Cancer: The Emperor of All Maladies | Film by Ken Burns

On March 30 through April 1, 2015, PBS aired a three-part documentary film by Ken Burns entitled "Cancer: The Emperor of All Maladies". The film is based on a book by Dr. Siddhartha Mukherjee entitled "The Emperor of All Maladies".

The film is a comprehensive account of the history of cancer, dating back to the late 1800's, tracing the evolution of cancer treatment from early experimental drugs, to surgery, radiation, and chemo-therapy, to current cutting-edge treatments like immunotherapy and oncogene-specific therapy.

Highlights of the first episode, Magic Bullets:

  • In the late 1800's, Dr. William Stewart Halsted performed the first radical mastectomy in the U.S., setting a standard method for the treatment of breast cancer that extended into the 1970's
  • Several years after the development of the "X-ray" in 1896, radiation was introduced as a treatment for cancer
  • In the early 1900's, Dr. Paul Ehrlich hypothesized that specific chemicals might be able to selectively target cancer cells like a "Magic Bullet"
  • In 1947, using an experimental drug called aminopterin, Dr. Sidney Farber conducted clinical trials and had some success in treating children with Leukemia, the results of which are published in The New England Journal of Medicine in an article entitled "Temporary Remissions in Acute Leukemia in Children Produced by Folic Acid Antagonist, 4-Aminopteroyl-Glutamic Acid (Aminopterin)"
  • In the 1940's and 50's, Mary Lasker became a "public force" in an effort to increase public spending for medical research (including cancer), and she along with her husband Albert Lasker gave birth to the American Cancer Society
  • In the 1940's, Mary Lasker joined forces with Dr. Sidney Farber, discovering combinations of drugs that caused leukemia to go into remission
  • The passage of the National Cancer Act of 1971, designed to accelerate the pace of cancer research and provide better cancer treatment

Highlights of the second episode, The Blind Men and the Elephant:

Highlights of the third episode, Finding the Achilles Heel:

  • In the 1980's, research by Dr. Bert Vogelstein comparing the DNA of mutated cancer genes with normal genes, and the discovery that cancer is a multi-step process involving multiple genes
  • The completion of the Human Genome Project in 2003 which maps all human genes
  • The Cancer Genome Atlas (TCGA) project (2005-2008) which identified and cataloged all of the mutated genes in all of the different types of human cancer, followed by the development of many different drugs designed to target specific, mutated genes
  • In the 2000's, the continued use of chemo-therapy using combinations of drugs as a standard treatment for cancer, partly because the cost of using targeted drugs is so high and often only extends life for a short period of time instead of causing remission
  • Cancer prevention, including the campaign to stop smoking which began in 1964, the last smoking ad to appear on television in January of 1971, the 1989 commercial airlines ban on smoking, the HPV vaccine, colonoscopy, mammograms, and PSA testing
  • The work of Dr. Mary-Claire King, who discovered a link between two different genes, BRC1 (breast cancer 1, early onset) and BRC2 (breast cancer 2, early onset), which when mutated result in a higher risk of breast and ovarian cancer
  • The work of Dr. Steven A. Rosenberg and Immunotherapy where the idea is to make human immmune cells (T cells) recognize and kill cancer cells
  • The work of Dr. James P. Allison and his discovery of how human T cells are activated so they will find and kill cancer cells, which ultimately led to the creation of the drug Yervoy
  • The work of Dr. Carl H. June and Adoptive T cell therapy where genetically-modified T cells are transfused into cancer patients
  • The promising results of Emily Whitehead, a young girl who was diagnosed with Acute Lymphocytic Leukemia and treated using Adoptive T cell therapy

The American Cancer Society website has good information about the evolution of cancer treatments:

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