Balanced and thoughtful
Having some years ago identified the stunned mullet syndrome affecting the cancer patient upon diagnosis, I welcome Joel Nathan's What to do when they say 'It's cancer' as the most steadying influence the patient (and family) could be given at this point. His first advice is 'to press the pause button,' regain control, don't rush into treatment. Having also known the indignity of the experience, he knows the value of dignity, and the importance of hope–early.

The subtitle's claim of being A survivor's guide is a very modest one for it provides more common-sense, practical, useful information than has so far been assembled. The bibliographical notes indicate a more than unusually informed mind on the wide scope of this subject.

Writing out of experience as a three-time survivor, first with leukemia, then 13 years later with lung cancer, and then with a recurrence of his leukemia, and altogether free from any hint of 'schmaltz,' Nathan has avoided the all too often extravagant claims of other survivors who maintain their way is the best way, even the only way. The book is not hyped as 'inspirational.' It has substance, pabulum.

This is a very readable book, but it is not only for the patient. The author's insights into the professional world of the practitioner, of all brands, is extremely useful, with much to be learned by those who rely only their skills and knowledge and who lack awareness of the significance of the right relationship with the patient.

Nathan's advice is to find the right doctor, get a second or third opinion. In this area, as throughout, there are specific practical down-to-earth ideas and observations.

The book has a very balanced chapter on alternative medicine, the author's wisdom born from his own struggle with leukemia. In desperation he had been induced to try dozens of alternative treatments, so he has an understanding of the cancer patient's vulnerability. His advice is wise and uncompromising: demand the facts, the evidence; be warned of the consequences of abandoning conventional treatment; know the myths, the origins and the track record.

It would be difficult to suggest any area of the cancer patient's needs that has not been addressed. Diagnosis and treatment are only two of the matters the patient is concerned with. Within those two headings there are sub-headings of great significance: psychological reaction and understanding your feelings, options and alternatives, patient's rights, side-effects, collaboration with your medical team, sexuality, stress and the immune system, caring and support, death and dying, living in the meantime.

This a readable, informative, practical book that will be of immense value to all involved in the care of the cancer patient. It provides the information and wisdom to prevent drama turning to tragedy.

The sooner people read it, the better. Not only the patient; the husband of a patient recently said of the chapter on carers, 'I wish I had read it 18 months ago.'

Review in Australian Medicine ( 5 October, 1998)
by Helen-Anne Manion, Cancer Care Home Hospice, Bundeena, NSW

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