Popular understanding holds that genetic changes create cancer. James DeGregori uses evolutionary principles to propose a new way of thinking about cancer’s occurrence. Cancer is as much a disease of evolution as it is of mutation, one in which mutated cells outcompete healthy cells in the ecosystem of the body’s tissues. His theory ties cancer’s progression, or lack thereof, to evolved strategies to maximize reproductive success.

Through natural selection, humans evolved genetic programs to maintain bodily health for as long as necessary to increase the odds of passing on our genes—but not much longer. These mechanisms engender a tissue environment that favors normal stem cells over precancerous ones. Healthy tissues thwart cancer cells’ ability to outcompete their precancerous rivals. But as our tissues age or accumulate damage from exposures such as smoking, normal stem cells find themselves less optimized to their ecosystem. Cancer-causing mutations can now help cells adapt to these altered tissue environments, and thus outcompete normal cells. Just as changes in a species’ habitat favor the evolution of new species, changes in tissue environments favor the growth of cancerous cells.

DeGregori’s perspective goes far in explaining who gets cancer, when it appears, and why. While we cannot avoid mutations, it may be possible to sustain our tissues’ natural and effective system of defense, even in the face of aging or harmful exposures. For those interested in learning how cancers arise within the human body, the insights in Adaptive Oncogenesis offer a compelling perspective.

In 1985 the media announced a new therapy for cancer. It was expensive, labor-intensive, and toxic--but, they said, it worked. How it worked is the story Ilana Löwy tells in Between Bench and Bedside, a compelling account of the clinical trials of interleukin-2 at a major French cancer hospital. Her book offers a remarkable insider's view of the culture of clinical experimentation in oncology--and of how this culture affects the development of new treatments for cancer.

Löwy, a historian of science who trained as an immunologist, makes the life of the laboratory and the hospital comprehensible and immediate. Before immersing us in the clinical drama, she fills in the history behind the action--a background of chemotherapy and radiation, controlled clinical trials, and the long line of immunological approaches that finally led to interleukin-2. The story then shifts to the introduction of interleukin-2 in a cancer ward. Löwy conveys the clinical investigation as a complex, multilayered phenomenon that defies the stereotypes of modern biomedicine. In this picture, the miracle-makers and arrogant, self-centered professionals of myth give way to moving images of real people negotiating the tensions between institutional and professional constraints, the search for a scientific breakthrough, and the obligation to alleviate the suffering of a patient. The result is a rare firsthand look at the multiple factors that shape real-life clinical experiments and the institutional tangle and emotional muddle that surround such trials--an invaluable view at a time when medicine is undergoing such great and confusing changes.

An ethnographic examination of the effects of structural inequalities on cancer treatment around the world.
 
Taking an ethnographic approach, the contributors to this book offer new examinations of cancer and its treatment to show how social, economic, race, gender, and other structural inequalities intersect, compound, and complicate health inequalities. Cancer experiences and impacts are explored across eleven countries: Argentina, Brazil, Denmark, France, Greece, India, Indonesia, Italy, Senegal, the United Kingdom, and the United States. The volume engages with specific cancers from the point of primary prevention to screening, diagnosis, treatment (or its absence), and end-of-life care. Cancer and the Politics of Care traverses new theoretical terrain by explicitly critiquing cancer interventions, their limitations and success, the politics that drive them, and their embeddedness in local cultures and value systems. Its diversity and innovation ensure its wide utility among those working in and studying medical anthropology, social anthropology, and other fields at the intersections of social science, medicine, and health equity.
 

An innovative theory proposes a new therapeutic strategy to break the stalemate in the war on cancer. It is called cancer stem cell (CSC) theory, and Lucie Laplane offers a comprehensive analysis, based on an original interdisciplinary approach that combines biology, biomedical history, and philosophy.

Rather than treat cancer by aggressively trying to eliminate all cancerous cells—with harmful side effects for patients—CSC theory suggests the possibility of targeting the CSCs, a small fraction of cells that lie at the root of cancers. CSCs are cancer cells that also have the defining properties of stem cells—the abilities to self-renew and to differentiate. According to this theory, only CSCs and no other cancer cells can induce tumor formation.

To date, researchers have not agreed on the defining feature of CSCs—their stemness. Drawing from a philosophical perspective, Laplane shows that there are four possible ways to understand this property: stemness can be categorical (an intrinsic property of stem cells), dispositional (an intrinsic property whose expression depends on external stimuli), relational (an extrinsic property determined by a cell’s relationship with the microenvironment), or systemic (an extrinsic property controlled at the system level). Our ability to cure cancers may well depend upon determining how these definitions apply to different types of cancers.

"The author's multiple voices--scholar, sociologist, victim--provide an academic, yet personal, professional, yet poignant, story....Readers face...the 'contradictory meanings' that an especially articulate woman brings to the final chapter of her life." --Women and Health In 1988, Marianne Paget published the Unity of Mistakes: A Phenomenological Interpretation of Medical Work (Temple) in which she argued that error is an intrinsic feature in medicine--an experimental and uncertain activity. Her subsequent research focused on medical negligence and on miscommunication and silence a as cause and product of error in medicine. While pursuing her research on negligence, she found out that she was an example of it. Chronic back pain that had been misdiagnosed as muscle spasms turned out to be a symptom of a rare and fatal cancer that claimed Paget's life in December 1989. This collection of her personal and professional writings on the phenomenon of error in medicine chronicles a young scholar's courageous struggle to make sense of a tragic coincidence. Discovering that she was living the charges and painful topic that she had studied so deeply, Paget write poignantly and analytically until the last week of her life about this uncanny parallel. "It is very tricky to come to terms with the reality of death without becoming trapped in that reality," wrote "Tracy" Paget to her friends. In this book, she describes "the odd way my life began to mirror my work"; her search for "life rites" when face with tasks involving wills, last rites, and farewells; and her indomitable and forthright attempt to remain intensely alive in the face of death. A Complex Sorrow, her final project, comprises essays, letters, and a journal recording her last year. Ever critical of the distanced and dispassionate stance taken in much social analysis, Paget had experimented with performance as a form for enlivening social science research. The script for her play, "The Work of Talk," about communication problems between a physician and his cancer patient, is also included. Her compelling life-text speaks to those living with illness and those who care for and about them, as the investigation and representation of lived experience. Excerpt Excerpt available at www.temple.edu/tempress "Strangely, my knowledge of error has helped me deal with the errors in my care. Had I not known about the prevalence of error in medicine I would not have been able to process what has happened to me without bitterness. But I had thought these matters through already, and more than once. I now live out the complex sorrow I have before described." --Marianne A. Paget Reviews "Paget's book is stunning. It's a tribute to the invulnerable human spirit. The woman burned like a flame; obviously she died well, because she lived well; she was loved because she was loving. The book is tremendously sad, but it isn't depressing; somehow, one is left with a sense of human possibility." --Joan Cassell, author of Expected Miracles: Surgeons at Work

An examination of obsession, gender, love, and loss in contemporary rural America.

In Country Songs for Alice, a nonbinary, queer narrator passes through the crucible of love, romance, and heartbreak against the backdrop of rural America—a landscape which offers luminous belonging, even as the hazards of homophobia, loneliness, and isolation loom large. Part roadtrip, part mixtape, these poems are explorations of love, music, romance, pageantry, loneliness, and belonging in the rural places and small towns that seem to preclude queer culture. Country Songs for Alice not only tells the story of a relationship and its dissolution but reclaims country western imagery and aesthetics for a queer audience, dousing the narrator’s experience in the language of cowboys, horses, rodeos, trucks, and desert skies.
 

During the late 1970s and 1980s, "cancer" underwent a remarkable transformation. In one short decade, what had long been a set of heterogeneous diseases marked by uncontrolled cell growth became a disease of our genes. How this happened and what it means is the story Joan Fujimura tells in a rare inside look at the way science works and knowledge is created. A dramatic study of a new species of scientific revolution, this book combines a detailed ethnography of scientific thought, an in-depth account of science practiced and produced, a history of one branch of science as it entered the limelight, and a view of the impact of new genetic technologies on science and society.

The scientific enterprise that Fujimura unfolds for us is proto-oncogene cancer research--the study of those segments of DNA now thought to make normal cells cancerous. Within this framework, she describes the processes of knowledge construction as a social enterprise, an endless series of negotiations in which theories, material technologies, and practices are co-constructed, incorporated, and refashioned. Along the way, Fujimura addresses long-standing questions in the history and philosophy of science, culture theory, and sociology of science: How do scientists create "good" problems, experiments, and solutions? What are the cultural, institutional, and material technologies that have to be in place for new truths and new practices to succeed?

Portraying the development of knowledge as a multidimensional process conducted through multiple cultures, institutions, actors, objects, and practices, this book disrupts divisions among sociology, history, anthropology, and the philosophy of science, technology, and medicine.

Diary of a Detour is film scholar and author Lesley Stern's memoir of living with chronic lymphocytic leukemia. She chronicles the fears and daily experience of coming to grips with an incurable form of cancer by describing the dramas and delving into the science. Stern also nudges cancer off center stage by turning to alternative obsessions and pleasures. In seductive writing she describes her life in the garden and kitchen, the hospital and the library, and her travels—down the street to her meditation center, across the border to Mexico, and across the world to Australia. Her immediate world is inhabited with books, movies, politics, and medical reports that provoke essayistic reflections. As her environment is shared with friends, chickens, a cat called Elvis, mountain goats, whales, lions, and microbes the book opens onto a larger than human world. Intimate and meditative, engrossing and singular, Diary of a Detour offers new ideas about what it might mean to live and think with cancer, and with chronic illness more broadly.

Cancer is that “loathsome beast, which seized upon the breast, drove its long claws into the surrounding tissues, derived its sustenance by sucking out the juices of its victims, and never even relaxed its hold in death,” a turn-of-the-century physician recorded. Even today cancer affects the popular imagination with dread. In a subtle and penetrating cultural history, James Patterson examines reactions to the disease through a century of American life.

The modern American preoccupation with cancer was apparent during the widely publicized illness and death from that ailment of Ulysses S. Grant in 1885. Awareness of the disease soon figured heavily in the public consciousness, and individual reactions to it continue to reveal broader tensions within American society. Patterson examines responses to cancer by researchers and physicians, quacks and faith healers, by the multitude who have heard sensational media reports of “cures,” as well as by many who have had firsthand experiences with the disease.

Optimistic attitudes of many experts contrast sharply with the skepticism of large segments of the population—often the less wealthy and the less educated—that reject the claims of medical science and resist the advice or, some argue, the paternalistic dictates of the government-supported cancer research establishment.

Expanding expectations of a cure from a confident medical profession; the rise of a government-supported Cancer Establishment managing a large research empire; the emergence of a “cancer counterculture”; a new emphasis on prevention through control of the environment and the self; and the private fears and pessimism of millions of Americans form a telling history of American social patterns. Whether the issue is smoking, pollution, or regular checkups, attitudes toward cancer reflect more general views on medicine, public policy, and illness, as well as on death and dying. This century has witnessed both a biomedical revolution and a vastly increased role of the state in the private lives of citizens; but not everyone has bought the medical package, and many have little faith in government intervention.

Readers interested in the cultural dimensions of science and medicine as well as historians, sociologists, and political scientists will be enlightened and challenged by The Dread Disease.

Freddie Steinmark tells the story of a legendary University of Texas football player whose courage on the field and in battling cancer still inspires the Longhorn nation.

Freddie Steinmark started at safety for the undefeated University of Texas Longhorns in 1969. In the thrilling “Game of the Century,” a come-from-behind victory against Arkansas that ensured Texas the national championship, Steinmark played with pain in his left leg. Two days later, X-rays revealed a bone tumor so large that it seemed a miracle Steinmark could walk, let alone play football. Within a week of the Arkansas game, his leg was amputated.

A gritty, undersized player, Steinmark had quickly become a fan favorite at Texas. What he endured during the Longhorns’ memorable 1969 season, and what he encountered afterward, captivated not only Texans but the country at large. Americans watched closely as Steinmark confronted life’s ultimate challenge, and his openness during his battle against savage odds helped reframe the national conversation surrounding cancer and the ongoing race for a cure.

Written with unfettered access to the Steinmark family and archives, Freddie Steinmark: Faith, Family, Football is the exploration of a brief but full life, one that began humbly but ended on a grand stage. It is a fitting tribute to a legendary Longhorn whose photograph, emblazoned with the word “Heart,” flashes on the Freddie Steinmark Scoreboard’s Jumbotron prior to each home football game in UT’s Darrell K Royal–Texas Memorial Stadium at Joe Jamail Field.

The brainchild of an obscure Yugoslav physician, Krebiozen emerged in 1951 as an alleged cancer treatment. Andrew Ivy, a University of Illinois vice president and a famed physiologist dubbed “the conscience of U.S. science,” wholeheartedly embraced Krebiozen. Ivy’s impeccable credentials and reputation made the treatment seem like another midcentury medical miracle. But after years of controversy, the improbable saga ended with Krebiozen proved a sham, its inventor fleeing the country, and Ivy’s reputation and legacy in ruins.

Matthew C. Ehrlich’s history of Krebiozen tells a quintessential story of quackery. Though most experts dismissed the treatment, it found passionate public support not only among cancer patients but also people in good health. The treatment’s rise and fall took place against the backdrop of America’s never-ending suspicion of educational, scientific, and medical expertise. In addition, Ehrlich examines why people readily believe misinformation and struggle to maintain hope in the face of grave threats to well-being.

A dramatic account of fraud and misplaced trust, The Krebiozen Hoax shines a light on a forgotten medical scandal and its all-too-familiar relevance in the twenty-first century.

An arresting memoir of love and unbending religion, toxicity and disease, and one family’s desperate wait for a miracle that never came.

Kathleen Dorothy Blackburn was the oldest of five children, a twelve-year-old from Lubbock, Texas, whose evangelical family eschewed public education for homeschooling, and wove improbable scientific theories into literal interpretations of the Bible. Then her father, a former air force pilot, was diagnosed with cancer at the age of thirty-eight, and, “it was like throwing gasoline on the Holy Spirit.” Stirred by her mother, the family committed to an extreme diet and sought deliverance from equally extreme sources: a traveling tent preacher, a Malaysian holy man, a local faith-healer who led services called “Miracles on 34th Street.”

What they didn’t know at the time was that their lives were entangled with a larger, less visible environmental catastrophe. Fire-fighting foams containing carcinogenic compounds had contaminated the drinking water of every military site where her father worked. Commonly referred to as “forever chemicals,” the presence of PFAS in West Texas besieged a landscape already burdened with vanishing water, taking up residence in wells and in the bloodstreams of people who lived there. An arresting portrait of the pernicious creep of decline, and a powerful cry for environmental justice, Loose of Earth captures the desperate futility and unbending religious faith that devastated a family, leaving them waiting for a miracle that would never come.

Between 1990 and 1993, breast cancer activism became a significant political movement. The issue began to receive extensive media attention, and federal funding for breast cancer research jumped dramatically. Describing the origins of this surge in interest, Maureen Hogan Casamayou attributes it to the emergence of politically potent activism among breast cancer survivors and their supporters. Exploring the creation and development of the National Breast Cancer Coalition (NBCC), she shows how many of its key leaders were mobilized by their own traumatic experiences with the disease and its treatments.

Casamayou details the NBCC’s meteoric rise and impressive lobbying efforts, explaining how—in contrast to grassroots movements founded by dedicated individuals—the coalition grew from the simultaneous efforts of a network of women who invested their time, energy, money, and professional skills in the fight for increased funding for breast cancer research. This multiple leadership—or collective entrepreneurialism, says Casamayou—was crucial to the NBCC’s success framing the issue in the minds of the public and policymakers alike.

Racing to a Cure is not a cancer memoir. It is a cancer cure memoir. In 1998 Neil Ruzic was diagnosed with mantle-cell lymphoma, the deadliest cancer of the lymph system, whose spread is reaching epidemic levels in the U.S. and Europe. Instead of following recommended courses of chemotherapy and radiation, he took control of his treatment by investigating cures being developed in the nation's cancer-research laboratories.

Although chemotherapy harms the immune system and is increasingly demonstrated to be an ineffective long-term cure for the vast majority of cancers, it remains the standard treatment for most cancer patients. Ruzic, a former scientific magazine publisher and originator of a science center, refused to accept this status quo, and instead plunged into the world of cutting-edge treatments, exploring the frontiers of cancer science with revolutionary results.

Ruzic went on the offensive: visiting scores of laboratories, gathering information, talking to researchers, and effectively becoming his own patient-care advocate. This book presents his findings. A scathing critique of the chemotherapy culture as well as unscientific "alternative" therapies, the book endorses state-of-the-art molecularly based technologies, making it an illuminating and necessary read for anyone interested in cancer research, especially patients and their families and physicians.

Neil Ruzic was expected to die within two years of his initial diagnosis. Five years later he has been declared cancer-free and considers himself cured.

The virus that changed how we think about cancer and its culprits—and the vaccine that changed how we talk about sex and its risks.
 
Starting in 2005, people in the US and Europe were inundated with media coverage announcing the link between cervical cancer and the sexually transmitted virus HPV. Within a year, product ads promoted a vaccine targeting cancer’s viral cause, and girls and women became early consumers of this new cancer vaccine. An understanding of HPV’s broadening association with other cancers led to the identification of new at-risk populations—namely boys and men—and ignited a plethora of gender and sexual issues related to cancer prevention.
 
Sexualizing Cancer is the first book dedicated to the emergence and proliferation of the HPV vaccine along with the medical capacity to screen for HPV—crucial landmarks in the cancer prevention arsenal based on a novel connection between sex and chronic disease. Interweaving accounts from the realms of biomedical science, public health, and social justice, Laura Mamo chronicles cervical cancer’s journey out of exam rooms and into public discourse. She shows how the late twentieth-century scientific breakthrough that identified the human papilloma virus as having a causative role in the onset of human cancer galvanized sexual politics, struggles for inclusion, new at-risk populations, and, ultimately, a new regime of cancer prevention. Mamo reveals how gender and other equity arguments from within scientific, medical, and advocate communities shaped vaccine guidelines, clinical trial funding, research practices, and clinical programs, with consequences that reverberate today. This is a must-read history of medical expansion—from a “woman’s disease” to a set of cancers that affect all genders—and of lingering sexualization, with specific gendered, racialized, and other contours along the way.

A book that bends time and fragments narrative.

In Small Altars, Justin Gardiner delves into the world of comic books and superheroes as a means for coming to terms with the many struggles of his brother’s life, as well as his untimely death, offering a lyric and honest portrayal of the tolls of mental illness, the redemptive powers of art and familial love, and the complex workings of grief.  
 

"No eyebrows. No eyelashes. When it rains the water will run straight down into my eyes," Catherine Lord wrote before her hair fell out during chemotherapy. Propelled into an involuntary performance piece occasioned by the diagnosis of breast cancer, Lord adopted the online persona of Her Baldness—an irascible, witty, polemical presence who speaks candidly about shame and fear to her listserv audience. While Lord suffers from unwanted isolation and loss of control as her treatment progresses, Her Baldness talks back to the society that stigmatizes bald women, not to mention middle-aged lesbians with a life-threatening disease.

In this irreverent and moving memoir, Lord draws on the e-mail correspondence of Her Baldness to offer an unconventional look at life with breast cancer and the societal space occupied by the seriously ill. She photographs herself and the rooms in which she negotiates her disease. She details the clash of personalities in support groups, her ambivalence about Western medicine, her struggles to maintain her relationship with her partner, and her bemusement when she is mistaken for a "sir." She uses these experiences—common to the one-in-eight women who will be diagnosed at some point with breast cancer—to illuminate larger issues of gender signifiers, sexuality, and the construction of community.

In 2014 Barbados introduced a vaccine to prevent certain strains of the human papillomavirus (HPV) and reduce the risk of cervical cancer in young women. Despite the disproportionate burden of cervical cancer in the Caribbean, many Afro-Barbadians chose not to immunize their daughters. In Suspicion, Nicole Charles reframes Afro-Barbadian vaccine refusal from a question of hesitancy to one of suspicion. Drawing on ethnographic fieldwork, black feminist theory, transnational feminist studies and science and technology studies, Charles foregrounds Afro-Barbadians' gut feelings and emotions and the lingering trauma of colonial and biopolitical violence. She shows that suspicion, far from being irrational, is a fraught and generative affective orientation grounded in concrete histories of mistrust of government and coercive medical practices foisted on colonized peoples. By contextualizing suspicion within these longer cultural and political histories, Charles troubles traditional narratives of vaccine hesitancy while offering new entry points into discussions on racialized biopolitics, neocolonialism, care, affect, and biomedicine across the Black diaspora.

Duke University Press Scholars of Color First Book Award recipient

“They Never Want to Tell You” transcends the negative metaphors and clichés of life-threatening disease to give voice to the culture of cancer and to the behavior and attitudes of those who function within that culture—as patients, medical professionals, family, and friends.

In these extraordinary narratives, children coping with cancer reveal their most personal experiences, and they speak with a candor that breaks through the cultural taboos ostensibly designed to protect us from the disease. The rich, compassionate, and honest words of these children give expression to concerns that adults who are struggling with cancer find nearly impossible to articulate. Free of social conventions and cognitive distortions, each story presents a powerful variation on the theme of survival in the face of the continuing uncertainties of life-threatening disease.

David Bearison, a developmental psychologist and psychotherapist, is keenly aware of the psychological impact of cancer on children, particularly as survival times for childhood cancers lengthen and complex treatments intensify concern about the emotional—not merely physical—well-being of children. Bearison has culled from scores of interviews the most salient moments that represent these individual children in their shared struggle with disease. In these pages the children express their wildest hopes and worst fears about cancer. They speak of the absolute necessity of full disclosure, the problems of relating to friends and family, the difficult adjustment to hair loss, their feelings of punishment, grief, and spirituality, and many other issues. In the course of these stories the children reveal not only their will to survive and their extraordinary capacity to understand themselves and their condition, but their altruistic desire to share that understanding with other children as well as with adults who have cancer. “They Never Want to Tell You” is rich and rewarding reading for cancer patients, their families, and health-care professionals alike.