"Brilliant and disturbing."
- Nature Magazine
"The writing is marvelous and the scholarship is incredible -- but you aren't prepared for the disarming humor, or the delicate dissection of the psyche. I could not stop reading this book."
- Siddhartha Mukherjee
author of Emperor of All Maladies
How Cancer Becomes Us
Nearly half of all Americans will be diagnosed with an invasive cancer. Amidst furious debates over its causes and treatments, scientists generate reams of data -- information that ultimately obscures as much as it clarifies. Award-winning anthropologist Lochlann Jain deftly unscrambles the high stakes of the resulting confusion.
Expertly reading across a range of material that includes history, oncology, law, economics, and literature, Jain explains how a national culture that simultaneously aims to deny, profit from, and cure cancer entraps us in a state of paradox -- one that makes the world of cancer virtually impossible to navigate for doctors, patients, caretakers, and policy makers alike. Malignant vitally shifts the terms of an epic battle we have been losing for decades: the war on cancer.
Paperback: 304 pages
Publisher: University of California Press (October 15, 2013)
"A whip -smart read."
- Discover Magazine
Victor Turner Prize
Gold Medal Winner:
Society for the
History of Technology
Diana Forsythe Prize
Silver Medal Winner:
Foreword Book of the Year
Society for the
Social Study of Science
Reviews of Malignant
"a remarkable achievement."
"searingly close to the bone but also deeply humane."
"an intellectual odyssey."
- David Napier, Medical Anthropology Quarterly
"a deft analyst of psychosexual significance."
- Emily Martin, Public Books
"an admirable achievement."
- Simon J. Craddock Lee, Anthropological Quarterly
"sustained demystification of expert knowledge."
- Ada Jaarsma, Hypatia
"a whip smart read about a disease that involves billions of dollars and millions of lives.”
“In this trenchant mix of science history, memoir and cultural analysis, Jain is thoughtful and often darkly humorous on everything from cancer statistics to treatments, trials and issues around sexuality. Brilliant and disturbing.”
“From the minute you start reading the first page of this book, to the moment (hours later) when you arrive at its last pages, Lochlann Jain manages to grip you and hold you captive. The writing is marvelous, of course and the scholarship is incredible – but you aren’t prepared for the disarming humor, or the delicate dissection of the psyche that Jain somehow achieves in these pages. I could not stop reading this book. In the end found myself enriched and wiser for it.”
--Siddhartha Mukherjee, author of Emperor of all Maladies.
"Malignant is a beneficent book, a tough gift for all of us. I--we--need this scholarly, angry, intimate, objective, smart, moving book that teaches us how to endure and even maybe thrive in the "rubble."
--Donna Haraway, author of Simians, Cyborgs and Women
"I found myself entertained, informed, surprised and ultimately transformed by this wonderful narrative." --Abraham Verghese, author of Cutting for Stone
"...the single best thing I've ever read about cancer."
--Nancy K Miller, Distinguished Professor of English and Comp Lit
"The book is a rare combination of first person experience...and intelligent, yet accessible analysis...Jain is fully and poignantly aware that for most readers, making sense of cancer is something that we'd simply rather not do. Malignant does not dwell in the darkness, but neither does it let us avoid it. The narrative voice feels like something out of a Camus short story...Malignant is an expressive and important work."
-- Lynda Payne, for "New Pages Book Reviews"
"Malignant is a brilliant piece of medical anthropology, a beautifully poetic fusion of the personal and the political"
--Robert Proctor, author of Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition
"An extraordinary work of disciplined observation and astonishing precision, Malignant reveals how the common course of cancer has worked its way into the American imagery."
-- Jonathan Simon, Adrian A. Kragen Professor of Law, UC Berkeley School of Law
"In my nineteen years as a cancer survivor I have never read a book that was so spot on when it comes to understanding the inadequacy of our current plan of attack in the war on cancer, which we have been fighting for over thirty years."
--Natalie Conforti, Three-time young adult cancer survivor and advocate
"Lochlann Jain is the rare academic whose writing is as beautiful as her ideas."
--Carl Elliot, author of White Coat, Black Hat: Adventures on the Dark Side of Medicine
"In this alternately galvanizing and moving report, Jain offers both a queer patient's eye view and an astute scholar's analysis. Malignant extends the scholarship and activism surrounding HIV/AIDS to alert us that, in the case of cancer, ubiquity* death."
--Lisa Duggan, author of the Twilight of Equality?: Neoliberalism, Cultural Politics, and the Attack on Democracy
"As cancer increasingly becomes a metaphor for our lives, what do we do about the growing evidence of the role of the environment in cancer causation? Jain's complex and nuanced picture challenges the reader to dig down for our own conclusions. Malignant will be of enormous value."
--Judy Norsigian, Executive Director Our Bodies, Ourselves
"Lochlann Jain offers a fresh and profound set of insights about the total social fact of cancer in the U.S. Patients and cancer prevention advocates will benefit enormously from reading this fascination book.
--Richard Clapp, Professor Emeritus, Boston University School of Public Health
"How is it possible, S. Lochlann Jain asks in this moving, brutally honest book, for cancer to "be inside so many people and remain outside of society." This searing exploration...helps us to understand how and why government, corporate and military leaders are so reluctant to embrace cancer as a public issue and the effects of not doing so for our understandings of the disease."
--Gerald Markowitz, author of Deceit and Denial: the Deadly Politics of Industrial Pollution
"Both extremely personal and highly analytical, Malignant offers an idiosyncratic, irreverent and probing mash up of cancer in the U.S. today. The cancer that emerges is untidy, more a set of relationships than a thing. While highly critical of the standard claims to authority and expert knowledge, suppressed politics, misplaced priorities and victim blaming, Jain retains empathy and humor."
--Robert Aronowitz, author of Unnatural History: Breast Cancer and American Society.
"Jain takes an anthropologist's approach to exploring the intricacies of an experience on a shared cultural stage. With this book, Jain brings new insights into the lived struggle of a patient, activist, and academic in understanding the full complexity of cancer."
--Karuna Jagger, Executive Director, Breast Cancer Action
"Lochlann Jain's brilliant memoir/documentary offers us a thoroughly uncomfortable, provocative and enticing read. We are led step by meticulously researched step into the abyss of the cancer culture, all the while being invited into the intimacy of Jain's own cancer story as a young adult. Malignant is a necessary read for our time, a remarkable achievement."
--Janie Brown, Executive Director, Callanish Society
"Not a pretty story, but a communication...that merits study by the government agencies, policymakers and health professionals."
"This masterwork is the most important book about cancer in decades."
--Jonathan Metzl, author of the Protest Psychosis: How Schizophrenia Became a Black Disease
Why did you write this book?
One day when I drove into the Stanford Hospital’s parking lot, I spotted a sign that said something like: “chemicals in this parking lots are known to the state of California to cause cancer…” This was one of the only times on the treatment side of cancer that cause was acknowledged – and this acknowledgement seemed cursory rather than a real acknowledgement of the fact that cancer is being caused, all around us, all the time, and we are all implicated.
Despite the ways that cancer is being produced and lived and treated, cancer culture encourages us to see those with cancer as “brave survivors” engaged in epic, individual battles for their lives. I wrote the book because I wanted to better understand these paradoxes, ones I was seeing everywhere in cancer culture. Ultimately, I came to understand the ways that cancer is actually a central aspect of American economic, social, and political life. This fact is very difficult to see, because the languages we use to discuss cancer tend to frame it as a disease outside of our culture to be fought off, or as a disease we are in the midst of curing, or as a tragic exception to the natural life course rather than as a predictable result of the ways we understand and deal with our environments. I wrote the book to better understand how this happens, and this limits our ability to see how cancer is caused and treated, and to provide a more accurate description of the role of cancer in American lives and cultures.
The second reason I wrote the book is that I was interested in how we have to turn to medicine to understand cancer. Cancer treatment, an event that nearly half of Americans will have to experience, is one of the most profound experience many of us will ever have to go through – and it is a central component of American lives and deaths. And yet, naturally enough, the languages we have to talk about it derive mostly from medicine.
Medicine is itself a complex, fraught, and highly political process which unfortunately does not have the answers to cancer. It is its own sort of labyrinth with its own hierarchies and blind spots.
Cancer serves as place where big science and technology meet big unanswered questions with huge multi-billion dollar, life and death stakes. In this sense, cancer provides a unique opportunity to see how medical expertise is built, because so little is known about the disease.
The way we treat cancer, people with cancer, carcinogens, and pharmaceuticals is an American story- and provides an opportunity to see US culture from a unique vantage point.
I wrote this book to give all of us who encounter cancer in the many ways we are forced to deal with it, critical tools to understand contradictions in medical and statistical worlds that people have to live in, and an analysis of the ways this reflects back on American culture and values.