Cancer's Biographer

by Ann Levin

Toward the end of his oncology fellowship at Massachusetts General Hospital, cancer physician and researcher Siddhartha Mukherjee donned a surgeon’s gown to await the birth of his first child. It wasn’t just to offer moral support to his wife. He also wanted to capture blood from the umbilical cord—a rich source of the blood-forming stem cells used in bone marrow transplants to treat leukemia—to bank for future research or patients.

Siddhartha Mukherjee (Image credit: Deborah Feingold)
Siddhartha Mukherjee
Image credit: Deborah Feingold

Five years later, Mukherjee, now an assistant professor of medicine at Columbia, is still studying leukemia and stem cells, the engine that drives cellular growth and repair and that also provides a model for the uncontrolled growth of cancer cells.

Mukherjee reveals the story of his daughter’s birth toward the end of his book The Emperor of All Maladies: A Biography of Cancer, which was published last month to great acclaim and extensive media attention. His elegant, graceful prose has been compared to that of Jerome Groopman (CC’72, P&S’76) and Atul Gawande, two other doctors who have set a modern standard for writing with clarity and compassion about complex medical issues. “You took on face value that you’d be embarking on a journey—a journey connected by an idea, but not in space and time,” he says about the process of writing the book.

Born in India, the 40-year-old Mukherjee traces his literary talents to his “rigorous” education at a Roman Catholic school in New Delhi where he was forced to memorize poetry.

He came to the United States after high school to attend Stanford and majored in biology, then won a Rhodes scholarship to Oxford, where he earned a Ph.D. in immunology. Later, at Harvard Medical School, he trained as an internist, and then specialized in oncology.

Initially the book was to be a journal of a grueling year in that cancer training program, which he says regularly left him “in stunned incoherence” after evening rounds. But it grew into a larger project as he struggled to answer questions from his patients: “Where are we in the war on cancer? How did we get here? What happens next?”

He began to envision cancer as a biographer would, and to trace its history from the first recorded description of breast cancer on ancient Egyptian papyrus to the labs where researchers today decode cancer genes to try to understand, and control, malignant growth.

Along the way, Mukherjee introduces us to a diverse cast of characters: research scientists with almost pathological perseverance; patients willing to endure any treatment for a few more months of life; and lobbyists, fund-raisers and activists who, in the second half of the last century, forced the public and politicians to reckon with a killer once discussed in hushed tones.

Mukherjee came to Columbia in 2009, setting up a lab to study acute myeloid leukemia and myelodysplasia, a pre-leukemic disease. He also sees patients as part of the oncology rotation at New York-Presbyterian Hospital. He lives in New York with his wife, Sarah Sze, a highly regarded sculptor who teaches at the School of the Arts, and their two daughters.

The focus of his research is the relationship between cancer and its cellular environment. “Cancer cells don’t live in isolation,” he says. “They create homes for themselves, often by co-opting signals from other parts of the body. … What are these home-building cells? Can we attack them and thereby affect the biology of cancer?”

Dr. Riccardo Dalla-Favera, director of the Herbert Irving Cancer Center at C.U.M.C., says Mukherjee’s research adds to the growing body of knowledge about cancer “stem cells,” which are believed to lurk in the body even after chemotherapy, and which can trigger recurrence of the disease.

“He’s a unique type of scientist,” says Dalla-Favera. “Not only is he totally dedicated to his science, on which he has a very original approach, but he’s a true intellectual and scholar.”

The prevalence of cancer, the anxiety it provokes and the vast sums of money spent to eradicate it, suggest that Mukherjee was on to something when he called it the “emperor” of all maladies. As for the odds of beating it, Mukherjee is hopeful, to a point.

“What’s encouraging is there’s an enormous amount of creativity and inventiveness” in cancer research, he says. “What’s discouraging is that it’s not as simple as we thought. There’s not a universal cure. We’re in the thick of one of the most elemental human projects we’ve ever launched: to find out what cancer is and what to do about it.”

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