FACT OR FICTION?

• 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.

"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)

Read Who Survives Cancer? Online

Hardcover: 280 pages
Author: Howard P. Greenwald
Publisher: University of California Press; 1 edition (October 23, 1992)
Language: English
ISBN-10: 0520077253
ISBN-13: 978-0520077256

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).

CONTENTS
Preface
Chapter One  The Problem and Its Context
Chapter Two  The Disease and Its Survivors
Chapter Three  Cancer Treatment: The Industry of Hope
Chapter Four  Can Cancer Be Prevented?
Chapter Five  Emotional Health and Cancer Survival
Chapter Six  Early Detection: The Key to Cancer Survival?
Chapter Seven  Class and Cancer Survival
Chapter Eight  The Health Maintenance Organization: A Model for the Future?
Chapter Nine  Conclusion: Personal Strategies and Public Issues
Appendix A  The Seattle Longitudinal Assessment of Cancer Survival (SLACS)
Appendix B  Statistical Methods and Tables
Index

PREFACE
The ancient Greek historian Thucydides knew that social and economic conditions can determine the health and illness of a people. This quotation from The Peloponnesian War reflects a profound awareness that the state of society may become a life-or-death matter. In the darkest days of that war, Sparta laid siege to Athens.

thenians from the countryside, forced to take refuge within the city's walls, soon began to sicken and die. A monstrous epidemic enveloped the city. Contemporary Athenians attributed the calamity to violation of sacred places by the newcomers. But Thucydides, the first "social epidemiologist," thought otherwise. His chronicle suggests that war, siege, and the crowding together of people in all available space gave rise to the uncontrollable plague.

Many view cancer as the plague of modern times. Like epidemics of past ages, cancer defies the efforts of the best physicians to cure the patient or prolong his or her life. As their forebears viewed other disease, people in the modern world view cancer with a special degree of terror. And people today explain this disease in spiritual terms, seeking the cause of illness in the individual's personal outlook, spirit, or life force. In this respect, today's spiritualists are no less in error than the ancient Greeks. ...

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