Sunday, March 25, 2012

The Emperor of All Maladies

1

Mukherjee stated that the first known breast cancer patient was the Persian Queen Atossa in 500BC. She received the most primitive form of mastectomy by her Greek slave. In 2500 BC, the cancer had another name, but there was no treatment. However, someone could perform a primitive form of surgery 2000 years after the first discovery of cancer. Two hundred years later, Hippocrates called cancer by the Latin name “karkinos.” In AD 168, Claudius Galen hypothesized the cause of cancer to be black bile. In 1778, John Hunter’s clinic in London figured out that Queen Atossa had localized breast cancer. Cancer has changed name and treatments throughout history. In 1986, BRCA-1 and BRCA-2 mutations were found from Atossa’s cancer. Cancer treatment has been improving and death rates from cancer had been reduced. However, still the best treatment is surgery if the cancer does not metastasize. In the future, Cancer-gene analysis and customized treatments will be available. However, most cancer is considered sporadic. People did not inherit cancer-causing mutations from their parents. Instead, cells in our body develop mutations and lead to cancer. These mutations can be caused by sun, radiation, chemicals or random events within the cell. Therefore, the fight for cancer will be continue forever as long as cancer exists. In other way, Mukherjee said that we are successful in the focus on prolonging life rather than eliminating death. He is optimistic about modern cancer treatments because they prolong cancer patients’ lives longer than in the past.

2

A biography is a detailed description or account of someone's life. It includes a history of one’s entire life and his most outstanding achievements. This book describes the history of cancer through the lens of Mukherjee’s eyes- a biography of cancer and the stories of cancer patients who suffered primitive treatments, advanced chemotherapy, or survived from cancer and radical treatments. The Emperor of All Maladies is a “biography of cancer.” According to this book, the first cancer was diagnosed in 1990 by a paleopathologist who found cancer marks from a Peruvian mummy. The first form of chemotherapy was developed from textile dyes and saved many cancer patients at that time. Now doctors could tell to the patients, “Your cancer can be treated.” Discovery of new treatments or causes of cancer might be small, but they can add up to transformative changes. Cholera, Asthma, and AIDS are diseases that also have biographies of their own.

3

When we look at the history of cancer causes or treatments, we can see that history does repeat itself. First, a scientist figured out that Atossa’s illness was that a swelling appeared on her breast that continued to spread and proliferated until a swelling was cut out by a knife. She had breast cancer in 500BC. Her cancer appeared and reappeared in one generation after the next. Her cancer has been moving through history because her tumor was frozen in its stage and remained the same now. Atossa’s case reminds us about the past and modern practice of cancer therapy as well as the future. Cancer happened in history and is happening in the present. Cancer comes into human lives again and again without exception. I cannot accept that something happens again and again without exception and it does it the exact same as the time before. Our medical technology has been changing and it can never be exactly like the previous time. The date, the time and the things involved are always changing. But complete banishing cancer is only one way that it is to be cut them off. If we cannot cut them off completely, cancer comes back in the past and now, maybe in future, too. We have to relive the past in order to move forward in the present, and achieve a solution in the future.

4.

We know now that all cancers are not the same. In the past, cancer had no treatments and it means that all cancer patients had to die. It is a reason why we tend to make a strong connection between cancer and death. Now, as long as we find them in its early stage, cancers are curable. “The War on Cancer” had so many sad stories about cancer patients. We all know that cancer causes death in general ignoring all of the medical scientists’ efforts because we don’t know exactly where cancer comes from. Determining what causes cancer is multifaceted challenge. All I know are the risk of cancer, including tobacco use, certain viruses, radiation, and damaged genes. Can we blame our ancestors because five to ten percent of cancers are entirely hereditary? Mukherjee points out those cancers are the most brutal of problems because mutated cells grow without normal regulation. and that it is the body’s own resources turned against us.

Early treatments focused on radical excision and chemotherapy. Doctors hoped to kill the cancer before it killed the patient. Chemotherapy has improved a lot within the last fifty years, and it has helped prolong the lifespan of cancer patients. Cancer survival rate has increased statistically. But I wonder whether scientists can also give cancer patients a productive lifestyle.

Thursday, March 15, 2012

Fourth set of questions

1. in the final chapter of the book, the author creates a fictional journey for Queen Atossa through time to demonstrate how cancer treatment has changed over the centuries. How might you have summarized this book? What image or metaphor, emerges most powerfully at the end of this book?
2. The author calls this book a biography. Can a biography be written of an illness? Are there other diseases that demand biographies?
3. IN what sense does history "repeat itself" in cancer research? In science, where new discoveries keep altering the landscape, what is the worth of reliving the past?
4. At the end of the book do you come away with optimism about science's efforts to combat cancer? Why or why not?

Wednesday, March 14, 2012

The Emperor of All Maladies

1.

So many of the scientific breakthroughs have impacted cancer research such as Wilhelm Röntgen's discovery of the X-Ray in 1895, and it occurred by accident as well as folic acid discovery. Sidney Farber thought that anemia is deficiency of red blood cells because of lack of iron. Farber investigated the way of treating anemia with various things. Farber had been working for vitamins and bone marrow. Lucy Wills found that folic acid could help the blood in malnourished patients. Farber started to think the same thing with leukemia. However, folic acid actually accelerated the progression of leukemia. Then he happened to think about that maybe an "anti-folate" could work something to stop the growth of white blood cells. Folic acid, discovered in 1941 in green leafy vegetables, derives its name from the Latin word for leaf, folium. It was called folacin or folate, too. Folic acid is important in preventing spina bifida, so it prevents birth defects of the neural tube. Pregnant women are recommended to take folic acid during their pregnancy. He thought about “anti-folate” as anti-cancer treatment. It is just miracle.

2.

The war on cancer is successful. In the past, people didn’t want to face the cancer, especially a breast cancer. As a result, women had to suffer a lot. Now women don’t need to die for the breast cancer. 1969, Dr. Sidney Farber, past President of the American Cancer Society, stated “We are so close to a cure for cancer. We lack only the will and the kind of money and comprehensive planning that went into putting a man on the moon.”

President Richard M. Nixon signed for the National Cancer Act on December 23, 1971. The law earmarked $1.5 million for cancer research over a 3-year period. Now we understand the biological and molecular bases of cancer including cancer genes. Cancer-related mortality rates have declined such as lung, breast, colon, and prostate cancer. We are winner!!!

3.

The 1980 Canadian mammography trial was possibly faulty because technicians disproportionately chose women who might have breast cancer for mammograms, likely out of concern. It means that some patients who have cancer could not get mammograms. I could not believe that it happened just 30 years ago.

4.

Multi-pronged chemotherapy, radiation, and surgery are modern treatments for cancer. Now preventative care is an important method to fight back to cancer. But it is a long journey to reach this point of treatment. This book tells me that the history of science to fight against cancer. Everybody hopes to go over cancer and survive. Nelene Fox was refused in 1991 to get pay for an expensive bone marrow transplant to treat her diagnosis of advanced breast cancer. Honestly speaking, advanced cancer has nothing to do even though by modern technologies. One of my friends spent over $200,000 to save her husband as the doctors promised her to save him. It is impossible to save anyone from the advanced cancer. So I feel that the doctors ripped off her for money. She should use all money to have wonderful time with her husband until he passed away. Any experimental treatments would not to extend survival if the cancer is advanced stages.

Tuesday, March 6, 2012

3rd set of questions

1. So many of the scientific breakthrough that impacted cancer research such as the discovery of X-rays occurred by accident. What other chance discoveries appear in the text.
2. Was the war on cancer a failure? why or why not?
3. The 1980 Canadian mammography trail was possibly flawed because technicians steered women with suspected breast cancer to get mammograms, likely out of compassion. Put yourself in the technician's lab coat. Would you have allocated your friend to the mammogram group? If so, how can trials ever be randomized?
4. Review the case of Nelene Fox. In your view was it appropriate for the HMO to refuse to pay for the expensive bone marrow transplant?