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This Battle Which I Must Fight. Cancer in Canada’s Children and Teenagers.
  1. ANNE DAVIDSON, Senior registrar in haematology and oncology

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    This Battle Which I Must Fight. Cancer in Canada’s Children and Teenagers. By S Huchcroft, A Clarke, Y Mao,et al. (Pp 110; paperback.) Supply and Services Canada, 1996. ISBN 0-662-24310-2. (The book can be obtained free from: Cancer Bureau, Laboratory Centre for Disease Control, Health Protection Branch, Health Canada, Ottawa K1A 0L2, Canada; fax 00 1 613 941 5497.)

    In addition to coping with the emotional impact of learning their child has cancer, parents have to contend with a bewildering amount of new information. Well written and easy to understand literature is an essential adjunct to the initial consultation. This is useful both for parents themselves and anyone involved in the care of the child, such as extended family members and teachers. Indeed, most parents quite quickly become ‘experts’ on their own child’s disease and its treatment, and often find themselves frustrated by the continual need to dispense sometimes painful information to everyone from the latest new senior house officer or locum GP to the school dinner lady.

    Parents of children diagnosed with malignant disease in the UK are usually offered the information booklets produced by the Leukaemia Research Fund and the United Kingdom Children’s Cancer Study Group.This Battle Which I Must Fight is a useful addition to these. It contains more detailed and complicated information than some families might require at diagnosis. However, despite my initial misgivings about this, parents and non-medical personnel who kindly read some of it for me found the text straightforward and easy to understand. The ‘vignettes’ provided by the children themselves are, as always, moving. I found these the most instructive aspects of the book. I have used some of the insights to help communicate with adolescents in particular.

    There are excellent sections on the causes of cancer, trials (including what phase I, II, and III trials mean), and unproved treatments. The emotional and psychological impact of the disease are particularly well dealt with. One of the parents to whom I showed the book found the section about the effect on siblings as particularly helpful. I thought the section ‘how to help’, aimed at relatives and friends, was sensitive and practical.

    The emphasis on Canadian data was slightly disorientating, but was presumably because the book was produced as part of a Canadian government funded health initiative. I found many of the tables and graphs superfluous and parents found them complicated. Another irritation was the title. ‘Battle’ is always a word I dislike in the context of childhood cancer. It is all too often used in tabloid newspaper reports and can leave families with an inappropriate sense of personal responsibility. One mother of a child with relapsed disease commented that the title to her suggested that ‘you lose the battle if you relapse’.

    However, these are minor points and overall I think many parents would find this book helpful. The book can be read in an evening, and I would certainly recommend it to GPs and other medical and nursing staff who may only see children with cancer occasionally.

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