Authors: Ernest Rosenbaum, MD, Isadora Rosenbaum, MA
Publisher: Andrews McMeel (September 1, 2005)
Reviewer: Lesley McKarney, PhD, Editorial Director, Geriatrics & Aging
A diagnosis of cancer brings with it many questions and a need for clear, understandable answers for both patients and their families. There is a multitude of information about cancer available at bookstores, on the Internet, and on television. It can be overwhelming and insufficient because not all the answers are available--from anywhere--and when they are available, they are not always accurate.
Author Ernest Rosenbaum, MD, FACP, a clinical professor of medicine at the University of California, San Francisco, is himself a survivor of esophageal cancer. Together with his wife Isadora and almost 80 medical advisors and contributing authors, all of whom serve as top specialists in their respective fields of cancer treatment and research, the Rosenbaums have assembled Everyone’s Guide to Cancer Supportive Care, a comprehensive assimilation of information relative to the disease of cancer written for patients and caregivers. It includes accurate but palatable descriptions of physiological changes and methods of psychological coping, and encourages patients to be more involved in their care. As correctly observed in the preface by Dr. I. Craig Hendersen, “…our modern medical system allows too little time for the doctor to provide everything the patient needs to live with and overcome this disease.”
The book serves as a companion read to Everyone’s Guide to Cancer Therapy: How Cancer Is Diagnosed, Treated, and Managed Day to Day. While the latter deals with issues surrounding the diagnosis and treatment of cancer, Cancer Supportive Care is designed to guide patients towards an organized program of comprehensive rehabilitation by examining psychosocial aspects (e.g., loneliness and stress), nutrition, exercise, sexuality, nursing, hospital issues, community services, medical economics, and end-of-life care.
A hefty reference running at 468 pages, Everyone’s Guide to Cancer Supportive Care is divided into six sections. The first section attends to what typically happens when a patient first learns about the diagnosis and what treatments are available, as well as treatment side effects and options for pain control. There are helpful chapters describing surgery, radiation therapy, bone marrow transplantation, chemotherapy, alternative and complementary therapies, and clinical trials, though the lengthy description of targeted therapy of cancer is far too advanced for the layperson. The two chapters on side effects of cancer therapy include information on the consequences of such (e.g., severe neutropenia, for example, can lead to delays in or termination of chemotherapy), advice on how the patient and/or doctor can reduce the impact of side effects, and what is tolerable. The chapter on pain control attempts to dispel the myths surrounding opioid use.
The second section coaches patients on regaining control of their confidence and self-esteem. Titled “The Role of the Mind,” it discusses coping strategies for stress and depression--natural responses to news that a person has cancer--and whether or not a patient’s attitude has an impact on medical outcome. In particular, this section has chapters discussing the value of religion, spirituality, and creative expression in helping patients confront and deal with their illness.
Perhaps the most valuable section of the book for the patient, section three focuses on the care of the body. In addition to emphasizing the importance of a well-nourished patient and achieving a balanced diet, this section also instructs on nutrition for symptom management and control, particularly as it relates to the type of treatment or cancer. Which foods least irritate the bowels of patients who have undergone a colonectomy or colostomy? How do you bypass the problem of difficulty swallowing, mucositis, and dry mouth in head and neck cancer cases? What can be done for loss of appetite due to chemotherapy or morphine-induced constipation? And so on. These are also dealt with to some extent in the chapters on modified diets, recipes for the chemotherapy patient, multivitamins, and complementary medications. Rehabilitation and fitness exercises (with illustrations), insomnia, and sexuality are also covered.
Section four includes supportive and social services for life and death issues, such as in-hospital routines, in-home support groups, home nursing, hospice care, grief, and recovery. Section five covers the sensitive topics of when to consider an advance directive, preparing a will, and arranging a funeral or memorial service. The last chapter, “Choosing Life,” reinforces the major messages throughout the book and reminds patients of the relevance of their will to live and the interaction of body, mind, and health.
Finally, the book finishes with a list of supportive care resources including Internet resources, support groups, and relevant literature.
This is an impressive resource for all those wanting to learn about cancer and its consequences. In truth, I have only one criticism to make of this book: the reference in the title to it being Everyone’s Guide is somewhat misleading. The book requires (or assumes) postsecondary education of its readers, or at least grade 10 comprehension--an all too common mistake made in medical literature. A physician would be wise to consider the patient’s and family’s abilities to read and understand the content before recommending such a detailed and possibly intimidating book.
Despite this, physicians and other health care providers will certainly appreciate this comprehensive and well-written overview of cancer supportive care as a teaching tool, and it is a valuable addition to the library of any cancer clinic.
