This is “Breast Cancer Awareness” month, the much-hyped recognition of a serious problem that we should be conscious of throughout the year. The associated “pink ribbon” campaign sometimes feels akin to a “Hallmark holiday" sales gimmick, rather than recognition of the pain of breast cancer and need for further research. Carmen Gonzalez just had a great post on this marketing ploy at OccupyHealthcare. For more appropriate acknowledgements of the gravity and magnitude of the problem, I suggest following Xeni Jardin on twitter (@xeni) and Lisa Adams (on twitter @AdamsLisa), as well as joining the Twitter #bcsm group chat, founded by Jody Schoger (@jodyms) and Alicia C. Staley (@stales) on Monday evenings at 9 p.m. (EST).
But among all the pink confections, this month also brought me something substantive and welcome—a review copy of the Breast Cancer Checklist by Fern Reiss, a Harvard graduate and dynamic author of The Publishing Game series.* Fern learned she had breast cancer 2 years ago and underwent surgery, radiation, and chemotherapy. She wrote this book to be the easy-to-use resource she wished she had at that time.
Fern has succeeded admirably in her goal of providing a comprehensive, user-friendly resource. She covers an array of topics, including questions to ask your doctor as you make treatment decisions, and things to help you through each step of treatment. Her suggestions are very pragmatic.
As anphysician, I was immediately entranced by her first two of the Top 30 suggestions. The first was “Make a dental appointment.” The second, “Get vaccinated.” While it may seem odd to nonmedical people, this was perfect for me, as it addressed one of my pet peeves—patients sometimes beginning chemotherapy so hastily that simple preventive measures which will be important later, when they are immunocompromised from chemo and at risk of infection, are overlooked. (Having a skin test for tuberculosis is also valuable, especially for older or immigrant patients).
Fern’s organizational skills are put into play with a series of practical checklists—from having one place (in her book) for contact information for each member of your health care team, to medical results, to insurance information. She has an extensive list of questions to ask your physicians—good for you, but likely more than can be tackled at one visit. And she stole a line I often use with my patients, “Is there anything else I need to know that I’ve forgotten to ask?”
I liked the practicalities of lists of supplies and products that will help make the surgical recovery more comfortable, like holders for surgical drains that I hadn’t seen before. Similarly, there are tips for help with meals and services like mealtrain, and groups that offer free or reduced fees for women with breast cancer, for services like housecleaning or transportation and supplies like wigs or head coverings.
As with Fern’s earlier book, Terrorism and Kids: Comforting Your Child, there are excellent suggestions for talking with your children about your cancer and treatment. Similarly, there are sound suggestions for telling friends and for communicating your needs to them so they can coordinate and better provide effective support.
Fern’s checklists for preparing for the hospital and your return home are quite helpful, not just for women with breast cancer, but anyone needing surgery or a hospital stay.
There is one chapter that raised my eyebrows—the diet recommendations. This is not an area that is taught well to physicians, and recommendations are constantly changing anyway. Many of Fern’s thoughts on diet are likely to be a bit controversial. Fortunately, she provides extensive references to medical journals to support her recommendations; I look forward to exploring these and learning more, as it appears that she has researched this in depth.
There are great chapters on coping with chemotherapy and radiation therapy that are again broadly applicable to anyone undergoing cancer treatment. Then there are specific chapters focusing on breast cancer, ranging from finding a prosthesis and preventing lymphedema to tumor markers and targeted therapy, such as Herceptin and Tamoxifen.
Fern has an interesting video clip on her website regarding how this book came into being as well as her goal of crowdfunding publication of this book.
I am extremely impressed by Fern’s thoroughness and the ease of use of her book. Her suggestions are applicable to many cancer or general surgical patients. The Breast Cancer Checklist is chock full of great ideas for women and their families! Many are things that I wouldn't have occurred to me or that I haven't seen elsewhere.
The Breast Cancer Checklist is a great resource and contains a wealth of practical information. I will suggest it to my oncologist friends for all their patients, not just those with breast cancer.
*(Full disclosure: I met the author, Fern Reiss in 2006 when I attended her workshop on publishing).
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Mammography procedure - NIH
Mammogram - NCI
Breast cancer cell - NCI