View source for The Cancer Chronicles: Unlocking Medicine's Deepest Mystery by George Johnson

{{infobox1
|title=The Cancer Chronicles: Unlocking Medicine's Deepest Mystery
|sort=Cancer Chronicles: Unlocking Medicine's Deepest Mystery, The
|author=George Johnson
|reviewer=Rebecca Foster
|genre=Popular Science
|rating=4
|buy=Maybe
|borrow=Yes
|isbn=9781847921666
|pages=304
|publisher=Bodley Head
|date=August 2013
|website=http://talaya.net/
|video=qDXh3n3Mzmw
|summary=From prehistoric times to current developments, a popular science writer surveys the phenomenon of cancer, all along blending personal anecdote with cutting-edge research.
|cover=0099556057
|aznuk=0099556057
|aznus=1847921663
}}
George Johnson, a popular science writer more comfortable in the fields of physics and cosmology, started his journey into cancer when his wife, Nancy, was diagnosed with a rare uterine variety. He took it as an opportunity not just for personal soul-searching (why her? why now?), but also for a wide-ranging odyssey into current research about what causes cancer and how long it has been with us.

'Jurassic Cancer', the first chapter (and my favourite), explores cancer in the prehistoric world. Travelling to palaeontology hotspots in Colorado, Johnson learns that cancer has been uncovered in dinosaur bones – even, on one occasion, in a T-Rex brain cavity. 'Maybe cancer was a great rarity before man began messing with the earth. But a core amount of cancer must have existed all along.' The archaeological record, too, documents cases of human cancer from thousands of years ago. Johnson only found evidence of some 200 cases, but that low number may be misleading; scientists have only examined about 250,000 ancient skeletons, out of nearly 100 billion humans who have ever lived.

What causes cancer? Johnson thoroughly investigates potential factors, including radiation and carcinogens in foods and the atmosphere. To each cause he brings a sceptic's eye: we may think we know that cigarettes and nuclear emissions greatly increase the incidence of cancer, but statistics tell a different story. 'Sometimes it feels like we're chasing our tails, obsessed with finding causes where there may be none.' For instance, much has been made of a supposed link between mobile phone use and brain tumours, but Johnson reports that even a 40 percent increased chance takes a person's risk from 0.0057 to 0.008 percent. Such numbers are so small they start to seem insignificant and arbitrary. Even lung cancer for smokers is not a foregone conclusion; only 1 in 8 succumbs. Interviewing Imperial College's School of Public Health director, Johnson discovered that 'for as much as 50 or 60 percent of cancer, we didn't have the slightest idea of where it comes from.' What we do know is that cancer discriminates 'against the elderly, the obese, [and] the poor.'

Interspersed throughout are passages about Nancy's diagnosis and treatment, as Johnson turns his research personal. What caused Nancy's cancer, specifically? It's thought that women who don't bear children have dangerously high oestrogen levels; was Johnson's refusal to have children to blame? Their home in Santa Fe, New Mexico (25 miles from the Los Alamos atomic test site) had higher than average levels of atmospheric radon; Johnson found that 90 percent of cancer cases, even with genetic predisposition, require an environmental trigger. What about diet? 'She always ate her vegetables,' he introduces Nancy. It seems what we always thought about vegetables is wrong; 35 of 63 plant-derived substances were found to be carcinogenic, with brassicas notably high in natural pesticides. (Coffee contains 19 different carcinogens, for goodness' sake!) 'You could live your life with a calculator,' he concedes – but would that really be living? 'There is something comforting about knowing that cancer has always been with us, that it is not all our fault, that you can take every precaution and still something in the genetic coils can become unsprung.'

Johnson successfully balances (auto)biographical information and hard science, though some may struggle with the level of detail about cell biology and medical trials. If I might have preferred more personal narrative, that mostly speaks to my love of memoirs. Nancy's story reveals the harsh reality of cancer treatment – especially in America, where bureaucracy and astronomical medical bills exacerbate an already horrible experience. 'How quickly the unthinkable becomes routine,' Johnson reflects. The book ends on a sad note – though not with Nancy's death, I hasten to add. I wish Johnson could have chosen to find more hope; instead he concludes, 'With our tools and intelligence, we can strike small victories and hold off death for a while. But it is the tide that will eventually prevail.' Ultimately, Siddhartha Mukherjee's Pulitzer Prize-winning ''The Emperor of All Maladies'' is the more comprehensive and optimistic study of cancer, but Johnson's is shorter and highly readable.

We have reached a point where no one is unaffected by cancer, directly or indirectly. That is to say, there is no one to whom this book will not be relevant. 'All of us acquire our own personal cancer clusters,' Johnson astutely notes. Whether this would be one's first choice of reading material is another matter. I like memoirs and popular science, so I enjoyed Johnson's erudite mixture of the two genres, but I can see how others would be put off by both the weighty scientific subject and the pessimistic tone. However, I encourage reluctant readers to give this one a try. You will learn more than you might expect, and explode many myths along the way.

Further reading suggestion: You might want to try another of the author's books, [[The Ten Most Beautiful Experiments by George Johnson|The Ten Most Beautiful Experiments]]. [[Spillover: Animal Infections and the Next Human Pandemic by David Quammen]] is a very gripping work of popular science.  You might also appreciate [[The Lazarus Effect by Sam Parnia]].

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