As I read on in The Emperor of All Maladies, some sections I find absorbing and fascinating, while others, such as those describing the efforts to understand the intricacies that lie within cancerous cells, are sometimes hard for me to follow. I persevere because overall it provides a realistic look at the nature of the beast. For decades, even centuries, doctors and scientists have been attempting to unravel and expose this mysterious and lethal ailment, and yet it proves to be complex, elusive, and even cunning in its ability to overcome attempts to destroy it. I think that though my doctors were concerned, I personally didn’t take my diagnoses seriously enough. It took reading this book to see how portentous the situation is. And now I continue reading, even through the rough or boring parts, because I look for some optimism that I have not so far found. No matter how many brilliant researchers and practitioners throw themselves into the fray, we are far from defeating this ferocious adversary. Having cancer is not the same as getting the flu, for instance, or even, as Henry Miller would put it, “a dose of the clap.” No. With cancer, once you’ve had it you can never be sure you are completely rid of it. It can go into remission, sure, but you never really know whether it is gone or if it might still be lurking in distant cells, ready to metastasize into deadly clusters at any moment.

*     *     *

As I plunged into the final chapters of The Emperor of All Maladies, I kept hoping for a satisfactory resolution, a glimmer of assurance, a light at the end of the dark, dark tunnel. Alas, this was not forthcoming. The book ends on a tragic note, as Mukherjee relates the story of a woman who is diagnosed with a rare cancer that she fights for several years but that eventually claims her life. It is an illustration of what the author states earlier of advanced stages of the disease: “Cancer is not a concentration camp, but it shares the quality of annihilation: it negates the possibility of life outside and beyond itself; it subsumes all living. The daily life of a patient becomes so intensely preoccupied with his or her illness that the world fades away.” As a patient battling acute leukemia told the author: “My friends often asked me whether I felt as if my life was somehow made abnormal by my disease. I would tell them the same thing: for someone who is sick, this is their new normal.” I can empathize with this attitude. After mere months of appointments, exams, biopsies, and procedures, I can’t imagine life without these seemingly endless traumas.

The author ultimately provides no solutions, but he does share suggestions of directions cancer medicine should take. His prognosis, however, is dark. Just as the patient he quotes says that cancer is her new normal, he writes that “quite possibly cancer is our new normal as well, that we are inherently destined to slouch toward a malignant end.” And “perhaps cancer, the scrappy, fecund, invasive, adaptable twin to our own scrappy, fecund, invasive, adaptable cells and genes, is impossible to disconnect from our bodies…it is possible that we are fatally conjoined to this ancient illness, forced to play its cat-and-mouse game for the foreseeable future of our species.” He says that “no simple, universal, or definitive cure is in sight – and is never likely to be.”

What does someone like me, who has been diagnosed with early-stage cancer, make of all this? Are we doomed forever to succumb to the evil beast? Not necessarily. And though this book provides no definitive answers, it is nonetheless a valuable read. First of all, it is a sobering wakeup call for people like me who initially take their diagnosis too lightly. But even more, in its account of excruciatingly slow but steady progress in the understanding of the disease and refinements in its treatment, it is in fact a powerful document of the tenacity of human endeavor and resilience of the human spirit in the face of a formidable adversary. The treatment that I receive is far more nuanced and effective than that of a century ago – or even a decade ago, for that matter. And researchers, scientists, and physicians are continually searching for more insights, more answers, and more cures. I’m not going to unequivocally state that everyone diagnosed with cancer should read this book, but I am exceedingly thankful that I did.