Like Solzhenitsyn, the main character, the Russian Oleg Kostoglotov, spent time in a labor camp as a "counter-revolutionary" before he was exiled to Central Asia under Article 58.

[7] On the day of his release from the hospital, he visits a zoo, seeing in the animals people he knew: "[D]eprived of their home surroundings, they lost the idea of rational freedom.

Writer and literary critic Jeffrey Meyers writes that the novel is the "most complete and accurate fictional account of the nature of disease and its relation to love.

It describes the characteristics of cancer; the physical, psychological, and moral effects on the victim; the conditions of the hospital; the relations of patients and doctors; the terrifying treatments; the possibility of death."

Like Solzhenitsyn, Kostoglotov is a former soldier and GULAG prisoner in a hospital for cancer treatment from internal perpetual exile in Kazakhstan.

Bureaucrats and the nature of power in Stalin's State are represented by Pavel Nikolayevich Rusanov, a "personnel officer," bully, and informer.

He is discomfited by signs of a political thaw, and fears a rehabilitated man he denounced 18 years ago (to obtain the whole apartment they shared) will seek revenge.

After he is discharged, he believes he is cured, but the staff privately give him less than a year to live; his cancer cannot be rooted any more than the corruption of the 'apparatchik' class to which he belongs.

Kostoglotov begins two romances in the hospital, one with Zoya, a nurse and medical student, though the attraction is mostly physical, and a more serious one with Vera Gangart, one of his doctors, a middle-aged woman who has never married, and whom he imagines he might ask to become his wife.

Both women invite him to stay overnight in their apartment when he is discharged, ostensibly as a friend, because he has nowhere to sleep; his status as an exile makes finding a place to lodge difficult.

The novel makes many symbolical references to the state of Soviet Russia, in particular the quote from Kostoglotov: "A man dies from a tumour, so how can a country survive with growths like labour camps and exiles?"

Solzhenitsyn writes in an appendix to Cancer Ward that the "evil man" who threw tobacco in the macaque's eyes at the zoo represents Stalin, and the monkey the political prisoner.

The editor, Tvardosky, equivocated and requested cuts, so Solzhenitsyn arranged the novel be distributed as samizdat, then it be discussed at a meeting in Moscow of the Central Writers' Club on 17 November 1966.

[2] Solzhenitsyn gave an unauthorized interview to a Japanese journalist that month about The First Circle, another novel of his the Soviet bureaucrats blocked, and read from Cancer Ward to six hundred people at the Kurchatov Institute of Physics.

[2] In 1968, a Russian edition was published in Europe,[4] and in April, unauthorized excerpts appeared in English in the Times Literary Supplement in the UK.