Charles Graeber: The Breakthrough

For this column, NASW book editor Lynne Lamberg asks NASW authors to tell how they came up with the idea for their book, developed a proposal, found an agent and publisher, funded and conducted research, and put the book together. She also asks what they wish they had known before they began working on their book, what they might do differently the next time, and what tips they can offer aspiring authors. She then edits the A part of that Q&A to produce the author reports you see here.

Publication of NASW members’ reports in Advance Copy does not constitute NASW’s endorsement of their books. NASW welcomes your comments, and hopes this column stimulates productive discussions.

Cover: The Breakthrough

Cover: The Breakthrough

Charles Graeber
Hachette Book Group/Twelve Books, November 13, 2018
U.S. $28.00, CAN $34.00
ISBN-10: 1455568503; ISBN-13: 978-1455568505
Ebook 978-1-4555-6849-9

Graeber reports:

The Breakthrough started as a surprising fact: cancer had evolved “secret handshakes” that tricked our killer immune cells, and we’d recently discovered some of those tricks and could block them, unleashing the immune system to fight cancer the way it did other diseases.

My reaction was: What, really? At the time (nearly five years ago), I’d heard nothing about it. Or, rather, I’d failed to recognize it as a penicillin moment in our war against cancer. This was new and complex news from a field (cancer immunotherapy) that had spent decades in scientific disgrace; an old idea that hadn’t worked in practice until, suddenly and recently, it did. Most doctors had been trained not to trust it. Siddhartha Mukherjee doesn’t even mention cancer immunotherapy in The Emperor of All Maladies.

Charles Graeber, photo by Robert Krivicich

Charles Graeber, photo by Robert Krivicich

When I approached my agent Susan Golomb about doing a book on the subject and its researchers (“They will win the Nobel someday”, I told her, which they did), she consulted her father, a retired oncologist. “He said not to bother,” she told me. “It doesn’t work.” Susan trusted me and sold the book anyway, inflamed by my need to correct the record.

The Breakthrough was incredibly difficult to report and write. I felt at times like I was trying to sketch a speeding bullet train. Before I could explain the science, I had to understand it- which only a handful of MD/PhDs truly did. The advance didn’t cover the years of research as I struggled to find compelling personal stories that also captured the big picture, and cobble science into a flowing human narrative with a “so what.” But of course, if it was easy or obvious, the book wouldn’t even be necessary.

Nearly every story in The Breakthrough is of a character who could have given up. They didn’t, and that made the difference. That’s the message of The Breakthrough for patients and researchers alike. Hope is warranted; don’t give up. It’s a lesson I’d like to pass on to my fellow authors as well.

Contact info:

Buy this book now in the ScienceWriters bookstore. Your purchase helps support NASW programs and services.

NASW members: will your book be published soon? Take advantage of this opportunity for shameless self-promotion. Submit your report for Advance Copy.

Tell your fellow NASW members how you came up with the idea for your book, developed a proposal, found an agent and publisher, funded and conducted research, and put the book together. Include what you wish you had known before you began working on your book, or had done differently.


View Advance Copy archives at

Thinking of writing a book? If you are a NASW member, you may access a list of more than 150 books and online resources to help you craft your book proposal, find an agent and funding sources, negotiate your contract, learn about self-publishing, publicize and market your book, and more at

Send book info and questions about book publishing to Lynne Lamberg, NASW book editor,

Apr. 3, 2019