The war against cancer: of course we know about it, of course we care about it, of course we cheer this week’s victories … except maybe the war is false. Oncologist Azra Raza, specialist in myeloid leukemia, has spent a lifetime on the frontlines of the war against cancer, and “The First Cell: And the Human Costs of Pursuing Cancer to the Last” is both her professional life story but also a very human plea against oncology’s ruling worldview. This is an extraordinary work, somehow combining real tales of cancer battlers, her own memoir that revolves around the death from cancer of her husband, Harvey Preisler, himself an oncologist, and also a powerful plea to rethink the decades-long, no-holds-barred war. She is convinced the world should switch “from chasing after the last cell to identifying the footprints of the first.”
I first came upon an oncologist’s disquiet in the closing pages of Siddhartha Mukherjee’s magisterial “The Emperor of All Maladies.” Perhaps, Mukherjee whispered, the war is being lost. Since then, I’ve observed friends enveloped by institutional cancer “battle” cycles – the ops, the chemotherapy, the radiotherapy, and (the latest) the immunotherapy. My unease festered. Now Azra Raza confirms my intellectual and emotional unrest. Lab-tested cancer drugs, she writes, fail with humans 95% of the time and the successful 5% see their lives only extended by a few months at most. In spite of progress with some cancers, in broad terms, overall “war against cancer” statistics flatline over the last three decades. “No one is winning the war on cancer. It is mostly hype, the same rhetoric from the same self-important voices for half a century.” Oncologists’ “inevitable slash-poison-burn cycles” hold out hope but mostly don’t deliver, in fact Raza cites a number of highly personal case studies that question whether the collateral suffering was at all effective or humane.
“The First Cell” is compulsory reading from a talented writer and a first-hand participant in history. Embrace it for an emotional rollercoaster and to open your eyes. Whatever your final judgement – it’s hard to jettison the “war against cancer” hopes – at least your reading will offer more choices when the Big C hits you or your family or your friends.