‘The Harmony of Cells’: An Oncologist Explains the Discovery That Changed Medicine Forever

“another life within a life. An individual living entity – a unit – is part of a whole. Living bricks contained within larger organisms.he described it like this The infinite complexity of cells Indian-American oncologist and science writer Siddhartha Mukherjeean international bestseller and its books generation and Lord of All Evilfor which he won a Pulitzer Prize.

In his new job, cellular harmonyMukherjee offers readers “a quest for medicine and a new human being” based on the history of cells since British scientists discovered them in the 17th century Robert Hooker and his powerful microscopes, to the novel treatments that use his research today treat various diseases.

“Hip fractures, cardiac arrest, immunodeficiency, Alzheimer’s dementia, AIDS, pneumonia, lung cancer, kidney failure, arthritis, can all be thought of as the result of abnormal functioning of cells or cellular systems. They can also be seen as for possibility Applied Cell Therapy’, the author is a professor of medicine at Columbia University and an oncologist at University Hospitals, a fellow at Oxford University and an MD from Harvard University.

Why are cells still the central axis of medicine four centuries after their discovery? What’s left to discover? How to explain the sudden transformation of cells and become malignant?what about those regenerative cells What is the key to preventing and solving various diseases?All this and more in cellular harmonyan exciting (even poetic) survey of over 600 pages edited by Debate.

In November 2017, I witnessed the death of my friend Sam P because his cells rebelled against his body.he was diagnosed with malignant melanoma Spring 2016. The cancer first appeared near her cheek as a dark purple, coin-shaped mole surrounded by a halo. His mother, Clara, a painter, first noticed him during a late-summer vacation on Block Island. She had tried to convince him—then pleaded and threatened—to see a dermatologist, but Sam, a busy, active sportswriter for a major newspaper, had little time to worry about the pesky blemish on his cheek.

When I saw and scanned him in March 2017 – I’m not his oncologist but a friend pointed me to his case – the tumor had grown to a thumb sized oblong mass with metastases to the skin signs. Sam frowned when I felt the tumor.

It is one thing to have cancer and quite another to witness its fluidity. Melanoma had begun to cover Sam’s face. towards the ear. If you look closely, its trajectory is like a ship sailing through the water, leaving purple spots of light behind. Even sports journalist Sam, who has devoted his life to covering speed, movement and agility, was amazed at how quickly the melanoma progressed.

She asked me persistently—how, how, how—a cell that had been motionless in her skin for decades suddenly gained the ability to run across her face while dividing like crazy?

but Cancer cells don’t ‘invent’ any of these abilities. Instead of creating something new, they use it, or rather, the cells that are best suited to survive, grow and metastasize are naturally selected. The genes and proteins that cells use to produce the structural elements needed for growth are appropriation of those that the developing embryo uses to fuel its violent expansion in the first few days of life.

The pathways that cancer cells follow to move across the vast spaces of the body are taken from the pathways of cell movement that allow the organism to move by its very nature. The genes that make cells divide unchecked are twisted and mutated versions of the genes in normal cells that make cells divide. In short, cancer is cell biology seen through the mirror of pathology. And, as an oncologist, I am a cell biologist first and foremost, but also a cell biologist who sees the normal cellular world reflected and turned upside down in the mirror.

In late spring of 2016, Sam was prescribed a drug that turned his own T-lymphocytes into an army to fight the growing rebels in his body. We can explain it this way: For years, perhaps decades, Sam’s melanoma and his T cells had coexisted, ignoring each other. His immune system couldn’t see his malignancy.. Every day millions of T lymphocytes pass through melanoma and keep going, like passers-by turning away in a cellular catastrophe.

The drug Sam is taking promises to reveal the tumor’s cloaking state and allow his T cells to recognize the melanoma as a “foreign” invader and reject it, just as T cells reject cells infected by microbes. Passive bystanders become active participants. We are modifying the cells of your body to make visible what was previously invisible.

The discovery of this “revelatory” drug is the culmination of some research. Major advances in cell biology Dating back to the 1950s: understanding the mechanism by which T lymphocytes differentiate self from nonself; identifying proteins that these immune cells use to detect foreign invaders; discovering how our normal cells avoid attack by this detection system; cancer cells exploiting this The way the mechanism becomes invisible, and the invention of a molecule that can strip off the invisibility cloak of malignant cells.

Almost immediately after Sam started treatment, A civil war broke out inside him. His T lymphocytes, now sensitized to the presence of cancer, launched an attack on the malignant cells, and their revenge set off a new cycle of revenge. One morning, the red boil on her cheek was burning hot as immune cells had infiltrated the tumor and set off a cycle of inflammation; then the evil organization packed up its camp and retreated, leaving behind the smoldering remains of a campfire.

When I saw him again a few weeks later, the oblong bumps and spots were gone. In its place were the dying tumor remnants, crumpled like large raisins. I was in remission. Let’s celebrate with coffee. Remission changed not only Sam’s body, but his life as well. It refreshed him. For the first time in weeks I saw the worry lines on his face relax. Serious. But then things got complicated: April 2017 was a brutal month. T cells that attack tumors attack their own liver insteadcausing autoimmune hepatitis, an inflammation of the liver that is difficult to control with immunosuppressive drugs.

Last November, we discovered that the cancer, which had been in remission weeks earlier, had spread to the skin, muscles and lungs, hiding in other organs and finding new spaces to survive against immune cell attacks.

Throughout these victories and setbacks, Sam maintained a steely dignity. At times, his biting humor seems to be his own form of counterattack: I’ll dry cancer to death. One day, when I visited him at his desk in the newsroom, I asked him if he wanted to go to a private place—such as the men’s room—so he could show me his new tumor. He smiled slightly”When we got to the restroom, they had gone elsewhere.. You’d better go see them while they’re still here. “

Doctors slowed down the immune offensive to control autoimmune hepatitis, but then the cancer returned. When immunotherapy was started again to attack the cancer, and the fulminant hepatitis relapsed, it was like watching a beast fight: If we controlled the immune cells, the beast would go on the attack and kill. If we release them, they attack cancer and the liver indiscriminately.

Sam died one spring morning, about six months after the tumor was first touched. In the end, melanoma won out.

❖ Born in New Delhi, India in 1970.

❖ He is a physician, oncologist and science communicator.

❖ He has published books such as “The Lord of All Evil”, “Gene”, “Medical Law” and “Cell Harmony”.

▪ Recipient of Rhodes Fellowship, Wilson Prize for Literary Science Writing (2011), Pulitzer Prize for Non-Fiction (2011) and Padmas Medal in Medicine (2014).