A FATAL INHERITANCE

A journalist tracks cancer through his family history.

“[My mother] was one of 318,500 Americans who died of cancer in 1968,” writes Ingrassia, former deputy managing editor of the New York Times and author of Billion Dollar Brand Club. “It was tragic, but what was there to say?” He adds that there is more to say, for cancer would befall the family again. His mother’s death coincided with an upsurge in cancer research, as well as its politicization, as scientists urged Richard Nixon to declare war on it, noting that for every $410 spent on national defense only $0.89 went to studying cancer. Scientists noted that there was a hereditary aspect to cancer, and though not every sibling might fall ill, many certainly did. Some suspected environmental causes; many researchers attributed cancer to a mysterious virus. One particularly difficult illness to figure out, given that cancer is generally rare in children, was pediatric retinoblastoma. When an explanation based on two gene mutations was proposed, “it was greeted with some skepticism, because it was based on a mathematical calculation rather than scientific evidence gathered in a lab experiment.” Even so, the implication of genes and mutation eventually carried the day in numerous studies that gained force when genes were sequenced, allowing a clearer understanding of hereditary cancers—which turn out, though, not to be statistically hugely significant, for all the pain they have brought to many families. As one Nobel Prize–winning scientist observed, “Every single cancer is different when you look at it on a genetic level. It’s not one disease, it’s many different diseases.” Still, writes Ingrassia in this memorable chronicle, the distribution of causation falls mostly on environmental factors, with viruses having a comparatively minor role.

An impressive, deeply researched contribution to popular studies of epidemiology and oncology.