国际肿瘤学杂志 ›› 2026, Vol. 53 ›› Issue (7): 385-387.doi: 10.3760/cma.j.cn371439-20260323-00053

• 医学人文 • 上一篇    下一篇

百年癌症史的医学审思——读《众病之王:癌症传》有感

田津()   

  1. 河北医科大学第一医院医院管理创新研究中心石家庄 050031

Medical reflections on a century of cancer history—a critical engagement with The Emperor of All Maladies A Biography of Cancer

Tian Jin()   

  1. Hospital Management Innovation Research CenterFirst Hospital of Hebei Medical UniversityShijiazhuang 050031, China

摘要:

美国肿瘤学家悉达多·穆克吉的《众病之王:癌症传》以百余年癌症诊疗史为线索,揭示了现代肿瘤学在技术演进背后的认知代价与制度困境。现围绕书中3个核心命题展开省思:其一,癌症发病率的现代性上升,部分源于医学延长寿命的结构性后果,而非单纯的疾病扩张;其二,从根治性乳房切除术的发明到化疗的诞生,治疗史同时也是一部由过度确信驱动的错误史,临床判断的局限性具有时代必然性;其三,预防医学的时间收益与现行医疗机构的激励结构之间存在系统性错配,这一困境在中国肿瘤防治实践中同样存在。在此基础上,将癌症理解为长寿时代需长期应对的医学难题,较之“战争”隐喻更具认识论价值,亦更符合当代肿瘤学的实践导向。

关键词: 人文科学, 循证医学, 癌症史, 医学认知, 肿瘤防治

Abstract:

American oncologist Siddhartha Mukherjee's The Emperor of All Maladies A Biography of Cancer traces over a century of cancer diagnosis and treatment, illuminating the cognitive costs and institutional challenges underlying the technological advances of modern oncology. This article reflects on three core propositions derived from the work. First, the modern rise in cancer incidence is partly a structural consequence of medicine's success in extending human lifespan, rather than a simple expansion of disease itself. Second, from the invention of radical mastectomy to the origins of chemotherapy, the history of cancer treatment is simultaneously a history of errors driven by excessive clinical certainty, the limitations of which were in each era historically inevitable. Third, there exists a systemic mismatch between the time benefits of preventive medicine and the incentive structures of contemporary medical institutions—a tension no less present in China's own oncology practice. On this basis, the article argues that framing cancer as a medical challenge requiring sustained engagement in an era of longevity carries greater epistemological value than the prevailing "war" metaphor, and better reflects the practical orientation of contemporary oncology.

Key words: Humanities, Evidence-based medicine, History of cancer, Medical cognition, Cancer prevention and control