Editorial Reviews of The Journey Through Cancer
Journal of the National Cancer Institute
Volume 92, Number 17
September 6, 2000
The Journey Through Cancer
Jeremy R. Geffen, MD
Crown Publishers, NY: 2000
288 pp, $24. ISBN 0-609-60450-3
When a 69-year-old friend was recently diagnosed with stage IIIB lung cancer, his family and friends wondered how he would manage his late-stage disease. Dr. Geffen's The Journey Through Cancer will be my gift to him to help him on his journey. An oncologist who integrates traditional and nontraditional medicine, Dr. Geffen offers a compassionate holistic approach for cancer patients and the people who love them.
Note that I wrote "journey." Dr. Jeremy Geffen dislikes the whole metaphor of war usually used for cancer, with terms like "battle" and "survivor." He offers in its place the metaphor of a journey, such as a whitewater rafting trip, with terms like "safe" or "frightening new turns." Although Dr. Geffen is a board-certified medical oncologist, he has more than 20 years of experience exploring the spiritual and healing traditions of the East, including Ayurveda, Tibetan Medicine, yoga, meditation, and other approaches to self-awareness. Offering his patients the scientifically proven therapies of Western medicine to deal with the illness, he then offers alternative approaches from other disciplines to help treat the person who has the illness.
After initial chapters that analyze the purpose of medicine, describing the strengths and vulnerabilities of the modern cancer patient, and finally outlining the scientific successes of surgery, chemotherapy, and radiation therapy in various types of cancer, he gives the readers a seven-level program that addresses all of the aspects of who we are as humans -- body, mind, heart, and spirit. He explores the "critically important role that all of these dimensions of ourselves play in the healing process."
At Level 1, the patient gathers information about his or her illness. As many cancer books do, Dr. Geffen advises patients to recognize that fear is natural and that the decision-making process can be slowed down. When he discusses choosing a doctor, however, he deviates from the usual advice; he strongly advises that the doctor selected should respect both body and spirit. Patients need to give attention to both realms and recognize that they need a leader for the journey. In this chapter, Dr. Geffen gives short, but useful, treatment summaries for common cancers, which gets the reader well on the road to pertinent information.
Level 2 involves people other than the patient, because "connection with other people lies at the heart of healing." When a patient uses a cancer diagnosis to make new connections rather than to lose old ones, cancer can become a bridge to a larger world, rather than imposing isolation. Citing the well-known research that support groups foster healing, he outlines many types of such support and why they work.
With Level 3, the patient finds ways of dealing with himself or herself, the person who has cancer, focusing on the body as a "garden that needs tending." In a long section on diet and nutrition, he admirably covers myths and realities, handling everything from fat to antioxidants before outlining a sensible eating program. A brief, powerful section clearly analyses how the family is not responsible for the patient's nutrition, surely a relief to many patients whose families are nagging them to eat more broccoli. This chapter also deals with Eastern medical tradition and alternative therapies, such as aromatherapy; yoga; massage, which releases endorphins; exercise; acupuncture; relaxation; and journaling. Daily writing about the journey improves the immune system and overall health. This chapter ends with a long list of things that patients can do to make themselves feel better during the journey.
Level 4 moves from the clinical issues of cancer toward the inward journey of the cancer patient. Dr. Geffen makes a strong case for vigorously moving patients to acknowledge emotional reactions to their disease. Again, he recommends journaling, support groups, and perhaps a private therapist as a means through this crucial stage.
Level 5 deals with habits of the mind. It seems obvious that thoughts, attitudes, and beliefs can radically alter the perception of disease. Dr. Geffen offers a quiz that begins with "What are my beliefs about cancer?" I have another friend now with ductal carcinoma in situ who is convinced that she will die in 6 months despite her doctor's reassurances that she has probably already been cured. My friend with stage IIIB lung cancer feels he can be cured, despite the written report saying that he is being offered palliative treatment. Obviously, these friends are experiencing their journeys differently. Other questions ask patients to examine their beliefs about chemotherapy, causes of cancer, doctors, spirituality, God, and life after death. During my bout with breast cancer 14 years ago, I would have had a hard time dealing with those questions, but they would have transformed my "bout" into a "journey," I'm sure.
Level 6 asks patients to make a life assessment, to explore the meaning of their lives and especially how they want to be remembered.
Level 7 suggests that the inevitable question "Why me?" is disempowering. It is better to ask how to learn and grow from illness, how to fulfill the purpose of life, and how to discover the self.
As a devotee of Western medicine and a skeptic of alternative therapies, I approached this book with a jaundiced eye. But Dr. Geffen's calm, balanced voice of experience convinced me that he is on to something. First of all, he endeared himself to me by challenging the war-on-cancer metaphor. Then he led me to understand the value of both hard and soft science when he acknowledged the responsible and irresponsible aspects of both. I'm sure that a reader approaching the book as a modern medicine doubter would reach the same conclusion. Throughout, we read case histories and conversations with patients. Although these conversations seem contrived, they do suggest that Dr. Geffen spends hours with patients trying to alleviate various pains. Modern managed care works against such efforts, so I'm not sure that Dr. Geffen's program would work any place other than his own clinic. Nevertheless, many medical care givers might find ways to incorporate its wisdom into their handling of cancer patients. The media would find a new metaphor for writing and talking about cancer. And a cancer patient at the start of the journey might find it a compassionate gift.
Merle O'Rourke Thompson
Correspondence to: Merle O'Rourke Thompson, PhD,
6012 Morgan Ct., Alexandria, VA. 22312
(email: firstname.lastname@example.org )