A valuable plea for honesty between medical professionals and their patients.
A surgeon argues passionately for doctors to notify cancer patients of their condition so they can make informed treatment decisions.
Papachristos (Differential Clinical Significance of Medical Information, 2016) has been the head of thoracic surgery at Greece’s 424 Military Hospital since 1999. He translated this book into English himself, with the assistance of editor George A. Rossetti. In his 32 years of clinical experience, he has developed a deep compassion for those with life-threatening conditions. But he notes that Mediterranean countries, including Greece, have had an unfortunate track record of withholding bad news from patients. In some situations, nondisclosure has even been “justified as a courtesy”: The author cites the example of England’s King George VI, who had no idea he had cancer when he underwent lung surgery in 1951. It is essential, the author argues, for patients to know the whole truth about their cancer so they can give informed consent for procedures. “We are duty-bound to disclose information we know to be true,” he insists. Practical chapters give useful, step-by-step advice on how to break bad news, even giving sample scripts for multiple sessions. In a first meeting, Papachristos suggests, cancer should not be mentioned, but body language cues can begin to prepare the patient. A second session will ready them psychologically; the third will feature “full frank disclosure” and an emphasis on what treatments are available. If time is short, two of the sessions can be combined. Later sections deftly discuss how to inform family and caregivers and decide on pain management. Most chapters open with vivid italicized case studies in which patients were kept in the dark; the author’s principles could have reduced heartache. The book is at times overwritten, with overabundant exclamation points and some moral simplification (for example, attributing the financial crisis in Greece to “poverty that generates nagging greed in the hearts of the wicked”). The writing is not wholly colloquial, with a tendency toward redundant or awkward phrasing and wordiness (“All too often, physicians hypocritically state publicly that they vehemently oppose disclosing cancer diagnoses to their patients out of a professed love and care for them, lest they cause them any distress”). But these minor infelicities of style can be overlooked because the contents are overall so helpful and down-to-earth.
A valuable plea for honesty between medical professionals and their patients.Pub Date: Oct. 26, 2017
ISBN: 978-1-977834-74-4
Page Count: 288
Publisher: CreateSpace
Review Posted Online: March 14, 2018
Kirkus Reviews Issue: May 15, 2018
Review Program: Kirkus Indie
Useful but disappointingly commonplace tips.
In a follow-up to The End of Illness (2012), which explored how technological advances will transform medicine, Agus (Medicine and Engineering/Univ. of Southern California) restates time-tested but too often overlooked principles for healthy living.
The author outlines simple measures that average citizens can take to live healthier lives and extend their life spans by taking advantage of modern technology to develop personalized records. These would include a list of medical tests and recommended treatments. Agus also suggests keeping track of indicators that can be observed at home on a regular basis—e.g., changes in energy, weight, appetite and blood pressure, blood sugar and general appearance. He advises that all of this information be made available online, and it is also helpful to investigate family history and consider DNA testing where indicated. Along with maintaining a healthy weight, Agus emphasizes the importance of eating a balanced diet, with plenty of fresh fruits and vegetables and a minimum of red meat. Avoid packaged vitamins and food supplements, and if possible, grow your own vegetables or buy frozen vegetables, which will generally be fresher than those on supermarket shelves. The author also warns against processed foods that make health claims but contain additives or excessive amounts of sugar or fat. Regular mealtimes and plenty of sleep, frequent hand-washing and oral hygiene are a must; smoking and excessive time in the sun should also be avoided. Agus recommends that adults should consider taking statins and baby aspirin as preventative measures. He concludes with a decade-by-decade checklist of annual medical examinations that should be routine—e.g. blood pressure, diabetes and cholesterol screenings, from one’s 20s on; colonoscopies, prostate exams and mammograms later—and a variety of top-10 lists (for example, “Top 10 Reasons to Take a Walk”).
Useful but disappointingly commonplace tips.Pub Date: Jan. 7, 2014
ISBN: 978-1-4767-3095-0
Page Count: 128
Publisher: Simon & Schuster
Review Posted Online: Sept. 30, 2013
Kirkus Reviews Issue: Oct. 15, 2013
BOOK REVIEW
BOOK REVIEW
Oncologist Agus (Medicine and Engineering/Univ. of Southern California) predicts that the application of advanced technology for modeling complex systems will transform 21st-century medicine.
The author writes that a remark Nobel Laureate Murray Gell-Mann made to him in 2009—“Look at cancer as a system"—transformed the way he views his own specialty and the entire field of preventative medicine. It made him realize that “[r]ather than honoring the body as the exceedingly complex system that it is, we keep looking for the individual gene that has gone awry, or for the one ‘secret’ that can improve our health.” Agus writes that although the ability to sequence the entire human genome is a great step forward, it is insufficient for achieving a significant breakthrough. Even though it may start with a mutation, cancer “is a dynamic process that's happening…far from the confines of a static piece of DNA”—it involves the body's immune system, its ability to regulate cell growth, metabolism and more. Agus directs his university’s Center for Applied Molecular Medicine and is the co-founder of two personalized medicine companies, Applied Proteomics and Navigenics. His hope is that their research will contribute to developing better analytical tools for preventative medicine and for the treatment of cancers. These will address the functioning of the body as a whole, applying digital technology already used by physicists to provide virtual models of cancers and model the action of proteins that regulate cell communication in the body. He also hopes to develop tools that will provide information on the concentration of different proteins in a drop of blood taken from a patient, which may reveal the onset of disease. The author also includes some guiding principles and warnings about certain healthy practices that may not be so healthy. A refreshing change of pace in the medical field, but by venturing beyond his field of expertise to pontificate on a wide range of subjects, Agus makes his otherwise intriguing narrative difficult to follow.
Pub Date: Jan. 1, 2012
ISBN: 978-1-4516-1017-8
Page Count: 288
Publisher: Free Press
Review Posted Online: Nov. 5, 2011
Kirkus Reviews Issue: Nov. 15, 2011
BOOK REVIEW
BOOK REVIEW
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