’“Cancer” as the oncologist Harold Burstein described it, “resides at the interface between society and science”. It poses not one but two challenges. The first, the “biological challenge” of cancer, involves “harnessing the fantastic rise in scientific knowledge… to conquer this ancient and terrible illness”. But the second, the “social challenge”, is just as acute: it involves forcing ourselves to confront our customs, rituals, and behaviours. These, unfortunately, are not customs or behaviours that lie at the peripheries of our society or selves, but ones that lie at their definitional cores: what we eat and drink, what we produce and exude into our environments, when we choose to reproduce, and how we age.’ – Siddhartha Mukherjee, The Emperor or All Maladies.

I love a good book. I also love a book that’s made into a film, and in fact, I came within a hair’s breadth of doing my dissertation on that very subject, but the overriding desire to get a picture of a Bell UH-1H Iroquois into a dissertation, and still get a first for it, led me into the terrain of Hollywood and the Vietnam War. Here is one for you now, any excuse is a good excuse where the Huey is concerned:

I still remain fascinated by the different experiences offered between the literary and cinematic mediums, and occasionally like to force myself to see the film first, just so I can get the other perspective from the normal ‘you must read the book before the film or it’ll ruin it!’ mantra. I’d agree with this to a certain extent, but I don’t think seeing the film first ‘ruins’ anything. It just offers an entirely different experience when engaging in both. Essentially, if you read the book first, your imagination and the writer’s skill are what come together to give you your understanding of the book. When you see it as a film, it is the imaginations of several people within the movie production, as well as the studio and the distribution agents, that are coming together to offer you their vision of the book. You may wonder why they have chosen to leave out something that was integral for you when you read the book; some things simply don’t translate to the visual medium, but also everyone’s interpretation of a book is different. We have all experienced different lives, under the yoke of different parents, caregivers and education facilities, in different cities, towns, hamlets and isolated islands, with different siblings, friends and influences. When we read a book or watch a film, we bring our entire selves to our interpretation of it, to how we make meaning. It’s not possible to be entirely objective and remove everything you know and are as a person from your engagement with a book or film, because just trying to do that means you are subjectively trying to remove yourself, and it can’t be done. You may form an objective opinion on something, but it’s still your opinion, it will still come from you. 

Which is a bit like cancer. 

The Emperor of All Maladies is a gripping book, up there with the best I’ve read. It is described by its own blurb as a ‘biography of cancer’, with cancer as the subject, object, star and central character of its own story. You probably don’t think that sounds very gripping – and maybe I wouldn’t think so either if I wasn’t on a mission to understand just what went on in Bad Tit to lead me to be sitting here writing about a book that someone else has written about cancer – but from where I’m sitting, it’s gripping. It’s a well written narrative tracing the origins of cancer throughout history, how our understanding of it as a species has developed, how the influence of technology has expanded our potential to treat it, and interspersed throughout are the sub-narratives of many patients recorded in history and treated by Mukherjee himself, providing the protagonists for cancer’s antagonistic antics. 

I now feel that I understand, although probably still can’t explain very well so I won’t try, what happens on a cellular level when cancer comes to town. I also feel like I can stop mulling over all the possible ’causes’ and trying to ascertain exactly what triggered that one cell to go into mass reproduction mode, like it was this year’s most wanted Christmas toy. There isn’t actually any way of knowing. Not with breast cancer. There is evidence now for the theory, from autopsies on healthy men and women killed in car crashes, that by a certain age many people are literally riddled with pre-cancerous cell clusters – don’t freak – that our bodies manage to quite effectively deal with. (Please watch this if you are worried to get a better understanding of that: http://blog.ted.com/2010/05/17/can_we_eat_to_s/) There are many things attributed to triggering these mutations that start an epic growth spurt not seen in your body since those wonderful years of your puberty, but one of the factors is simply age. As we age, so our cells are more likely to wander off into another room and forget what they went in there for. Yes, there are known carcinogens that cause damage at a cellular level, the obvious one here being smoking. Science is now fully aware that the damage caused by smoking doesn’t start making itself known for about 30 years, hence the lung cancer boom of the 70s and 80s following the post-second World War effort to make cigarettes the number one consumer choice. Now that governments feel they’ve got that message across, the drive to scare the shit out of the current generation consumers has lost momentum – and funding – and tobacco companies are rolling in a new global rise in smoking in both developing countries and also amongst stupid western teenagers, who probably haven’t had to witness half their family dying of lung cancer, so have gone back to thinking it makes them look cool. Man. 

Wish I’d never started smoking when I was a teenager.

But really, what’s the use of worrying? Stress is also a known risk factor in several cancers, including breast cancer, which is why for some considerable time, I wondered whether working 60-70 hours a week had actually been killing me. Alcohol is linked to breast cancer, and I know I drank too much before all this. If one is to believe everything the Daily Mail says about cancer, we might as well all give up now. But if you haven’t had cancer, or someone close to you hasn’t had cancer, how much do you really know? Being diagnosed with cancer is pretty much the same as watching the movie first, without even knowing what it’s about, then you can choose whether you want to buy the book. Considering current estimates are that one in two people will be diagnosed with cancer at some point in their lifetime, it may be worth more people reading the book before seeing the film. 

So, when they make the movie of The Emperor of All Maladies, these are my suggestions for the main starring roles: Susan Sarandon as the first ever recorded cancer case – an Egyptian Queen with suspected breast cancer. Myla Kunis as Marie Curie because, well, phonetically it works, and also Nate won’t go and see the film unless she’s in it. Christopher Lloyd as Sidney Farber, the father of modern chemotherapy (but there needs to a stipulation in his contract that he plays this in the Doc Brown manner). Tom Cruise as a chimney sweep, hacking up phlegm and providing the first evidence of a carcinogen. Jimi Mistry as Siddhartha Mukherjee, researching the personality of this epic disease and re-writing its story so the lay person can understand it, with handy analogies and examples to illustrate complex points. And to play the part of cancer – Michael Gove. Now, I know he has no acting experience, but he didn’t need experience for his current job either. Plus, he’s already insidious, malignant and ruining the lives of millions of children, so he wouldn’t need to act. It’s got ‘summer blockbuster’ written all over it.