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Book Review: Surviving Childhood Cancer--A Guide for Families

Book Review: Surviving Childhood Cancer--A Guide for Families

"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 book.

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 health-care professionals.

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 is fact.

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.

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