© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 16, 1418-1419,
August 18, 1999
© 1999 Oxford University Press
BOOK REVIEW |
Women's Cancers: How to Prevent Them, How to Treat Them, How to Beat Them
Kerry A. McGinn, Pamela J. Haylock, eds. Alameda (CA): Hunter House Publishers, 1998. 496 pp., illus. $19.95. ISBN 0-89793-223-4.
Correspondence to: Merle O'Rourke Thompson, Ph.D., 6012 Morgan Ct., Alexandria, VA 22312.
In this excellent book, Kerry McGinn and Pamela Haylock use their experience as oncology nurses to give comprehensive information about the cancers that affect women most often: those that occur primarily in women (breast, ovary, uterus, cervix, vagina, and vulva cancers) and those that occur in large numbers of women (lung and colorectal cancers). McGinn has experienced breast cancer, and both authors are daughters of cancer patients. Each author handles the cancer she knows best: McGinn, breast cancer; Haylock, the reproductive, lung, and colorectal cancers.
In Part One, both authors discuss women's cancers in general, including such topics as prevention, diagnosis, treatment, and emotions. Immediately, in a discussion of what cancer is, the reader finds one of the best attributes of the book, highlighted medical words with definitions such as atypical, lymph system, and metastasis, all woven seamlessly into the text. These words are also listed alphabetically in a glossary at the end. I applied my usual test for a glossary, which is to look up infiltrating, the word the pathology report used for my breast cancer, and bingo! it was cross-referenced to invasive, the word my doctor was using. It is rare for a book to cover such minor material, but it would have saved me several weeks of frustration (read anxiety) at the beginning of my trek through the disease. So simple now, those words seemed so complicated to me then, as would similar ones to the newly diagnosed woman. McGinn covers so many topics in her chapters that I was not too surprised to find within her discussion of cancer causes an outline of the "hits" theory, as in a cell might need several "hits" (tobacco, alcohol, age, heredity, diet, environment, etc.) before it reaches critical mass and the cancer switch turns on. This theory is my favorite, one not often explained by authors, but it settles for me competing claims about life habits that guarantee to forever prevent you from getting cancer. McGinn also addresses one of my piques in Chapter 3 on "Early Detection," when she cautions the reader to be skeptical of early detection statistics, because "early detection" sometimes simply finds a cancer a little earlier, which then progresses the way it would have in any case. The woman dies the same day she would have died had it not been found "early." To be truly effective, early detection must make a real difference in survival.
Part One continues through careful chapters on "Diagnosis" with detailed descriptions of various biopsies; "A Woman and Her Doctors," with good information on getting second opinions and working with a medical team; "The Rest of the Team," with paeans for support groups; "Local Treatments" and "Systemic Treatments," which are exhaustive in explaining the reasons for these differing therapies; "Alternative Therapies," which bows to herbs, diet, drugs, and so on; and finally "Feelings," in which McGinn wields her satisfying language skills to useful effect, saying that on diagnosis, "women . . . feel an intense blast of fear or anxiety," or quoting a therapist who hates that "positive attitude bullshit." At the end of Part One, I was ready to follow McGinn anywhere.
Part Two, which happened to discuss breast cancer, covered territory that I am most familiar with. Disliking the language "breast disease," she uses "breast changes," which stands well throughout the chapter, including an eight-page discussion with diagrams of breast self-examination. The cancer diagnosis section includes a comprehensive list of types of invasive cancer, which named comedocarcinoma, which was my type 12 years ago and I've yet to find it listed in any of the books I've since reviewed. Next follows a comprehensive chapter on surgery that covers everything from packing for the hospital, to cleaning the drain when you're home again, and one on treatment beyond the basics, such as regaining arm mobility, prostheses, and reconstruction. Diagrams here tend to be symbolic rather than realistic, and there is no mention of the pain associated with implants under the muscle (personally, it felt like a horse was sitting on my chest making sure I couldn't breathe). Such caution vanishes in the section on recurrence, however, which follows the relatively minor local recurrence to multiple distant metastases, treatments from chemotherapy to bone marrow transplants, concluding with a discourse on the importance of pain control, "when cure is not possible, comfort always should be."
Part Three, "Reproductive Cancers," reads just as easily, written in Haylock's voice; the material is as thorough, clear, and comprehensive as in other sections.
Part Four, "Lung and Colon Cancers," interested me because of the link between breast and colon cancers and because they discovered a polyp in my recent colonoscopy. Haylock reassured me that evidently I'm getting proper care, and I've asked the best questions. Again, there are lists of the types of colon disease that includes cancer, diagrammatic lists of staging, details of surgery and post-surgery conditions, and a candid review of prognosis, all using highlighted technical terms with definitions. I found out all I needed to know.
Covering all the details of these dreaded diseases, including a painful death while maintaining calm, tender, and concerned voices is the most amazing quality of this book. The authors enact what they advise: you maintain your personality and dignity best by learning and living with the truth, which is the true positive attitude.
Part Five, "Life after Cancer," is again comprehensive, and confronts issues as modest as the ironic overwhelming fear a cancer patient faces an hour after the treatment ends and as significant as monthly searches of the scar, looking for recurrence. McGinn uses her personal experience to lead the reader through normal reactions, from what I and my friends call the "hang-nail syndrome" to the anxiety triggers such as the annual anniversary. My adult offspring asked me after 2 years to get my annual checkup in an off-month, so that I wouldn't ruin Christmas as my January anniversary anxiety approached. There are the issues of body image, of sexual relationships, of instant menopause. I don't think McGinn ever had night sweats if she thinks light clothing will help or daily, hourly hot flashes if she thinks a paper fan would help. And I found it sad that the list of sleep aids did not include low dose antidepressive medicines, such as Deseryl or Elavil for their sedative effect. These medications don't so much put you to sleep as they keep you asleep so that you don't become a night-wandering woman. Over half of my friends in their 60's and 70's are taking one of these medicines to great effect. But these complaints are quibbles in an almost encyclopedic section.
Throughout their book, the authors weave into their concern for patients relevant particular advice on dealing with hospitals, insurance, the contemporary problems of HMO's, legal facts, and the finances of ongoing care. Continually, they refer to many resources: Internet, e-mail, books, and organizations, both general and disease-specific. I've rarely seen a better, more exhaustive list than the one with which this book concludes. It caps one of the best and most comprehensive cancer books I've ever reviewed.
Oncology nurses are often the best people to write such books, combining as they do their scientific knowledge, practical experience, and close interaction with patients. I've never advised this before, but I say now that everyone should rush out and buy this book for each woman in the family. I will. Any woman would do well to have this book on her personal reference shelf. As she gets older (as this book points out), it is probable that she will need it.
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