Former Memorial Sloan-Kettering Cancer Center president and CEO Marks delivers a panoramic view of developments in cancer research and treatment over the last 40 years, from both the researchers’ and administrators’ perspectives.
In this boldly presented argument, written with the assistance of Wall Street Journal senior business writer Sterngold (Burning Down the House: How Greed, Deceit, and Bitter Revenge Destroyed E.F. Hutton, 1990), Marks passionately explains how best to pursue a course of action to control cancer’s tenacity. Cancer is protean, individualistic, complex, elusive and efficient. “The truth,” writes the author, “uncomfortable and inconvenient as it may be, is that medical science has never faced a more inscrutable, more mutable, or more ruthless adversary.” Thus, understanding its biology, as well as its ability to shape-shift between patients, is vital, and we must also remember that as long as cell division is how we propagate and survive, cancers will develop, for that, too, is how they work. It’s not surprising that Marks calls cancer “the existential illness.” This excellent elementary grounding in cancer’s workings allows readers to appreciate the importance of, say, the differences between empirical and mechanistic methods of developing treatments; why seemingly random advances in molecular biology and genetics are potentially valuable (“basic research has been the engine for most of the successes in the war on cancer”); why flexibility in research is critical to its creativity and innovation; and why a close coordination between the lab and the clinic, the diagnostic and therapeutic programs, researchers and doctors, is so essential. Marks also interweaves his own story into the changes in cancer medicine: his particular research interests against the background of the politics of medicine and how to “not throw too much money at the false promise of quick cures.” Most importantly, we must translate scientific insights into therapies.
On a level with Lewis Thomas for its clarity and verve in presenting the science of the cell and the ability of cancer to assume multiple guises.