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  • Read This Book Or Suffer The Consequences – The Emperor of all Maladies: A Biography of Cancer

    It’s ethereal to be able to dream and soar – to be informed – to be let down only to be raised again.

    Way before I started Upstart: Business and Management for 20-40 Year Old Professionals, I became a voracious reader: actually I tend to think of myself as an autodidact – yet I know it was my growing love for learning: life-long learning and my intrinsic curiosity, which led me to the world of books.

    Growing up in the Bronx, New York, reading was not promoted as it should have been within our shared living spaces – and unfortunately, there are missed opportunities, even consequences, for not being able to see beyond your house – beyond your community. There are fantastic adventures that will never happen — that will never even be considered: most of us will never go to Paris in our dreams, because the exposure was not there, nor was an encompassing worldview considered particularly valuable.

    I feel fortunate to start the very first “Read This Book or Suffer the Consequences Series.” I believe it’s important – almost ethereal to be able to dream and soar: to be informed – to be let down only to be raised again –  and do all this from within your bedroom – on a park bench: absolutely anywhere.

    You might be asking, why did I choose The Emperor of all Maladies – A Biography of Cancer, especially if this is a business site. Well – I was moved by it: by the humanness — by the defeat and resurrection within it. I connect the book to our members by illustrating that they too will have to adjust to surprising “blows” and continue on: survive them and thrive within  unsettling adversity — and the book shows that in the course of fighting for your life: it becomes more than your fight — it becomes a freedom.

    At Upstart, we will try to provide recommendations on books, articles commentaries and video, where we hope our members will find such material valuable and empowering. Our first selection: my very own choice.

    The Emperor of all Maladies
    A Biography of Cancer
    Siddhartha Mukherjee


    By the early 1990’s, cancer biologists could begin to model the genesis of cancer in terms of molecular changes in genes. To understand that model, let us begin with a normal cell, say a lung cell that resides in the left lung of a forty-year old fire-safety equipment installer. One morning, in 1968, a minute sliver of asbestos from his equipment wafts through the air and lodges in the vicinity of that cell. His body reacts to the sliver with an inflammation. The cells around the sliver to divide furiously, like a miniscule wound trying to heal, and a small clump of cells derived from the original cell arises at the site….In one cell in that clump an accidental mutation occurs in the ras gene. The mutation creates an activated version of ras. The cell containing the mutant gene is driven to grow more swiftly than its neighbors and creates a clump within the original clump of cells. It is not yet a cancer cell – cancer’s primordial ancestor…A decade passes. The small collection of ras-mutant cells continues to proliferate, unnoticed, in the far periphery of the lung. The man smokes cigarettes, and a carcinogenic chemical in tar reaches the periphery of the lung and collides with clump of ras-mutated cells. A cell in this clump acquires a second mutation in its genes, activating a second oncogene….Another decade passes. Yet another cell in that secondary mass of cells is caught in the path of an errant X-ray and acquires yet another mutation, this time inactivating a tumor suppressor gene. This mutation has little effect since the cell processes a second copy of that gene. But in the next year, another mutation inactivates the second copy of the tumor of suppressor gene, creating a cell that possesses two activated oncogenes and on inactive tumor suppressor gene….Now a fatal match is on; an unraveling begins. The cells, now with four mutations, begin to outgrow their brethren. As the cells grow, they acquire additional mutations and they activate pathways, resulting in cells even further adapted for growth and survival. One mutation in the tumor allows it to incite blood vessels to grow; another mutation within this blood-nourished tumor allows the tumor to survive even in areas of the body with low oxygen…..Mutant cells beget cells beget cells. A gene that increases the mobility of the cells is activated in a cell. This cell, having acquired motility, can migrate through the lung tissue and enter the bloodstream. A descendent of this mobile cancer cell acquires the capacity to survive in the bone This cell having migrated through the blood, reaches the outer edge of the pelvis, where it begins yet another cycle of survival, selection, and colonization. It represents the first metastasis of a tumor that originated in the lung. The man is occasionally short of breath. He feels a tingle of pain in the periphery of his lung. Occasionally, he senses something moving under his rib cage when he walks. Another year passes, and the sensations accelerate. The man visits a physician and a CT scan is performed, revealing a rindlike mass wrapped around a bronchus in the lung. A biopsy reveals lung cancer. A surgeon examines the man and the CT scan of the chest and deems the cancer inoperable. Three weeks after that visit, the man returns to the medical clinic complaining of pain in his ribs and his hips. A bone scan reveals metastasis to the pelvis and ribs…..Intravenous chemotherapy is initiated. The cells in the lung tumor respond. The man soldiers through a punishing regimen of multiple cell killing drugs. But during the treatment, one cell in the tumor acquires yet another mutation that makes it resistant to the drug used to treat the cancer. Seven months after his initial diagnosis, the tumor relapses all over the body – in the lungs, the bones, and the liver. On the morning of October 17, 2004, deeply narcotized on opiates in a hospital bed in Boston and surrounded by his wife and children, the man dies of metastatic lung cancer, a sliver of asbestos still lodged in the periphery of his lung. He is seventy-years old.

    If you have a great book, article or video recommendation and are willing to give us a paragraph or two about why our members should consider it: send it to my email address at the bottom of the page. Always — thank you.

    Good Luck.

    Calvin Wilson
    Founder and CEO
    Upstart: Business and Management for 20-40 Year Old Professionals

    Filed Under: Gamechangers


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    1. Cancer is something that nearly all of us Westerners are familiar with. Its effects are devastating and the impact it has our communities are deep.

      Reading “Emperor of Maladies” can help crystallize some of our latent thoughts and feelings about the disease.

      Our struggle can be our freedom!

      I’m looking forward to watching this series progress!

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