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janey's review against another edition
3.0
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 [b:The Emperor of All Maladies: A Biography of Cancer|7170627|The Emperor of All Maladies A Biography of Cancer|Siddhartha Mukherjee|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1280771091l/7170627._SY75_.jpg|7580942]. 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 [b:Bad Blood: Secrets and Lies in a Silicon Valley Startup|37976541|Bad Blood Secrets and Lies in a Silicon Valley Startup|John Carreyrou|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1556268702l/37976541._SX50_.jpg|59699437]). 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.
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 [b:The Emperor of All Maladies: A Biography of Cancer|7170627|The Emperor of All Maladies A Biography of Cancer|Siddhartha Mukherjee|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1280771091l/7170627._SY75_.jpg|7580942]. 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 [b:Bad Blood: Secrets and Lies in a Silicon Valley Startup|37976541|Bad Blood Secrets and Lies in a Silicon Valley Startup|John Carreyrou|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1556268702l/37976541._SX50_.jpg|59699437]). 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.
moorlady's review against another edition
emotional
informative
inspiring
reflective
sad
medium-paced
4.5
adriannagraz's review against another edition
3.0
Pros - She is an incredibly intelligent oncologist and is passionate and empathetic in her work. I respect her for putting patients first and admire that she leads with intellect while remaining emotional and caring, especially in a field like oncology. As a researcher, it’s important to acknowledge the limitations of our in vitro and in vivo models so I really valued her perspective. Someone should be championing a paradigm shift in the field, and I’m thankful to have read this book to shift my own thinking.
Cons - I can’t imagine her writing being accessible to patients and their families, aside from the well connected and educated favorites she mentions in her book. Her writing is also lofty and comes across as pompous at times. Raza’s main message is that we should be putting more resources into preventative testing and early detection, so it was disappointing that she didn’t initiate a conversation surrounding inaccessibility to this type of healthcare.
Cons - I can’t imagine her writing being accessible to patients and their families, aside from the well connected and educated favorites she mentions in her book. Her writing is also lofty and comes across as pompous at times. Raza’s main message is that we should be putting more resources into preventative testing and early detection, so it was disappointing that she didn’t initiate a conversation surrounding inaccessibility to this type of healthcare.
kwheeles's review against another edition
3.0
Interesting review of the disappointing progress in oncology. Large research expenditures resulting in costly drugs with (mostly) marginal improvements in life expectancy. Argues for moving the point of engagement earlier (as early as detection is possible - ideally, 'the first cell') - that once cancer moves beyond its simple origin it evolves and becomes too complex to be eliminated (to the last cell). (Does not take the engagement back to lifestyle changes - clearly the most promising and cost-effective line of attack, in my opinion - but the author writes from the point of view of an oncologist addressing the disease once it starts). Makes a compelling case that the reductionist animal-based trials currently central to research have limited clinical applicability and value.
harinid's review against another edition
5.0
The First Cell by Azra Raza is a book that is in equal parts harrowing, stimulating and informative. Dr. Raza in establishing her hypothesis that the more effective way to spend R&D dollars in cancer therapy is on having a disproportionate amount of resources allocated to early detection (detection of the first cell) vs. spending billions on drugs that work on specific indications/ manifestations of the disease, draws on the pragmatic problems faced by the cancer patients and families as well as emotional. In highlighting that majority of cancer therapies available take a slash (surgery), poison (chemotherapy) or burn (radiation) approach, she brings out almost a medieval mindset that still persists in oncology.
This book was not a bland/ drag read on a very technical subject. The book, in drawing inspiration from poetry (English and Urdu alike), personal stories of patients and from other fields of study, makes the conversation on cancer far more accessible to all. Highly recommend this book- if for nothing else, just to rethink how we approach any class of therapy for any disease really; and of course for the interspersed poetry in the book, directly and indirectly through the author's own command over language.
This book was not a bland/ drag read on a very technical subject. The book, in drawing inspiration from poetry (English and Urdu alike), personal stories of patients and from other fields of study, makes the conversation on cancer far more accessible to all. Highly recommend this book- if for nothing else, just to rethink how we approach any class of therapy for any disease really; and of course for the interspersed poetry in the book, directly and indirectly through the author's own command over language.
cobyrowley's review against another edition
challenging
emotional
hopeful
informative
inspiring
reflective
tense
fast-paced
4.5
Dr. Raza explores many patients' stories, including the perspective of family members. This storytelling and addition of multiple points of view from close friends and family make each person's story tragic and heartbreaking in their own right. The heartbreak and grief of these patients and their respective families underscores the importance of the much-needed paradigm shift she has been endorsing for decades: the study of cancer-specific screenings to detect and possibly locate aggressive cancers in their infancy. She speaks out against in vivo and in vitro studies that pursue cancer medications and explains the passenger mutations of clonal cells to the reader at a simple level; at the same time, Raza's literacy and descriptiveness challenged me to attempt to understand these concepts intricately yet at a surface level. This is a great book and a blaring wake-up call to the current state of cancer medicine research.