How hype, money, and bias can mislead the public into thinking that many dubious or unproven treatments are effective. Every week, people read about new and exciting drug therapies for cancer. Some of these treatments are genuinely transformative, providing significant improvements in the quality and duration of patients' lives. However, often missing from the widespread narrative is the fact that many of these new therapies have tiny or limited benefits. Some are even harmful. In the book "Malignant," hematologist-oncologist Dr. Vinayak K. Prasad highlights many troubling examples of how patients are frequently let down by cancer policies and oncology practices. In this work, Prasad illuminates misleading practices that: • promote new cancer therapies long before robust evidence supports such treatment, and • exaggerate the potential benefits of new therapies, many of which cost thousands and sometimes hundreds of thousands of dollars. Prasad also critiques the financial conflicts that govern the realm of oncology, the pharmaceutical industry, and the US Food and Drug Administration. It is a book that examines how human actions—our policies, standards of proof, and drug regulations—encourage the pursuit of marginal or unproven therapies at high and unsustainable prices. Prasad guides us through the process of conducting cancer clinical trials, how drug treatments reach the market, and how pricing decisions are made, questioning how we can ensure more cancer drugs provide greater benefit and lower cost. Ultimately, he states that: • more cancer clinical trials should measure outcomes that genuinely matter to cancer patients; • patients in these trials should more closely resemble real-world citizens; • we need drug regulators who raise, and not continually maintain, the bar for approval, and • we need unbiased patient advocates and experts. This well-crafted, insightful, and engaging book explains what we can do differently to make serious and lasting progress against cancer—and how to avoid repeating the mistakes of past policies and practices.