On Wednesday evening, Pulitzer Prize-winning author, physician and assistant medical professor Siddhartha Mukherjee ’93 delivered the 2018 Presidential Lecture in the Humanities and Arts, discussing cancer through both cultural and scientific perspectives. The lecture was titled “Notes from the Edge of an Experiment (or Cancer’s Anxieties).” In his talk, Mukherjee detailed the cultural history of cancer as well as modern medicine’s approach to treatment.
The annual event, funded by the President’s office and sponsored by the Stanford Humanities Center and the Cantor Arts Center, aims to bring distinguished scholars, artists and critics to speak on campus.
Caroline Winterer, director of the Stanford Humanities Center, opened the event and introduced University President Marc Tessier-Lavigne. Tessier-Lavigne then introduced Mukherjee, not only highlighting his accomplishments as a “renaissance man”but also describing him as a “close personal friend.”
“[Mukherjee is] a master storyteller who makes scientific cancer exploration come alive for millions of readers around the world,” Tessier-Lavigne said, referencing Mukherjee’s best-selling novel “The Emperor of All Maladies: a Biography of Cancer.”
Mukherjee’s lecture focused on the dynamic nature of cancer, outlining its origins through both science and cultural history. He described how cancer has been approached in various ways since antiquity, from more traditional approaches to the modern computational, machine learning approach.
According to Mukherjee, the etymology of the word “cancer” can be traced back to the ancient Greek word “karkinos,” meaning “crab.” In ancient Greece, cancer was thought of as an unnatural resident in the body, like a crab living under the sand. For a long time, theories around cancer for a long time revolved around that idea that the disease was caused by a foreign body and treatment focused on removing tissue to eradicate it.
It wasn’t until the 1970s that the locus of the disease shifted from being thought of as something foreign to something “stemming from within us.” Mukherjee talked about the cultural and “mystic” implications of that idea. “We have met the enemy and he is us,” his slides read.
According to Mukherjee, modern medicine has increasingly shifted the cancer discussion in the direction of prevention rather than treatment. To describe this new focus, Mukherjee used the “Orwellian” term “previvor,” which refers to “a survivor who has not yet developed a disease that he may develop in the future.”
“We think of people as patients before they [are] patients,” he said. “My talk as a humanist is to address what happens when the focus shifts from survivors to previvors and from exterior to interior.”
Mukherjee further addressed modern medical technologies’ impact on cancer. He cited the use of genome sequencing, which allows researchers to personalize patients’ cancer treatment through targeted therapy.
He also highlighted the growing role of machine learning in identifying cancerous cells. Mukherjee showed pictures of a melanoma that, an algorithm correctly identified the tumors as malignant when he, as a trained oncologist, would have classified them incorrectly as benign.
Mukherjee stressed that these methods rely on data and require the constant “surveillance” of people’s bodies. He ended his lecture by calling cancer a “totalitarian institution,” and raised concerns about the cultural risk of inducing constant anxiety by having people’s bodies incessantly screened for diseases.
“How does being a previvor change how we imagine ourselves?” he asked the audience.
Audience member Karthik Sivaram M.A. ’17 related the lecture to Mukherjee‘s book “The Gene: An intimate history.”
“[Mukherjee] comes from a family with significant genetic schizophrenia, and in his book he talks about how that was his motivation [for writing],” Sivaram said. “He never got his genome sequenced because he said he would rather live in a world where he doesn’t know [if he has the disease].”