stigmatization of, 316
see also HIV
AIDS activists:
access to experimental therapies demanded by, 319, 322, 424
public campaign of, 318–19
Akhmatova, Anna, 461
ALGB, 130–31, 133, 144
alizarin, 82
ALL, see acute lymphoblastic leukemia
Allen, Woody, 384
Allgemeines Krankenhaus, 58–59, 62
All’s Well That Ends Well (Shakespeare), 191
Alsop, Stewart, 202–3, 206
American Association for Cancer Research, 24–25
American Cancer Society (ACS), 111–12, 172, 180, 259, 266, 296
American Cyanamid Corporation, 31
American Heart Association, 259
American Lung Association, 266
American Medical Association, 110, 251
American Society for the Control of Cancer (ASCC), 111, 112, 253, 254
see also American Cancer Society
American Society of Clinical Oncology (ASCO), 326–27, 427–29
American Surgical Association, 67–68, 78
Ames, Bruce, 277–78, 455–56
Ames test, 278, 303, 455–56
amethopterin, 143
see also VAMP regimen
aminopterin, 12, 33, 35, 36, 95, 96, 101, 121, 162, 220, 406, 433
aminotriazole, 457
anatomy:
cancer’s distortion of, 59
Halsted’s study of, 61
Vesalius’s study of, 51–53
Anatomy of Melancholy, The (Burton), 335
Andersson, Ingvar, 300
anemia, 27–29, 30, 31, 88, 203
folic acid and, 31
anesthesia, 56, 58, 62–63
angiogenesis, 387, 388, 389, 391, 407, 443, 458
aniline, 81–82, 84, 87, 340, 432
antagonists, 31, 36
antibiotics, 21–22, 122
development of, 131, 229
resistance to, 132
antibodies, 84, 410–11
for Her-2, 416–22
humanizing of, 418–19
antiemetics, 205–6
antiestrogen, 216
antifolates, 29, 31, 33, 34, 35, 87, 91, 92, 95, 96, 100, 103, 114, 121, 136, 162, 406
antimalaria drugs, 130
antinausea drugs, 226
anti-oncogenes, see tumor suppressor genes
antisepsis, 57–58
antitobacco campaigns, 401, 446
Antman, Karen, 426
Apollo space program, 178–79, 186
Archaemedes, 48
asbestos, 276–77, 278, 388, 390, 456
Asclepius, 40
asparaginase, 127
associations, as characteristic of American culture, 107–8
Atacama Desert, mummies of, 42–43, 45
Atlantic Monthly, 264
atomic bomb, 119
Atossa, Queen of Persia, 5, 41–42
thought experiment involving, 463–65, 467
ATP, 31
Au antigen, 279–80
Auden, W. H., 448
Auerbach, Oscar, 258–59, 284, 286, 289, 384–85, 386
Aufderheide, Arthur, 42–44, 45
Australian aborigines, 279
autopsy, meaning of word, 53
Avastin, 443
Avedon, Richard, 303
Avery, Oswald, 344–45
bacteria, 163, 346
as carcinogens, 281–84, 303
as cause of infection, 57
lateral transmission of genes in, 344
mutations of, 277–78, 455
as research subjects, 20, 204, 277–78, 349, 455
Bailar, John, 229, 230–34, 329–32
Baillie, Matthew, 53–54
Bainbridge, William, 32
Baltimore, David, 353, 354, 371, 431
Bang the Drum Slowly, 181
Bannister, Roger, 439
Banzhaf, John, 265–66, 401
Barbacid, Mariano, 374, 376
Bari, Italy, 89–90
Barnes Hospital, 72, 256–57
Bayer, 87
Bayne-Jones, Stanhope, 260
Bazell, Robert, 429
Bcr-abl oncogene, 431, 433–34, 435, 467–68
Gleevec-resistant, 442
Bcr gene, 431
Beadle, George, 345
Beatson, George, 214, 215, 216, 217, 456, 466
Becquerel, Henri, 73–74
Bellevue Hospital, 61–62
Belloc, Hilaire, 11
Bennett, John, 12–13, 14, 16, 44, 341, 365, 430, 431, 466
benzene compounds, 278
Beowulf, 363
Berne, Germaine, 467–70
Berry, Donald, 301, 320, 402
Bertipaglia, Leonard, 49
Beth Israel hospital, 313, 321
Bezwoda, Werner, 321, 323–24, 326–28
Biermer, Michael Anton, 17
biliary cancer, 381
Billroth, Theodor, 58–59, 62, 67
Bishop, J. Michael, 352, 359–63, 364, 365, 369, 370, 371, 375, 380, 418
black bile, 48–50, 53, 79, 214
black fever, 245
bladder cancer, 71
Blake, William, 237
blasts, 3, 17, 34, 35
Blatnik, John, 263
bleomycin, 205, 206
blood:
hematopoietic stem cells and, 458
in theory of humors, 48, 53
umbilical, 398–99
see also red blood cells; white blood cells
blood antigens, 279–80
blood-brain barrier, 147, 167
Bloodgood, Joseph, 65
blood tests, 2, 3, 7
blood transfusions, 196, 280
Blumberg, Baruch, 278–81
Bobst, Elmer, 172, 185
Bologna, Italy, 434–35
Bombay, India, 28–29, 30
Bonadonna, Gianni, 220–21, 222, 228
Bone, Homer, 25, 26
bone marrow:
biopsies of, 7, 17–18, 36, 147
as blood cell factory, 17–18, 29, 309, 407, 458
effect of nitrogen mustard on, 88, 90
leukemia in, 35, 136, 306–7
bone marrow transplants, 398–99, 421
allogeneic, 309, 434–35, 437
bone marrow transplants, autologous (ABMTs), 308, 309–10
Bezwoda’s claimed successes with, 323–24, 326–37
Bezwoda’s falsified data on, 327–28
dearth of clinical trials for, 325–26
escalating use of, 321–27
legal mandates for, 325
lethal complications associated with, 326, 328
secondary cancer as risk of, 325, 328
STAMP protocol for, 310, 311–15, 320, 325, 326, 328–29
bone tumors (osteosarcomas), 43
bortezomib (Velcade), 443
Boston Braves, 97–99, 102, 172
Boston Red Sox, 102, 172
Botstein, David, 418, 427
Boveri, Theodor, 341–42, 343, 348, 350, 365, 366, 390
Boyd, Norman, 299
Bradfield, Barbara, 419–22, 454
brain:
radiation therapy and, 127
as “sanctuary” for leukemia, 127, 146–47, 442
brain cancer:
genomes of, 450–52
radiation therapy for, 77
surgical removal of, 71–72
Brandt, Allan, 242
BRCA-1 gene, 381, 457, 464
BRCA-2 gene, 457, 464
breast cancer:
adjuvant chemotherapy for, 220–21, 222, 402, 464
as age-related, 302
of Atossa, 5, 41–42, 463–65
bone marrow transplants and, 312–13, 314, 320, 321–29
chemotherapy for, 122–23, 162, 232, 306, 308–9, 329, 427–28
cure rate of, 233, 326
ER-positive vs. ER-negative, 215, 221, 222–23, 456, 464
; genomes of, 450, 451, 457, 464
Halsted and, 6, 23, 60, 64–69, 70–71, 73, 78, 173, 193–95, 196, 197, 198, 218, 225, 291, 463
Her-2 positive, 413–22, 423–29, 454, 464
heritability of, 346, 381
hormonal therapies for, 214–17, 218, 221–22, 456, 464, 466
inflammatory, 41–44
local surgery (lumpectomy) combined with radiation for, 195–96, 197, 201, 464
metastasis of, 67, 76, 161, 197, 217, 218, 221, 302–3, 314, 322, 325, 329, 419, 422, 424, 463, 465
mortality rates in, 296, 297, 300–301, 401–2, 465
radiation therapy for, 75–76, 77, 158, 161, 195–96, 201, 464
relapses of, 64, 66–69, 197, 208, 221, 329, 419
remissions in, 217, 222, 314, 454, 456
risk of, 44, 303, 457–58
screening and, 457, 464; see also mammography
stages of, 67, 218, 222, 428, 463, 464
surgeons as dominating field of, 219
surgery on, 58, 59, 62, 195–96, 197, 201, 402, 456, 464; see also mastectomies
targeted therapies for, 413–22, 443, 454, 464, 465
as unmentionable topic, 26–27
Breast Cancer Action (BCA), 425–26
Breast Cancer Action Newsletter, 423
Breast Cancer Detection and Demonstration Project (BCDDP), 296–98, 302
Breast Cancer Symposium, 320
breast exams, 295n
breast MRIs, 457, 464
Brenner, Sydney, 345
Brian’s Song, 181
Brigham and Women’s Hospital, 30, 189
Bristol-Myers Squibb, 442
British American Tobacco, 274
British Medical Journal, 246
broadcast media:
cigarette advertising on, 265–67
fairness doctrine for, 265–66, 267
Broder, Samuel, 135
Brodeur, Paul, 267
bronchogenic carcinoma, 244
Brown, John, 60
Brown & Williamson, 273
Brugge, Joan, 358
Brunschwig, Alexander, 70–71
Buchdunger, Elisabeth, 433, 435
Buffleben, Gracia, 423, 425
Burchenal, Joseph, 92, 130, 132, 167n, 184, 338
Burdette, Walter, 261
Burkitt, Denis, 174–75
Burkitt’s lymphoma, 174–75, 207
Burroughs Wellcome laboratory, 91, 92
Burstein, Harold, 447
Burton, Robert, 335
Bush, Vannevar, 118–21, 122, 183, 404
BusinessWeek, 111
BVP regimen, 205
Byron, George Gordon, Lord, 38
Cairns, John, 227–29, 231, 350
California, University of:
at Los Angeles (UCLA), 415, 417, 418, 420–21, 424
at San Francisco (UCSF), 359–60, 418, 424
Calvino, Italo, 412
Camel cigarettes, 268
Canadian National Breast Screening Study (CNBSS), 298–300, 302
cancer:
Achilles’ heels of, 405–7, 443
adaptability of, 38, 387
as age-related disease, 6, 44, 230, 300–303
in ancient world, 40–42, 43–44, 47–49
causes of, see carcinogenesis
cell growth in, see hyperplasia, pathological
centrifugal theory of, 194–95, 199
chemotherapy for, see chemotherapy
children with, 123, 331
as clonal disease, 39
commonalities of, 333
detection of, 44
as doppelgänger, 38–39
drug resistance in, 441–43
Galen’s theory of, 48–50, 53–54, 55, 79, 90, 214, 238, 281, 342, 434, 463
hallmarks of, 390–92, 407, 443, 449
heritability of, 253, 346–47, 381
heterogeneity of, 390, 465
as iconic “modern” illness, 38, 241
immortality of, 6, 312, 458–59
increasing rate of, 24
limitless replicative potential of, 391
local to systemic progression of, 405
as metaphor for social and political ills, 182–83
metastasis of, see metastasis, metastases
as migratory, 386, 387, 388, 391, 442, 467
morphological change in cells of, 288–89
mortality rates of, see mortality rates, of cancer
mutation in, see mutation, genetic
natural anatomy distorted by, 59
as “normal,” 449, 459
origin of term, 47
perceived as infectious, 175
perceived as single disease, 155, 173, 332–33
presymptomatic stages of, 290
in public discourse, 111–13, 181–83
radiation as cause of, 77–78, 173
radiation therapy for, see radiation therapy
Red Queen syndrome and, 443, 444, 446, 470
relative malignancy of, 292
as resistant to cell death signals, 391, 402, 407
as revealed by longevity, 44
six-degrees-of-separation rule for, 412
smoking and, see tobacco-cancer link
social challenge of, 447
social change as affecting incidence of, 44–45
specificity of, 80–81, 84–88, 90–92, 210, 222, 433
stages of, 55, 67, 160–61, 163, 164–65, 289, 290, 384–86, 463
surgery for, see surgery
survival rates of, 292–93
as systemic disease, 79, 80, 138, 172, 405
targeted therapies for, see targeted therapies
tumors, see tumors
see also specific cancers
Cancer: The Evolutionary Legacy, 46
“Cancer: The Great Darkness,” 23–24
Cancer and Leukemia Group B (CALGB), 320
Cancer Chemotherapy National Service Center (CCNSC), 122
Cancer Genome Atlas, 450–54
Cancer Genome Atlas consortium, 450–51
cancer patients:
doctors’ relationships with, 199, 202, 209, 306–8, 449
identity of, as obliterated by cancer, 4, 398
and Internet chat rooms, 438, 467
“seventh sense” of, 2
side effects and, 209, 305–6
stigmatization of, 126, 316
cancer prevention, 229–30, 233–34, 238–39, 242, 281, 455–58
Ames test and, 278, 303, 455–56
Auerbach’s research and, 258–59, 284, 286, 289
primary vs. secondary, 290
risk factors and, 44, 276, 303, 445–46, 455–57
screening in, see screening
smoking and, see tobacco-cancer link
social networks and, 445–46
understanding of carcinogenesis as critical to, 284–85, 303
cancer registry, 227–28
cancer research:
boldness vs. caution in, 130, 137–38, 139, 140, 144, 164, 166, 167, 208, 310
clinical trials in, see protocols
clinical vs. laboratory-based, 337, 339, 354–55, 375, 402, 404, 455–56
Congress and, 24–25, 113–14, 122, 150, 177, 184–89, 455
effect of AIDS crisis on, 319
as historically underfunded, 23–25
“one cause, one cure” approach in, 93, 155, 173, 223, 332–33, 342–43, 403
relevance of past in, 466
understanding of carcinogenesis downplayed in, 304
World War II and, 26
see also specific cancers, researchers, and therapies
Cancer Research, 254
“cancer stem cells,” 458–59
“Cancer Undefeated” (Bailar and Gornik), 330–32
Cancer Ward (Solzhenitsyn), 4, 181, 316, 461
Canellos, George, 159, 162, 163, 164, 207, 220, 312, 313
Cantor, David, 235
Cantor, Eddie, 94
carbolic acid, 57–58, 62
Carbone, Paul, 219–20
Carboplatin, 403–4
carcinogenesis, 285
Auerbach’s research on, 258–59, 284, 286, 289, 384–85, 386
chromosomes and, 341–42, 343, 348, 365–66, 402
as downplayed by researchers, 304
epidemiology and, 276
genetic mutation as mechanism of, 6, 39, 176, 278, 357, 362, 364–69, 370, 380–83, 384–88, 390–92, 403, 406, 449–50, 462, 464–65
internal vs. external agents in, 342, 349, 350
molecular model of, 388–90
premalignant stages of, 385
prevention as dependent on understanding of, 284–85, 303
risk factors and, 44, 276, 303, 349, 445–46, 455–57
somatic mutation hypothesis of, 173–74
two-hit hypothesis for, 367–69, 376, 377, 380
unitary cause of, 342, 347, 348, 390
Varmus/Bishop (proto-oncogene) theory of, 361–63, 364, 369, 370, 375, 380
carcinogens:
bacterial, 281–84, 303
chemical, 276–77, 388, 446
DNA as damaged by, 75, 77, 122, 351, 406, 462
environmental, 173–74, 176, 238, 349, 388, 446, 456–57
genes as, see oncogenes; tumor suppressor genes
genetic mutation caused by, 278, 362, 364
inflammations as, 281, 284, 303, 340, 388, 456n
mutagens as, 278, 303, 347, 348, 362, 364, 406, 456
radiation as, 77–78, 347, 349, 364, 389
tobacco as, see tobacco-cancer link
viral, 173, 174–76, 278–81, 303, 342–43, 349–50, 351–56, 357, 362
Carey, William, 180
Carroll, Lewis, 357, 360, 362, 441, 443
Carson, Rachel, 199–200, 456
Carter, Paul, 419, 420, 427
case-control studies, 245, 246–47, 276, 280, 294
Castle, William, 11
causality:
in disease, 253–56, 290
Hill’s postulates for, 255–56
Koch’s postulates for, 254, 382
see also carcinogenesis; carcinogens
Cautions against the Immoderate Use of Snuff (Hill), 239–40, 276
Cavenee, Webster, 376, 377
cell death (apoptosis), 391, 402, 407
cell growth:
hyperplastic, see hyperplasia
hypertrophic, 15
neoplastic, see neoplasia
cell phones, glioma and, 446–47
cells:
membranes of, 410–11
normalcy vs. abnormalcy of, 449, 459
cellular theory of disease, 14–16
Centers for Disease Control (CDC), 315
cervical cancer, 381n
Pap smears and, 288–90, 331, 385, 401
premalignant stage of, 385
CGP57148, see Gleevec
Chabner, Bruce, 304, 405, 439
Chappaquiddick scandal, 179
Charlotte’s Law, 325
“chemical castration,” 213, 215
chemicals, synthetic, 81–86, 91, 277
medicine and, 83–84