The National Cancer Institute (NCI) introduced clinical trials to test the efficacy of chemotherapy. Louis Goodman and Alfred Gilman also used nitrogen mustard to treat lymphoma. Sidney Farber induced temporary remission in pediatric leukemia using antifolates developed by Yellapragada Subbarow. In the 20th century, cancer became the second most common cause of death after heart disease in the United States. Rudolph Virchow first observed leukemia, and Franz Ernst Christian Neumann localized the pathology to the bone marrow. Additionally, Emil Grubbe used X-rays to treat cancer, thus identifying another treatment modality.

In the 19th century, surgeons devised various approaches to remove tumors, like William Halsted and the radical mastectomy. Galen's theory was later challenged by the work of Andreas Vaselius and Matthew Baille, whose dissections of human bodies failed to reveal black bile. The procedure was believed to have been successful temporarily. In 440 BCE, the Greek historian Herodotus recorded the first breast tumor excision of Atossa, the queen of Persia and the daughter of Cyrus, by a Greek slave named Democedes. Galen applied this idea to cancer, believing it to be an imbalance of black bile. Hippocrates thus considered illness to be an imbalance of four cardinal fluids: blood, black bile, yellow bile, phlegm. The Greeks had no understanding of cells, but they were familiar with hydraulics. Mukherjee gives the history of cancer from its first identification 4,600 years ago by the Egyptian physician Imhotep. The book weaves together Mukherjee's experiences as a hematology/ oncology fellow at Massachusetts General Hospital as well as the history of cancer treatment and research. In the end, cancer truly emerges, as a nineteenth-century surgeon once wrote in a book's frontispiece, as 'the emperor of all maladies, the king of terrors.' Content Here, too, there are victories and losses, campaigns upon campaigns, heroes and hubris, survival and resilience-and inevitably, the wounded, the condemned, the forgotten, the dead. In a sense, this is a military history-one in which the adversary is formless, timeless, and pervasive.

The book explains its title in its author's note:

The Guardian wrote that 'Mukherjee manages to convey not only a forensically precise picture of what he sees, but a shiver too, of what he feels.' Literary Review commended Mukherjee's narrative: 'It is so well written, and the science is so clearly explained, that it reads almost like a detective story-which, of course, it is.' Title The Emperor of All Maladies won the 2011 Pulitzer Prize for General Non-Fiction: the jury called it 'an elegant inquiry, at once clinical and personal'. It was published on 16 November 2010 by Scribner. The Emperor of All Maladies: A Biography of Cancer is a book written by Siddhartha Mukherjee, an Indian-born American physician and oncologist.

The emperor of all diseases