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The Cancer Chronicles
Cover of The Cancer Chronicles
The Cancer Chronicles
Unlocking Medicine's Deepest Mystery
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When the woman he loved was diagnosed with a metastatic cancer, science writer George Johnson embarked on a journey to learn everything he could about the disease and the people who dedicate their lives to understanding and combating it. What he discovered is a revolution under way—an explosion of new ideas about what cancer really is and where it comes from. In a provocative and intellectually vibrant exploration, he takes us on an adventure through the history and recent advances of cancer research that will challenge everything you thought you knew about the disease.
Deftly excavating and illuminating decades of investigation and analysis, he reveals what we know and don't know about cancer, showing why a cure remains such a slippery concept. We follow him as he combs through the realms of epidemiology, clinical trials, laboratory experiments, and scientific hypotheses—rooted in every discipline from evolutionary biology to game theory and physics. Cogently extracting fact from a towering canon of myth and hype, he describes tumors that evolve like alien creatures inside the body, paleo-oncologists who uncover petrified tumors clinging to the skeletons of dinosaurs and ancient human ancestors, and the surprising reversals in science's comprehension of the causes of cancer, with the foods we eat and environmental toxins playing a lesser role. Perhaps most fascinating of all is how cancer borrows natural processes involved in the healing of a wound or the unfolding of a human embryo and turns them, jujitsu-like, against the body.
Throughout his pursuit, Johnson clarifies the human experience of cancer with elegiac grace, bearing witness to the punishing gauntlet of consultations, surgeries, targeted therapies, and other treatments. He finds compassion, solace, and community among a vast network of patients and professionals committed to the fight and wrestles to comprehend the cruel randomness cancer metes out in his own family. For anyone whose life has been affected by cancer and has found themselves asking why?, this book provides a new understanding. In good company with the works of Atul Gawande, Siddhartha Mukherjee, and Abraham Verghese, The Cancer Chronicles is endlessly surprising and as radiant in its prose as it is authoritative in its eye-opening science.

When the woman he loved was diagnosed with a metastatic cancer, science writer George Johnson embarked on a journey to learn everything he could about the disease and the people who dedicate their lives to understanding and combating it. What he discovered is a revolution under way—an explosion of new ideas about what cancer really is and where it comes from. In a provocative and intellectually vibrant exploration, he takes us on an adventure through the history and recent advances of cancer research that will challenge everything you thought you knew about the disease.
Deftly excavating and illuminating decades of investigation and analysis, he reveals what we know and don't know about cancer, showing why a cure remains such a slippery concept. We follow him as he combs through the realms of epidemiology, clinical trials, laboratory experiments, and scientific hypotheses—rooted in every discipline from evolutionary biology to game theory and physics. Cogently extracting fact from a towering canon of myth and hype, he describes tumors that evolve like alien creatures inside the body, paleo-oncologists who uncover petrified tumors clinging to the skeletons of dinosaurs and ancient human ancestors, and the surprising reversals in science's comprehension of the causes of cancer, with the foods we eat and environmental toxins playing a lesser role. Perhaps most fascinating of all is how cancer borrows natural processes involved in the healing of a wound or the unfolding of a human embryo and turns them, jujitsu-like, against the body.
Throughout his pursuit, Johnson clarifies the human experience of cancer with elegiac grace, bearing witness to the punishing gauntlet of consultations, surgeries, targeted therapies, and other treatments. He finds compassion, solace, and community among a vast network of patients and professionals committed to the fight and wrestles to comprehend the cruel randomness cancer metes out in his own family. For anyone whose life has been affected by cancer and has found themselves asking why?, this book provides a new understanding. In good company with the works of Atul Gawande, Siddhartha Mukherjee, and Abraham Verghese, The Cancer Chronicles is endlessly surprising and as radiant in its prose as it is authoritative in its eye-opening science.

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Excerpts-
  • Chapter 1

    Jurassic Cancer

    As I crossed a dry, lonesome stretch of the Dinosaur Diamond Prehistoric Highway, I tried to picture what western Colorado--a wilderness of sage-­covered mesas and rocky canyons--­looked like 150 million years ago, in Late Jurassic time. North America was breaking away from Europe and Asia--­all three had formed a primordial supercontinent called Laurasia. The huge land mass, flatter than it is today, was drifting northward a few centimeters per year and was passing like a ship through the waters of what geographers would come to call the Tropic of Cancer. Mile-­high Denver was near sea level and lay about as far south as where the Bahamas are today. Though the climate was fairly dry, webs of rivulets connecting shallow lakes and swamps covered part of the land, and vegetation abounded. There were no grasses or flowers--­they had yet to evolve--­just a weird mix of conifers commingling with ginkgos, tree ferns, cycads, and horsetails. Giant termite nests soared as much as thirty feet high. Splashing and stomping through this Seuss-­like world were Stegosaurus, Allosaurus, Brachiosaurus, Barosaurus, Seismosaurus--­their bones buried far below me as I made my way from Grand Junction to a town called Dinosaur.

    Occasionally one can glimpse outcroppings of the Jurassic past, exposed by erosion, seismological uplift, or a highway department road cut--­colorful bands of sediment that form a paleontological treasure house called the Morrison Formation. I knew what to look for from photographs: crumbling layers of reddish, grayish, purplish, sometimes greenish sediment--­geological debris piled up over some 7 million years.

    Just south of the town of Fruita on the Colorado River, I hiked to the top of Dinosaur Hill, stopping for a moment to pick up a pinch of purplish Morrison mudstone that had fallen near the trail. As I rolled it in my fingers it crumbled like dry cookie dough. On the far side of the hill, I came to a shaft where in 1901 a paleontologist named Elmer Riggs extracted 6 tons of bones that had belonged to an Apatosaurus (the proper name for what most of us call a Brontosaurus). Alive and fully hydrated, the 70-­foot-­long reptile would have weighed 30 tons. Riggs encased the bones in plaster of paris for protection, ferried them across the Colorado on a flat-­bottom boat, and then shipped them by train to the Field Museum in Chicago, where they were reassembled and put on display.

    After making my way north to Dinosaur (population 339), where Brontosaurus Boulevard intersects Stegosaurus Freeway, I stood at an overlook and watched Morrison stripes in a canyon reddening with the setting sun. But it was a little farther west, along the Green River in the western reaches of Dinosaur National Monument, that I saw the most beautiful example: a cliffside of greenish grays slumping into purples slumping into browns. It indeed resembled, as the woman at the park headquarters had told me, melted Neapolitan ice cream.

    It was somewhere in these parts that a dinosaur bone was discovered that displays what may be the oldest known case of cancer. After the dinosaur died, whether from the tumor or something else, its organs were eaten by predators or rapidly decomposed. But the skeleton--­at least a piece of it--­gradually became buried by windblown dirt and sand. Later on, an expanding lake or a meandering stream flowed over the debris, and the stage was set for fossilization. Molecule by molecule minerals in the bones were slowly replaced by minerals dissolved from the water. Tiny cavities were filled and petrified. Several epochs later dinosaurs were long extinct, their...

About the Author-
  • GEORGE JOHNSON writes regularly about science for The New York Times. He has also written for National Geographic, Slate, Discover, Scientific American, Wired, and The Atlantic, and his work has been included in The Best American Science Writing. A former Alicia Patterson fellow, he has received awards from PEN and the American Association for the Advancement of Science, and his books were twice finalists for the Royal Society's book prize. He is a cohost of Science Faction on bloggingheads.tv and writes the blog Fire in the Mind for Discover. He lives in Santa Fe, New Mexico.



Reviews-
  • Publisher's Weekly

    Starred review from June 10, 2013
    It’s his wife Nancy’s grueling fight against a rare and “rabid” uterine cancer that prompts science writer Johnson (The Ten Most Beautiful Experiments) to delve into the efforts to study, treat, and beat what Siddhartha Mukherjee dubbed “The Emperor of All Maladies.” This elegant and insightful chronicle is at once intensely personal and meticulously studious, focusing not just on one cancer, but on the evolution of all cancers. He finds it “comforting... knowing that cancer has always been with us, that it is not all our fault, that you can take every precaution and still something in the genetic coils can become unsprung.” Cancer, he explains, can be blamed on “factors that have been present for a long time” (the disease beset even prehistoric dinosaurs). In fact, researchers are finding that any one case of cancer may have multiple causes, whether environmental, hereditary, or “elusive… bad luck.” Cancer, he concludes, “is a phenomenon” that is “mostly random.” Yet we are getting a clearer picture of how it works: cancer’s “metabolic puzzle” may lie in “how the body stores and uses energy… Insulin, estrogen, obesity, cancer—all are tied in to the same metabolic knot.” This is extraordinary scholarship delivered with an intimate poignancy. Agent: Esther Newberg, ICM.

  • Kirkus

    June 15, 2013
    Not quite "abandon all hope," but there's not much to cheer about in this wide-angled survey of where we are in the fight against cancer. Science writer Johnson (The Ten Most Beautiful Experiments, 2008, etc.) has steeped himself in cancer lore, attended conferences and interviewed experts to conclude that the more we learn about the disease, the more complex it gets. Yes, there have been declines in incidence, but new cases will offset those declines simply because people are living longer; cancers essentially reflect the accumulation of DNA hits to a cell as it divides and divides again over time. Johnson's involvement took off with the discovery of a rare uterine cancer in his wife, Nancy, which, when diagnosed, had metastasized to her groin. The detailed chapters on her surgery and multiple drug and radiation therapies enable Johnson to explain why such triple-prong treatment is standard today and what new drugs are in the pipeline. Nancy's story may have also inspired his reporting on risk factors and cancer prevention. Here, the facts may shock: Cigarette smoking, ionizing radiation and certain viruses are serious cancer risks, but the contributions of other known carcinogens, environmental pollutants and conjectured microwave transmissions via cellphones are minor or unproven. Furthermore, there is no evidence that eating 5-per-day servings of fruits and vegetables will prevent cancer. Instead, researchers see cancer as an evolutionary process in which increasingly aberrant cell lines may compete or cooperate, stimulate the development of a blood supply and acquire the ability to metastasize. Factors that may encourage this behavior include hormones like estrogen, which stimulates cell division, and changes in metabolism due to obesity; insulin resistance may also play a role. But for the majority of cancers, as was the case with the head and neck cancer that ended the life of Johnson's younger brother, the cause is unknown, a random event. A thorough and nuanced presentation of the state of the science of cancer research, refreshing in its honest appraisal that the war is far from over.

    COPYRIGHT(2013) Kirkus Reviews, ALL RIGHTS RESERVED.

  • Booklist

    July 1, 2013
    Science writer Johnson (The Ten Most Beautiful Experiments, 2008) tackles cancer on a technical and personal level. He concludes that cancer is a disease of information. Although a single renegade cell can kindle a tumor, that cell still has hurdles to overcomeavoiding apoptosis (programmed cell death) and growing its own blood supply (angiogenesis). Cancers can be caused by chemicals, radiation, and viruses, but certain behaviors are instigators, too. Tobacco use accounts for as many as 30 percent of cases. A sedentary lifestyle and obesity increase your chances of the disease. Dinosaurs with malignancies, rebellious mitochondria, and other attention-grabbing characters populate the book. Sadly fascinating are the rare medical personnel who've accidentally inoculated themselves with cancer cells and acquired the disease (including a woman who developed colon cancer in her hand). Johnson's discussion of the science of cancer is entwined with two tales of loss. Despite aggressive treatment, his youngest brother dies from cancer of the head and neck. His wife is diagnosed with uterine cancer and recovers, but their 17-year marriage ends.(Reprinted with permission of Booklist, copyright 2013, American Library Association.)

  • Library Journal

    March 15, 2013

    Science journalist Johnson began investigating cancer after his wife's diagnosis with the disease. Here he shows that an entirely new understanding of cancer is evolving as scientists downplay dietary and environmental factors while studying the petrified tumors still attached to the crumbly bones of dinosaurs and early humans.

    Copyright 2013 Library Journal, LLC Used with permission.

  • The New York Times Book Review "Among a small cluster of very good recent books on cancer, including The Emperor of All Maladies, by Siddhartha Mukherjee; The Philadelphia Chromosome, by Jessica Wapner; and The Truth in Small Doses, by Clifton Leaf, Johnson's stands out as especially illuminating, forceful and, in its own quiet way, profound."
  • The Economist "The ideal primer for those who want to know the real story of cancer, rather than the version that is usually presented in the media."
  • The Times Literary Supplement "A highly captivating book that meticulously explains the current scientific understanding of cancer....George Johnson has captured the curiosity and empathy that drives scientists to tackle this calamitous disease."
  • Mother Jones "A provocative and also a personal exploration of the myths and misunderstandings that surround this most formidable enemy to our health and well being."
  • Shelf Awareness "Richly informative, unerringly balanced and undeniably compelling."
  • Publishers Weekly "This elegant and insightful chronicle is at once intensely personal and meticulously studious...This is extraordinary scholarship delivered with an intimate poignancy."
  • Kirkus Reviews "A thorough and nuanced presentation of the state of [cancer] science, refreshing in its honest appraisal that the war is far from over."
  • Paul Davies, Principal Investigator, Center for Convergence of Physical Science and Cancer Biology "It is very rare to find a writer who can weave a compelling narrative that combines the intrinsically fascinating nature of cancer with its peculiar horror. George Johnson has penetrated the arcane world of cancer biology and oncology and exposed the bewilderment and frustration felt by researchers and clinicians grappling to understand and control this pervasive disease. He makes a convincing case that the field is floundering because we are thinking about the problem the wrong way. Cancer touches every family on the planet. For those who want to gain some serious insights into the subject, this book is a great place to start."
  • Charles C. Mann, author 1491 "This compact, elegant book is really three books: a memoir of a year in Cancerland, a shrewd investigation into what's known (and not known) about this still-mysterious condition, and a gripping account of coming to terms with living in a universe that includes a deadly disease with no predictable cause. Everyone who is concerned about cancer--that is, every thinking adult--should read The Cancer Chronicles."
  • Barbara Ehrenreich, author, Nickel and Dimed "The Cancer Chronicles is a rich and sweeping exploration of the history, prehistory, and future of cancer, all anchored in harrowing personal experience. Surprisingly--and especially gratifying to me as a former biologist--it is also an appreciation of cancer as a cellular strategy and a rebellion against the tyranny of the multicellular body. Completely accessible to the lay reader, this is a book for anyone whose life has been touched by cancer, which is just about everyone."
  • New York Journal of Books "A masterpiece of clarity."
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