Acclaimed documentarian Ken Burns (The Civil War, Baseball, Jazz, The Central Park Five, and The Roosevelts: An Intimate History) has been making films for more than 35 years. His most recently completed project, scheduled to air on PBS this spring, is Ken Burns Presents Cancer: The Emperor of All Maladies, A Film by Barak Goodman, a three-part documentary directed by Barak Goodman and based on the best-selling book The Emperor of Maladies: A Biography of Cancer, by Siddhartha Mukherjee, MD, PhD.

The ASCO Post talked with Mr. Burns, Executive Producer, Cowriter, and Senior Creative Consultant on the new documentary, about the making of the film, how the process differed from his experiences on earlier films, and what he learned from the project.

Waking the Dead

Cancer: The Emperor of All Maladies is dedicated to your mother, Lyla, who died of breast cancer when you were 11. How has her death influenced your past work and your desire to create this documentary on cancer?

Just the absence of somebody in your life makes you interested in history. I had a father-in-law who told me that what I did for a living was wake the dead and that I could make Abraham Lincoln, Jackie Robinson, and Louis Armstrong come back to life. “Who do you think,” he asked, “you are trying to wake up?” And that is a good way to understand why I do what I do.

There was no way I could not make The Emperor of All Maladies. First of all, Sid [Mukherjee] has written an extraordinary book—a work of literature—and we’re obligated now as citizens not to ignore the subject of cancer any longer, but to become participants in its story. One way of thinking about it is, if cancer is, in fact, the emperor of all maladies, that makes us its subjects. And the question is are we going to be willing slaves to this disease or are we going to put up a fight?

I think the film is an attempt to describe what the fight has been so far, where we are now in cancer research, and where we might be going, so one would hope that it would light some minds on fire. At the most basic level, the film is an amazing detective story, a series of biographies and discoveries of false dawns, and new legitimate hopes for more effective treatments. We stand right now at the threshold of an amazing age in cancer research that we cannot deny. We just have to be willing to look at the progress that has been made and the prospects for the future clearly.

One out of two men and one out of three women will get cancer; you can’t put your head in the sand and be an ostrich, pretending the disease is not there right in front of us. Cancer affects all of us, and we think we’ve told a riveting story that will engage everyone.

A Historical Thriller

How would you describe the film?

I think most of all it is a historical thriller. The number 1 question is what is cancer? The film takes viewers through the history of millennia of mistakes. The early cancer researchers didn’t know what caused the disease, but they thought if they cut it out or zapped it or poisoned it, the cancer would go away, and the film shows the limited successes and multitude of failures they had.

Then you see how the researchers began to refine their discoveries and ask some important questions, including is cancer a virus? And sometimes the answer came back “yes.” Is cancer caused by environmental factors? Yes, certainly, the most obvious example being smoking. Is cancer caused by genetics? Yes to that question, too.

The film also has a long section on prevention strategies and how researchers are investigating the use of a person’s immune system to fight cancer. We show how all of the conventional therapies of surgery, chemotherapy, and radiation are still around but are being used in conjunction with more refined, less toxic therapies.

Cancer has been around for as long as we’ve been around, and in the film we introduce the audience to a series of human beings who have tackled the problem. Since most of the progress in cancer research has happened over the past 3 or 4 decades, many of those researchers are still alive; we’ve got them in our film. And we get to interview them now with the virtue of some hindsight.

The film shows how we are now at a time in the history of cancer that can’t be ignored. We are obligated to get involved, ask some hard questions, and follow the leads. It is one hell of a story.

New Challenges

Were there some challenges and concerns making this film that were different from your previous documentaries?

Yes, there were some obvious challenges that were different in so far as we were integrating more complex science into a film than we usually do. I’ve done a film on the engineering complexities of building the Brooklyn Bridge (Brooklyn Bridge, 1981), and there are other films where we have gotten deep in the scientific weeds, but this film is one in which the actual detective story is a scientific one, so that’s different.

At the end of the day, though, you’ve got a narrative, you’ve got a master, and what I found is that my reactions to it were no different than any other film I’ve made. My main concern was how do we make the elements of the film better, how do we tell this story better, does the audience really need to know that much science, can we simplify a specific term for them in our writing, is that talking head sound bite really the best one to use for this moment, is that music working, does that animation serve us?

Of course, we also have the cinema verité scenes, the patient case studies in which we were granted extraordinary privilege—principally at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medicine in Baltimore and Charleston Area Medical Center in West Virginia—to accompany people on some of the most arduous journeys of their lives or their loved ones’ lives.

Irony and Urgency

Two people instrumental in getting this film made—producer Laura Ziskin, who died of metastatic breast cancer before production on the film began, and actor Edward Herrmann, the narrator of the film, who died of glioblastoma shortly after completing work on the film—never got to see the finished product. How did their deaths affect the final production?

Ed died within weeks of completing the film, so the irony of his and Laura’s death is not lost on us. Ed was also the voice on my last major series, The Roosevelts: An Intimate History. It is part of the difficult but inevitable triage of life that we would lose Laura and we would lose Ed in the course of producing this film. And that adds a kind of urgency, it seems to me, for everyone to work together and figure out what we can do about this disease.

Funding for basic research, essential research, general research has been cut so significantly in the past decade-and-a-half, which doesn’t bode well if we are going to take the opportunities that are presented to us right now and make some real, true advances in curing cancer. We need help. So I think an informed public becomes an active and vocal constituency for the support of that research.

Real Heroism

What did you learn about the people portrayed in this film—in particular, the patients, their caregivers, and the health professionals who treat them?

In our superficial media culture we use the word “hero” all wrong. We expect heroism to be about perfection. Heroism, the Greeks taught us, is never about perfection. It’s about the negotiation between a person’s strengths and weaknesses.

I think we have all forgotten that the real heroism in life takes place in the unknown moments, away from the glare of the cameras. Heroism is in the courage displayed by people as they struggle with this particular disease. So for me, just the privilege of engaging this story, the privilege of getting to know not just the so-called ordinary folks—the patients and their family members—who are in our scenes, but also the extraordinary surgeons and scientists who have helped those people overcome cancer or are on the cusp of figuring out strategies and therapies that will make cancer chronic and treatable instead of fatal for many people, was beyond inspiring to me. ■