Abstract
Lung cancer is the leading cause of cancer death worldwide and yet receives considerably less research attention and funding compared to other cancers. This is but one of a range of surprising facts that Carsten Timmermann brings to light in his book. Predominantly a history of lung cancer within the United Kingdom, the book also draws upon developments in mainland Europe and the United States. This social history takes the reader right through from the beginnings of identifying the disease in the early nineteenth century to the present day. In doing so, Timmermann examines the various ways in which lung cancer has persistently been an uncontrollable disease throughout its history and how this has shaped the way that lung cancer has come to be perceived and approached in contemporary society. Much of the book, particularly the earlier chapters, is largely concerned with innovations in medical practice which influenced how lung cancer came to be classified and subsequently diagnosed and treated. In this respect the book might appeal more strongly to those with an interest in the history of science, the history of medicine, or those with a background in medicine. However, the book also has much to offer for sociologists. Chapter 4 explores the politics around smoking and lung cancer, which includes details of an extensive health campaign in Scotland in the 1950s to reduce smoking which had very little effect. Discussion of health promotion campaigns to reduce smoking and of the findings of evaluative studies in this area is quite detailed and would undoubtedly be useful to those interested in the politics of health promotion and awareness. In addition, chapter 7 investigates the rise of stigma associated with lung cancer and, in relation to this, examines recent efforts by a lung cancer charity to de-stigmatise the disease. Here Timmermann draws on previous studies on the history of breast cancer and discusses these with reference to the case of lung cancer. Furthermore, Timmermann highlights how the specific facets of lung cancer serve to shape the configuration of charitable organisations in the methods and practices they employ to raise money and in the way that money is used. My own experiences of doing research through a regional prostate cancer charity resonate with this finding and Timmermann's work reiterates the importance of recognising the reflexive relationship between a physical disease and the ways it is socially constructed. The concept of recalcitrance, too, is one that is of continued interest to medical sociologists and in his conclusions, Timmermann offers some insights into how the recalcitrance of lung cancer socially shapes how lung cancer is perceived and addressed by different groups. This book is detailed and draws upon a diverse range of sources to present the history of lung cancer and also to evidence arguments. Whilst the book might have run the risk of getting bogged down in the many statistics, meeting records, and other sources that it draws upon, the book reads well. There is frequent signposting to other sections of the book and it is fairly accessible to a lay person with little knowledge of medicine or medical terms. There are points, particularly in the second chapter, where some technical terms are not clearly explained but in such cases they are either defined in a later section or picked up quite quickly through context. The chief difficulty with the book, however, is the sobering and sad history of this disease in which little progress has been achieved in developing effective treatments. Timmermann's history is troublesome in that because of the recalcitrant nature of lung cancer and the lack of progress that has been achieved, the historical account cannot follow the more common and more enthralling progress narratives that can be found in other histories of medicine. However, as Timmermann rightly asserts, this history offers an opportunity to explore how medical practi-tioners deal with the difficulties of long standing impotence and lack of progress. Moreover, Timmermann finds opportunities throughout the book to add flavour to the narrative to keep the reader engaged, a choice example being a description of the death of King George VI to illustrate a broader change of mood within society regarding lung cancer. Lastly there is some evidence towards the end of the book that more fascinating developments in the history of lung cancer will emerge over the coming decades. The ongoing controversy over the possibility of spiral CT scanning being used for selective lung cancer screening and the development of new but expensive life prolonging cancer drugs both offer potentially rich new areas of study. Yet regardless of where social research on lung cancer may be directed in the future, this book will undoubtedly be an invaluable guide for those wishing to engage with it.
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