The Emperor of All Maladies

  chemical stains, 84–85

  Chemical Warfare Unit, 90, 92

  chemotherapy, 7, 114, 304, 355, 448

  adjuvant, 219, 220–21, 222, 223, 320, 400, 464

  bone marrow transplants in, see bone marrow transplants

  for breast cancer, 122–23, 162, 232, 306, 308–9, 427–28

  “cancer stem cells” and, 458–59

  cure rates for, 228, 231; see also specific cancers

  as cytotoxic, 43–44, 143n, 162–63, 165, 168, 176, 207, 208, 220, 223, 305, 309, 312, 320, 405, 427–28, 452

  dose limits of, 309

  Ehrlich and, 84–88

  fixed percentage of cells killed by, 141

  high-dose multidrug regimens in, 132–34, 135, 140–43, 162, 163, 166, 167, 172, 173, 176–77, 204–5, 207–9, 216, 232, 305, 306, 308–9, 329, 389, 400, 443, 452; see also bone marrow transplants; specific regimens

  for Hodgkin’s lymphoma, 163–66, 208, 308, 315, 401

  immune system compromised by, 165, 315

  indiscriminate use of, 210

  for leukemia, 19–20, 21, 27, 29–30, 31, 33–36, 92, 100, 101, 103–4, 122, 132–34, 135, 140–42, 167–70, 308, 339, 401, 443

  for lung cancer, 308–9, 389, 403–4, 443

  for lymphomas, 90–91, 96–97, 122, 132–34, 135, 162, 401, 443

  nontoxic, 439

  radiation in combination with, 123–24, 154, 168–70, 400

  secondary cancers as outcome of, 165, 306, 312

  side effects of, 18, 96, 123, 165, 205–6, 209, 226, 305

  specific affinity in, 80–81, 84–88, 90–92, 433, 434, 439

  sterility caused by, 165

  surgeons’ hostility to, 219–21

  targeted, see targeted therapies

  for tumors, 122–23, 154, 207, 308–9

  as universal cure, 93

  white blood cells and, 127, 315

  Chesterfield cigarettes, 268

  Chiari, Hans, 62

  Chicago Tribune, 187, 189, 235

  chickens, sarcomas in, 173, 174

  child labor, 239

  children:

  cancer in, 123, 331

  leukemia in, 7, 12, 17, 19, 32–36, 92, 96, 101, 103–4, 123, 133, 139, 163, 166, 170, 179, 231, 232, 401

  Children’s Cancer Research Fund, see Jimmy Fund

  Children’s Hospital (Boston), 11–12, 19, 22, 27, 29, 30, 33, 34, 94, 95–96, 97, 99, 101, 387

  Children’s Hospital (Buffalo), 133

  chimeras, 366, 409–10, 430–31

  Chimney Sweepers Act (1788, British), 239

  chimney sweeps, 173, 237–39, 241

  China, cigarette consumption in, 273–74

  Chiribaya mummies, 42–43, 45

  chloramphenicol, 22

  cholesterol, 444

  choriocarcinoma, 135–36, 139, 168, 228

  choriogonadotropin (hcg), 136, 137, 138

  Christakis, Nicholas, 445

  Christie, Agatha, 444

  Christie Hospital, 216–17

  chromosomes, 340

  in cancer cells, 341–42, 343, 348, 430–31

  genes as carried on, 344

  pairing of, 377

  staining of, 340, 365

  translocation of, 365–66, 402, 409–10, 430–31

  chronic myeloid (myelogenous) leukemia (CML), 365–66, 430–31, 433, 444

  bone marrow transplants and, 434–35, 437

  drug resistance in, 441–43

  Gleevec trial for, 436–38

  remissions of, 437–39, 441, 443, 465

  Ciba-Geigy, 431–32, 433–34, 436

  cigarettes:

  consumption of, see smoking

  filter tips on, 263, 268

  warning label on, 264–65, 267, 273, 401

  see also nicotine; tobacco; tobacco industry

  Cipollone, Anthony, 268, 270

  Cipollone, Rose, 267–72, 273, 401

  cirrhosis, chronic, 279

  cisplatin (cis-platinum), 203–4, 205, 208, 406, 421

  nausea from, 205–6

  cis-retinoic acid, 408–9

  c-kit gene, 467–68

  Claire-King, Mary, 381

  Clauson, Phyllis, 395–96, 397

  Cleland, John, 204–5

  Clements, Earle, 264

  Cleveland Clinic, 196

  clinical trials, see protocols

  clones, 39

  clotting factors, 415

  CMF regimen, in adjuvant chemotherapy, 220–21

  CML, see chronic myeloid (myelogenous) leukemia

  c-myc (myc) gene, 382–83, 384, 391, 410, 412, 453–54, 458

  cocaine, 62–63, 225

  Cochran, William, 259, 261

  Codman, Ernest, 30n

  Cold Spring Harbor Laboratory, 403

  Cold War, 182

  Cole, Mary “Moya,” 216–17, 218–19, 221

  Coley, William B., 30n

  Coley’s toxin, 30n

  Collett, Mark, 358

  Collins, Francis, 450

  colon cancer, 59, 116–17, 208, 331, 381, 401, 443, 450, 451

  colonoscopy, 331, 401

  Commission on the Conquest of Cancer, 184

  “compassionate use” issue, experimental therapies and, 423–26

  complexity, 20

  compound 606 (Salvarsan), 86

  Comprehensive Cancer Centers, 208

  Conant, Marcus, 317

  concentration camps, 397

  “Concerning the Origin of Malignant Tumors” (Boveri), 342

  Congress, U.S.:

  antiregulatory posture of, 262

  cancer research and, 24–25, 113–14, 122, 150, 177, 184–89, 455

  tobacco industry and, 260, 264

  Congress for Internal Medicine, 86

  Conquest of Cancer Act (Kennedy/Javits bill), 185–86, 187

  Cooper, Geoff, 374

  Cooper case, 258

  cotton, 81

  cowpox, 342, 343

  creatine, 31

  Crick, Francis, 345

  Crile, George, Sr., 196

  Crile, George Barney, 68, 196–97, 198, 199

  Crimean War, 240

  cryptococcal meningitis, 316

  CT scans, 389, 422

  Cullman, Joseph, 262

  Cummings, Karen, 396

  Curd, John, 418, 424, 426

  cure, patients’ expectations of, 22

  Cure for Cancer: A National Goal (Garb), 177–78, 234

  Cure of Childhood Leukemia, The (Laszlo), 21

  Curie, Marie, 74–75, 76, 77

  leukemia of, 78, 347

  Curie, Pierre, 74–75, 76, 77

  Cushing, Harvey, 65, 71–72

  Cyclophosphamide, 127

  Cyrus, King of Persia, 41

  cytarabine, 127

  cytotoxic drugs, 43–44, 143n, 162–63, 165, 168, 176, 207, 208, 220, 223, 305, 309, 312, 320, 405, 427–28, 452

  Cytoxan, 162, 220, 427–28

  Dakhleh, Egypt, 43

  Dameshek, William, 146

  Dana-Farber Cancer Institute, 153, 190, 310–14, 374, 433–34, 468

  Institutional Review Board at, 312

  D’Angio, Giulio, 123

  Darius I, King of Persia, 41–42

  dasatinib, 442–43

  David, Ed, 186

  Davis, Marvin, 171

  DDT, 457

  death, oncologists and, 4, 306–8, 337–38

  decoy molecules, 31, 87

  Degos, Laurent, 408–9, 410

  de Gouvêa, Hilário, 347, 366, 367, 381

  de Koning, H. J., 128

  Delbruck, Max, 345

  Democedes, 41–42

  De Morbis Artificum Diatriba (Ramazzini), 238

  deoxyribonucleic acid, see DNA

  DES (diethylstilbestrol), 213, 277, 278

  developing countries, tobacco-industry targeting of, 273–74

  DeVita, Vincent, 151, 163–65, 171, 172, 220, 315

  diabetes, 284, 414, 415

  Diamond, Loui
s, 34

  Dick, John, 458

  Dickens, Charles, 239

  Dickersin, Kay, 426

  Dictionary of Practical Surgery, A, 55

  Didion, Joan, 420

  diethylstilbestrol (DES), 213, 277, 278

  diphtheria, 84

  disease(s):

  Galen’s theory of, 48–50, 52–54, 55, 79, 90, 214, 238, 281

  naming of, 14, 46–47

  risk factors for, 444–45

  Virchow’s cellular theory of, 14–16

  Djozer, King of Egypt, 40

  DNA (deoxyribonucleic acid), 360, 455

  in cell division, 28–29, 75

  as damaged by carcinogens, 75, 77, 122, 351, 406, 462

  folic acid and, 28–29

  inhibiting formation of, 91–92

  mutations of, 6, 406, 462

  nitrogen mustard as damaging to, 163, 406

  reverse transcription from RNA to, 352–54, 371

  transcription to RNA of, 352

  transfer of, 372–74

  see also genes, genomes

  dogs, prostate cancer in, 212–13

  Doisy, Edward, 213, 215

  Doll, Richard, 243, 244, 273, 462, 465

  lung cancer studies of, 245–49, 250–51, 253–54, 260, 262, 263, 276, 294, 350, 401, 455

  Donne, John, 51

  Dorchester, Mass., 32

  Doyle, Arthur Conan, 9

  Drebin, Jeffrey, 411n

  Drew, Elizabeth, 265

  Druker, Brian, 433–40

  drug resistance, 132, 441–43

  drugs, definition of, 413–14

  Dryja, Thad, 376–80, 415

  DuBridge, Lee, 183

  Duesberg, Peter, 358

  Duke University, 315, 319, 325, 326

  Dulbecco, Renato, 350, 351, 371

  dwarfism, 415

  dye industry, 81–86

  dyes, synthetic, 81–86, 278, 340

  E. coli, 20

  Edell, Marc, 269–71, 272

  Edinburgh, Scotland, 298, 302

  Edson, Margaret, 205, 209

  Edwards, Ralph, 97–99, 396

  Egan, Robert, 291

  Egypt, ancient, 39–41, 463

  Ehrlich, Paul, 80, 84–88, 237, 340, 432, 439

  magic bullets of, 86–88, 222, 234, 304

  Einhorn, Larry, 204–5, 208, 228

  Einstein, Albert, 370

  electrometer, 74

  Eli Lilly, 31, 139

  Elion, Gertrude, 91–92

  Eliot, T. S., 191

  “Ella” (VAMP protocol survivor), 148–50

  Ellie: A Child’s Fight Against Leukemia (Tucker), 21

  embryonic stem cells, 458

  Enders, John, 22, 94

  Endicott, Kenneth, 162, 171, 177, 260

  environmentalists, 456

  enzymes, viral, 352–53, 354

  epidemiology, 238, 243, 245

  case-control studies in, 245, 246–47, 276, 280

  causality and, 253–56, 276, 290, 350

  Framingham longitudinal data and, 444–45

  meta-analysis and, 261

  molecular, 457

  preventive medicine and, 290, 457

  recall bias in, 446

  tobacco-cancer link and, 241–42, 247, 248–49, 250, 261

  Epstein-Barr virus (EBV), 175

  Erikson, Ray, 358, 361, 368, 375

  Erk protein, 387, 454

  Erwin, Bob, 429

  esophageal cancer, 274, 305

  estrogen, 211, 213, 456

  breast cancer and, 215, 221, 222–23, 456, 464

  receptor in, 215, 216, 217, 464

  etoposide, 206

  Evans, Audrey, 123

  evolution, 39, 247–48

  Ewing, James, 30n

  extended field radiation, 159–61, 163

  extirpations, 23

  Faget, Max, 178

  fairness doctrine, 265–66, 267

  “Fall, The” (Milosz), 116

  false positives, false negatives, 291–92

  Farber, Emmanuel, 259, 261

  Farber, Norma, 30

  Farber, Sidney, 129, 162, 286, 395

  as advocate for cancer research, 100, 171–72, 189

  background of, 18–19

  cancer research hospital project of, see Jimmy’s Clinic

  cancer research of, 122–23, 126–27

  chemotherapy regimens devised by, 103

  chemotherapy seen as universal cure by, 93, 155, 403

  colostomy of, 118

  death of, 189–90, 193, 461

  as fund-raiser, 102

  isolation of, 27, 35, 101–2

  at Jimmy’s Clinic, 125–26, 153, 189–90

  leukemia research of, 19–20, 21, 27, 29–30, 31, 33–36, 92, 100, 101, 114, 121, 122–23, 130, 132, 136, 158, 309, 338, 433, 439

  M. Lasker and, 114–15, 116, 122, 171, 177, 190

  as pediatric pathologist, 11–12, 19

  VAMP survivors and, 149–50

  viral origin of cancer advocated by, 175

  in War on Cancer, 114, 118, 122, 150, 155, 178, 184, 188, 190, 234

  Federal Cigarette Labeling and Advertising Act (FCLAA; 1965), 264–65, 267, 273

  Federal Communications Commission (FCC), 265–66

  Federal Trade Commission (FTC), 263–64, 401

  feminism, doctor-patient relationship and, 199

  Fidler, Isaiah, 173

  Fieser, Louis, 260–61

  Figuoeroa, Rodolfo, 60

  Fisher, Bernard, 198–99, 200, 219–20, 221–23, 228

  Fitz, Katherine, 307–8, 400

  5-fluorouracil, 154

  Fleming, Alexander, 465–66

  Flemming, Walther, 340, 341, 344, 364, 365

  fluorouracil, 154, 220

  foci, of cancer cells, 351, 372, 373–74, 376, 384

  folic acid (folate), 28, 29, 31, 406

  Folkman, Judah, 387

  Food and Drug Administration (FDA), 262–63, 319, 322, 423, 429, 455

  Foote, Emerson, 112, 113, 185

  Ford, Edmund, 247–48

  “Forsaken Garden, A” (Swinburne), 461

  Fortas, Abe, 264

  Fortune, 23–24, 25, 227

  fossil record, 248

  Fowler, James, 445

  Fox, Nelene, 321–24

  Fox Chase Cancer Center, 279

  Framingham, Mass., longitudinal studies of, 444–45

  Frankfurter Anilinfarben-Fabrik, 85

  “Frank Statement to Cigarette Smokers, A,” 250, 252

  Frei, Emil “Tom,” 129–30, 132, 133, 134, 137–38, 139, 140, 153, 162–64, 206, 228, 260, 375

  at Dana-Farber, 310–14

  STAMP and, 310, 311, 312, 314

  VAMP and, 141–42, 143–47, 166, 310

  Freireich, Emil, 128–30, 132, 134, 136, 137–38, 139, 140, 163–64, 206, 228, 260, 366

  VAMP and, 141–42, 143–47, 166

  Friend, Steve, 379–80

  fruit flies, 344, 346, 347, 348, 349, 350

  Furth, Jacob, 261

  Galbraith, John, 23

  Gale, Thomas, 48

  Galen, Claudius, 46, 48–50, 52–54, 55, 79, 90, 158, 214, 238, 281, 342, 434, 463

  gallbladder cancer, 465

  Gallie, Brenda, 376, 377

  Gallo, Robert, 318

  gangrene, 57

  Gans, Hiram, 461

  Garb, Solomon, 177–78, 184, 234

  gastritis, 276, 281–84

  gastrointestinal stromal tumor (GIST), 467–70

  Gay Men’s Health Crisis, 318

  gay-related immune deficiency (GRID), see AIDS

  Geller, Henry, 265–66

  gemcitabine (Gemzar), 154

  Genentech, 413, 414–19, 423–29

  Herceptin trials of, 420–22, 424, 426–29, 430

  Nelson’s “funeral procession” at, 425–26

  genes, genomes, 6

  as carcinogens, see oncogenes

  as carried on chromosomes, 344

&nbs
p; chimeras, 366, 409–10, 430–31

  as composed of DNA, 345

  functional view of, 364, 366, 368–69, 431, 455

  inherited traits transmitted by, 343–44, 364, 366

  mechanism of, 345–46, 364–69

  mutations of, see mutation, genetic

  RSV and, 351–52

  sequencing of, 450–54, 464

  structural view of, 364, 365–66, 431, 455

  translocation of, 365–66, 402, 409–10, 430–31

  tumor suppressor, see tumor suppressor genes

  unidirectional flow of information from, 346, 352, 354

  genetic anthropology, 278–79

  Germany, dye industry in, 82–86

  Ghosh, Amitav, 196

  Gilbert, Rene, 159

  Gilman, Alfred, 90

  Gladwell, Malcolm, 302

  Gleevec (imatinib):

  CML and, 434–40, 441–43

  as “four-minute mile” of cancer therapy, 439

  GIST and, 467–68

  resistance to, 441–43, 468

  glioblastomas, 71

  glioma, cell phones and, 446–47

  Glück, Louise, 405

  Goldman, John, 436

  Goldstein, David, 124, 125–26

  Goldstein, Sonja, 124–25

  Goodfield, June, 1

  Goodman, Louis, 90

  Gorman, Michael, 393

  Gornik, Heather, 330–32

  Gould, Stephen Jay, 37

  graft-versus-host disease (GVHD), 309, 437

  Graham, Evarts, 72, 242, 260

  laboratory experiments of, 254–55, 456

  lung cancer and death of, 250, 256–57, 258

  tobacco-cancer study of, 244–45, 246–47, 252, 253–54, 256, 260, 263, 401

  Great Britain:

  child labor in, 239

  doctor registry in, 249, 294

  dye industry in, 82

  Million Women Study in, 456

  textile industry in, 81–82

  tobacco use in, 240

  Great Depression, 109

  Greaves, Mel, 46

  Greco-Persian wars, 42

  Greece, ancient, medical knowledge in, 47–48

  Greene, Mark, 411n

  growth hormone, 414, 415

  Grubbe, Emil, 75–76, 77, 78, 195

  Gustafson, Einar “Jimmy,” 96–99, 172, 395–97

  Guy’s Hospital, 156

  gynecological diseases, 287

  Haagensen, Cushman, 193–94, 198

  Haldane, J. B. S., 6

  Halley’s comet, 370

  “Hallmarks of Cancer, The” (Weinberg and Hanahan), 390–92, 443

  Halsted, Caroline Hampton, 63

  Halsted, William Stewart, 60–69, 158, 201, 219, 319

  centrifugal theory of, 194–95, 199

  drug addictions of, 62–64, 225

  mistaken kindness scorned by, 65

  radical surgery pioneered by, 6, 23, 60, 64–69, 70–71, 73, 78, 173, 193–95, 196, 197, 198, 218, 225, 291, 463

  Hamill, Peter, 259

  Hamlet (Shakespeare), 1

  Hanafusa, Hidesaburo, 361, 368

  Hanahan, Douglas, 390–92

  Harlow, Ed, 403

  Harmon, Steve, 305–6, 399