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The First Cell: And the Human Costs of Pursuing Cancer to the Last


Written by Azra Raza

Reviewed by Amal Rohail

Oncologist Azra Raza’s The First Cell: And the Human Costs of Pursuing Cancer to the Last presents an innovative perspective on the ongoing war on cancer. Drawing from both personal narrative and cutting-edge research, Dr. Raza underlines the importance of early detection and lends an empowering voice to the suffering of cancer patients.

Early on, Raza challenges the societal and medical mistreatment of cancer, emphasizing that cancer research should focus on improving early detection of cancer cells. The First Cell is then segmented according to stories told by Raza of her experiences as a medical practitioner, friend, and partner, with the titles of chapters named after important people in her life, all of whom battled cancer. The experiences, afflictions, and included pictures of each person are particularly resonant for readers, as they breathe reality into cancer suffering. Throughout each chapter, Raza also integrates explanations of cancer research development, and the biological basis of cancer, as well as her own devastating experience with her husband Harvey, an oncologist who also developed cancer. This amalgamation of information allows readers to gain a comprehensive understanding of cancer from multiple viewpoints.

A strong point of The First Cell is Raza’s challenging of the status quo on cancer treatment unwillingness to deny the failure of the current system. Throughout the text she questions, “Recognizing the complexity of cancer as a system . . . isn’t it better to turn to strategies that actually deal with complex systems?” (144). This serves as the crux of Raza’s push for better early detection. Raza continues to ask tough questions, each time pointing out problems within different aspects of the cancer treatment system. On systemic and individual levels, she asks, “Why is 70 percent of the budget funding research that concentrates [on] clinical trials with a failure rate of practically 90 percent? . . . How many Omars, how many Andrews, will it take?” (230). Raza’s frequent use of pointed inquiry is incredibly powerful because her questions seem obvious while the answers are actually quite complicated. The reference to Omar and Andrew here – actual cancer patients discussed in the book – represents the suffering of millions of people. This weaving of fact and narrative brings cancer patients back to the forefront of the discussion. Although The First Cell lacks a definitive structure, Raza proves her ability to seamlessly transition from big picture questions to individual experience to everything in between, which not only solidifies her argument but makes it much more compelling.

The First Cell offers a fresh yet evidence-based perspective on the cancer epidemic that emboldens readers to question the integrity of the institutions built around them. Raza’s perspective is reflected in her unconventional writing style, which is just as complex as the system that she wishes to reform. However, it is exactly this expressive writing that draws readers in and will convert them to her side.

Azra Raza is the Chan Soon-Shiong professor of medicine and the director of the MDS Center at Columbia University. In addition to publishing widely in basic and clinical cancer research, Raza is also the coeditor of the highly acclaimed website 3QuarksDaily.com. She lives in New York City.




Amal Rohail studies Global Public Health and anthropology with a focus on chemistry and Chinese at New York University, where she is expected to graduate in May 2020. She is on the premed track and has conducted research regarding hepatic encephalopathy and hepatitis C. In addition to working for IJP, she writes reviews for Somatic Psychotherapy Today.


Raza, A. (2019). The First Cell: And the Human Costs of Pursuing Cancer to the Last. New York, NY: Basic Books. ISBNs: 978-1-5416-9952-6 (hardcover); 978-1-5416-9950-2 (eBook). Available in hardcover and eBook. Hardcover. 347 pages. Includes references, credits, and index.