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Who Survives Cancer?

by Howard P. Greenwald

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From Publishers Weekly
Addressed more to health-care professionals and policymakers than to the lay public, this book by Greenwald ( Social Problems in Cancer Control ), a professor in the University of California's School of Public Administration, makes it clear that we are not winning the war against cancer. In a well-documented text, he looks at how class, race, sex, psychological state and available treatments can affect one's chances of survival. Much of the book focuses on the Seattle Longitudinal Assessment of Cancer Survival, whose researchers have collected data of patients with diagnoses of four cancers--lung, pancreatic, prostate and cervical. Greenwald claims that preventive and experimental therapy have limited value, and that conventional medical care is crucial in influencing cancer survival. He underscores the need for early detection, but is quick to note some of its limitations, especially in certain kinds of cancer (e.g., pancreatic). Instead of concentrating on research and the hope of a breakthrough, he believes the goal should be extending access to basic care for all Americans. People can increase their chances of surviving, he believes, by getting practical--learning more about therapeutic options and obtaining second opinions.
Copyright 1992 Reed Business Information, Inc.

From Library Journal
Epidemiological studies reveal surprises about the likelihood of surviving cancer, according to this important book. The author's original research on cancer mortality indicates that timely access to health care--readily available to affluent white Americans but not to impoverished minorities--is one of the most important factors in cancer survival. Greenwald's findings also cast doubt on many psychosocial theories of cancer survivorship. He contends that more health-care dollars ought to be allocated to making conventional health care available to all races and classes rather than to experimental treatments and preventive approaches. Thought-provoking and highly recommended for research collections.
-Judith Eannarino, Washington, D.C.
Copyright 1992 Reed Business Information, Inc.

Book Description
*A white male earning over $35,000 a year has a better chance of surviving most types of cancer than an unemployed African-American male.
*Psychological factors predispose people to contracting cancer and improved emotional health promotes recovery.
*Early detection is useless in curing cancer.
*Experimental, not conventional, treatments offer the most benefits and longer survival rates to cancer patients.
*A scientific breakthrough of practical and immediate significance in cancer treatment is imminent.
*Cancer prevention is ineffective in many areas and campaigns will probably never achieve a reduction of cancer mortality approaching 50 percent.
*Health Maintenance Organizations (HMOs) increase survival chances for most cancer patients.

Howard Greenwald takes an incisive new look at how class, race, sex, psychological state, type of health care and available treatments affect one's chance of surviving cancer. Drawing on an original ten-year survival study of cancer patients, he synthesizes medical, epidemiological, and psychosocial research in a uniquely interdisciplinary and eye-opening approach to the question of who survives cancer and why.
Scientists, health care professionals, philanthropists, government agencies, and ordinary people all agree that significant resources must be allocated to fight this dreaded disease. But what is the most effective way to do it? Greenwald argues that our priorities have been misplaced and calls for a fundamental rethinking of the way the American medical establishment deals with the disease. He asserts that the emphasis on prevention and experimental therapy has only limited value, whereas the availability of conventional medical care is very important in influencing cancer survival. Class and race become strikingly significant in predicting who has access to health care and can therefore obtain medical treatment in a timely, effective manner. Greenwald counters the popular notion that personality and psychological factors strongly affect survival, and he underscores the importance of early detection. His research shows that Health Maintenance Organizations, while sometimes prone to delays, offer low-income patients a better chance of ultimate survival. Greenwald pleads for immediate attention to the inadequacies and inequalities in our health care delivery system that deter patients from seeking regular medical care.
Instead of focusing on research and the hope for a breakthrough cure, Greenwald urges renewed emphasis on ensuring available health care to all Americans. In its challenge to the thrust of much biomedical research and its critique of contemporary American health care, as well as in its fresh and often counterintuitive look at cancer survival, Who Survives Cancer? is invaluable for policymakers, health care professionals, and anyone who has survived or been touched by cancer.

From the Inside Flap
"Who Survives Cancer? is by far the most comprehensive analysis of studies of cancer survival. Howard Greenwald evaluates heredity, diet, emotional state, treatment protocols, early diagnosis and access to care. Of all of these, early access to diagnosis and care were the major factors in "transforming cancer from a sure killer to a manageable risk." This book is a must-read for the American health care debate."--Dr. Jane Fulton, University of Ottawa

"Into the cauldron of controversy about how to finance health care in these United States, Greenwald injects a new variable: the impact of payment on the survival of cancer patients. He makes a compelling case for the life-prolonging benefits of standard procedures for the early detection and treatment of cancer. If cancer concerns you, read this book. Its conclusions could save your life."--Charles Haskell, M.D., author of Cancer Treatment

"Reading Who Survives Cancer? will help people understand why progress against cancer is slow. In particular, it highlights the important non-biomedical factors in cancer survival and patiently explains why some popular notions are not supported by science."--Lester Breslow, M.D., M.P.H., University of California, Los Angeles

From the Back Cover
"Who Survives Cancer? is by far the most comprehensive analysis of studies of cancer survival. Howard Greenwald evaluates heredity, diet, emotional state, treatment protocols, early diagnosis and access to care. Of all of these, early access to diagnosis and care were the major factors in "transforming cancer from a sure killer to a manageable risk." This book is a must- read for the American health care debate." (Dr. Jane Fulton, University of Ottawa)

About the Author
Howard P. Greenwald is Professor in the School of Public Administration at the University of Southern California and the author of Social Problems in Cancer Control (1980).



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