Everyone's Guide to Cancer Supportive Care

As an oncologist, I am always on the lookout for good patient education material. This book, which is based on the experience of the Stanford Integrative Medicine Clinic Cancer Supportive Care Program, is a good choice for a highly literate, print-oriented patient or family member. The book is divided into five parts: (1) Cancer: Diagnosis, Information, and Treatment, (2) The Role of the Mind, (3) The Care of the Body, (4) Supportive and Social Services for Life and Death Issues, (5) Planning for the Future, and (6) Resources. These five parts are divided into 50 individual chapters covering specific topics, and the chapters are focused, concise, and practical.

The best of the chapters address common patient concerns from a clinically responsible point of view. A chapter entitled "Does Your Attitude Make a Difference?" covers the scientific knowledge on this topic in a very accessible way. Another detailed chapter on "Nutrition for Symptom Management and Control" gives many practical suggestions.

The comprehensive book covers a wide range of supportive care issues, with material ranging from pathophysiology and medication tables to visualizations, recipes, and financial worksheets. Most of the 83 contributors are from Stanford or the University of California at San Francisco, and they share a great deal of clinical and practical wisdom from a seasoned perspective. Oncologists can point patients toward this book as a source of quality information, as it is hard to imagine a patient making unsound choices based on this material. The format emphasizes small bite-sized pieces of text, sometimes offset in boxes, so that the overall impression is somewhat like an encyclopedia.

The encyclopedic nature of the book may, however, present difficulties for some readers. The organization into the parts described above does not follow the trajectory of a patient's experience with cancer, so readers must be prepared to browse extensively. While the table of contents and index are useful, the graphic organization requires that readers flip back and forth in a very large volume to find what they are looking for. These issues may present little difficulty for highly literate readers who are accustomed to looking in print media for health information, but represent daunting tasks for readers who are less literate or are emotionally overwhelmed by the cancer experience.

Some of the chapters are less useful. A chapter on exercise has grainy, difficult-to-see photographs of Jack LaLanne doing routines in bed. A chapter entitled "Dealing With Death if Cancer Becomes Terminal" fails to mention the term "palliative care," which in many cancer centers and hospitals describes the supportive care services.

The book seems aimed toward patients who are undergoing anticancer therapy for the first time. No chapter covers the difficult transitions that many patients must make when anticancer treatment is no longer feasible, and survivorship is not specifically addressed. Finally, although the authors are affiliated with an integrative medicine program, there is relatively little material on complementary and alternative medicine, and patients who want to pursue these avenues will likely want additional information.

Family caregivers will find the book useful but will need to read selectively, as many chapters mix advice for patients and family caregivers. There is a box on "When your spouse has cancer," but it is located far from the chapter on depression and is not listed in the table of contents. There is a chapter for family members on grief and bereavement, but no chapter dealing with the last days of the patient's life.

In summary, this book is a good choice for highly literate patients who are used to dealing with print media, and the balance of topics is most suited for patients with earlier-stage cancers who are actively undergoing anticancer therapy.

—Anthony Back, MD