The Emperor of All Maladies
mustard gas, see nitrogen mustard
mutagens, mutagenesis, 278, 303, 347, 348, 362, 364, 406, 456
mutation, genetic, 377
in bacteria, 277–78
Cancer Genome Atlas and, 450–54
causes of, see mutagens, mutagenesis
driver (active), 453
frequency of, 451–52
in fruit flies, 347
functional vs. structural view of, 455
as governing all aspects of cancer, 387–88, 462
as mechanism of carcinogenesis, 6, 39, 176, 278, 357, 362, 370, 380–83, 384–88, 390–92, 403, 406, 449–50, 462, 464–65
passenger (passive), 452–53
see also oncogenes
myc (c-myc) gene, 382–83, 384, 391, 410, 412, 453–54, 458
mycobacteria, 84, 131
myelodysplasia, 306, 309, 312
myeloid cells, 16–17
Myriad Genetics, 381
Nathan, David, 140
National Alliance of Breast Cancer Organizations (NABCO), 327
National Breast Cancer Coalition (NBCC), 426, 429
National Cancer Act (1971), 188, 189
National Cancer Institute (NCI), 15, 114, 130, 158, 159, 166, 177, 188, 228, 231, 318, 325, 330, 339, 374, 393, 443
chemotherapy protocols of, 132–42, 143–50, 164–66, 206–8, 219–20, 232, 310, 317
Clinical Center of, 128–29, 139, 145, 162, 165, 260
creation of, 25–26
Institutional Board of, 137
mammography project (BCDDP) of, 296–98, 302
Pap smear trial of, 289–90
preventative strategies neglected by, 233–34
Special Virus Cancer Program of, 175–76, 280–81, 356, 357
National Cancer Institute Act (1937), 25
National Health Service, British, 294
National Institutes of Health (NIH), 25n, 121, 187, 188, 202–3, 260, 319
National Library of Medicine, 261
National Program for the Conquest of Cancer, 184
National Science Foundation (NSF), 121
National Surgical Adjuvant Breast and Bowel Project (NSABP), 200–201
National Tuberculosis Association, 259
natural selection, 248
Nature, 354, 379
Nature Medicine, 435
nausea, from chemotherapy, 165, 205–6, 209, 226, 305
Nazis, 290
Neely, Matthew, 25, 173
negative statistical claims, 197–98
Nelson, Marti, 424–25, 429
“funeral procession” for, 425–26
neoplasia, 16, 42, 385
neu, 410–11, 412, 413, 420
neuroblastomas, 410, 413
New England Journal of Medicine, 35–36, 161, 229, 330, 385
Newton, Isaac, 370
New York, HIP in, 294–96, 297
New York, N.Y., AIDS in, 316, 318
New York Amsterdam News, 286
New York Times, 24, 26–27, 105, 117, 119–20, 180–81, 183, 319, 327, 455
Neyman, Jerzy, 197–98
nicotine:
addictive properties of, 270–71
see also cigarettes; smoking; tobacco; tobacco industry
Nisbet, Robert, 193
nitrogen mustard, 207, 220, 257
bone marrow affected by, 88, 90
DNA damaged by, 163, 406
hyperplasia as halted by, 163, 406
as mustard gas, 87–88, 89–90, 162–63
nitrosoguanidine derivatives, 278
Nixon, Richard M., 180–81, 183, 184, 187–88
Nobel Prize, 28, 87, 91, 176, 348, 363
Norris Center, 323
Norton, Larry, 327, 426
Novartis, 436, 439
Nowell, Peter, 365
NSABP-04 trial, 200–201, 203, 220
Nuland, Sherwin, 38
Ochsner, Alton, 256–57
Oedipus the King (Sophocles), 321
Office of Scientific Research and Development (OSRD), 90, 119
Oliver Twist (Dickens), 239
oncogenes, 363, 366, 370–71, 380, 384, 402, 409–11, 412, 415, 431, 439, 443, 450, 453, 454, 462, 466
amplification of, 416
pathological hyperplasia induced by, 357–59, 372, 431
proto-, see proto-oncogenes
see also specific genes
oncology, oncologists, 304, 433
AIDS and, 316–17
death and, 4, 306–8, 337–38
fellowships in, 2–5, 168
origin of term, 47
overconfidence of, 223, 226, 231–32, 234, 308, 310
palliative care and, 224–26, 307
patients’ relationships with, 199, 202, 209, 306–8, 449
radiation, see radiation therapy
OncoMouse, 382–83, 384
onkos, 47
etymology of, 466–67
“On Some Morbid Appearances of the Absorbent Glands and Spleen” (Hodgkin), 157
opiates, 226
Oregon Health and Science University (OHSU), 434
Orman, Ben, 151–53, 155, 399–400
Osler, William, 45
osteosarcomas (bone tumors), 43
ovarian cancer, 59, 162, 346, 381, 450, 451, 457
ovaries, removal of, 214, 215
Pacific yew tree, 206
Pack, George, 70–71
Padhy, Lakshmi Charon, 410–11
Page, Irvine, 187
paleopathology, 42
palliative care, 223–26, 231, 307
drug trials for, 226
pancreas, 154, 414
pancreatic cancer, 154, 158, 450, 451, 465
Panel of Consultants, 184, 188
Panzer, Fred, 270
Papanicolaou, George, 286–90, 291, 384–85, 386, 401
Papanicolaou, Maria, 287
papillomavirus, 174, 349n, 381n
Pap smears, 228, 286, 287–90, 296, 303, 331, 381, 385, 401
Paré, Ambroise, 49
Paris, University of, 51
Park, Roswell, 24, 45
Parliament cigarettes, 269
Pasteur, Louis, 57
pathology, pathologists, 11–12, 14
Hodgkin’s approach to, 156–57
Patterson, James, 183
PCP (Pneumocystis carinii), 165, 315–16
Pearson, Egon, 197–98
pectoralis major, 64–65
pectoralis minor, 64
pellagra, 110
penicillin, 21–22, 122, 129, 465–66
Penicillium, 122
Pepper, Claude, 26n
peptic ulcers, 281–84
Perkin, William, 81–82, 83
pernicious anemia, 27–28, 31
Peru, 42–43
pesticides, 456–57
Peters, Vera, 159–60
Peters, William, 311–15, 319–20, 321, 325, 326, 329
Peto, Richard, 241, 249, 273–74, 462
pharmaceutical industry, 426
see also specific companies
Philadelphia chromosome, 365, 430–31
Philip Morris, 251, 269–71, 273
phlegm, 48
phosphorylation, 358–59, 361, 380, 418, 431–32
Piccolo, Brian, 181
Pim, Isabella, 58
Pinkel, Donald, 123, 167–68, 170, 178
pitchblende, 74
pituitary cells, 414
placebos, in randomized trials, 131–32, 319
placenta, 135, 219
platelets, 18
Plato, 370
Pneumocystis carinii (PCP), 165, 315–16
pneumonectomy, 242
pneumonia, 45
PCP, 165, 315–16
Poet Physicians, 60
polio, 22, 229, 342, 466
national campaign against, 93–94, 175
Popper, Karl, 370
population, U.S., aging of, 230
Postmortem Examination, The (Farber), 19
Pott, Percival
l, 173, 237–39, 241, 276, 447
precancer, 286, 306, 455
Auerbach’s research on, 258–59, 284, 289
prednisone, 127, 140, 143, 149
see also VAMP regimen
Premarin, 213
preventive medicine, 281
epidemiology and, 290
see also cancer prevention
procarbazine, 162, 164
product-liability lawsuits, 269–73, 401
progesterone, 456
“Progress Against Cancer?” (Bailar and Smith), 229, 231–32, 329–30
Prohibition, 262
promyelocytes, 407–8, 409
prostate, 211–13, 215
prostate cancer, 211, 443
in dogs, 212–13
hormonal therapy for, 213–14, 222
remissions in, 214
surgical removal of, 59, 71, 216
prostatectomy, radical, 71
prostatic fluid, 211–12
protein drugs, 414
proteins, 345–46, 442
as molecular switches, 387
phosphorylation of, 358–59, 361, 380, 418, 431–32
signaling pathways of, 387, 388, 389, 402, 406, 432, 443, 453–54, 457, 458, 464–65
structural view of, 432
protocols (clinical trials):
for ABMT, 325–26
for breast cancer, 200–201, 294–302, 420–22, 423, 424, 426–29
for choriocarcinoma, 135–38, 139
conflicts of interest in, 198
for, CML, 436–38
for Hodgkin’s lymphoma, 163–66, 208
for leukemia, 132–34, 135, 139, 140–42, 143–50
of mammography, 294–302
multi-institutional, 207–8
for palliative care, 226
randomization in, 131–32, 160, 243, 293, 298–300, 302, 314, 319, 321, 426
proto-oncogenes, 361–63, 364, 369, 370, 380, 384, 412
activation of, 386–87, 388, 406, 407
pteroylaspartic acid (PAA), 33
public health and hygiene, 22
Public Health Service, U.S., 257, 259, 260
purines, 92
pus, 13, 14
radiation, 74–75
as carcinogen, 75, 77–78, 347, 364, 389
radiation therapy, 23, 154, 158–59, 405
for breast cancer, 75–76, 77, 158, 161, 195, 464
chemotherapy in combination with, 123–24, 154, 168–70, 400
extended field, 159–61
for Hodgkin’s lymphoma, 159–61, 163
involved field, 160
local surgery combined with, 195–96, 197, 464
for lung cancer, 158, 403
for lymphomas, 77, 158
radium in, 76, 195
staging and, 160–61
X-rays in, 75–76, 158–59
radical surgery, 6, 59, 60, 304, 308, 406
see also mastectomies, radical
radio, see broadcast media
radium:
discovery of, 74–75, 76
radiation poisoning from, 74–75, 77–78, 173, 347
in radiation therapy, 76, 195
Radium girls, 78, 278
Ramazzini, Bernardino, 238
Ramses V, King of Egypt, 41
randomization of trials and studies, 131–32, 160, 243, 247, 293, 294, 302, 314, 319, 321, 426
ras gene, 374–75, 376, 379–80, 383, 384, 385, 387, 388, 391, 410, 412, 431n, 453–54, 458
Ras-Mek-Erk pathway, 387, 453–54
Rauscher, Frank, 191, 223, 234
Rb gene, 364, 367–69, 376, 377–80, 381, 391, 412, 453–54, 458
Reader’s Digest, 112
recall bias, 446
receptors, 31
in estrogen, 215, 216, 217, 464
recombinant DNA, 413, 414
red blood cells, 3, 18, 88
Red Queen syndrome, cancer and, 443, 444, 446, 470
Reed, Carla, 1–3, 7, 17–18, 126–27, 168–69, 190, 337, 338–39, 398, 400, 448–49, 459
Reimann, Stanley, 121–22
relapses, 59, 138, 443
of breast cancer, 64, 66–69, 197, 208, 221, 329, 419
of leukemia, 35, 91, 132, 133, 147, 165, 166, 170, 442
remissions:
of ALL, 127, 190, 338–39, 400
of APL, 409–10
of breast cancer, 217, 222, 314, 454, 456
of Hodgkin’s lymphoma, 160–61, 171, 179
of leukemia, 34, 35, 101, 127, 133, 145–46, 179, 190
of, CML, 437–39, 441, 443, 444
retinoblastoma, 366–68, 376, 377, 380, 391
retinoic acid, 408–9
retroviruses, 318, 352, 353, 354, 360, 361–62, 363, 380
as carcinogens, 354, 355–56, 357, 415, 431n
reverse transcriptase, 352–54, 371
Revlimid, 443
Rhoads, Cornelius “Dusty,” 92, 114
Richards, A. N., 121
Richardson, Dora, 216
Rieff, David, 306
risk factors, for disease, 444–45
for cancer, 44, 276, 303, 445–46, 455–57
in social networks, 445–46
risky prediction, 370
R. J. Reynolds, 273
RNA (ribonucleic acid), 91, 345–46
reverse transcription to DNA of, 352–54, 371
transcription from DNA to, 352
viral, 352–54
Roe v. Wade, 199
Rogers, Paul, 187–88
Rollin, Betty, 200
Rome, ancient, medical knowledge in, 48–49
Romeo and Juliet (Shakespeare), 89
Röntgen, Anna, 73
Röntgen, Wilhelm, 73–74
Roosevelt, Franklin D., 25, 94, 404
Rosenberg, Barnett, 204
Rosenberg, C. E., 46
Rosenow, Fanny, 26–27
Rosensohn, Etta, 286
Roswell Park Cancer Institute, 133, 167n
Rous, Peyton, 173, 174, 175, 176, 335, 342–43, 350, 355, 362, 382, 383
Rous sarcoma virus (RSV), 174, 342, 349–50, 351, 358–59, 372, 466
genome as modified by, 351–52
as mutated src gene, 361–62
as retrovirus, 353
Rowley, Janet, 365–66, 376, 409–10, 430–31
Rubin, Harry, 351
Ruijin Hospital, 408, 409–10
Sabin, Albert, 22, 94
St. Bartholomew’s Hospital, 195
St. Christopher’s hospice, 225
St. Jude’s hospital, 167–68, 170
Saint Louis Hospital (Paris), 408
St. Luke’s Hospital, 64
St. Thomas’ Hospital, 156, 157
Salecl, Renata, 182
Salk, Jonas, 22, 94
Salmonella, 277, 278
Salomon, Albert, 290
Salvarsan (compound 606), 86
Samuel, Book of, 305
Sandler, Elliott, 33, 34
Sandler, Robert, 32–34, 35
San Francisco, Calif., AIDS in, 317–18
San Francisco General Hospital, Ward 5B at, 317–18, 424
sarcomas, 173, 174, 443, 467
SARS, 182
Saunders, Cecily, 225–26
Sawyers, Charles, 436, 437, 438, 441–42
Schabel, Frank, 312
Scheele, Leonard, 235
Schleiden, Matthias, 15
Schmidt, Benno, 184–85, 187
Schope, Richard, 174
Schuman, Leonard, 261
Schwann, Theodor, 15
science:
Apollo program and public perception of, 179
goal-driven vs. basic research in, 119–22, 183
measurement in, 19, 74, 197–98, 227
technology vs., 462
Science the Endless Frontier (Bush), 120
Scientific American, 227–28, 350
scientific revolutions, 196
screening:
for breast cancer, 457, 464; see also mammography br />
colonoscopy, 331, 401
molecular biology and, 457–58
over- vs. underdiagnosis in, 291–92, 293, 302
Pap smears, 288–90, 296, 303, 331, 401
as prone to error, 302
scrofula, 47
scrotal cancer, 173, 237–39, 241, 276
scurvy, 110
sea urchins, 341, 348, 349
secondhand smoke, 260
Senate, U.S., 122, 185
see also Congress, U.S.
Shakespeare, William, 1, 89, 191
Shapiro, Sam, 294–95, 296, 297, 299, 302
Shelby County, Tenn., 289–90
Shepard, Mike, 418, 420, 427
Sheridan, Catherine Variety, 95, 96
Shih, Chiaho, 373–74, 376
Shimkin, Michael, 107
Shinder, Jason, 398
signaling pathways, 387, 388, 389, 402, 406, 432, 443, 453–54, 457, 458, 464–65
Silent Spring (Carson), 456
6-mp (6-mercaptopurine), 92, 127, 132–33, 140, 143, 338
see also VAMP regimen
Skipper, Howard, 139, 140–41, 143, 196, 206, 311–12
Skolnick, Mark, 381
Slamon, Dennis, 415–19, 433
Herceptin trials of, 420–22, 423, 426–29
sleeping sickness, 85, 245
slime molds, 345, 346, 349
smallpox, 24, 41, 175, 225, 343
Smith, Anna Deavere, 305
Smith, Edwin, 39
Smith, Elaine, 229, 231–34
Smith papyrus, 39–41
smoking, 45, 250, 251, 267–68, 272, 273–74, 275, 445–46
cancer and, see tobacco-cancer link
decrease in, 401
increase in, 240–42, 445
social networks and, 445–46
by women, 268, 445
see also cigarettes; nicotine; tobacco; tobacco industry
Smoking and Cancer (Graham), 257
“Smoking and Carcinoma of the Lung” (Doll and Hill), 246
snuff, 239–40
social networks, as risk factors for disease, 445–46
Solzhenitsyn, Aleksandr, 4, 181, 316, 461
Sontag, Susan, vii, 37–38, 202, 306, 316, 388, 449
soot, 173, 238, 239, 364
Sophocles, 321
Sorenson, Beatrice, 153–55
Special Virus Cancer Program, 175–76, 280–81, 356, 357
specificity, specific affinity, 80–81, 84–88, 90–92, 210, 222, 432, 433, 434, 439
Spector, Deborah, 361
Speyer, Maria, 17
Spiegelman, Sol, 186, 355–56, 357, 360, 362
spinal fluid:
chemotherapy and, 167–68
leukemia in, 146–47
spinal taps, 127, 146
spleen, leukemia and, 14
src gene, 375, 418, 431, 433
endogenous, 361–62, 364, 368, 371, 466
viral, 358–60, 364, 368, 370, 372
stages, staging, of cancers, 55, 67, 160–61, 163, 164–65, 218, 222, 289, 290, 385, 428, 463
STAMP (Solid Tumor Autologous Marrow Program) protocol, 310, 311–15, 320, 325, 326, 328–29
as adjuvant therapy, 320
Statistical Unit, 245