Newsletter – March 2014

Chapter’s winter program
Book Club Notes: The Emperor of All Maladies
Upcoming Book Club Meetings

Five panelists led discussion at Chapter’s winter program 
By Karen M. Steinhilber 

The Winter 2014 chapter program was held at the St. Anthony Library in Minneapolis on Saturday, February 22.  Given the road conditions, the program was attended mainly by local members, who braved icy streets to be there.  Five panelists (Mary Van Beusekom, Ruth Taswell, Theresa A King-Hunter, Michael Livingston and Marty Swain) conducted a lively discussion around five scenarios faced by medical writers or people who hire medical writers and offered valuable perspectives on handling medical writing emergencies with professionalism.  Following the program, several panelists and attendees gathered at Brasa Rotisserie for lunch and networking.

For those members interested in learning more, AMWA offers a self-study module titled “Essential Ethics for Medical Communications” that explores the AMWA Code of Ethics in action.  AMWA also offers a multistep model for making ethical decisions.

We hope everyone will join us again for the Spring Program!  Watch for details in an upcoming newsletter.

Book Club Notes: The Emperor of All Maladies
Reviewed by Paul W. Mamula, PhD

The North Central Chapter book club met on January 27, 2014 for a discussion of The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee. The book is an award-wining tour-de-force that details what we know about cancer from its earliest mention in antiquity to modern cutting-edge therapies. Dr Mukherjee is a cancer medicine specialist at the Dana Farber Institute.

The Emperor of All Maladies is organized into six sections, plus a prologue and a final chapter. The book also includes copious notes; a brief, but welcome, glossary; photographs; and a bibliography. The paperback edition includes an interview with the author that answers questions readers might have about cancer and the book. Portions of the interview also appeared in OncNurse in February 2011.

The book is fairly long (about 500 pages), but it is well written—not too technical or complicated. Dr Mukherjee provides enough detail to understand the topics addressed, but not to overwhelm readers with too many complicated particulars. The readability probably accounts for the critical acclaim the book received. It has garnered multiple awards, including the Pulitzer Prize in 2011 for general nonfiction.

Dr Mukherjee began the book as a means to diffuse the stresses he encountered as a physician at Boston’s Dana Farber Cancer Institute. At the institute, he was responsible for treating cancer patients and had to confront the pressures of dealing with patients facing death. A colleague told him during his first week, “It’s called an immersive training program. But by immersive, they really mean drowning.” He told Dr Mukherjee, “Have a life outside the hospital. You’ll need it, or you’ll get swallowed.”

The book became much more during the writing. Rather than just a cold medical account, it includes accounts of philanthropists, chemical and pharmaceutical companies, scientists, and physicians who have contributed to the field. Dr Mukherjee interweaves his tale with stories about patients from his own practice in Boston and presents a fascinating story of cancer and its evolving therapies. It also describes different types of cancer, the founding of the Dana Farber Institute, and funding for research.

The Emperor of All Maladies contains several heart-warming surprises and interesting presentations, including the identification of the patient who served as the impetus for one of the institute’s research funds (“The Jimmy Fund”). The patient’s identity had been protected, but his successful treatment for childhood leukemia served as the example of what a well-funded institute could accomplish. The patient had been lost to follow-up shortly after being treated, but resurfaced many years later. Another clever presentation occurs in final chapter (Atossa’s War). The chapter retraces the steps of therapies as seen through the eyes of one cancer victim from antiquity, a Persian queen.

At our meeting we had 5 attendees, including 2 new chapter members, and everyone reported enjoying the book. Attendees unanimously found Part Six (The Fruits of Long Endeavors) the most interesting. That section describes the new therapies based on developments derived from an understanding of the proteins involved in selected cancers.  Curiously, several reviewers thought that section to be the least interesting, a fact we all found puzzling.

Part Six includes a discussion of how “rational drug design,” based on the protein target, led to the drug Gleevec—the first successful “molecular therapy” for chronic myelogenous leukemia (CML). Rational drug design relies on producing compounds that can interact with molecular targets, such as a structural pocket or binding site, and interfere with the protein’s function, thus selectively attacking the cancer. Dr Mukherjee presents a nice account of how the drug was developed and an overview of the enormous potential that molecular therapies offer. In the case of Gleevec, the drug turned what had been a fatal disease into a manageable one.

Dr Mukherjee balances the account by explaining what still remains to be learned, and the potential pitfalls of these therapies. He notes that while Gleevec represents a spectacular scientific and medical achievement, the treatment is not foolproof. Patients often develop resistance to the drug and relapse. Posttreatment relapse implies that other pathways are involved in cancer and points to our need for additional research to identify other targets for different cancers. He has also addressed this topic in an article that appeared in the New York Times Magazine shortly after the book was published (The Riddle of Cancer Relapse: The Cancer Sleeper Cell, October 29, 2010).

The Emperor of All Maladies is being made into a 3-part series by Ken Burns, the noted documentary filmmaker. Burns’ mother died of cancer when he was 11 years old, and he said that experience guided his work. Dr Mukherjee will collaborate with Burns on the series. For those strapped for time, you can wait for the upcoming miniseries based on the book; however, the series isn’t scheduled to run on PBS until the spring of 2015. Even slow readers should be able to finish the book before then!

We still have two additional book club meetings this year, so if you haven’t attended one or picked up a title to read, you still have time. Watch for details about future selections in the upcoming announcements. Note that one of the upcoming selections (Salt, Sugar, Fat by Michael Moss) is now available in paperback. An excerpt and an article in the New York Times Magazine suggest a fascinating read.

Upcoming Book Club Meetings

The End of Illness by David B. Agus
Saturday, April 26: 10:30 a.m., Caribou at Cedar Ave. & Minnehaha Pky., south Minneapolis (maybe it’ll be nice enough to meet outdoors on the patio!)

Salt Sugar Fat: How the Food Giants Hooked Us by Michael Moss
Monday, September 29: 6:30 p.m., Caribou just west of Har Mar (2111 Snelling Ave N, Roseville, 651-636-5655)