P53: THE GENE THAT CRACKED THE CANCER CODE
Sue Armstrong
Bloomsbury Sigma
287 pages (paperback); Rs 399
In Illness as Metaphor, Susan Sontag writes: "In popular imagination, cancer equals death." Written and published in 1978, while Sontag was undergoing treatment for breast cancer, the book challenges the metaphorical language associated with the disease that tends to mythologise it rather than take a hard, clinical look at it.
Cancer - the malignant growth of rogue cells - has existed in living creatures since Jurassic times: palaeontologists have discovered tumours in the bones of dinosaurs. It has been known to humans at least since the Greeks. In the Pulitzer Prize-winning The Emperor of All Maladies, oncologist Siddhartha Mukherjee writes that the Greek historian Herodotus was the first person to record the disease in 440 BCE. When almost all diseases were mysterious and fatal, cancer was just another thief of life. But as the progress of medical sciences since the Industrial Revolution demystified maladies and found cures for almost all of them, cancer continued to be incurable, "terminal", making it synonymous with death, inspiring sentimental fantasies like Erich Segal's Love Story or ideological narratives such as Alexandr Solzhenitsyn's Cancer Ward, where the disease represents the perverse mutation of Marxism through Stalinism.
A year after Sontag's book was published, teams of scientists working independently at labs in New York, New Jersey, London and Paris discovered p53, a gene that can prevent cancer. Since then, research and the quest for cures has moved ahead in leaps and bounds, making p53, unsurprisingly, the most studied single gene in history. Science and health journalist Sue Armstrong tracks the research in her book P53: The Gene that Cracked the Cancer Code.
Ms Armstrong begins her book by reversing a popular conception about the disease: while most of us seem to be asking why so many people - according to one set of statistics, one in every three - are suffering from it, scientists are asking: "Why so few?" Every time a cell divides, there is a possibility of genetic error and it takes just one cell to mutate improperly and cause endless replication. Considering that millions of cells are constantly dividing themselves in our body, the development of cancer is rare, prompting scientists to believe that a strong defence mechanism is at work. There are many causes for cancer and the malignancy can occur in many parts of the body but the single unifying factor for the disease is p53: for cancer to develop, this gene has to malfunction or its activity has to be suppressed.
Since its discovery, p53 has generated 70,000 research papers but much of this exciting frontier of science has been inaccessible to the layperson, and has remained confined to the pages of academic journals, written in, to quote Ms Armstrong, "dry as dust" language, filled with discouraging scientific terms. Not only does this book make the progress accessible in an engaging language but also reveals the process of scientific discovery, with all the frustration of failure, the dogged perseverance of the researchers, the scepticism of the scientific community and the excitement of discovery.
Ms Armstrong is no stranger to such a narrative. She reported from the front lines of the war against AIDS in Africa, Asia and the Caribbean for the New Scientist magazine, World Health Organization and UNAIDS for many years. (Sontag, too, wrote a book on AIDS: AIDS and Its Metaphors, 1989, revealing the social attitudes to fatal diseases). In her book, Ms Armstrong brings to life the researchers cloistered in their laboratories, poring over the microscope, painstakingly following every tantalising clue, and combating the prejudices and politics of scientific community, in search of irrefutable proof. From Peyton Rous, who found that viruses caused tumours in 1911, only to be greeted with scepticism till his discovery was recognised by a Nobel Prize for Medicine more than 50 years later, to David Lane, one of the scientists credited with the discovery of p53, who was told by a colleague that "he would one day be ashamed of the claims he had made for p53's significance". She also throws light on wrong roads that scientific research can sometimes take. For instance, till 1989, p53 was supposed to cause cancer, till it was revealed to be the suppressor of tumours.
The reading can get a little heavy with all the details of the cycles of scientific research, the constant going forward and backward. Ms Armstrong's book is likely to inspire hope in the readers of a "cure of cancer" being developed, but it might also cause frustration with the enormous amount of time taken to make minute progress.
In any case, a reader of this book is likely to emerge with a clear understanding - away from the mythologising metaphors - of the disease. One suspects Sontag would have approved; we definitely do.
