."
Mukherjee says one of the book's key messages was "There is
unlikely to be a single magic bullet against cancer given the
level of heterogeneity."
Secondly, given the fact that "many cancers are part of our normal
genome, it's unlikely that we'll eradicate or cure every form of
cancer" - like we did with smallpox or polio.
"Some variation of this disease is inherent to our genetic makeup
and it's more likely that we'll learn to control it rather than
eradicate it or cure it in the future," says Mukherjee.
Though "still in a daze about what's going on about this book", he
is quite sure he is not going to turn a full-time writer. "No I
think, I will stay with where I am - which is practising medicine
and writing about medicine."
(Arun Kumar can be contacted at arun.kumar@ians.in)
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