Siddhartha Mukherjee - The Emperor of All Maladies: A Biography of Cancer

by Siddhartha Mukherjee

  "A spider's web"

  286 It is to earlier diagnosis that we must look: J. P. Lockhart-Mummery, "Two Hundred Cases of Cancer of the Rectum Treated by Perineal Excision," British Journal of Surgery 14 (1926-27): 110-24.

  286 The greatest need we have today: Sidney Farber, letter to Etta Rosensohn, November 1962.

  286 Lady, have you been "Paptized"?: "Lady, Have You Been 'Paptized'?" New York Amsterdam News, April 13, 1957.

  286 George Papanicolaou: For an overview, see George A. Vilos, "After Office Hours: The History of the Papanicolaou Smear and the Odyssey of George and Andromache Papanicolaou," Obstetrics and Gynecology 91, no. 3 (1998): 479-83; S. Zachariadou-Veneti, "A Tribute to George Papanicolaou (1883-1962)," Cytopathology 11, no. 3 (2000): 152-57.

  287 By the late 1920s: Zachariadou-Veneti, "Tribute to George Papanicolaou."

  287 As one gynecologist archly remarked: Edgar Allen, "Abstract of Discussion on Ovarian Follicle Hormone," Journal of the American Medical Association 85 (1925): 405.

  287 Papanicolaou thus began to venture: George N. Papanicolaou, "The Cancer-Diagnostic Potential of Uterine Exfoliative Cytology," CA: A Cancer Journal for Clinicians 7 (1957): 124-35.

  288 "aberrant and bizarre forms": Ibid.

  288 Papanicolaou published his method: G. N. Papanicolaou, "New Cancer Diagnosis," Proceedings of the Third Race Betterment Conference (1928): 528.

  288 "I think this work will be carried": Ibid.

  288 Between 1928 and 1950: George A. Vilos, "After Office Hours," Obstetrics and Gynecology 91 (March 1998): 3.

  288 A Japanese fish and bird painter: George N. Papanicolaou, "The Cell Smear Method of Diagnosing Cancer," American Journal of Public Health and the Nation's Health 38, no. 2 (1948): 202-5.

  289 At a Christmas party in the winter of 1950: Irena Koprowska, A Woman Wanders through Life and Science (Albany: State University of New York Press, 1997), 167-68.

  289 "It was a revelation": Ibid.

  289 In 1952, Papanicolaou convinced the National Cancer Institute: Cyrus C. Erickson, "Exfoliative Cytology in Mass Screening for Uterine Cancer: Memphis and Shelby County, Tennessee," CA: A Cancer Journal for Clinicians 5 (1955): 63-64.

  289 In the initial cohort of about 150,000: Harold Speert, "Memorable Medical Mentors: VI. Thomas S. Cullen (1868-1953)," Obstetrical and Gynecological Survey 59, no. 8 (2004): 557-63.

  289 557 women were found to have preinvasive cancers: Ibid.

  290 In 1913, a Berlin surgeon named Albert Salomon: D. J. Dronkers et al., eds., The Practice of Mammography: Pathology, Technique, Interpretation, Adjunct Modalities (New York: Thieme, 2001), 256.

  291 "trabeculae as thin as a spider's web": H. J. Burhenne, J. E. Youker, and R. H. Gold, eds., Mammography (symposium given on August 24, 1968, at the University of California School of Medicine, San Francisco) (New York: S. Karger, 1969), 109.

  294 In the winter of 1963, three men set out: Sam Shapiro, Philip Strax, and Louis Venet, "Evaluation of Periodic Breast Cancer Screening with Mammography: Methodology and Early Observations," Journal of the American Medical Association 195, no. 9 (1966): 731-38.

  294 By the mid-1950s, a triad of forces: Thomas A. Hirschl and Tim B. Heaton, eds., New York State in the 21st Century (Santa Barbara, CA: Greenwood Publishing Group, 1999), 144.

  294 By the early 1960s, the plan had enrolled: See, for instance, Philip Strax, "Screening for breast cancer," Clinical Obstetrics and Gynecology 20, no. 4 (1977): 781-802.

  295 Strax and Venet eventually outfitted a mobile van: Philip Strax, "Female Cancer Detection Mobile Unit," Preventive Medicine 1, no. 3 (1972): 422-25.

  295 "Interview . . . 5 stations X 12 women": Abraham Schiff quoted in Philip Strax, Control of Breast Cancer through Mass Screening (Philadelphia: Mosby, 1979), 148.

  296 In 1971, eight years after the study: S. Shapiro et al., "Proceedings: Changes in 5-Year Breast Cancer Mortality in a Breast Cancer Screening Program," Proceedings of the National Cancer Conference 7 (1972): 663-78.

  296 "The radiologist," he wrote: Philip Strax, "Radiologist's Role in Screening Mammography," unpublished document quoted in Barron H. Lerner, "'To See Today with the Eyes of Tomorrow': A History of Screening Mammography," Canadian Bulletin of Medical History 20, no. 2 (2003): 299-321.

  296 "Within 5 years, mammography has moved": G. Melvin Stevens and John F. Weigen, "Mammography Survey for Breast Cancer Detection. A 2-Year Study of 1,223 Clinically Negative Asymptomatic Women over 40," Cancer 19, no. 1 (2006): 51-59.

  296 "The time has come": Arthur I. Holleb, "Toward Better Control of Breast Cancer," American Cancer Society press release, October 4, 1971 (New York: ACS Media Division), Folder: Breast Cancer Facts, quoted in Lerner, "'To See Today with the Eyes of Tomorrow.'"

  296 the Breast Cancer Detection and Demonstration Project: Myles P. Cunningham, "The Breast Cancer Detection Demonstration Project 25 Years Later," CA: A Cancer Journal for Clinicians 47, no. 3 (1997): 131-33.

  298 Between 1976 and 1992, enormous parallel trials: See below for particular studies. Also see Madelon Finkel, ed., Understanding the Mammography Controversy (Westport, CT: Praeger, 2005), 101-5.

  298 In Canada, meanwhile, researchers lurched: A. B. Miller, G. R. Howe, and C. Wall, "The National Study of Breast Cancer Screening Protocol for a Canadian Randomized Controlled Trial of Screening for Breast Cancer in Women," Clinical Investigative Medicine 4, nos. 3-4 (1981): 227-58.

  298 Edinburgh was a disaster: A. Huggins et al., "Edinburgh Trial of Screening for Breast Cancer: Mortality at Seven Years," Lancet 335, no. 8684 (1990): 241-46; Denise Donovan et al., "Edinburgh Trial of Screening for Breast Cancer," Lancet 335, no. 8695 (1990): 968-69.

  298 The Canadian trial, meanwhile: Miller, Howe, and Wall, "National Study of Breast Cancer Screening Protocol."

  298 For a critical evaluation of the CNBSS, HIP, and Swedish studies, see David Freedman et al., "On the Efficacy of Screening for Breast Cancer," International Journal of Epidemiology 33, no. 1 (2004): 43-5.

  298 Randomization problems in the Canadian National Breast Screening Study: Curtis J. Mettlin and Charles R. Smart, "The Canadian National Breast Screening Study: An Appraisal and Implications for Early Detection Policy," Cancer 72, no. S4 (1993): 1461-65; John C. Bailar III and Brian MacMahon, "Randomization in the Canadian National Breast Screening Study: A Review for Evidence of Subversion," Canadian Medical Association Journal 156, no. 2 (1997): 193-99.

  299 "Suspicion, like beauty": Cornelia Baines, Canadian Medical Association Journal 157 (August 1, 1997): 249.

  299 "One lesson is clear": Norman F. Boyd, "The Review of Randomization in the Canadian National Breast Screening Study: Is the Debate Over?" Canadian Medical Association Journal 156, no. 2 (1997): 207-9.

  300 Migration into and out of the city: See, for instance, Scandinavian Journal of Gastroenterology 30 (1995): 33-43.

  300 In 1976, forty-two thousand women enrolled: Ingvar Andersson et al., "Mammographic Screening and Mortality from Breast Cancer: The Malmo Mammographic Screening Trial," British Medical Journal 297, no. 6654 (1988): 943-48.

  300 "There was only one": Ingvar Andersson, interview with author, March 2010.

  300 In 1988, at the end of its twelfth year: Andersson et al., "Mammographic Screening and Mortality." Also Andersson, interview with author.

  300 When the groups were analyzed by age: Ibid.

  301 In 2002, twenty-six years after the launch of the original: Lennarth Nystom et al., "Long-Term Effects of Mammography Screening: Updated Overview of the Swedish Randomised Trials," Lancet 359, no. 9310 (2002): 909-19.

  301 Its effects, as the statistician Donald Berry describes it: Donald Berry, interview with author, November 2009.

  301 Berry wrote, "Screening is a lottery": "Mammograms Before 50 a Waste of Time," Science a Go Go, October 12, 1998, http://www.scienceagogo.com/news/ 19980912094305data_trunc_sys.shtml (accessed December 29, 2009).

  302 "This is a textbook example": Malcolm Gladwell, "The Picture Problem: Ma
mmography, Air Power, and the Limits of Looking," New Yorker, December 13, 2004.

  303 "All photographs are accurate": Richard Avedon, An Autobiography (New York: Random House, 1993); Richard Avedon, Evidence, 1944-1994 (New York: Random House, 1994).

  304 "As the decade ended," Bruce Chabner: Bruce Chabner, interview with author, August 2009.

  STAMP

  305 Then did I beat them: 2 Samuel 22:43 (King James Version).

  306 Cancer therapy is like beating the dog: Anna Deveare Smith, Let Me Down Easy, script and monologue, December 2009.

  306 "If a man die": William Carlos Williams, The Collected Poems of William Carlos Williams: 1939-1962 (New York: New Directions Publishing, 1991), 2: 334.

  306 In his poignant memoir of his mother's illness: David Rieff, Swimming in a Sea of Death: A Son's Memoir (New York: Simon & Schuster, 2008), 6-10.

  306 "Like so many doctors": Ibid., 8.

  308 "To say this was a time of unreal": Abraham Verghese, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (New York: Simon & Schuster, 1994), 24.

  308 "There seemed to be little that medicine could not do": Ibid., 24.

  309 E. Donnall Thomas, had shown that bone marrow: E. Donnall Thomas, "Bone Marrow Transplantation from the Personal Viewpoint," International Journal of Hematology 81 (2005): 89-93.

  309 In Thomas's initial trial at Seattle: E. Thomas et al., "Bone Marrow Transplantation," New England Journal of Medicine 292, no. 16 (1975): 832-43.

  310 "We have a cure for breast cancer": Craig Henderson, interview with Richard Rettig, quoted in Richard Rettig et al., False Hope: Bone Marrow Transplantation for Breast Cancer (Oxford: Oxford University Press, 2007), 29.

  311 "It was an intensely competitive place": Robert Mayer, interview with author, July 2008.

  311 In 1982, Frei recruited William Peters: Shannon Brownlee, "Bad Science and Breast Cancer," Discover, August 2002.

  311 In the fall of 1983, he invited Howard Skipper: William Peters, interview with author, May 2009.

  312 a "seminal event": Ibid.

  312 George Canellos, for one, was wary: George Canellos, interview with author, March 2008.

  312 "We were going to swing and go for the ring": Brownlee, "Bad Science and Breast Cancer."

  312 The first patient to "change history" with STAMP: Ibid., and Peters, interview with author.

  313 "The ultimate trial of chemotherapeutic intensification": Peters, interview with author.

  314 "Suddenly, everything broke loose": Ibid.

  314 The woman was thirty-six years old: Ibid.

  314 "the most beautiful remission you could have imagined": Ibid.

  315 In March 1981, in the journal Lancet: Kenneth B. Hymes et al., "Kaposi's Sarcoma in Homosexual Men--a Report of Eight Cases," Lancet 318, no. 8247 (1981): 598-600.

  316 "gay compromise syndrome": Robert O. Brennan and David T. Durack, "Gay Compromise Syndrome," Lancet 318, no. 8259 (1981): 1338-39.

  316 In July 1982, with an understanding of the cause: "July 27, 1982: A Name for the Plague," Time, March 30, 2003.

  316 In a trenchant essay written as a reply: Susan Sontag, Illness as Metaphor and AIDS and Its Metaphors (New York: Picador, 1990).

  317 For Volberding, and for many of his earliest: See ACT UP Oral History Project, http://www.actuporalhistory.org/.

  317 Volberding borrowed something more ineffable: Arthur J. Amman et al., The AIDS Epidemic in San Francisco: The Medical Response, 1981-1884, vol. 3 (Berkeley: Regional Oral History Office, the Bancroft Library, University of California, Berkeley, 1997).

  317 "What we did here": Ibid.

  318 In January 1982, as AIDS cases boomed: "Building Blocks in the Battle on AIDS," New York Times, March 30, 1997; Randy Shilts, And the Band Played On (New York: St. Martin's Press).

  318 In January 1983, Luc Montagnier's group: Shilts, And the Band Played On, 219; F. Barre-Sinoussi et al. "Isolation of a T-Lymphotropic Retrovirus from a Patient at Risk for Acquired Immune Deficiency Syndrome (AIDS)," Science 220, no. 4599 (1983): 868-71.

  318 Gallo also found a retrovirus: Mikulas Popovic et al., "Detection, Isolation, and Continuous Production of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and Pre-AIDS," Science 224, no. 4648 (1984): 497-500; Robert C. Gallo et al., "Frequent Detection and Isolation of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and at Risk for AIDS," Science 224, no. 4648 (1984): 500-503.

  318 On April 23, 1984, Margaret Heckler: James Kinsella, Covering the Plague: AIDS and the American Media (Piscataway, NJ: Rutgers University Press, 1992), 84.

  318 In the spring of 1987: Steven Epstein, Impure Science: AIDS, Activism, and the Politics of Knowledge (Berkeley: University of California Press, 1998), 219.

  318 "genocide by neglect": Ibid., 221.

  318 "Many of us who live in daily terror": "The F.D.A.'s Callous Response to AIDS," New York Times, March 23, 1987.

  318 "Drugs into bodies": Raymond A. Smith and Patricia D. Siplon, Drugs into Bodies: Global AIDS Treatment Activism (Santa Barbara, CA: Greenwood Publishing Group, 2006).

  318 "The FDA is fucked-up": "Acting Up: March 10, 1987," Ripples of Hope: Great American Civil Rights Speeches, ed. Josh Gottheimer (New York: Basic Civitas Books, 2003), 392.

  318 "Double-blind studies": "F.D.A.'s Callous Response to AIDS," New York Times.

  318 He concluded, "AIDS sufferers": Ibid.

  320 By the winter of 1984, thirty-two women: Peters, interview with author.

  320 "There was so much excitement within the cancer community": Donald Berry, interview with author, November 2009.

  320 Peters flew up from Duke to Boston: Peters, interview with author.

  The Map and the Parachute

  321 Oedipus: What is the rite of purification?: Sophocles, Oedipus the King.

  321 Transplanters, as one oncologist: Craig Henderson, quoted in Brownlee, "Bad Science and Breast Cancer."

  321 Nelene Fox and bone marrow transplantation: See Michael S. Lief and Harry M. Caldwell, And the Walls Came Tumbling Down: Closing Arguments that Changed the Way We Live, from Protecting Free Speech to Winning Women's Sufferage to Defending the Right to Die (New York: Simon & Schuster, 2004), 299-354; "$89 Million Awarded Family Who Sued H.M.O.," New York Times, December 30, 1993.

  322 On June 19, a retinue: Lief and Caldwell, And the Walls Came Tumbling Down, 310.

  322 "You marketed this coverage to her": Ibid., 307.

  323 In August 1992, Nelene Fox: Ibid., 309.

  323 "The dose-limiting barrier": S. Ariad and W. R. Bezwoda, "High-Dose Chemotherapy: Therapeutic Potential in the Age of Growth Factor Support," Israel Journal of Medical Sciences 28, no. 6 (1992): 377-85.

  323 In Johannesburg, more than 90 percent: W. R. Bezwoda, L. Seymour, and R. D. Dansey, "High-Dose Chemotherapy with Hematopoietic Rescue as Primary Treatment for Metastatic Breast Cancer: A Randomized Trial," Journal of Clinical Oncology 13, no. 10 (1995): 2483-89.

  324 On April 22, eleven months after: Lief and Caldwell, And the Walls Came Tumbling Down, 309.

  324 In 1993 alone: Papers were assessed on www.pubmed.org.

  324 "If all you have is a cold or the flu": Lief and Caldwell, And the Walls Came Tumbling Down, 234.

  324 On the morning of December 28, 1993: Ibid.

  324 That evening, it returned a verdict: "$89 Million Awarded Family," New York Times.

  325 In Massachusetts, Charlotte Turner: "Cancer Patient's Kin Sues Fallon" and "Coverage Denied for Marrow Transplant," Worcester (MA) Telegram & Gazette, December 7, 1995; Erin Dominique Williams and Leo Van Der Reis, Health Care at the Abyss: Managed Care vs. the Goals of Medicine (Buffalo, NY: William S. Hein Publishing, 1997), 3.

  325 Between 1988 and 2002: See Richard Rettig et al., eds., False Hope: Bone Marrow Transplantation for Breast Cancer (New York: Oxford University Press, 2007), 85, and Table 3.2.

  325 "complicated, costly and potentially dangerous": Bruce E. Brockstein and Stephanie F. William
s, "High-Dose Chemotherapy with Autologous Stem Cell Rescue for Breast Cancer: Yesterday, Today and Tomorrow," Stem Cells 14, no. 1 (1996): 79-89.

  325 Between 1991 and 1999, roughly forty thousand: JoAnne Zujewski, Anita Nelson, and Jeffrey Abrams, "Much Ado about Not . . . Enough Data," Journal of the National Cancer Institute 90 (1998): 200-209. Also see Rettig et al., False Hope, 137.

  326 "Transplants, transplants, everywhere": Robert Mayer, interview with author, July 2008.

  326 As Bezwoda presented the data: W. R. Bezwoda, "High Dose Chemotherapy with Haematopoietic Rescue in Breast Cancer," Hematology and Cell Therapy 41, no. 2 (1999): 58-65. Also see Werner Bezwoda, plenary session, American Society of Clinical Oncology meeting, 1999 (video recordings available at www.asco.org).

  326 three other trials presented that afternoon: Ibid.

  326 At Duke, embarrassingly enough: Ibid.

  326 "even a modest improvement": Ibid.

  326 A complex and tangled trial from Sweden: Ibid.

  326 "My goal here," one discussant began: Ibid.

  327 "People who like to transplant will continue to transplant": "Conference Divided over High-Dose Breast Cancer Treatment," New York Times, May 19, 1999.

  327 Investigation of Bezwoda's breast cancer study: Raymond B. Weiss et al., "High-Dose Chemotherapy for High-Risk Primary Breast Cancer: An On-Site Review of the Bezwoda Study," Lancet 355, no. 9208 (2000): 999-1003.

  328 Another patient record, tracked back to its origin: "Bezwoda," Kate Barry (producer), archived in video format at http://beta.mnet.co.za/Carteblanche, M-Net TV Africa (March 19, 2000).

  328 "I have committed a serious breach of scientific honesty": "Breast Cancer Study Results on High-Dose Chemotherapy Falsified," Imaginis, February 9, 2000, http://www .imaginis.com/breasthealth/news/news2.09.00.asp (accessed January 2, 2010).

  328 "By the late 1990s, the romance was already over": Robert Mayer, interview with author.

  328 Maggie Keswick Jencks: Maggie Keswick Jencks, A View from the Front Line (London, 1995).