Book Review: The Thinking Woman's Guide to Breast Cancer by Janet Maker

The Thinking Woman’s Guide to Breast Cancer is a concise and well-written gift for women navigating the medical system and trying to make better-informed decisions. Based on her personal experience with breast cancer and well-honed investigative and critical thinking skills, Janet Maker Ph.D. offers readers a full spectrum of insights, resources, and even warnings when facing a breast cancer diagnosis and treatment that applies just as well to any other crucial health issue. Highly recommended.

–Bonnie Spanier, Associate Professor Emerita, University at Albany (SUNY),

Janet Maker’s The Thinking Woman’s Guide to Breast Cancer offers insights and resources for women diagnosed with breast cancer as they navigate the challenges of a complex health care system that is full of as many promises as it is shortcomings.

Diagnosed with a breast cancer of an uncertain origin in 2011 at the age of 68, Janet Maker found a new use for the analytical and critical thinking skills she honed as a Ph.D. in Educational Psychology, professor, and textbook author. The breast cancer identified in three lymph nodes were nowhere to be found in the rest of her body, breasts included. With disparate medical opinions from doctors who were uncertain about how to manage the atypical diagnosis, Janet went on her own fact-finding quest to find out what approaches and options felt right to her. She soon became well aware of the strengths and limitations of modern medicine.

As Janet skillfully tells her breast cancer story in the context of a longtime history with fibrocystic and dense breast tissue, she shares the specifics of her diagnosis, reliable information about treatments and breast reconstruction, and the tests she used to help make treatment decisions while drawing on both conventional and complementary cancer medicine to stay mentally and physically healthy.

Throughout the book, Maker reveals insightful details about her dealings with doctors and the rest of the healthcare system that would help anyone to navigate serious illness. For instance, learning what insurance covers, accessing your health file, keeping a medical journal, checking your local hospital’s safety record, managing advice from multiple doctors, and comparing a doctor’s treatment advice to medical consensus (such as NCCN, National Comprehensive Cancer Network) to make informed, evidence-based medical decisions. She also cautions that while the Americans with Disabilities Act protects employees from being fired due to illness, it does not prevent employers from aggravating you enough to quit.

Maker’s book goes well beyond case specifics that are essential to understanding valid options. Citing reliable critiques lends credibility when she offers advice and highlights the ways that biomedicine systematically falls short of its promises. Chapters on treatment decisions and results (Chemotherapy, Radiation, Hormones, The Aftermath, and Lifestyle Changes) grapple with how she handled incomplete or contradictory answers to the questions she had, for example, about whether to get a reconstruction after a mastectomy or choose a lumpectomy/wide excision. Describing how she worked to understand the potential benefits and harms of these and other treatment options, she contextualizes her decisions and experiences by sharing the questions she asked and what she learned from a variety of sources, including other women, local and online groups, chat room peers, and medical sources.

Janet Maker makes two major recommendations in the “how-to” section of the book. Be sure to have a strong “patient advocate,” preferably with a medical degree, and also an “integrative oncologist” who combines conventional (allopathic) medicine with complementary / alternative / holistic medicine. Although “integrative medicine” can mean different things, such as relying on multidisciplinary medical teams, Maker is referring to an approach from Keith Block’s Life over Cancer in which integrative oncology is based on the generally accepted theory of controlling cancer by modifying the local environs around it to keep tiny or larger masses in check. In practical terms, this means using complementary treatments that often include prescribing nutritional supplements (based on in-depth blood and other tests) aimed especially at minimizing the side effects of drugs and treatments to maintain good general health.

Concerned, like many of us, about alleviating the collateral damage of conventional (over)treatment, Maker also cites Servan-Schreiber’s popular Anticancer: A New Way of Life. That book is rooted in scientific promise based in cell and animal research and some very small human studies, making its claims of benefits in mortality reduction iffy. But it offers an antidote to feeling helpless in the face of cancer. Though she adopts this anti-cancer / integrative approach, she makes clear that it bears no guarantee of success.

Throughout her book, Janet Maker does not claim to have “the right answers” and accepts that evidence-based medicine offers few absolute certainties. But she does subscribe to the point of view that cancer-causers and –promoters are everywhere and that, had she known this sooner, she would have addressed lowering her risk from these influences. The final chapters on (What You Should Know about Breast Cancer and Take Action) share this perspective while offering clear evidence about cancer-promotion. She considers individual actions toward prevention that include lifestyle changes and addressing chemical toxicities in everyday products, and acknowledges that societal changes to clean up the environment at large are essential.

Janet Maker’s voice is clear and compassionate, and her individual insights and recommendations are set within sound biomedical information. Her values are explicit and persuasive about individual and societal responsibilities for health. And for those of us who have not endured a diagnosis but want to be part of the solution, this book is important reading.

Janet Maker earned her Ph.D. in Educational Psychology from the University of Southern California, an M.S. in Social Work from Columbia University, and a B.A. in English from the University of California, Los Angeles. She retired in 2003 from a distinguished career as a professor and author of leading textbooks in the field of College Reading.

The Thinking Woman’s Guide to Breast Cancer: Take Charge of Your Recovery and Remission by Janet Maker. Jane Thomas Press (2017). 342pp. ISBN (Hardcover) 978-0-9976619-0-3 | ISBN (Paperback) 978-0-9976619-1-0 | ISBN (eBook) 978-0-9976619-2-7.


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