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The PBS Documentary, “Cancer: The Emperor of All Maladies” – My Review

Recently dear hubby and I sat down to watch the PBS documentary – Ken Burns Presents, Cancer:  The Emperor of All Maladies, a film by Barak Goodman, based on the 2010 Pulitzer-Prize winning book, The Emperor of All Maladies:  A Biography of Cancer, by Siddhartha Mukherjee. I read the book a couple of years ago and thought it was very good, though I did have to take many breaks and read and re-read sections at times. It took me a really long time to get through it. I’ve become a very slow reader and yes, I do attribute this in part to my cancer treatment.

I had been looking forward to watching this PBS documentary ever since I heard about it. I am one of those people who does watch TV shows and movies about cancer. I read all I can about cancer too. However, I totally understand why some opt out of watching or reading about cancer anything.

It turns out, I was traveling while it aired therefore my viewing was after the fact; hence, this review is as well.

If I were to summarize this documentary in a sentence or two, it would be that it’s a conglomerate of stories. It is the combined stories of cancer researchers, physicians, politicians, advocates, patients, philanthropists and of course, cancer itself.

Finding answers to cancer requires us to closely look at, listen to and analyze all the various cancer angle stories. They all matter. They always do.

Episode One

Episode one of the documentary, “Magic Bullets,” was mesmerizing. While watching the condensed cancer history lesson, which focused heavily on the work of Dr. Sidney Farber, I couldn’t help but think about all the researchers who have worked so incredibly hard to make painstakingly slow progress, and of course how patients have suffered through brutal cancer treatments. It was fascinating to realize that cancer has been around as long as mankind and how in the beginning there was no treatment at all. No treatment at all.

Can you imagine?

Episode one began by calling cancer a world-wide scourge; a disease also referred to as The King of Terrors, A Hidden Assassin and most recently, The Emperor of All Maladies.

The shunning of cancer patients, which went on for years largely due to that fear and an incomplete understanding of cancer, was well depicted in this episode.

Sadly, even today shunning still happens in parts of the world. Cancer and shame do still go together, even in our modern society and yes, I would venture to say, even in the US to some degree.

Episode one was an emotional segment to watch because of the intense focus on children enduring childhood leukemia and unimaginable harsh treatments on their fragile bodies. Some of the early experimental leukemia treatments must have been an absolute nightmare for parents to witness.

Episode one also focused on the philanthropy work of Mary Lasker. It takes a lot of effort, a lot of money and a lot of different people working in different capacities to bring about even slow progress. This is an important reminder to us all, or at least it was to me, to do what we can, no matter how small or insignificant what we do seems.

Episode two

Episode two was titled, “The Blind Men & the Elephant,” and was the hardest part for me to watch because much of it focused on breast cancer. It opened with the story of Nixon’s War on Cancer.

Watching the segment about the once predominantly accepted and over-utilized treatment for breast cancer, the Halsted radical mastectomy, was chilling. Learning more about the controversy surrounding how the lumpectomy evolved as an accepted alternative treatment was eye-opening and again, made me grateful for the perseverance of Dr. Bernard Fisher and others who dared to question the status quo and activists such as Rose Kushner as well.

Dr. Susan Love’s comments about a woman with breast cancer going into surgery not knowing whether or not she would come out with her breast(s) or not were stunning. It’s hard to even imagine such a thing.

It is heart breaking to think about the mutilation women have endured and granted, though to a lesser extent, still do.

Episode two also focused on the rise of three different theories about what causes carcinogenesis, or abnormal cell growth – viruses, chemicals in the environment and gene mutations. There was lots of debate at the time, but not much cohesiveness or working together it seems. It turns out, all theories play a role.

Episode Three

Episode three, “Finding the Achilles Heel,” was another information-packed two hours. This episode highlighted (among other things) the Human Genome Project and the subsequent development of the Cancer Genome Atlas as turning points for cancer researchers.

We now know a whole lot more about cancer, but at the same time, the more we know the more complex and the more elusive cancer seems to become.

As dear hubby remarked to me while we were watching, “It’s almost like cancer is an alien being inside the human body that we keep trying to kill, but it keeps mutating. It keeps outsmarting us, always staying one step ahead.”

Episode three ended with an optimistic focus on cancer immunotherapy. Did it end too optimistically? Perhaps.

However, it’s pretty tough to not end such a production on a note of optimism. We all want to believe that researchers will never give up. We all want to believe we can catch up to the monster that is cancer. We all want to believe that one day we will slay the beast.

It’s daunting even attempting to write a review on a comprehensive six-hour documentary of this magnitude. I attempted to highlight a few parts that stood out for me, but I know fully well I didn’t do it justice. It’s not really even possible in a relatively brief blog post such as this.

Watching this documentary as a person who has personally faced cancer humbled me. For many reasons, watching was an emotionally draining experience for me and I know it was for dear hubby too. His body language when we watch this kind of thing is always quite telling.

Ultimately, what I felt and continue to feel after watching this documentary is a deep sense of gratitude.

I feel a deep sense of gratitude to physicians, researchers, and patients who have worked so hard and endured so much. Their efforts and tenacity have made my cancer experience easier. Not easy, but easier.

I am grateful that others have cared and still care. I am grateful patients before me have shared their stories, tried new therapies and paved the way for those like me. Mostly, I am grateful that so many others have not and do not give up.

This film exemplifies perfectly that as always, answers will only come through research. We need to step up our cancer research efforts, not make cuts.

Was this film perfect?

Of course not. I was disappointed it did not tackle the complexities of survivorship adequately, other than this stunningly accurate quote from Barbara Bradfield:

Cancer’s a funny thing because once you have it – it sits like a little monkey on your shoulder – it never goes away. It’s been 20 years and it’s still part of my psyche and it changes who you are. There’s a little element of fear that never goes away. 

This might be my favorite quote in the entire documentary because it’s true. So very true.

I also felt the nurses’ stories were left out.

Overall, I felt this documentary was well done, perhaps mainly because it didn’t sugar-coat cancer.

What it certainly did accomplish was to generate lots of interest, many discussions and countless reviews far superior to this one. All good things.

If you haven’t watched it yet, I recommend that you do. If you are up to it of course. You can watch any or all of the episodes right here or click on the image below.

It seems fitting to end my review the same way the documentary ended, with a quote by Siddhartha Mukherjee:

The cancer cell is evolving, and we are evolving with it.

Let’s hope we can evolve faster.

Did you watch this documentary and if so, what did you think of it and was it hard for you to watch?

If you watched and read the book as well, which did you prefer?

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Image via pbs.org

 

 

28 thoughts on “The PBS Documentary, “Cancer: The Emperor of All Maladies” – My Review

  1. Nancy, I have not watched the documentary yet. I haven’t been able to find the time recently but will do so soon. I am disappointed, but not surprised, to hear that survivorship needs and concerns, and nurses’ stories were not included. I believe those are as important as anything else, because it is about how people live their lives after undergoing all these treatments that are supposedly life-saving, but can have a range of effects on quality of life. The human experience of cancer is worthy of at least a similar length documentary. I look forward to watching it and will comment further then. Thanks for sharing your thoughts and perspective.

    1. Alene, In all fairness, the documentary couldn’t possibly cover all the angles, but merely a statement or two about the difficulties of survivorship would have made an important point. Plus, hearing a story from a nurse or two, would have been more inclusive. After all, the nurses are in the trenches with the patients. I hope you do watch it at some point. It’s not perfect, but is very well done. I highly recommend it. Thank you for sharing. I look forward to your additional comments if and when you do watch it.

  2. Well done, Nancy! I finished watching the series this week. The parts I found hardest to watch were the children with leukemia and the man considering stopping treatment. You’re right that we should feel profoundly grateful to the medical professionals, including the nurses, who have laboured to find effective treatments or cures for cancer, and those who have treated us with great attention and kindness through our illness.

    1. Kate, I have been wondering if you finished watching it, so it’s good to know you made it through all three episodes. Yes, those two parts you mentioned were tough to watch. I found it emotionally draining to watch period. But I thought it was very good. Thank you for reading and commenting too.

  3. I dvr’d it and watched it every night until I fell asleep (my regular nightly routine) so it took me a couple weeks to get through it. I bought the book a few months ago but since my free time is limited to weekends when I have chores and errands to accomplish, I have not been able to crack the first chapter yet. But I intend to, particularly since I found the documentary to be excellent. I had a similar reaction to the 2nd episode and was horrified to see what women went through with the radical mastectomies and the awful surprise so many women woke up to. It will be interesting to rewatch it maybe 10 years in the future (assuming I’m around, knock wood) and compare where we are then. Driving home tonight while listening to NPR, I heard of a new technique that enables doctors to test chemo drugs on the patient’s own cancer cells to determine which chemo drugs will be most effective. Now that is definitely progress. And I am waiting for the day when scientists can target cancer cells with the chemo drugs and leave the healthy cells alone. Ditto for Aromatase inhibitors, by the way – I hate that freaking drug and what it does to me.
    Thanks for the great post/blog – as always. Best to you and all readers.

    1. Kathy, Sounds like your nightly routine is similar to mine! Yes, the second episode highlighting the Halsted radical mastectomy (among other things) was horrifying indeed. That NPR show you listened to sounds intriguing. It would be really nice to have more targeted therapies available which would leave the healthy cells alone. And yes, the AIs… with you all the way there. Hope you make your way through the book. If you’re anything like me, it might take a while. Thank you for reading and for the kind words. Best to you as well.

  4. The programme isn’t available here but if/when it is I will be watching. Much of my life has been spent in an unintended yet intimate relationship with cancer, firstly witnessing my Aunt’s treatment in the ’80s and Mother’s in the 90’s. Both were brutal, both women gave their all, both lost their lives. There was stigma and shame, people turning their backs on us, except the medical staff who also gave their all. I will never forget that.
    More recently I underwent the same chemo regime as Mom (scared the bejesus out of me), benefitted from Herceptin (still a new drug in cancer terms) and participate in two research programmes because it is the right thing to do. My experience with other people is, sadly, not so different to my Mom or Aunt’s. Some tried to erase my existence… chemo patients spoil the image of certain places. But my medical team are as wonderful as those who cared for my family members. Dealing with fear, confusion, pain and death on a daily basis is very hard yet they never give in. I am hugely grateful and have enormous compassion for them because in choosing to help improve, sustain or ease the passing of others lives they have chosen to embrace the harsh reality of cancer every day. That is no small feat. Research really matters because cancer is emperor of all maladies. It’s complexity is well beyond our thinking, well beyond degree or even Masters level science and to stop it we need all the researchers, patients, patience and determination we can muster.
    Thank you for a great post on a programme everyone needs to see, even if it hurts.

    1. Tracy, The program is available online, so you should be able to view it via the links I shared in the post. I’m sorry your family has been impacted so much by cancer. As you may know, my mother died from mbc too. Stigma and shame still very real today, but thankfully not to the degree they once were. I am hugely grateful to all who choose to work in the field of oncology too, no small feat for sure to face cancer’s reality day in and day out. And yes, the answers and improvements will only come through research. Thank you for reading and sharing. I hope you are able to watch the documentary at some point.

  5. Hi Nancy,

    Thank you for your comprehensive discussion of all three episodes. As you know, I was unable to watch it for psychological reasons, but I was hoping you’d write on it, as I still have been curious about what each episode focused on. I’m bummed that it didn’t cover much on survivorship issues. I think these will have to be addressed better in our society. Even today, people expect one to be “over” the cancer. After all, if one is lucky enough to be NED, why think about the cancer that happened in the past? The problem is that, for many of us, it’s not over. Collateral damage of the physical kind is a major problem, and psychological problems like mine resulting from treatment are not going away. Like so many “survivors” (whatever that means), I’ve paid a heavy price.

    Wouldn’t it be great if there were a fourth part of the series that covered survivorship?

    Thank you, Nancy, for a great post!

    1. Beth, I felt survivorship issues were neglected, but it’s next to impossible to cover everything, even in a six-hour documentary like this one. As Alene eluded to in her remarks, that topic could be a whole separate six-hour documentary, or as you suggested, a fourth part. Thank you for reading my review. I totally understand why you chose not to watch.

  6. I liked the documentary. It was incredibly hard to watch, but it also focused on a woman that had metastatic breast cancer who was “cured” – this adds to the fact that we have to consistently explain that stage IV does not have a cure (media hangs on to the few rare cases because they are amazing, they give us hope!). I am hoping it helps convince people to spend the money on research, that more research is needed, that it is helpful – and that we don’t have a solution yet.

    1. Mandi, I liked it too and also agree that parts of it were incredibly hard to watch. I imagine it was even harder watching it from your vantage point, as a woman with metastatic disease. I thought the message about the need for more research was pretty well delivered. I just hope the message is well received and acted upon as well over time. Thank you for reading and sharing.

  7. I was pleasantly surprised by the film. Of course there are always little things I could quibble about but overall it was good. I hope the takeaway most people have is the complexity of cancer, that it cannot be simplified to slogans (like early detection is not a guarantee people think it is). I want to go back and re-read/listen to the book. I read/listened to it while still in radiation and while I remember most things–some stuff is fuzzy (thanks, cumulative effects of treatment!).

    1. CC, I went in expecting it to be well done and overall, I wasn’t disappointed. Was it perfect? Of course not, but it covered a lot of ground and covered a lot of issues worth addressing. I’d like to re-read the book, too, at some point. Thank you for your comments.

  8. Nancy,

    Well done review! I, too, watched most of the series but unlike you and out of respect for my husband, I watched it alone. My family has been saturated with cancer because I have two-times being diagnosed. If they ask, I engage. Otherwise, I now closely follow the development of treatments and outcomes of research because that is my choice. I engage with others like you to find my information.

    I must share a special story with you. There was a pre-screening of the documentary a week before the showing at a local community center in my town. I went. While I was there and much to my surprise they announced that Dr. Mukherjee, the author of this Pulitzer Prize winning book, was going to be in our town the following week. Another one of our fellow bloggers, Claudia Schmidt, http://myleftbreast.net/, also wrote a review of the book. Someone commented on her blog that they were going to get the book for their oncologist. I thought, what a wonderful idea and planned on purchasing the book for my plastic surgeon. I was going to be traveling for phase 2 of my breast reconstruction the day after Dr. Mukherjee was in town. Now I was really excited because I not only could buy the book for my plastic surgeon but also get a signed copy. The evening I went to see Dr. Mukherjee was inspiring. He gave a wonderful presentation and his intelligence and grace in speaking about the topic was memorable. And yes, I did get that signed copy with a personalized note to my reconstruction surgeon who I was going to see for my pre-op just two days following the book signing.

    Here’s what happened the day I gave it to him. With a tearful thank you to him for all he had done for me, I looked at him and told him I had something for him. I handed him the book and he said, “Oh my gosh! I don’t have this.” I told him, “Open the front.” As he looked inside to view the personalized signature he became suddenly quiet. He sat there for a moment and then looked up at me, held out his arm to show me and said, “My God, you’ve given me goosebumps.”

    I will never forget that day. Forever memories are made of small moments. That was surely one for me.

    1. Terri, What an incredible and moving story you shared and how generous of you to give your oncologist that signed copy of the book. I am very impressed every time I hear Dr. Mukherjee (only on TV for me). He sounds so warm, caring and knowledgeable. All such important qualities for any oncologist. Thank you for sharing that story. I’m glad you liked my review.

      1. Nancy,

        Warm, caring and knowledgeable is exactly how he presented himself. I posted my link above with my own response to my experience. We are fortunate to have these brilliant minds in cancer research. Again, thank you for your valued review.

  9. Thank you for featuring this show. I didn’t see it but appreciate and respect your viewpoint. I think it would be too hard for me to watch at this stage of my cancer. xxx

  10. Nancy, I finally did watch the entire documentary over the past two days. It was well-done, and did a good job of talking about the historical context and the struggles with statistics, costs, and emotions. It was done largely from a technical and research perspective, from the medical community’s standpoint. Nothing wrong with that. They did address the human impact stories to a degree, but mostly with pediatric cases. Just a few adults. What the documentary missed entirely was the in depth look at what goes on in people’s bodies, psyches, and lives after they brush with cancer. That in itself would require an equally long series of documentaries to explain all of the impacts cancer has on peoples’ lives that are never seen, rarely acknowledged or addressed in a complete way. Social workers and nurses stories would be an important part of that but the most important part would be the stories of people experiencing the impacts themselves from their own cancer experiences.

    The theme I always see, and have yet to see addressed by the medical community, is the acknowledgement that hike we have been hard at work with prevention, diagnosing, and treating, the resulting effects (some, such as Dr. susan Love refer to this as collateral damage) are things that cannot be fully addressed by the medical community given the constraints of our health care system and the training doctors receive. There is nothing wrong with the doctors inability to do that themselves, yet the majority of doctors still neglect to participate in a process that allows for continuity of care for the person after the medical treatment is completed. What doctors need to do is acknowledge their own limitations in the post-treatment phase and make an effort to inform themselves about resources for their patients. Right now those are often done in the form of “survivorship care plans” which are inadequate to address the real needs of the human beings who must return to their lives and pick up somewhere.
    That gap in care is what I am working hard to address in my own efforts to move beyond the lip service and cookie cutter approach of these survivorship care plans and actually work with individual people to help them build skills and knowledge so they can feel better about their lives going forward, gain confidence in their ability to focus forward and take action on their real needs while advocating for themselves more effectively.
    I respect and admire what many have done in medicine and research and we need that to continue, but we also need to deal with the human experience of cancer. When we only look at things from the doctors perspectives, we lose a critically important viewpoint, the patients’ and that ultimately is what should be guiding all of our work. It’s about PEOPLE’S LIVES.
    Thanks for allowing me to spout my opinion here…

    1. Alene,

      Spout all you want! I follow you on Twitter and want to thank you for your work and this insightful post. I agree with you about looking closely at the human/patient impact of a cancer diagnosis. It is varied and complex just as each individual is. Acknowledgement of feelings, compassion, being void of judgement & respect for each situation is so important in the arena of cancer patients and their healing.

      As an educator I keep having this reoccurring goal to write a curriculum and present it to medical students/physicians to address our perspective as patients as we return to our “new” life after diagnosis or living with cancer. Intertwining a diagnostic approach with patient testimony might just be the ticket for value-added human experience in the medical field. There are those doctors who “get it” but there are those who definitely need some guidance in this arena.

      “Focus forward” is a positive and empowering concept but one that is not easily attained by all patients. I think the most important part is to continue to shore each other up and do just that… get on with life!

    2. Alene, I’m glad you had a chance to view the film. As I mentioned in my post, I also felt the whole survivorship aspect was not addressed, but as you mentioned, this probably needs to be an entirely different documentary. I agree about the inadequacies of follow-up care. Survivorship is filled with issues for many, and too often patients are left dangling. I am so thankful there are people like you out there trying to make a difference in this area. You are doing important work. Thank you for sharing. Feel free to ‘spout’ any time.

  11. I watched it and thought it was very well done. I had tried to listen to the book but found the material so very dry. Ken Burns made a topic that is so raw for me very palatable. Great review Nancy!

  12. Nancy, I now have to see this documentary I have been avoiding. I must admit I no longer like watching cancer-related films. Today I had the privilege to meet Barak Goodman in person and he spoke for 2 hours. There were tons of questions asked and many patients made some really good comments, including those you highlighted in this post (what you didn’t like about the film). I regret not seeing this film before seeing him. They did show clips of two of the stories, one included breast cancer (the surgeon). I would have loved to participate in the discussion. As it turns out, Mr. Goodman is focusing on another documentary and some patients expressed some concerns about what was left out from the original film. So he might actually cover more areas in the next documentary.

    Thanks for the review of this documentary.

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