On the Cancer Frontier

December 23, 2013
Blending biography and medical history, Marks, former head of Memorial Sloan-Kettering Cancer Center, and journalist Sterngold, deliver a sobering panorama of cancer research and treatment. "The truth is that basic research has been the engine for most of the successes in the war on cancer," they write, warning that "finding a single âcure' for all cancers is unlikely." As a medical student in 1948, Marks was devastated by the loss of a young leukemia patient, but in 1971 the nation declared a "war" on cancer and at Sloan-Kettering, Marks helped lead the charge, backing "novel methods for treating both the disease and the whole patient," introducing a "day hospital" and psychological services. He emphasizes the importance of "serious science" to understand and treat cancer, including the fascinating evolution of a drug that "brought a patient back from the dead" yet was "too weak" to help in most cancers. "I do not think we will ever eliminate the disease so long as cells replicate and we are exposed to the environmental and biological âinsults' that can cause genetic abnormalities," Marks writes. Nevertheless, this survey illustrates a doctor's determination to fight for scientific and medical victories that will extend life and hope.

Starred review from February 1, 2014
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.

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March 15, 2014
This well-written, often dramatic book about the nation's second-largest killer is a cross between memoir and cancer history. With help from his skillful coauthor, Wall Street Journal writer Sterngold, Marks, president emeritus of the Memorial Sloan-Kettering Cancer Center, presents his life in and out of the lab. In the middle of the book, Marks mentions that when he was five, his seven-months-pregnant mom died in a horrific accident when she tumbled down the stairs of her father's clothing store. He discusses hospital politics and research and the infamous war on cancer, which is more about containment than a final victory. Still, he remains upbeat because of better prevention, early diagnosis, and personalized treatment that keeps many cancer patients alive for years. Marks himself is the beneficiary of new knowledge. In 2009, he learned that he had bladder cancer, and today is alive and healthy and sharing such insights as, Cancer is, in a way, the body's war on itself. A good addition to the growing number of engaging titles about this disease.(Reprinted with permission of Booklist, copyright 2014, American Library Association.)