This book is Siddhartha, an Indian-American doctor, scientist and writer. Author Mukherjee.

This book is about the history of cancer, telling the changes of an ancient disease that lasted for 4000 years.

1. Why is cancer the king of all diseases?

First of all, the incidence of cancer is high. According to statistics, 40% people will get cancer at some point in their lives.

This number means that no matter who you are, where you live, how high your reputation and status are, you will definitely have an intersection with cancer in your life-maybe your relatives, maybe your friends, maybe yourself.

About 8 million people worldwide die of cancer every year.

The lifetime cancer probability of China residents is 22%, and the cancer mortality rate is 13%. Every year, there are about 310.2 million new tumor cases and 2.7 million deaths.

Six people are diagnosed with malignant tumors every minute in China, and 1 in every seven people will die of cancer.

Second, the human anti-cancer road from rough to precise

1, surgery

Since ancient Egypt, doctors have been operating on cancer patients, trying to directly remove tumors.

Surgery is still an important weapon in the fight against cancer, and nearly half of cancer patients will receive surgery. Especially for early cancer, surgery is the most routine and mainstream, and it may also be the most effective and cheapest means.

Especially in the19th century, after the invention of anesthesia technology and disinfection technology, doctors have better conditions to carefully remove dangerous tumors in cancer patients.

Many people still think that the more thorough, comprehensive and incisive the better.

This sentence sounds like no problem.

Until the middle of last century, surgeons still used a method called "radical mastectomy" to treat breast cancer patients.

How thorough was this operation?

In order to treat breast cancer, doctors will not only remove the tumor of the breast, but also remove the diseased breast, large muscles in the chest, lymphatic tissue in the armpit, and sometimes even remove half of the body's ribs, collarbone and arms!

After this operation, patients usually need several months to get out of bed, and they will be disabled for life.

What's the effect?

It can only be said that it is unsatisfactory. It seems that there will always be some cancer cells that can escape the scalpel, survive and make a comeback in a short time.

After the analysis and interpretation of cancer cells, a method called "frozen section pathological diagnosis" has been widely used in cancer surgery.

During the operation of the surgeon to remove the tumor, a pathologist will cooperate with him to quickly freeze the cut tumor, then cut it into very thin pieces and examine it carefully under the microscope.

With the help of microscopic observation, the pathologist can quickly tell the surgeon whether the cancer cells remain in the tumor honestly or have begun to spread and metastasize. Whether the surgeon has cut to the edge of the tumor or needs to cut again, and so on.

In this way, the surgeon can finish his operation more accurately. In other words, the cognitive upgrading of the morphological characteristics of cancer cells directly helps the technical upgrading of surgery.

This is a great progress from rough to accurate in the treatment of cancer.

2 ~ 1, drug therapy

No matter how accurate the operation is, it can't cope with all cancer patients.

Especially those patients with advanced cancer who have spread and metastasized. No matter scalpel or radiation, it is difficult to go deep into the whole body tissue to carefully find and kill all the free cancer cells.

So what should we do?

At this time, drugs will come in handy.

The chemicals in drugs may reach all parts of the body with the human circulatory system, and constantly identify and kill cancer cells along the way!

This is why in most cases, surgical treatment, radiotherapy and drug treatment are always used together. Use surgery and radiotherapy to fight against large tumors, and use drugs to fight against cancer cells that have escaped.

This is what we call "chemotherapy" clinically. Using corresponding chemotherapy drugs according to different cancers greatly improves the survival rate of cancer patients.

However, chemotherapy drugs have not yet achieved the ideal perfect effect, that is, killing cancer cells without harming normal tissues.

2 ~ 2, the birth of precise targeted drugs

Accurate targeted drugs are the subject of medical research and the expectation of cancer patients.

In order to develop more perfect drugs, we need to understand the biological characteristics of cancer cells.

Is there any more essential difference between cancer cells and normal somatic cells besides continuous division and reproduction?

The answer is yes.

A landmark case in this regard is a drug called Gleevec. It is also the real protagonist in the popular movie Dying.

In the1960s, American scientist Norwell, who worked in Philadelphia, found that in leukemia, or more accurately, in a patient named chronic myeloid leukemia, their cancer cells showed completely different characteristics from other normal somatic cells.

This feature is so accurate that if we can use this feature to develop drugs, we can get the perfect anti-cancer drugs in our dreams.

Almost 40 years later, this idea has really come true.

In the late 1990s, scientists from Novartis in Switzerland developed a chemical substance that can specifically bind this hybrid protein and shut down its function, thus inhibiting the growth of cancer cells.

At the same time, Gleevec, which almost only fires on BCR-Abl hybrid protein, has little inhibitory effect on normal cells, making the side effects of this drug much less than traditional chemotherapy drugs.

This is the famous drug Gleevec in the history of cancer.

The drug itself has improved the five-year survival rate of patients with chronic myeloid leukemia from 30% to 90%, and to a large extent, these patients have led a normal life.

In 2003, Herceptin was applied to the treatment of breast cancer, which improved the survival rate of patients with Her-2 positive breast cancer by 33%. This is also a reasonable and accurate targeted therapy.

The appearance of Herceptin and Gleevec also announced that the development of cancer drugs really moved from rough to precise.

As long as we can find the essential difference between cancer cells and normal somatic cells at the biological level, we can develop drugs to accurately identify and kill cancer cells.

We look forward to this amazing evolution and expect more targeted drugs to follow.

Third, can cancer be cured?

In the face of cancer, no one can cure it easily.

In order to catch up with this disease, human beings create and learn new knowledge again and again, and abandon old strategies.

We are obsessed with anti-cancer, sometimes smart, sometimes desperate, sometimes exaggerated, sometimes violent, sometimes crazy, sometimes awe-inspiring.

This inevitable war has been going on for thousands of years.

Cancer is difficult to treat because it is a disease caused by an autosomal mutation.

Fourth, can cancer be prevented?

In 20 13 and 20 15, Julie broke the headlines of the global media twice, but this time it was not because of work, but because of surgery.

Therefore, she completely removed her breasts and ovaries.

Julie's radical action caused great social repercussions, which made many people suddenly realize that we could have done something to put cancer in the cage ahead of time.

Cancer didn't happen suddenly, but was discovered suddenly. The diagnosis of cancer may only take one second, but its emergence and development is a long process.

Therefore, the prediction, early warning and prevention of cancer are very important.

We know that both internal and external factors will affect the probability of cancer, so what can be done to reduce the probability of cancer?

The answer is prediction and prevention.

Prediction is aimed at internal factors.

We can tell who is more likely to get cancer and what cancer through genetic testing, and then take measures in advance.

For example, since we know that the mutation of BRCA 1 gene is an important internal cause of cancer cells, maybe everyone of us, especially those whose family members have suffered from breast cancer and ovarian cancer, can do a genetic test to see if there is a mutation of BRCA 1 gene in our body.

If there is such a mutation, maybe we can learn from Angelina Jolie and make full preparations. In fact, whether Julie's operation is absolutely necessary is still controversial.

Prevention is aimed at external causes.

It can tell us what makes us more susceptible to cancer, so we can try to avoid these things.

Early warning is the early detection of cancer.

Put it in the cage in advance when it is still weak.

Five, how to coexist with cancer * * *

In traditional Chinese medicine, preventing diseases before they occur in the body means preventing them in advance.

But what if cancer has been diagnosed?

With my second anti-cancer experience, I tell you that there is really no need to be afraid or worried.

With the improvement of medical technology, the treatment of cancer has been systematized and tends to be specific and individualized.

As long as you have firm confidence, there is no difficulty you can't cross. At the same time, I am glad that I was born in this era, born in this era and sick in this era.

Once cancer is diagnosed, you should learn to manage yourself and cancer after receiving regular treatment. It is not impossible to live with illness.

Although cancer is still invincible on the whole, it still poses a serious threat to human health. Even in the sense of evolution, cancer may accompany human beings for a long time.

However, many times, cancer is no longer the king of many diseases that we talk about, but has actually been put in a cage by human wisdom.

Along the road of human cognition and cancer struggle, we will continue to reap one victory after another in the future.

I am optimistic that at some point in the future, we or our descendants will recall today's era of being cautious and timid about cancer, and they will feel as incredible as listening to fairy tales!

Let's look forward to the early arrival of that day!