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The First Cell: And the Human Costs of Pursuing Cancer to the Last

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With the fascinating scholarship of The Emperor of All Maladies and the deeply personal experience of When Breath Becomes Air, a world-class oncologist examines the current state of cancer and its devastating impact on the individuals it affects -- including herself. In The First Cell, Azra Raza offers a searing account of how both medicine and our society (mis)treats cance With the fascinating scholarship of The Emperor of All Maladies and the deeply personal experience of When Breath Becomes Air, a world-class oncologist examines the current state of cancer and its devastating impact on the individuals it affects -- including herself. In The First Cell, Azra Raza offers a searing account of how both medicine and our society (mis)treats cancer, how we can do better, and why we must. A lyrical journey from hope to despair and back again, The First Cellexplores cancer from every angle: medical, scientific, cultural, and personal. Indeed, Raza describes how she bore the terrible burden of being her own husband's oncologist as he succumbed to leukemia. Like When Breath Becomes Air, The First Cell is no ordinary book of medicine, but a book of wisdom and grace by an author who has devoted her life to making the unbearable easier to bear.


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With the fascinating scholarship of The Emperor of All Maladies and the deeply personal experience of When Breath Becomes Air, a world-class oncologist examines the current state of cancer and its devastating impact on the individuals it affects -- including herself. In The First Cell, Azra Raza offers a searing account of how both medicine and our society (mis)treats cance With the fascinating scholarship of The Emperor of All Maladies and the deeply personal experience of When Breath Becomes Air, a world-class oncologist examines the current state of cancer and its devastating impact on the individuals it affects -- including herself. In The First Cell, Azra Raza offers a searing account of how both medicine and our society (mis)treats cancer, how we can do better, and why we must. A lyrical journey from hope to despair and back again, The First Cellexplores cancer from every angle: medical, scientific, cultural, and personal. Indeed, Raza describes how she bore the terrible burden of being her own husband's oncologist as he succumbed to leukemia. Like When Breath Becomes Air, The First Cell is no ordinary book of medicine, but a book of wisdom and grace by an author who has devoted her life to making the unbearable easier to bear.

30 review for The First Cell: And the Human Costs of Pursuing Cancer to the Last

  1. 5 out of 5

    Aamir Jafarey

    Aamir Jafarey, Karachi Pakistan I found the reading of “The First Cell” unnervingly disturbing, to the point that I had to put the book down periodically to let myself ‘recover’. I cannot even imagine what Azra Raza must have gone through personally in putting to paper her own extremely private thoughts, and those of the contributors, who found the courage to share their immense pain with unknown readers through this narrative. While Raza has a clear mission, that of advocating a fresh approach t Aamir Jafarey, Karachi Pakistan I found the reading of “The First Cell” unnervingly disturbing, to the point that I had to put the book down periodically to let myself ‘recover’. I cannot even imagine what Azra Raza must have gone through personally in putting to paper her own extremely private thoughts, and those of the contributors, who found the courage to share their immense pain with unknown readers through this narrative. While Raza has a clear mission, that of advocating a fresh approach to the battle against cancer, and something she has been pursuing for a while despite significant opposition from her own oncology circles, the fact that she chose to embed her scientific pursuit into a very human plot poignantly brings out the urgency of her struggle. It is the human factor that makes her struggle against cancer a very personal one for the reader. And the way she seamlessly weaves seemingly different disconnected human stories into each other, and into the science behind the failure, makes for gripping reading. Her stress on differentiating disease from illness is particularly appealing. This is in fact the ability that gets lost as many of us go through medical schooling, and residency training, gradually losing our humanness. Good communication with patients, something that emerges repeatedly from these narratives, is such a rarity apparently all over the world. In objectifying the patient and the disease, we have severed our ties from what was once a vocation, and has now been reduced to a mere business. But for me, the most appealing part of this book is how Raza has brought in literature to drive home the points she wish to make. What a treat it is to see how the poet Iqbal reflects on cancer, and how the great poet Ghalib explains, through Azra’s voice, that “the cure part is the pearl; heating is the tear. You can do both”. Wah! I was familiar with this verse but never ever had I thought of applying that to training and education and patient care. I can see Raza taking a whole session woven around just this one couplet, unpacking the pearls of wisdom that Ghalib locked in this oyster, and that only she can pry open. Even though I have a declared bias towards Urdu poetry, I enjoyed how the author repeatedly brings English literature into the discussion equally effectively. This is a book that both scientists, as well as the general public, will find appealing at a very personal level.

  2. 4 out of 5

    Syed T.

    In her remarkable book “The First Cell,” Azra has been brutally honest at every level. President Nixon declared “War on Cancer” in 1972, but as shown in this book there has been little improvement in the prognosis of most cancers. The only decline in the death rates from cancer we have seen are due to early diagnosis from routine screening and the ability to treat cancers at such an early stage. Yet we hear of new miracle cures, transformational new drugs and so on frequently, followed by the sa In her remarkable book “The First Cell,” Azra has been brutally honest at every level. President Nixon declared “War on Cancer” in 1972, but as shown in this book there has been little improvement in the prognosis of most cancers. The only decline in the death rates from cancer we have seen are due to early diagnosis from routine screening and the ability to treat cancers at such an early stage. Yet we hear of new miracle cures, transformational new drugs and so on frequently, followed by the same disappointments. No one in the leadership of those treating cancers are willing to accept their failure and continue to give false hope to the patients. If we really are serious about winning the war on cancer we need to start by exactly what this book does. Take stock of where we are. What have we learnt from the billions of dollars spent on research in the cancer field and how to go forward. The book informs us that 95% of the new drugs tried for treating cancer don’t make it through the FDA approval and the 5% that do get approved have increased the survival by a few months only. Azra correctly asks if it is not time to acknowledge our failure and try some new venues of research. To think outside the box. To make a 180 degree turn. This book is a must read for all physicians and everyone who has been effected by cancer personally or in their loved ones and by those who have even remote interest in cancer. It should be required reading for those in cancer research and for those in the medical bureaucracy who are in positions of power to make decisions where the research funding goes.

  3. 4 out of 5

    Mrs. Danvers

    This book reflects some very important thinking about the deficiencies in the way that cancer drug research is performed in this country and recommendations for a different protocol, and I totally buy what she says. Unfortunately, it also is very detailed about the molecular mechanisms in a way that is difficult for the layman to follow. The more powerful statement is the simple one, the one she tells in stories about her patients. Here, too, though, it is sometimes hard to connect the human sto This book reflects some very important thinking about the deficiencies in the way that cancer drug research is performed in this country and recommendations for a different protocol, and I totally buy what she says. Unfortunately, it also is very detailed about the molecular mechanisms in a way that is difficult for the layman to follow. The more powerful statement is the simple one, the one she tells in stories about her patients. Here, too, though, it is sometimes hard to connect the human story with the point she is trying to illustrate. Edit to add: A couple of other points have been weighing on me since I wrote the above review. First, I think that she overlooks some rather remarkable strides in the treatment of breast cancer that have come about in the last 50 years or so, and which her colleague Siddartha Mukherjee wrote about in The Emperor of All Maladies: A Biography of Cancer. But then, perhaps more problematic, she talks about the future of testing for cancer markers and repeatedly discusses the ideal of "one drop of blood" holding all the information necessary. That would be great but frankly every time she mentioned that kind of work, I couldn't help but wonder if she were referring to the now wholly discredited claims of Elizabeth Holmes and her company Theranos (see Bad Blood: Secrets and Lies in a Silicon Valley Startup). And then that illustrated another problem, which is that her citation method made it pretty much impossible for me to figure out whose work she was citing when she was talking about the innovative theories, so I couldn't reverse engineer to determine who sponsored the studies. I hope she is not chasing pipe dreams here, but the whole Theranos debacle made me wary of her predictions.

  4. 5 out of 5

    Syed Mohammad

    Cancer has impacted everyone on this planet in some way, and this book offers hope while also reflecting how medicine needs to reevaluate how it tackles this disease. Through this book, it is clear that the author deeply cares about her patients, and it is an inspiring and sobering read at the same time.

  5. 5 out of 5

    Gily

    Dr. Azra Raza is a trail blazer. She would not take no for an answer. She is a warier. She will fight cancer cells at their origin. She is a champion for developing new approach of early detection of pre-cancerous cell at the first mutation toward immortality. As a person, a researcher and a physician she earn my respect and admiration. She explained her ideas very clearly in her book. That said, there were a lot of repetitions through the book to the level that more than once, I question myself Dr. Azra Raza is a trail blazer. She would not take no for an answer. She is a warier. She will fight cancer cells at their origin. She is a champion for developing new approach of early detection of pre-cancerous cell at the first mutation toward immortality. As a person, a researcher and a physician she earn my respect and admiration. She explained her ideas very clearly in her book. That said, there were a lot of repetitions through the book to the level that more than once, I question myself if I insert previous CD instead of the next. On the other hand using abbreviations of 3 word cancer disease names after one time of saying their full names or complex names of medications sometime were hard to follow. All in all I find this book a must read. Her ideas are radical and may bring new hope for eradicate this awful disease.

  6. 4 out of 5

    Michelle Hopkins

    I enjoyed the first half very much. It got repetitive, I thought, in the second half, confusing in spots, a little syrupy for my taste (everyone was her dearest friend) and a little too strident in tone. I guess she wrote that part more for the people she has seen as opponents since 1984. Still, highly illuminating and I am highly sympathetic to the views she expresses, especially how nominally many people benefit from radiation and chemo, yet how tortured they are physically and financially.

  7. 5 out of 5

    Debbie Notkin

    This is not ordinarily a book I would read during the plague days, but it was first on my nonfiction list when I agreed to pick up chairing the Otherwise Award jury late in 2019, and one of my closest frineds recommended it very highly. Raza is an oncologist specializing in certain leukemias, has intense personal history with cancer deaths, and has a radical take on how we treat cancer, and how we could do much better. Especially now, I don’t want to go into detail about this book, but I will sa This is not ordinarily a book I would read during the plague days, but it was first on my nonfiction list when I agreed to pick up chairing the Otherwise Award jury late in 2019, and one of my closest frineds recommended it very highly. Raza is an oncologist specializing in certain leukemias, has intense personal history with cancer deaths, and has a radical take on how we treat cancer, and how we could do much better. Especially now, I don’t want to go into detail about this book, but I will say that she is extremely aware of the way various systems intertwine to preserve the status quo in not only cancer treatment but cancer research, and she is very convincing about how that can and must be changed. She also writes like an angel, with a precise combination of the personal and the scientific, and lots of poetry in both English and Arabic. If this is your kind of book, it’s one of the best of that kind.

  8. 4 out of 5

    Marcos Malumbres

    Do you want to read a shortlist of major problems in cancer therapy? This is your book. Do you want to hear how difficult is to cure cancer patients? This is your book. Have you or your relatives suffered from cancer and have no one to blame? This is your book. Do you want to hear a few dramatic cancer stories (including the writer’s husband's) mixed with some poetry? This is your book. Are you willing to hear that medical oncologists that suffer with cancer patients are the heroes, whereas molecula Do you want to read a shortlist of major problems in cancer therapy? This is your book. Do you want to hear how difficult is to cure cancer patients? This is your book. Have you or your relatives suffered from cancer and have no one to blame? This is your book. Do you want to hear a few dramatic cancer stories (including the writer’s husband's) mixed with some poetry? This is your book. Are you willing to hear that medical oncologists that suffer with cancer patients are the heroes, whereas molecular oncologists and most cancer researchers are arrogant, overconfident and content with current status? This is your book. Do you know that investigating the origin of cancer is the key, that the author has keeping proposing it since 1984, whereas no one hears her claiming and this is why patients die of cancer? Please find, further details in the book. Do you know that current cancer models should be mostly abandoned because the advances are very limited? Yes….? But do you want to hear what the alternative is? Well…, then you should look for good books on the topic. I do agree that the book may call for new ways of thinking, re-visit the cost of current treatments, etc. but the views are really biased.. You may agree with them (and I do agree with all numbers and many criticisms provided) and they can be discussed, of course, but what is unacceptable is to go against all the effort that is being put to cure cancer without proposing any alternative [investigating the first cell is what everyone wants to do, especilly using cells (by definition), mouse models and other "models" of human cancer (everything is a "model" unless you want to do the whole research, from scracht, in a single patient)]. And there is no need to repeat in every chapter the idea that "molecular biologists" or "basic researchers" are the ones to blame whereas compassionate medical oncologists are the only professionals doing something useful for patients. I would say that this may be a stimulating book for some cancer researchers (after removing a lot of dirty stuff) and very harmful for some cancer patients or funding agencies that may take the wrong message.

  9. 5 out of 5

    Maureen Grigsby

    Dr. Azra Raza, a medical researcher, makes a very compelling argument that there needs to be a paradigm shift in cancer research so that we are looking for very early signs of cancer and finding the first cells, rather than our pretty unsuccessful approach of trying to eradicate the last remaining cell after cancer is pretty advanced. A very thought provoking book.

  10. 4 out of 5

    Henry

    Something is seriously wrong with the way cancer research is being done today. Dr. Raza, a prominent oncologist, has written a devastating critique of the way cancer care is being researched and practiced and she is calling for a revolutionary new treatment paradigm. Currently, cancer research is centered on the end stages of care, and the drugs approved through that research, at almost inconceivable expense and excruciatingly long years of research, are producing drugs that, according to Dr. Ra Something is seriously wrong with the way cancer research is being done today. Dr. Raza, a prominent oncologist, has written a devastating critique of the way cancer care is being researched and practiced and she is calling for a revolutionary new treatment paradigm. Currently, cancer research is centered on the end stages of care, and the drugs approved through that research, at almost inconceivable expense and excruciatingly long years of research, are producing drugs that, according to Dr. Raza, extend the survival of patients by months, not years. She believes that there is a better way, focused on detecting and curing the disease at the earliest stages before it becomes too complicated. People may disagree about the paradigm that she proposes, but it is an inescapable fact that the staggering costs of research that she cites call for a thorough reevaluation of what we are doing. There must be something wrong with a system that requires 10 years of drug development at a total cost of about 3 billion dollars for a single approved drug! We must face the question of how a “free” society gets itself into this kind of a predicament. Why have we lost our freedom to take the responsibility of making our own life and death decisions about our health? What are the implications of having the FDA protecting our health? The book does not raise these questions, but they are a logical consequence in terms of the drug costs, suffering and life expectancy of cancer patients. If the change in incentives that Dr. Raza is calling for to allow the development of this new paradigm is to occur, then a reevaluation of what the FDA is protecting us from needs to be done. What we need is for our health to be protected, not to be killed by that protection and prevented from doing all the required research needed to eradicate cancer. In politics, as in medicine, we must ask: “is the cure is worse than the disease?” As individuals, we must accept responsibility for making our own decisions about health care in consultation with our doctors, privately incentivized researchers (who don’t look to government for funding politically approved research), and privately incentivized certification agencies. Anyone should read this book who wants to understand why medical progress is so interminably long and so incredibly expensive, why the patients must endure so much suffering, which she describes in extraordinary detail, and why a paradigm change is needed to avoid becoming a victim of the medical bureaucracy.

  11. 5 out of 5

    Nolan Beatty

    As a cancer biology PhD student, I’ll be the first to say that these are all known facts in the field. Like not only known but well understood across every scientific field. Dr. Raza doesn’t share one original idea or anything close to novel. She rants the majority of the book without offering any clear solutions. And these rants didn’t originate from her. Yes, Dr. Raza, we know animal models are artificial so what’s your solution? She reveals her extraordinary bias of her own research which has As a cancer biology PhD student, I’ll be the first to say that these are all known facts in the field. Like not only known but well understood across every scientific field. Dr. Raza doesn’t share one original idea or anything close to novel. She rants the majority of the book without offering any clear solutions. And these rants didn’t originate from her. Yes, Dr. Raza, we know animal models are artificial so what’s your solution? She reveals her extraordinary bias of her own research which has produced no solution to her stated problems. It’s as if this book wasn’t peer-reviewed. I originally got this book as a gift simply because of sid’s review on the front – one of my favorite authors. In the book you learn repeatedly why he left such a review – not only are they colleagues but they are close friends and her daughter even worked in his lab. The humble brag throughout the book is unbelievably annoying. She finishes the book with “I will not be silenced” nonsense. That’s really what caused me to leave this review. EVERYONE WITH THE IQ OF A POTATO KNOWS WHAT YOU ARE CLAIMING. It’s not original so quit acting like you are some hero in the field. MDs are notorious for this. They don’t recognize their own bias, they think they know everything and are not up to date on scientific literature. Her writing style is beautiful when she describes her interaction with her patients. Stick with that and write another book.

  12. 4 out of 5

    Cindy Lauren

    Love this book, truly. Wasn't sure what to expect and did also love Emperor of All Maladies.This gives a new, exciting, if painful, perspective on the whole cancer landscape. From her own first professional, then intensely personal experience with the relentlessness of the disease, the author is exemplary is her discussions. Her detailed knowledge of the process of disease, diagnosis and treatment mirrors the clusterfuck having cancer in this day and age really is. From the pursuit of a cure - s Love this book, truly. Wasn't sure what to expect and did also love Emperor of All Maladies.This gives a new, exciting, if painful, perspective on the whole cancer landscape. From her own first professional, then intensely personal experience with the relentlessness of the disease, the author is exemplary is her discussions. Her detailed knowledge of the process of disease, diagnosis and treatment mirrors the clusterfuck having cancer in this day and age really is. From the pursuit of a cure - similar in many cases to locking the barn door after the horses have fled, to the shotgun of let's try everything, the approach has been backwards. With the knowledge we have now, looking at cancer from the first cell is only logical and reasonable. I too have had cancer, and it did and continues to scare me....I can only hope that her voice and call resonate for all of us who have had and will have to face that situation. Nipping it in the bud is far and away more preferable than chasing errant, racing cells throughout the body, and laying waste to things in its path. Thorough, detailed and thoughtful, thank you. I enthusiastically recommend and am gategelu for the advance copy.

  13. 4 out of 5

    Derek Emerson

    Azra Raza makes a bold claim in this book and backs it up. "The art of medicine, once based purely on experience and observation, a hostage to tradition, gradually evolved into a practice increasingly driven by scientific evidence. More recently, it has undergone an unexpected transition by morphing into a monstrous business enterprise" (144). Raza is not against funding for cancer research as she has made this profession and knows the personal costs as her husband died because of cancer. Her fru Azra Raza makes a bold claim in this book and backs it up. "The art of medicine, once based purely on experience and observation, a hostage to tradition, gradually evolved into a practice increasingly driven by scientific evidence. More recently, it has undergone an unexpected transition by morphing into a monstrous business enterprise" (144). Raza is not against funding for cancer research as she has made this profession and knows the personal costs as her husband died because of cancer. Her frustration revolves around how funds are distributed and how research is separated from treatment. "The funding agencies continue to reward basic research in petri dishes and mouse models that bear little relevance for humans" (143). She is not alone in this as she quotes another critic, oncologist Vinay Prasad, who claims that the $700 billion spent on health care still leaves practiced medicine occurring based on scant evidence. Raza has a solution. "The two immediate steps should be a shift from studying animals to studying humans and a shift from chasing after the last cancer cell to developing the means to detect the first cancer cell." She is after the causes for cancer instead for treating it after cancer has been diagnosed. The books tries to add a personal side with stories, but many go on too long and Raza is very good at quoting other people saying how incredible she is. "Call Azar, mom. She is on the cutting edge of cancer. I want her involved in my care" (199) is an example that happens often and her "aw, shucks" at all this praise is thin since she puts it in so often. She does not seem to need this type of support as she makes a strong argument on her own. Having watched my six-year-old die from neuroblastoma cancer, this is personal for me. We has the opportunity to have a researcher who was a practioner work with him after his first relapse and he made good progress for a year before succumbing. That connection between research and practice is what Raza wants, and I think she is right.

  14. 5 out of 5

    Lisa

    Physicians are not scientists and their play science efforts are part of the problem this book rails against. This smug intro is written as though her family is the only one to have had the miserable experience with cancer - after treating patients for years now she finally gets to reflect. Her enormous ego let her write this book as though she presents anything new or creative. Nope, in fact, limitations in research design and the understanding that prevention and early detection are the best d Physicians are not scientists and their play science efforts are part of the problem this book rails against. This smug intro is written as though her family is the only one to have had the miserable experience with cancer - after treating patients for years now she finally gets to reflect. Her enormous ego let her write this book as though she presents anything new or creative. Nope, in fact, limitations in research design and the understanding that prevention and early detection are the best defenses is nothing new. Arrogance aside, at least the tone is an improvement over Emperor of all Maladies, as she doesn’t perceive succumbing to cancer as a failure of strength. (Although like that book, this one needed to cull the epigraphs.) It would make a nice tribute to her patients if that were the author’s intent. But as much as she is saddened by her patients’ bankruptcy due to the cost of care, she is content to flaunt her material wealth and access to specialists. She wants to rail against the science and offers no solutions. Because she is a clinician, not a scientist.

  15. 4 out of 5

    Curt Worden

    After reading The First Cell, I realized how I’ve misunderstood the misguided war on cancer. Dr. Azra Raza has written a powerful and insightful book drawing from the passion for her work, and being a firsthand witness to the human impact of this disease. A range of emotions are present; from the stories of patients and their families who show extraordinary strength and determination, to the frustration of the unjust realities present in the “business” of cancer. Beautifully written with unbridle After reading The First Cell, I realized how I’ve misunderstood the misguided war on cancer. Dr. Azra Raza has written a powerful and insightful book drawing from the passion for her work, and being a firsthand witness to the human impact of this disease. A range of emotions are present; from the stories of patients and their families who show extraordinary strength and determination, to the frustration of the unjust realities present in the “business” of cancer. Beautifully written with unbridled honesty. A must read! https://www.amazon.com/dp/1541699521/...

  16. 5 out of 5

    Michael

    I am giving this four stars because it is an important book on cancer by an oncologist working in the US, Azra Raza, who lost her own husband (another oncologist) to cancer. Raza wants to convey her concern that "cancer cures" have been oversold, and that much of the research is misguided. But be warned: she holds back nothing about the misery of failed treatments. I do NOT recommend this book for anyone undergoing cancer treatment or with a loved one suffering from cancer. As I am in the first I am giving this four stars because it is an important book on cancer by an oncologist working in the US, Azra Raza, who lost her own husband (another oncologist) to cancer. Raza wants to convey her concern that "cancer cures" have been oversold, and that much of the research is misguided. But be warned: she holds back nothing about the misery of failed treatments. I do NOT recommend this book for anyone undergoing cancer treatment or with a loved one suffering from cancer. As I am in the first category, I could only manage a few chapters. Perhaps I will return at some later date....

  17. 4 out of 5

    Logan Daul

    was good

  18. 5 out of 5

    Jennifer Bentley

    How much do you not want to die? Author Azra Reza challenges us to think deeply about what the cost of an extra six weeks or six rounds of treatment would really mean. Is it worth putting your family's financial security on the line to extend your life, if only for a few weeks? I guess this could be a depressing thought, but she philosophizes on death and life... James Baldwin (one of my favorite authors) is quoted heavily and I loved her initial chapters about how the west views death (by avoid How much do you not want to die? Author Azra Reza challenges us to think deeply about what the cost of an extra six weeks or six rounds of treatment would really mean. Is it worth putting your family's financial security on the line to extend your life, if only for a few weeks? I guess this could be a depressing thought, but she philosophizes on death and life... James Baldwin (one of my favorite authors) is quoted heavily and I loved her initial chapters about how the west views death (by avoiding it) and life (the pursuit). Also, I have always thought of cancers as exponential, in that the rate of production grows out of control... never have I thought to think of the initial cancer cell / to even think of cancer at the cellular level! Cancer always seems to large and looming- it was a change and challenge to think of cancer as infinitesimally small and potentially curable. It was depressing to find that this physician-author confirms your worst fears about cancer: money lies at the root of great potential and great harm. What I did like was that this author, over years of research and getting to know her patients and getting to know cancer intimately, told the stories of where an extra six weeks of extended patient life was worth a lifetime. I don't know... maybe my poor girl cynicism ruined what could have been a touching narrative of personal accounts of how her experimental treatments worked; I am left feeling a bit "sweet lemons and sour grapes," over the fairness/unfairness of it all. The wealth is the depressing part... all to extend life in terms of weeks or months, rarely- if ever- years. She does speak of the toll on families, homelessness experienced by not being able to afford your home because your family had to file bankruptcy to escape medical debts. If you are looking for grit, this is not the book. This is the book you want to read if you want to ponder worth versus cost. If you knew you were going to die tomorrow, what would an extra six weeks be worth- damn the costs. And that's why we will never cure cancer.

  19. 5 out of 5

    Amera Raza

    It is a beautifully written, easily understandable, emotionally stirring, and yet soundly- supplemented -with -scientific -data, book. One gets a lot of basic information about cancer as a disease, how it develops and affects its victims, it’s current and past treatment strategies and challenges and best of all select patients’ and their care givers’ personal accounts of how they feel, face and handle this harrowing disease. Azra’s main thrust is of course on how some of the cancer treatment and It is a beautifully written, easily understandable, emotionally stirring, and yet soundly- supplemented -with -scientific -data, book. One gets a lot of basic information about cancer as a disease, how it develops and affects its victims, it’s current and past treatment strategies and challenges and best of all select patients’ and their care givers’ personal accounts of how they feel, face and handle this harrowing disease. Azra’s main thrust is of course on how some of the cancer treatment and cure finding strategies have stagnated over the years or decades and need fresh foci and fresh methodologies to arrive at effective, substantial results. There have been newer and effective strategies and researches but according to her they have not resulted in long term ultimate cures. Her recommendations then follow including her description of the tissue repository which she has collected and maintained for last three decades and which can be a valuable resource for cancer cure-finding research. In my opinion the book is not only valueable from the point of view of cancer research but also for its literary beauty in how it is written and the data presented. I leave the rest to the reader but in conclusion: it’s a strong and loving book. Strong in its challenge to the cancer research community and loving in its invitation to do better for the sake of suffering patients. I thoroughly enjoyed reading the book and Azra, congratulations for producing this beautiful thing. I strongly recommend it to everybody to read, not just doctors, scientists or cancer researchers who also do, I hope

  20. 5 out of 5

    Ronald J.

    We had the great honor of interviewing Dr. Azra Raza on our radio show: The Soul of Enterprise: Business in the Knowledge Economy. You can listen to the entire 1 hour interview here: https://www.thesoulofenterprise.com/t... Here are the questions I and my co-host Ed Kless asked Azra: Ron’s Questions Welcome to TSOE, Azra. It is such an honor to get to speak with you. Before we get into your book, during this COVID crisis, how are you holding up, personally? Do you still have to see some patients for We had the great honor of interviewing Dr. Azra Raza on our radio show: The Soul of Enterprise: Business in the Knowledge Economy. You can listen to the entire 1 hour interview here: https://www.thesoulofenterprise.com/t... Here are the questions I and my co-host Ed Kless asked Azra: Ron’s Questions Welcome to TSOE, Azra. It is such an honor to get to speak with you. Before we get into your book, during this COVID crisis, how are you holding up, personally? Do you still have to see some patients for cancer treatments? Azra, we were introduced to you and your book from Russ Robert’s podcast, EconTalk, Ed’s and my favorite podcast. We jokingly refer to TSOE as the “poor man’s Econtalk.” I read your book after hearing the interview, and Russ Roberts said it best: Your book is hard to read, and harder to put down.” It is beautifully written. I had to stop to cry many times, I lost count. It’s so human, so profound, thank you for writing it and educating us lay people on the effects of cancer. Let’s start with what type of cancer you specialize in. You actually started in pediatric oncology and couldn’t handle it, is that right? You write, Today, one in two men and one in three women will get cancer. Nearly 18 million worldwide. You wrote: "My surroundings may not have changed much, but my perceptions have. Like the difference between illness and disease; between what it means to cure and to heal; between what it means to feel no pain and to feel well. I have felt like a fraud, a posturing intellectual phony. In the march to death, I have begun to catalog the tragedies of survival." That is profoundly self-introspective. What brought on these feelings? You write that “treatments for cancer haven’t changed in 50 years. Cancer treatment was just as primitive a century ago. With minor variations, a protocol of surgery, chemotherapy, and radiation—the slash-poison-burn approach to treating cancer—remains unchanged. It is an embarrassment. Equally embarrassing is the arrogant denial of that embarrassment.” Azra, why is that? Azra, before we get into the more hopeful things, I just want to ask you one more thing. You say no one is winning the war on cancer. It is mostly hype. I would think most folks probably think since president Nixon declared a war on cancer progress we have been making progress. What’s the disconnect there? Let’s pivot to your strategy and the name of your book. You think the strategy is to stop chasing after the last cancer cell and focus on eliminating the first. You believe experiments with animals, mice in particular, don’t teach us much on how treatments will work in humans. Is it really possible, Azra, with your strategy to reduce cancer deaths by 75 percent? When you say the first cell, you quoted one of your colleagues who basically said that early detection screening for cancer has not fulfilled our expectations, PSA tests, things like that. You’re actually talking about things that are being worked on like a machine that automatically images your body while you are in the shower, or wearing a smart bra that has two hundred tiny biosensors, and other ways of measuring things from your urine, blood, and saliva. You’re optimistic that some of things they are working will come to fruition? Azra, is a cancer vaccine possible? Azra, this was painful for me to read: “I wish I felt like an exceptional oncologist. Most days, I feel like a complete failure.” I have to tell you, even though I know you work against great odds, my Mom is a three-time cancer survivor, she had Uterus, Breast, and liver cancer. Her oncologists are heroes to me, because she’s still living at 87. You tell a story at the end of the book about walking in the mall with your older sister and your brother, Tasnim, a cardiac surgeon at Buffalo General Hospital, and people were running up to him and hugging him. Your mother said: “You have been in Buffalo for almost ten years. I have never met any of your patients. Why are heart patients doing so much better than cancer patients?” Wow, that’s profound. Azra, we’re at the end of our time together, and I just wanted to point out the other thing I learned from your book that I just loved, I didn’t know that “The response to a greeting from a younger person in Arabic is often, ‘May you live to bury me.’ That is beautiful. Ed will take you home, thank you so much for appearing on TSOE. Ed’s Questions I learned so much about cancer from your book. The thing that struck me was the complexity of cancer. As a layperson, I think we look at disease as monolithic. You write in the book, “If you biopsy a patient with breast cancer twice in the same day, once in the breast and once in the lymph node, you can get cancer cells with different sequences.” So cancer is not the same in the same person even hours apart, or even in different parts of their body. I never realized the level of complexity, can you expound on that? You mention the four different causes. Do we think those different causes cause the different forms of cancer, or could all four of those cause similar cancers? The complexity of what is happening with COVID is an example of a macrocosm of the cancer cell. It is so complex, and you are talking about small little cells in the body, and now we are trying to figure this out for all of society. I just thought it was an interesting parallel. Would you address the so-called CAR-T therapies that are being developed? Another treatment going after the last cell rather than the first cell, hence the name of your book. Hopefully for the second half of our conversation we can begin to transition over to the positive side of things and what you’re doing to get people to think about this differently. I wanted to take us in a different direction. I was intrigued about smart bras, etc., to detect cancer. Are there privacy concerns with this scanning, like with 23andMe worries about some insurance company is going to find about the results. Are there are any privacy concerns we have to worry ourselves with regards to this type of screening? Talk a little about the research lab you run. You created this lab two decades ago, is that correct? I wish I had $200 million to give you. Hopefully, we’ll help get your message out. Is there anyone else who has done anything similar? One of the things that is also great about your book is it is peppered with great references to literature, I know it’s something you are very passionate about. I’m a word guy as well, and I found the whole thing about “pharmakon,” the Greek word meaning remedy, poison, and sacrifice. Do I have that right? One of the things I wanted to share with you, is the importance of art and literature in the treatment of us as human beings. I also saw this in one of your videos as well, the whole notion of sacrifice came out, I was reminded of the William Butler Yeats poem, “Easter 1916,” I’m going to share part of it with you that I’ve committed to memory: Too long a sacrifice Can make a stone of the heart. O when may it suffice? That is Heaven's part, our part To murmur name upon name, As a mother names her child When sleep at last has come On limbs that had run wild. What is it but nightfall? No, no, not night but death; Was it needless death after all? For England may keep faith For all that is done and said. We know their dream; enough To know they dreamed and are dead; And what if excess of love Bewildered them till they died? I write it out in a verse— MacDonagh and MacBride And Connolly and Pearse Now and in time to be, Wherever green is worn, Are changed, changed utterly: A terrible beauty is born. Dr. Raza ended by citing Emily Dickinson’s poem, “I measure every Grief I meet”: I measure every Grief I meet With analytic eyes – I wonder if It weighs like Mine – Or has a different size. I wonder if They bore it long – Or did it just begin – I cannot find the Date of Mine – It been so long a pain – I wonder if it hurts to live – And if They have to try – And whether – could They choose between – They would not rather – die – Recommended by Ron: A Taste of My Own Medicine: When the Doctor Is the Patient, Dr. Edward E. Rosenbaum, 1988 The Movie: The Doctor (1991), starring Will Hurt

  21. 4 out of 5

    Meredith

    This book caught my eye, with comparisons to The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee and When Breath Becomes Air by Paul Kalanithi. I’d read and adored both of these books: the former a fascinating treatise on the history and science of cancer and the latter a poetic, moving account of a young physician dying of cancer. I listened to The First Cell, loved the narrator, and only afterward, realized the narrator was the author’s daughter, Sheherazad Raza Priesler This book caught my eye, with comparisons to The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee and When Breath Becomes Air by Paul Kalanithi. I’d read and adored both of these books: the former a fascinating treatise on the history and science of cancer and the latter a poetic, moving account of a young physician dying of cancer. I listened to The First Cell, loved the narrator, and only afterward, realized the narrator was the author’s daughter, Sheherazad Raza Priesler. I give the book high regards, because it combines elements of science, history, and personal accounts of those with cancer, their loved ones, and their doctors (notably, Dr. Azra Raza, an oncologist specializing in MDS and AML). Her thesis is that we need to focus more of our energy on detecting and getting rid of the first cancer cell instead of trying to eliminate the last. She promotes the development of liquid biopsies to detect early signs of cancer, before cancer could cause symptoms or even be detected by imaging. She demands nothing short of a paradigm shift in how we research and treat cancer. The infusion of human stories throughout the book helped underscore her point that we must do better to retain the complexity inherit in treating cancer in humans. We can’t rely on reductionist animal models or hunts for simple genetic solutions. It also serves as a stark reminder that so many cancer treatments do as much harm as good. We spend billions of dollars on experimental drugs that fail to produce effects 95% of the time. And when they do, they often prolong life by only a couple months, and with harmful side effects. Raza also suggests we need to do better about talking about death, about quality of life in terminal cases, the role of hope, and not always pursuing aggressive treatment until the bitter end. The personal narratives in Raza’s book include patients with whom she forged special bonds (and I get the sense she bonded with many of her patients), her own husband (a fellow oncologist who died of cancer), and her daughter’s good friend who died of cancer at a young age. In this way, the intertwining of human stories with science and medicine was like a bridge between Mukherjee’s tome on cancer and Kalanithi’s elegiac account. I would also add Atul Gawande’s Being Mortal: Medicine and What Matters in the End to the list. I give it only 4 out of 5 stars, because her pleas for redirecting money and time toward detecting the first cell became a bit repetitive, without adding new information. Further, the transitions between the personal narratives and the scientific portions could have been more seamless. It jumped around a bit, perhaps because portions of the book were previously published, as mentioned in the acknowledgments. At times, it felt like she was trying to do too much. But alas, I appreciate the inclusion of human stories, references to literature that captures the human experience, and the power and limits of science, while describing the current state of affairs in cancer treatment. If you’ve been impacted by cancer or want to see more effective treatments than the typical “slash, poison, burn” method that has persisted for decades with little advancement, read her book.

  22. 4 out of 5

    Bruin Mccon

    “We are all tested. But it is never in the way we prefer, not at the time we expect.”—Dr. Azra Raza’s husband, Harvey, discussing the disease that killed him “The prevention I am talking about is through identification and eradication of transformed cancerous cells at their inception, before they have had a chance to organize into a bona fide malignant, incurable disease.” Are current methods to treat cancer making a difference in the lives of patients? The First Cell would say hell no, and within “We are all tested. But it is never in the way we prefer, not at the time we expect.”—Dr. Azra Raza’s husband, Harvey, discussing the disease that killed him “The prevention I am talking about is through identification and eradication of transformed cancerous cells at their inception, before they have had a chance to organize into a bona fide malignant, incurable disease.” Are current methods to treat cancer making a difference in the lives of patients? The First Cell would say hell no, and within the first pages the book argues we need to start looking at treating this disease through a prevention-based strategy that acknowledges that diet and exercise are not enough to stop cancer. “There is a crisis in the field. The bizarreness of things we are doing both in clinical and basic science is effectively cloaked under important-sounding terms, conveying a reassuring sense of objectivity—best practices, evidence-based medicine, precision oncology, genetically engineered mice. Mostly euphemisms to sweeten the bitter truth that we don’t have better treatments than what we were offering fifty years ago.” Dr. Raza is not an impartial observer, a fact she makes clear early on when discussing how she was trained by her husband, in the same exact field, to always remain impartial. Yet when he got cancer, she was the only doc he trusted, despite his wife’s obvious failure to meet his number one criterion. It’s hard to see how any of us could make it through the death of a spouse at the hands of our life’s inanimate nemesis. She discusses young brilliant minds in the field and why they are deluded. It’s simple, really: cancer drugs tested in mice have no predictive value in terms of human efficacy. It’s easy to feel her frustration. “Do other cancer patients experience variations on these themes, the vertigo pf evanescent, soul-destroying, irreducible suffering? Do they run their weary fingers through serrated edges of anguish, say farewells in unspoken, unheard of languages in the silence of sleepy nights?” The author doesn’t hide the pain of losing her husband; rather, she uses this viewpoint as a family member left behind to move her search for better cancer prevention forward to spare others her pain. About midway through her book, Dr. Raza discusses Zen and the Art of Motorcycle Maintenance, a book I tried to finish this year—and failed. Throughout she uses poetry and book quotes to illustrate ideas and points and she uses the Robert Pirsig classic to discuss dynamic quality. Her description of the book makes me want to try again to read it, as if missing out on its wisdom will impact me beyond just this section of her book. She quotes the book, “the only Zen you find on tops of mountains is the Zen you bring there.” This book will give me nightmares. JC, a 34-year-old who had an uncontrollable urge to sniff gasoline while pregnant—and who succumbed to leukemia when her twins were 2.5 as a result. The First Cell will change your mind about cancer research. It’s frustrating that the American system is so useless. We’ll all be touched by cancer in this lifetime—and we all must push for a better system to fight it.

  23. 5 out of 5

    Ed Bernard

    More like 3.5 stars. An extraordinary book, in many ways, though not as good as it might’ve been, in my opinion. I should start by saying that I am humbled by the author’s accomplishments, her passion, her original thinking in the face of overwhelming institutional inertia, her exceedingly human and humane empathy for her patients. Raza is an oncologist specializing in a form of leukemia. Her book is many things — a recounting of many moving stories of the patients she has treated, a personal rec More like 3.5 stars. An extraordinary book, in many ways, though not as good as it might’ve been, in my opinion. I should start by saying that I am humbled by the author’s accomplishments, her passion, her original thinking in the face of overwhelming institutional inertia, her exceedingly human and humane empathy for her patients. Raza is an oncologist specializing in a form of leukemia. Her book is many things — a recounting of many moving stories of the patients she has treated, a personal recounting of the deep suffering of her husband, who ultimately died from the very disease she treats and studies, and a blistering attack on the state of cancer research and its genuinely terrible record of results over the past 50 years. Raza’s title defines one reason for this — she believes that cancer research is focused on getting rid of the disease before it kills us (the “last” cell) whereas it should be working to kill the disease when it first emerges (the first cell), long before it begins to have clinical impact. She believes that nearly all the improvement in cancer survival is due to early detection, and she has lots of evidence to back that up. She also proposes a number of avenues of research that would improve performance in this area, including creating a personalized map of each person’s genetic structure (not the correct term!) when they are a newborn and tracking the changes. It’s a brilliant idea — and one she has trouble getting funded, which makes sense given our nation’s obsession with (profitable) treatments rather than good health (where no one makes any money). That’s all great. The problems with the book are that the science is very dense and the explanations are a bit opaque. Also, her stories about her patients tend to jump around a bit and also become pretty repetitive. She’s a tiny bit self-serving in her storytelling (it isn’t bad, just accumulates by the end), and she has a VERY annoying habit of invoking poetry to explain feelings and reactions that don’t need it — especially when the poetry is in untranslated Urdu, which may sound lovely but doesn’t mean a thing to me. I learned a lot from this book and it definitely caused me to think more deeply about cancer research (which is, after all, the point), but I’d had enough about 3/4 of the way through. Grade: B

  24. 4 out of 5

    Henry David

    I'd give it 6 stars if I could... Couldn't have said it better than Nature Book Reviewer, Barbara Kiser: "Each year, the United States spends US$150 billion on treating cancer. Yet as oncologist Azra Raza notes in this incisive critique-cum-memoir, the treatments remain largely the same. Raza wants to see change: eliminating the first cancer cell rather than “chasing after the last”, which is doable with current technologies. Meanwhile, she braids often-harrowing stories of patients, including he I'd give it 6 stars if I could... Couldn't have said it better than Nature Book Reviewer, Barbara Kiser: "Each year, the United States spends US$150 billion on treating cancer. Yet as oncologist Azra Raza notes in this incisive critique-cum-memoir, the treatments remain largely the same. Raza wants to see change: eliminating the first cancer cell rather than “chasing after the last”, which is doable with current technologies. Meanwhile, she braids often-harrowing stories of patients, including her own husband, with insights gleaned from laboratory and literature on this complex, often confounding array of diseases." However, that said, there are some limitations of this book – notably Dr Raza's tone-deaf approach to the overall health of the US, which can only be attributed to cultural differences – as a wealthy Pakastani immigrant – as she emphasizes stark differences of the elite class of Karachi, yet never really mentions differences between the clear haves and have nots in NYC and elsewhere in the country. She seems, too, to have a limited idea of Americans live – having only lived in Morningside Heights where Columbia University is located, as well as Rush Medical Center in Chicago in the West Loop, with many references to Hyde Park, Chicago where the infamous Ivory Tower of UChicago is located – and all of these places are essentially Ivory Towers that represent a small slice of the pie of this nation – its problems and outlines of possible solutions for all. While the US is the "most affluent nation," there is a dearth of information about the uninsured, those with medicaid and medicare. Does her practice even have a diversity of patients form socioeconomic backgrounds? Has she developed a charity fund to help those seeking medical care when they cannot otherwise afford to do so for their MDS? Obviously there is racial diversity in her practice, but she seems to focus on the patients who would "pay anything to get rid themselves of this disease," hardly mentioning the disadvantaged Americans suffering with subpar healthcare within the US and especially NYC (Brooklyn, Queens, Staten Island all suffer with huge differences in the quality of care in comparison to Manhattan). It's a great book, but limited in scope in terms of solving such intranational health crises currently going on this US. Bottom line: TENS OF MILLIONS of Americans are afraid to seek healthcare even when displaying cringe-worthy symptoms because they are afraid to lose their houses and savings to medical bills.

  25. 4 out of 5

    Jill Meyer

    Dr Azra Raza is a Pakistani-born oncologist, who has lived and practiced medicine in the US since she graduated from medical school. She's from a family of doctors and was married to an oncologist, who died of cancer. Raza has many ideas about cancer; it's origins and the treatment of the patient. She has a beautifully written book, "The First Cell: And the Human Costs of Pursuing Cancer to the Last". Azra Raza's book is the latest in books by doctors about cancer. Many people have read "When Bre Dr Azra Raza is a Pakistani-born oncologist, who has lived and practiced medicine in the US since she graduated from medical school. She's from a family of doctors and was married to an oncologist, who died of cancer. Raza has many ideas about cancer; it's origins and the treatment of the patient. She has a beautifully written book, "The First Cell: And the Human Costs of Pursuing Cancer to the Last". Azra Raza's book is the latest in books by doctors about cancer. Many people have read "When Breath Becomes Air" by the late Paul Kalanithi and "The Emperor of All Maladies", by Siddhartha Mukherjee. (Why are so many of these books written by South Asians? Do they have a better/different perspective on the disease?) Raza takes a slightly different approach to her subject than other doctor/authors. It's personal in that it talks about her husband's illness and death, but she also goes outside the personal and looks at many other patients she's treated. Some have lived, some have died, but she remembers the "cost of pursuing" the disease for her patients. She makes several points in her book, one being that "cure" rates are improving not because of new miracle cures (I think she quotes a 95% fail rate of new medicines.) but rather because of early detection of many cancers. Early detection usually makes for easier cures. She also writes about the human cost of the patient's pursuit of the cure. Sometimes, often times it seems, the methods of curing are worse than the disease itself. I cringed while reading the parts about two men who ultimately died of their cancer after horrible chemo and other methods of "curing". Azra Razi's book is not particularly positive about her subject. Some of the heavy duty medical info I didn't understand, but I still got a lot from the book. The reason the book's not positive is that cancer is not a disease that lends itself to positive endings.

  26. 4 out of 5

    Anna

    This was a little over my head at times and I didn't always like the organization. But I learned a lot and I think it's a really important book. Her basic argument is that of all the money spent on cancer treatment, there is not enough spent on prevention or early stage treatment and that we have actually made little progress on treating end stage cancer and we are basically using the same treatments as 40 years ago. For a few people (and unicorns), these treatments work but for most people, the This was a little over my head at times and I didn't always like the organization. But I learned a lot and I think it's a really important book. Her basic argument is that of all the money spent on cancer treatment, there is not enough spent on prevention or early stage treatment and that we have actually made little progress on treating end stage cancer and we are basically using the same treatments as 40 years ago. For a few people (and unicorns), these treatments work but for most people, they extend life only for a few months at most and as considerable physical and financial cost. I found that to be quite depressing, to be honest. Chemo and radiation therapies cause collateral damage hurting the body indiscriminately, injuring organs both diseased and healthy. She says that although everyone understands that early detection is the key to treatment and screening procedures have reduced mortality, 70% of the National Cancer Institute budget goes to advanced malignancies conducted on animals and tissue that lead to clinical trials with a failure rate of 95% (and the "successes" extend life for a few months). Screening has helped save lives for colorectal, cervical and breast cancers. She says that mice trials need to end in terms of cancer drug development because all we have learned is how to give and cure cancer in mice but that hasn't added anything to the fight to cure or treat cancer in people. The other super depressing thing in this book, is that non-treatment isn't an option either because cancer is often incredibly painful. Palliative care and hospice care for cancer patients requires some kind of actual treatment for the pain.

  27. 4 out of 5

    Nancy

    Lots of interesting material here, though the author paints a rather bleak picture regarding cancer treatment and research, and the potential for finding any significant new treatments anytime in the near future. Also, I really could have done without the mentions of her political leanings. The fact that she mentions her patients whom she became friends with, often based (at least in part on) shared political views, was disturbing and unsettling. I thought doctors were supposed to be unbiased an Lots of interesting material here, though the author paints a rather bleak picture regarding cancer treatment and research, and the potential for finding any significant new treatments anytime in the near future. Also, I really could have done without the mentions of her political leanings. The fact that she mentions her patients whom she became friends with, often based (at least in part on) shared political views, was disturbing and unsettling. I thought doctors were supposed to be unbiased and rise above such things? It's a little scary to ponder. In the meantime I will be extra careful not to share any of my personal religious or political views with any doctors I may have. It really came across as undermining her professionalism in a big way. I was left with the implication that if you didn't share her views, she would deem you as inferior, and maybe not give you the same care and her absolute best effort. There was a lot of repetition, and I felt like some of the patient stories she told could have used some editing in this regard. And some of the writing was so scientific and technical that I zoned out, but I expected a bit of that. It was okay, not sure if I recommend or not. I would say that if you haven't read it yet, instead, definitely read Being Mortal: Medicine and What Matters in the End.

  28. 4 out of 5

    Lindy

    If I could, I would give this book 3.5 stars. It is a very fascinating, under-discussed judgement on the fruits of 50+ years of cancer research and drug development using cell lines and animal models. She is not subtle in her dismay over the drug products that have been brought to market as a result of this method of science/discovery. She argues that scientists, funding agencies, physicians should judge this method by the end results, which have not been very encouraging. She also discusses in s If I could, I would give this book 3.5 stars. It is a very fascinating, under-discussed judgement on the fruits of 50+ years of cancer research and drug development using cell lines and animal models. She is not subtle in her dismay over the drug products that have been brought to market as a result of this method of science/discovery. She argues that scientists, funding agencies, physicians should judge this method by the end results, which have not been very encouraging. She also discusses in some detail patient stories and examples of the harsh effects of the therapy options available to patients. She argues that, as a society, we should hold researchers, physicians and funding agencies to a higher standard. At the end of her book, she makes a brief argument about what that higher standard could look like. I really appreciated the data provided in favor of her argument and also the nature of the argument. I haven’t heard many people arguing against this type of scientific approach before, and I am involved in the fields of science and medicine. I also really appreciate that she frequently points to patients, keeping them forefront in her argument. These are the reasons why I rounded up my review to 4 stars. Less favorably, she frequently uses scientific jargon without explaining the concepts. If I did not have a strong background in this field, I would have been lost many times. Finally, in my opinion, her argument for the better approach to studying cancer - namely, earlier detection - lacks much detail. I thought this was unsatisfying.

  29. 5 out of 5

    Ginger Hudock

    Raza is an oncologist who has had a first-hand look at cancer through the eyes of both her patients and her husband, who died of cancer. She has seen death up close through these patients and recounts the stories of a number of them. This book is a personal memoir but is also a great discussion of the history of cancer research and treatment. Raza sees that most research funding has not been very well spent. Drugs have been developed that cost huge amounts of money, have many negative side effec Raza is an oncologist who has had a first-hand look at cancer through the eyes of both her patients and her husband, who died of cancer. She has seen death up close through these patients and recounts the stories of a number of them. This book is a personal memoir but is also a great discussion of the history of cancer research and treatment. Raza sees that most research funding has not been very well spent. Drugs have been developed that cost huge amounts of money, have many negative side effects, and often extend life very little. She states that the current medical model of cancer treatment of slash/poison/burn (surgery/chemotherapy/radiation) is not curing most cancers. Raza decided to focus on studying cancers in the earliest stages, including precancels in order figure out how to arrest the disease before it progresses. A quote: "there is much exciting work going on the area of detecting the first rather than the last cancer cell". This book was a difficult read because it does not whitewash all of the negative symptoms faced by her patients. I took a course on nutrition for cancer during my nutrition program. My interest in cancer treatments through nutrition were revitalized this year when my husband was diagnosed with precancerous esophageal dysplasia. This book solidified my desire to prevent cancer with natural methods and, if cancer is found, help combat it with natural treatments, including diet.

  30. 4 out of 5

    Abdullah M.

    The First Cell is an exceptional piece of work by a caring doctor, brilliant scientist, a public speaker, a mentor for countless students, and an eloquent writer who is also a widow of a cancer victim. As one can imagine someone wearing so many hats and with 35+ years in the field of oncology brings a lot of experience with her. In this book, Dr. Raza channeled all that experience and energy to bring the state of cancer care with scientific facts, opinion, and advice nicely weaved with patients The First Cell is an exceptional piece of work by a caring doctor, brilliant scientist, a public speaker, a mentor for countless students, and an eloquent writer who is also a widow of a cancer victim. As one can imagine someone wearing so many hats and with 35+ years in the field of oncology brings a lot of experience with her. In this book, Dr. Raza channeled all that experience and energy to bring the state of cancer care with scientific facts, opinion, and advice nicely weaved with patients stories. I highly recommend this book is for everyone, but particularly for those affected by cancer, either directly or indirectly. It is for researchers, scientist, oncologist, medical students and fellows, community doctors, peer reviewers of science funding agencies and investors who invest millions and billions trying to develop drugs for cancer. For everyone there is a message, there is admonition and advice, and there is a plan and future directions. Dr. Raza is well-read, as evident from the poems, couplets, quotes from authors, poets, and writers from East to West. Highly engaging and a must-read. The First Cell: And the Human Costs of Pursuing Cancer to the Last

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