Cancer: a handbook

In The Sunday Telegraph Rosie Squires revealed that statistics from the NSW government agency tasked with improving outcomes in cancer diagnosis, treatment, care and survival, the Cancer Institute of NSW, indicated that the war on cancer is being won. Amen to that.

Ms Squires reported that five-year survival rates are soaring to record levels."The odds of beating the dreaded disease have risen to 64 per cent compared with49 per cent in 1982". And "mortality rates from breast, prostate and thyroid cancer have plunged in the past three decades following ground-breaking advancements in screening and treatment of all forms of the disease".

For those diagnosed with cancer this is terrific news. In fact, so good that leading oncologists predict that if Australian research continues at this rate, within two decades some of the most feared cancers will have been cured and turned into chronic diseases. After all, diagnostic tools have, in the last five years greatly improved clinicians 'understanding of tumours and specialists now know which cancers best respond to chemotherapy and which need a different treatment.

Another bit of good news included the story of Ms Kylie Darmanin from far western Sydney who was diagnosed two years ago with Stage 3 Melanoma who found support in Mr Jay Allen, who had prevailed over the same disease two years earlier.

Mr Allen's reaction to his diagnosis was emblematic of most sufferers: "I was 32, it was a total shock. I felt alone and very frightened. I thought I was going to die for eight months after diagnosis."

What was clear from Rosie Squires' three-part report is what was not mentioned. And what was not mentioned is a reality for many Australian patients awaiting confirmation of the news that they may or may not have the dreaded disease. That is, that there is an absence of a much-needed guidebook to cancer. A book that addresses the concerns of patients and their families. A book that comforts, informs and helps traverse the pathways to understanding what is cancer, why some people develop it and how it can be treated.

An easy to read, easy to find, popular, well informed handbook for patients explaining the whole shebang from diagnosis to acceptance to options to managing cancer seems invisible in the Australian market.

Out of luck at local bookstores, I was one such patient.

But fortunately for me, in the weeks after I was told my (hand) tumour looked "suspicious" I happened to be in a bookshop in Anchorage when I discovered Dr Mathew D. Galsky. Or more correctly, a book penned by the former oncologist with the Genitourinary unit at Memorial Sloan Kettering Medical Center, arguably the world's leading centre for cancer treatment. He is now with the Comprehensive Cancer Center in Las Vegas, Nevada.

In Everything You Need to Know about Cancer he presents a guide to the disease that is neither encyclopaedic nor folksy in style. He doesn't offer a menu as to what to eat and what pills to pop to help you steer the disease. His contribution is 130 odd pages of step-by-step explanations from the moment of diagnosis. Topics covered include:

· What is cancer? Here he describes benign tumours, malignancy, carcinomas, leukaemia, lymphoma, mass, metastasize and sarcomas.

· What is the bone marrow and why is it important in cancer? Bone marrow Galsky explains is a factory, which produces three major types of cells: white, red and platelets. White blood cells are infection-fighting cells. When they are reduced in numbers or functioning abnormally, one is at risk of developing infections. Red blood cells carry oxygen from the lungs to other parts of the body. When they are decreased in number, the condition is referred to as anaemia. Platelets are the cells that keep us from bleeding. When the number of platelets is short, one is more susceptible to bleeding. The chapter explains that while cells are constantly produced by the bone marrow, problems develop if a cancer arises in the bone marrow (called "liquid" tumours as opposed to cancers that start in solid organs like the colon, called "solid" tumours) or if the side effects of chemotherapy suppress the body's bone marrow's ability to manufacture cells.