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Microscipic view of pancreatic cancer cells.
Microscipic view of pancreatic cancer cells. Photograph: Stocktrek Images, Inc. / Alamy S/Alamy Stock Photo
Microscipic view of pancreatic cancer cells. Photograph: Stocktrek Images, Inc. / Alamy S/Alamy Stock Photo

Top 10 books about cancer

This article is more than 8 years old

Treatment of this cruel disease has advanced hugely in recent years, but writers from Philip Roth to Christopher Hitchens show the awful human cost it still exacts

My relationship to cancer is professional but also personal, such that the terms used to characterise it – doctor, oncologist, investigator – can be added to, unhappily, by the words nephew, grandson, friend and son. Being a doctor is no protection of course, and can even, I’ve found, be spectacularly unhelpful. Nothing drains objectivity more than a family member’s name in the top left hand corner of the CT scan you search for confirmation, or for the signs of spread and damage. For years, I could also add the term “writer”, but only in secret, working at it in the morning before going to work, the way some people do their yoga or run.

With the publication of my novel This Living and Immortal Thing, this secret is less zealously held and even to be publicised. Perhaps it will not matter. Perhaps I’ll be fired when it’s found out.

But before there is a writer there’s a reader. These are some of the books I’ve read where cancer has figured, either as the dominating theme or in a walk-on role that you won’t forget. The list is personal, not exhaustive. Some of them I read as an oncologist, some as an interested bystander, and some with the pathos and pain of that nephew, grandson, friend and son.

By the way, I’ve left out the most prominent recent book, The Emperor of All Maladies by Siddhartha Mukherjee. This is not because I didn’t like it, but because I haven’t read it. (Apparently it’s very good.)

1. The Immortal Tale of Henrietta Lacks by Rebecca Skloot
I was halfway through my novel when I discovered – to my horror – that this book was coming out. Lacks is an important woman in cancer history and features in my book, albeit figuratively. She died of an aggressive cervical cancer in the 1950s, which was then maintained after her death as an immortalised cell line. I calmed down when I found out that Skloot’s book was biographical and, I like to think, a non-fictional counterpart to my own.

2. Sabbath’s Theater by Philip Roth
One of the books where the illness is confined to a devastating side role. Although you could say the themes of Roth’s book – bodily cravings, pushed to their limit – are part of the same spectrum, the other end of it maybe. I had just moved to New York to begin a hospital fellowship when I read the part where Drenka, Mickey Sabbath’s lover, lies in the final stages of ovarian cancer. I remember well the terrible stillness in which I sat for minutes, the book closed in front of me, stunned by Roth’s highly specific language, the best depiction of a cancer patient I have ever read, before getting up and crossing First Avenue to go to clinic.

3. Memoir by John McGahern
My favourite of all McGahern’s books, the narrator’s tone that of a small boy who will go through his entire life never quite getting over the early death from breast cancer of his adored mother. I got to know John a bit during his final illness while still working in Dublin. (I always tried to turn the conversation towards literature; he kept turning it back to his treatment.) Near the end of things he gave me a copy of this book bearing an inscription in handwriting I was too embarrassed to admit I couldn’t make out. (He had been a schoolteacher after all.) It was only when I eventually came to the end of the book, and after John’s passing, that I recognised his words as those of the last section in the book, among the most beautiful I have ever read: “I would want no shadow to fall on her joy or her deep trust in God. She would face no false reproaches. As we retraced our steps, I would pick for her the wild orchid and the windflower.”

4. Cancer Ward by Aleksandr Solzhenitsyn
Perhaps the most famous work of fiction dealing directly with the disease. Definitely one of the books I read with my oncologist’s hat on. What struck me most was how dated and limited the treatments were. You either got radium or an “injection”. This was the 1950s. I believe the book was intended mainly as a commentary on the failures of communism as a reality, and its datedness now probably attests even further to this. From a science point of view it also attests to how far we’ve come in such a short time. It is a book from the beginning of an era, a primitive origins story.

5. The Newton Letter by John Banville
Cancer as insidious player, shaper of behaviour, the quiet ongoing tragedy that you live with, hidden. (It is not the dreaded end I admire patients for bearing up to, but the everyday, the school runs and meals and holidays that must still go on, the breathing in and out, the paying the bills.) You can never know what other people are going through.

6. A Scattering by Christopher Reid
The poet eulogises, remembers, draws out of the mundane episodes of vivid intensities, and generally introduces us to his late wife who died of sarcoma. The humour is always there, pointing at the devastation. One of the most moving books I have ever read.

Moving ‘from the country of the well across the stark frontier’ ... Christopher Hitchens, soon after his cancer diagnosis, at home in Washington, DC. Photograph: Brooks Kraft/Corbis

7. Birds of America by Lorrie Moore
Specifically the penultimate and most harrowing story in the collection – People Like That Are the Only People Here – where the narrator, a famous writer, finds herself in a pediatric oncology ward (“peed onk”), after her son develops a Wilm’s tumour. Two things stick in the memory: the image of how the tumour presented itself in the infant’s bloody stool (“startling against the white diaper, like a tiny mouse heart packed in snow”) and the terrifying and then awful moment where a doctor pulls her aside to speak in private, only for him to ask for her autograph.

8. The Biology of Cancer by Robert Weinberg
A textbook, but pretty accessible as these things go. If you want to know the whys and hows of it, this would be worth a slow study.

9. It’s Not About the Bike by Lance Armstrong
I was gutted when I found out that the No 7 yellow jerseys were worthless. But his cancer battle was real. (He had brain metatasis, for Christ’s sake.) And many good things came out of his foundation. They still do. I confess that I found myself skipping the oncology bits to his material on cycling.

10. Mortality by Christopher Hitchens
A gathering of his Vanity Fair articles dealing with his sudden diagnosis of oesophageal cancer, which he experienced as a “gentle and firm deportation … from the country of the well across the stark frontier”. Brilliant and wry, obviously, but you can sense his fear and confusion, the furious struggle of the alert and combative mind to understand its new surroundings. I read this one as an oncologist, but also as a researcher. Hitchens was a defender of science and innovation. But I can’t help feeling we let him down. His descriptions of the limitations and toxicities of the standard therapies he received, as well as the transient hope of the experimental ones that didn’t work for him, remind us that while it is absolutely beyond question that we have come a long way from Solzhenitsyn’s comrade Rusanov getting his radium and his injections, nobody is or should be satisfied with the pace of things.

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