"Surviving Childhood Cancer, A Guide for Families" meets
a tremendous need for easy-to-read, simple-to-understand information
about the childhood cancer experience. All too often health-care
professionals myopically focus attention and support on the hospital
and clinic experiences. Families may find that they are quite
unprepared to work through and survive those stresses of daily
living that don't suddenly disappear when cancer is diagnosed.
All aspects of a family's life undergo a temporary instability,
a rethinking of priorities, and a renegotiation of roles and responsibilities.
Relationships with family and friends, requirements of work and
school, and the financial strains that inevitably come to bear
on families touched by cancer are each addressed in Ms. Fromer's
The book begins by describing common emotional responses to the
diagnosis of childhood cancer. Compelling stories are told of
how different families cope and survive. These stories clearly
respect the strength, culture, and traditions of each unique family.
Ideas are offered to assist the individual and family in coping
with some of these overwhelming emotions.
Sections describing and defining common cancer terminology and
a description of cancers common to children are also included.
These provide a very basic foundation for the reader and should
reinforce and complement the information provided by the child's
A section devoted to cancer treatment describes basic treatment
modalities, their common side effects, and issues and concerns
associated with specific modalities. Advice is offered to the
family considering an alternative or nontraditional treatment.
The special concerns and fears associated with the cessation of
treatment are specifically addressed.
Interpersonal relationships are considered throughout the book,
including several references to the health-care team. Sections
on relating to the patient's siblings and grandparents, one's
spouse, employers, coworkers, and friends are realistic and helpful.
Suggestions are included for how to talk about the illness and
how to survive the "long haul."
It is safe to assume that almost all health-care professionals
in pediatric oncology have access to the same information included
in "Surviving Childhood Cancer," such as resource listings,
reimbursement information, and textbook material. What professionals
may not have, however, is Ms. Fromer's unique style of conveying
the information through stories and lay language that makes the
book interesting, easy to read, and instructional.
Unfortunately, it is this same personal, almost conversational
style that may be the book's greatest weakness as well as its
strength. Without a commitment to treat each issue and subject
fairly and completely, there is a risk that the reader may be
unable to discern what is opinion and generalization from what
As one reads the experiences shared throughout the book, it is
easy to falsely assume that they somehow represent an unavoidable
outcome or the only real truth of a situation. An example of this
can be found in the section on ethical issues. In a discussion
of participation in medical research, only one very negative experience
is related, and no other story or experience is cited. The reader
is clearly left with the perception that participation in research
is a frightening prospect and likely to be unpleasant. The author
then generalizes that "Medical research, with its attendant
competition for grant money, academic publication, and collegial
recognition, is an almost dog-eat-dog endeavor. As in all such
efforts, sometimes the 'consumer' is treated shabbily."
Ms. Fromer's choice of example and her accompanying comments demonstrate
the danger of this style of writing for the lay reader. The section
concludes without providing the reader with information or stories
from individuals who have had positive experiences with participation
in clinical research. This unequal treatment of the issue leaves
the reader with an inaccurate, incomplete picture.
A Valuable Resource
Despite this weakness, "Surviving Childhood Cancer"
remains a valuable resource for childhood cancer patients, their
families, and friends. It gives voice to issues and concerns long
experienced by pediatric cancer survivors and may promote the
resolution of certain issues by encouraging open and direct communication
with families, friends, and the health-care team.
The book is filled with hopeful, inspirational stories that should
be interesting and uplifting to families involved in any stage
of the pediatric cancer experience. However, readers should be
cautioned against assuming that these stories will necessarily
reflect their own experience. They should also keep in mind that
the book includes modest amounts of unlabeled opinion mixed with
fact. Nonetheless, "Surviving Childhood Cancer" still
meets many of the unique needs of patients and families struggling
to live, and live fully, through the entire childhood cancer experience.