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

"Surviving Childhood Cancer, A Guide for Families" meetsa tremendous need for easy-to-read, simple-to-understand informationabout the childhood cancer experience. All too often health-careprofessionals myopically focus attention and support on the hospitaland clinic experiences. Families may find that they are quiteunprepared to work through and survive those stresses of dailyliving 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 andschool, and the financial strains that inevitably come to bearon families touched by cancer are each addressed in Ms. Fromer'sbook.

The book begins by describing common emotional responses to thediagnosis of childhood cancer. Compelling stories are told ofhow different families cope and survive. These stories clearlyrespect the strength, culture, and traditions of each unique family.Ideas are offered to assist the individual and family in copingwith some of these overwhelming emotions.

Sections describing and defining common cancer terminology anda description of cancers common to children are also included.These provide a very basic foundation for the reader and shouldreinforce and complement the information provided by the child'shealth-care professionals.

A section devoted to cancer treatment describes basic treatmentmodalities, their common side effects, and issues and concernsassociated with specific modalities. Advice is offered to thefamily considering an alternative or nontraditional treatment.The special concerns and fears associated with the cessation oftreatment are specifically addressed.

Interpersonal relationships are considered throughout the book,including several references to the health-care team. Sectionson relating to the patient's siblings and grandparents, one'sspouse, employers, coworkers, and friends are realistic and helpful.Suggestions are included for how to talk about the illness andhow to survive the "long haul."

It is safe to assume that almost all health-care professionalsin pediatric oncology have access to the same information includedin "Surviving Childhood Cancer," such as resource listings,reimbursement information, and textbook material. What professionalsmay not have, however, is Ms. Fromer's unique style of conveyingthe information through stories and lay language that makes thebook interesting, easy to read, and instructional.

Unfortunately, it is this same personal, almost conversationalstyle that may be the book's greatest weakness as well as itsstrength. Without a commitment to treat each issue and subjectfairly and completely, there is a risk that the reader may beunable to discern what is opinion and generalization from whatis fact.

As one reads the experiences shared throughout the book, it iseasy to falsely assume that they somehow represent an unavoidableoutcome or the only real truth of a situation. An example of thiscan be found in the section on ethical issues. In a discussionof participation in medical research, only one very negative experienceis related, and no other story or experience is cited. The readeris clearly left with the perception that participation in researchis a frightening prospect and likely to be unpleasant. The authorthen generalizes that "Medical research, with its attendantcompetition for grant money, academic publication, and collegialrecognition, is an almost dog-eat-dog endeavor. As in all suchefforts, sometimes the 'consumer' is treated shabbily."

Ms. Fromer's choice of example and her accompanying comments demonstratethe danger of this style of writing for the lay reader. The sectionconcludes without providing the reader with information or storiesfrom individuals who have had positive experiences with participationin clinical research. This unequal treatment of the issue leavesthe reader with an inaccurate, incomplete picture.

A Valuable Resource

Despite this weakness, "Surviving Childhood Cancer"remains a valuable resource for childhood cancer patients, theirfamilies, and friends. It gives voice to issues and concerns longexperienced by pediatric cancer survivors and may promote theresolution of certain issues by encouraging open and direct communicationwith families, friends, and the health-care team.

The book is filled with hopeful, inspirational stories that shouldbe interesting and uplifting to families involved in any stageof the pediatric cancer experience. However, readers should becautioned against assuming that these stories will necessarilyreflect their own experience. They should also keep in mind thatthe book includes modest amounts of unlabeled opinion mixed withfact. Nonetheless, "Surviving Childhood Cancer" stillmeets many of the unique needs of patients and families strugglingto live, and live fully, through the entire childhood cancer experience.