J. W. Cullen. B. H. Fox, and R. N. Isom, editors CANCER: THE BEHAVIORAL DIMENSION New York: Raven Press, 1976, 390 pp., $1 7.50 (a National Cancer Institute monograph).
This is an interesting volume by an assortment of capable observers who approach the subject with the insights provided by their own discipline. It sets out to "identify and explore the application of the behavioral sciences in cancer prevention, detection, diagnosis, treatment, rehabilitation and continuing care." While a great deal more is known about cancer than was the case in the earlier decades of this century, it is still an enigma. The conference that produced this volume was intended to assess present knowledge of the behavioral sciences as they relate to cancer management "and to strengthen the interest of behaviorists in this chronic disease . " The Division of Cancer Control and Rehabilitation, formed within the National Cancer Institute, has as its mandate to translate into use the knowledge of cancer that is being assembled from all disciplines.
One cannot go into detail about a nearly 400-page volume, but one will be enticed to read further on reading in the Foreword that
The majority of all cancers are preventable and result from exposure to environmental carcinogens. Reducing and eliminating cigarette smoking, altering dietary habits, reducing overexposure to sunlight and controlling occupational hazards are examples of how behavioral modification could effect meaningful cancer prevention.
The book states that while we have apparently made more progress in acquiring knowledge about cancer in the past 25 years than in the entire previous history of humanity, there are still too many physicians and teachers who have defeatist attitudes regarding cancer therapy. It will interest psychiatrists to read that there is a strong and understandable propensity for physicians in all specialties to "concentrate on the presenting medical problem and its solution rather than on the patient as a person." Psychiatrists will recall wryly that they have been trying to get physicians to consider all patients as persons rather than simply to consider the presenting medical problem.
Psychiatrists will also recognize the name of Allen J. Eneiow, who contributed a chapter on "Group Influences on Health Behavior: A Social Learning Perspective." Undoubtedly it would do psychiatrists good to sample the whole volume, for it is possible that many of us harbor covertly the statement of August Bier, a German surgeon who died in 1948: "There is a tremendous literature on cancer, but what we know for sure can be printed on a calling card." As we mentioned earlier, this is not true. We have made enormous strides in our understanding of cancer, and it might be of help for the psychiatrist to know about them, for it is certain that he will encounter patients who could benefit from his knowledge of their problems. It is encouraging to read that all research on the subject is being collated by a government agency.