Wednesday, November 30, 2011

Thoughts on reading The Emperor of All Maladies: a Biography of Cancer

As a holistic practitioner, if you want to help people try to prevent cancer, or to support their physical and emotional well-being while facing it, this book offers an overview of the medical world's view of the phenomenon. Not a complete history or a medical textbook, it reads more like a historical novel, delivering a timeline of discovery over the centuries.
Siddhartha Mukherjee, a cancer physician and researcher, writes about Sidney Farber, the pioneer of modern chemotherapy, who recognized that cancer was an illness that required many approaches – physical, social, and emotional. He added social workers, psychiatrists and nutritionists to his team. I would propose that patients could also benefit from a gentle army of holistic practitioners of their choosing. Imagine adding acupuncture, homeopathy, Reiki, yoga and more to a healing program.

The author emphasizes how varied the behavior of different types of cancer is. Lung cancer often spreads to the brain; pancreatic cancer to the bones and liver. But Hodgkin’s lymphoma moves from one gland to the next one, growing locally, lending itself to local treatment. That is why Hodgkin’s is one of the few diseases that respond well to chemotherapy, along with acute lymphoblastic leukemia and testicular cancer. Historically, researchers have sought one cure for cancer, but over time, it is realized that cancer is not one disease, but a wide spectrum of conditions. The medical world has developed treatments, but ones that do not often result in long term cures.
As holistic professionals, reading this book you will readily see how big of a need there is to fill. People need help increasing their immune function, improving their overall health, and learning how to cope with stress. These are important elements in preventing cancer and in complementing medical treatments, as surgery, radiation and chemo are hard on the immune system and the psyche. The book, like the medical community, focuses mostly on surgical and chemical approaches to cancer. A small fraction of research dollars is allocated to studying the role of diet. Holistically-minded people are more inclined to think that a “cure” for cancer is not going to be found in a new drug. After all, cancer is not the result of a deficiency of drugs.
One fascinating chapter examines the history of mammography. Metastasis is what kills patients with breast cancer, the author explains, so the ability to detect and remove premetastatic tumors can be lifesaving.  However, the author says, “Just because a breast tumor is small does not mean that it is premetastatic. Even relatively small tumors barely detectable by mammography can carry genetic programs that make them vastly more likely to metastasize early. Conversely, large tumors may inherently be genetically benign – unlikely to invade and metastasize….” (p. 303).
The role of genetic mutations in the cancer process is explained. It is amazing to read about how many steps the mutations go through.The medical research world’s focus is getting smaller and smaller, encouraged by advances in drugs targeted at mutated genes. But in manipulating at the microscopic level, has research lost sight of the big picture? There are natural ways to balance hormones, encourage cell differentiation, and increase macrophages that eat cancer cells. Stress is clearly identified as one cause of cancer. Can stress be antidoted by gene-targeted drugs? Is the concept of a healthy mind and body such a mystery?  It may be a challenge, one that holistically minded people may be able to help others meet.
Mukherjee’s work is beautifully and sensitively written. If you want to better understand the allopathic world of cancer, I know of no better book on the subject.
Note: My thanks to Susan Silberstein, PhD and Randi Shayne, ND at the Center for the Advancement of Cancer Education. Their insights gained from counseling over 30,000 families facing cancer gave me more perspective on this work.

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