The Cancer Chronicles

Before a full year has passed, I am finally filing a progress report. I have completed the manuscript for The Cancer Chronicles. At this point I am revising and refining — sending the manuscript to friends, colleagues, and scientists. I’ve described this before as feeling like there are two readers perched on my shoulders — the layman who, like me, longs for clarity and simplification, who is moved by the right metaphor — and the scientist, who is pushing and pushing for more precision. Steering a course between these ideals is the hardest part of this kind of writing.

I had intended to post here more frequently while working on the book. But I never resolved the dilemma of how much to reveal of the surprising things I have been learning about cancer and how much to save for the book. What makes sense to me now is to hold off on writing much about the content until publication date approaches next spring or summer.

Meanwhile I’ll post more often about the process of writing the book — some of the problems I’m struggling with in this final stage. How much, for example, should I include about the so-called cancer stem cell hypothesis? As cancer cells evolve and compete inside a tumor, any one of them is capable of acquiring the characteristics — what Hanahan and Weinberg called “the hallmarks” — of cancer: the ability to break through an intricate web of checks and balances and grow indefinitely. That is the dominant view. Cancer stem cell theory holds, to the contrary, that only a few of the tumor cells — the cancer stem cells — have this proliferative power. That they are the ones that should be aimed at with chemo.

A prominent scientist who recently read a chapter where I mention cancer stem cells cautions that I should not give the idea too much prominence — that it is rapidly losing ground. Others however continue to support the theory.

As I ponder this (and do more research), I’ll mention one of my other projects. A story — three years in the making! — on the science of lightning appears in this month’s National Geographic Magazine: http://ngm.nationalgeographic.com/2012/08/chasing-lightning/johnson-text.