JUDY WOODRUFF: Now: a deep and unique look at the history of cancer and the battles to end it or slow it.
It’s the focus of a three-night documentary on PBS that starts tonight and continues through Wednesday called “Cancer: The Emperor of All Maladies.” It’s produced by Ken Burns and based on the book of the same name by Dr. Siddhartha Mukherjee.
First, an excerpt from tonight’s episode. It’s about what happened to Olivia Blair, a toddler diagnosed with an acute type of leukemia that has spread to her brain and spinal column. The film follows her as she and her parents struggle with difficult decisions, including this moment, when doctors discuss the option of radiation to her brain.
MAN: So, obviously, the question is what does this mean for…
WOMAN: Well, I — yes, I’m automatically thinking that the leukemia is in her spine, it’s in her brain. So, it’s more serious then. It’s high-risk.
MAN: So — well, what that means is that her therapy will be more intense, that she will get extra chemotherapy, and then we also are going to recommend that she gets spine radiation and radiation to the brain.
WOMAN: I don’t want to do radiation.
MAN: I know.
WOMAN: Right.
MAN: So, we…
WOMAN: Why are — why are we doing that?
MAN: Because we know that radiation will treat it. But we know that the radiation therapy could potentially have effects on her cognitive abilities going forward.
MAN: I just…
WOMAN: Come on. They’re right.
MAN: We gave you one scenario yesterday.
MAN: She’s such a smart child.
MAN: I know.
WOMAN: She is. And she is going to continue to be smart. She has me and you as parents.
MAN: She won’t see me like this, but I need to get this out.
WOMAN: She is an extremely smart child.
MAN: How is this going to affect her? You don’t know, right?
MAN: Right.
MAN: If Olivia was 7 years old, we wouldn’t have a big problem irradiating her brain. The problem is that, because she’s 17 months, her brain has not fully developed. It’s almost there, but it’s not fully developed.
So one of the things that we’re very worried about and thinking about for Olivia is the role of radiation therapy.
JUDY WOODRUFF: I sat down recently with Ken Burns, the executive producer and co-writer of the film, and with Dr. Mukherjee, the book’s author, who is also an assistant professor of medicine at Columbia University.
Ken Burns, Dr. Siddhartha Mukherjee, thank you very much for being here.
As we see from that clip, there are moments in this program that are very, very difficult to watch.
Let me ask you first, though, about why you called it “The Emperor of All Maladies”? How did you come up with that?
DR. SIDDHARTHA MUKHERJEE, Author, “The Emperor of All Maladies”: Well, the title is from kind of an incidental note that I found in a surgeon’s writings.
And so I thought it was very poetic, the idea that there is an empire of disease. And we are citizens of that empire. And, you know, our struggle against cancer is a resistance movement. So there were lots of metaphors that I thought worked. And I wanted a title that was a little bit more — took us backwards in time and talked about sort of, you know, what is it like inhabiting this empire, if you will?
But it was mostly a poetic idea that I tried to bring to this history.
JUDY WOODRUFF: It is a resistance. There’s a resistance movement, Ken Burns, that’s going on.
And you not only — this is an historical documentary. It’s about the science, but it’s also very much, of course, about the people, the patients and their families. And we saw that in that clip.
KEN BURNS, Documentary Filmmaker: I think that’s the important part.
It is a very, very complicated and fascinating history across all of human history, because the disease has been with us as long as we have been here as human beings. And it’s also a very interesting science, a kind of CSI of discovery and investigation, of disappointment and serendipity, of mistakes turning into great discoveries.
But anchoring it all is, I think, the fact that this is still a human equation. And too often in our discussions, our larger political discussions, even the personal ones about cancer, we have left out the agency of patients. And we have tried to in this film return that agency to them.
But these are very tough decisions. You see parents worrying about a 17-month-old girl, wondering what the radiation is going to do to her, and we’re just — we’re there. We understand exactly those dynamics. And because one of — either Sid or I will get cancer, you or Judy — I mean Gwen or you or Margaret will get cancer in your lifetime, these are impossible odds to consider, and yet we don’t talk about it.
And I think what Sid’s book has done is bring it to the fore and said, look, we must talk about it. It is the emperor. We are obligated to be part of that resistance movement.
JUDY WOODRUFF: And, Sid Mukherjee, it’s full of — there are moments of breakthrough in this story. Yes, there are grindingly depressing parts of it, but you — but you show, you celebrate the moments when science has made a difference, and the whole picture is there.
DR. SIDDHARTHA MUKHERJEE: There are epic moments of breakthrough.
I mean, the epic moments of breakthrough come throughout the film. And what is important to realize is that you have to go through grinding moments into the moments of discovery. They are part and parcel of the same thing. You don’t get the discoveries for cheap. This is a profoundly human story. It has to be.
But the discovery — when the discoveries come, they are so epic. They are one — they are — I would say they rank among the great discoveries of human history, even outside science itself. So, and you — we wanted you, we wanted viewers to feel them.
And you don’t feel the discovery, I think, unless you live through the grind of that discovery. You don’t feel it. You’re not brought to that. There’s a catharsis that happens. It’s a detective story, but you have got to watch the whole — you know, the whole thing play itself out.
JUDY WOODRUFF: You do come away, Ken Burns, humbled by this disease, because, after all the money, after all the effort — it’s been centuries since they figured out it wasn’t black bile that was causing cancer.
KEN BURNS: Right.
JUDY WOODRUFF: And a lot of very smart people have been trying ever since then to figure it out, but it’s still winning, in many ways.
KEN BURNS: It is indeed. And it is wily and crafty, a kind of elegant version of ourselves that is destroying ourselves.
And so, yes, we are humbled by it. The story that Sid has told, that we have tried to retell, Barak Goodman and myself, is one in which we’re saying, there are these wonderful moments of discovery, and it seems to be an aha moment. The word cure is put forward, and then suddenly reality comes in. And then you have another moment.
And so it’s a kind of respiration, an inhalation, an exhalation, as we move closer and closer. But the cumulative one — the cumulative story is one of hope. We are getting closer. We know so much more than we did even 30 years ago, even 10 years ago. And when you realize that, then the lives will continue to be lost, this will be deadly, this will be this emperor, we are moving forward, and we can see a horizon in the not-too-distant future in which so many of the cancers, like a few now, are merely chronic.
JUDY WOODRUFF: And, in fact, Dr. Mukherjee, you have a doctor at the very beginning saying the next 20 years is going to be the age of discovery and you end on a hopeful note about immunotherapy.
DR.SIDDHARTHA MUKHERJEE: Absolutely.
And, you know, already, every year, hundreds of thousands of men and women are — and children are being cured or treated in very effective ways because of the discoveries that have happened in the last 10 years. So our general approach is, you have got to know this story; you have got to know this story for your own sake. Otherwise, you know, it’s going to become part of your own story. It’s going to intersect with your life.
So we have to anticipate that intersection. And you have got to know it. And this is a kind of state-of-the-world report on cancer. And you have got to know it because it’s going to come into your life, whether you want it to or not.
KEN BURNS: That’s right.
JUDY WOODRUFF: We should point out — and I do want to end with this — both of you come to this with your own personal experience about cancer.
I mean, Ken, for you, it was your mother.
KEN BURNS: Judy, I wouldn’t be sitting here. My mother died when I was 11. She was sick for the 10 years before that. There wasn’t a moment growing up that I wasn’t aware of her impending death.
And I spent my life trying to wake the dead, trying to have a conversation with an American past. And participating in this project has been an extraordinary honor because it’s in some way a continuation of a conversation with a woman that’s been interrupted for 50 years.
JUDY WOODRUFF: And, for you, it was a patient.
DR. SIDDHARTHA MUKHERJEE: It was absolutely.
The whole story for me begins with a woman who asked me, “I want to know where we’re going.” And, in a sense, the — Ken and Barak and this documentary has allowed me — us to tell that story for everyone, which is to say, where are we going, how did we get here, and what happens next?
JUDY WOODRUFF: And you’re asked questions like that. And the patients — patients want — they want a final — they want an explanation that they can take home.
DR. SIDDHARTHA MUKHERJEE: And it’s not — and the point is, it’s not going to be a one-line, one-word explanation.
JUDY WOODRUFF: Right.
DR. SIDDHARTHA MUKHERJEE: You have to know the full history, I think, to appreciate why we’re here today and what’s happening next.
And I think, you know, with Ken’s help and with Barak’s help — I was thinking about this.
Ken, you did such an amazing job with “Civil War,” but this is another civil war.
KEN BURNS: Exactly
DR. SIDDHARTHA MUKHERJEE: This is a civil war in your body. And we have got to know that history. Just like if you want to be a citizen of this world, you need to know the history of that war.
You need to know the history of this war in order to be who you are.
JUDY WOODRUFF: Dr. Sid Mukherjee, Ken Burns.
It is “The Emperor of All Maladies.”
And we thank you both. It’s a gift to all of us. Thank you.
KEN BURNS: Thank you.
JUDY WOODRUFF: You can watch more of our conversation on adapting cancer from page to screen on our home page. That’s PBS.org/NewsHour.
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