Survivors

By Patricia Blake

WE THE VICTORS by Curtis Bill Pepper Doubleday; 322 pages; $17.95

LIFE AND DEATH ON 10 WEST by Eric Lax

Times Books; 267pages; $14.95

As Critic Susan Sontag has pointed out, cancer unjustly serves as a metaphor for the monstrosities of our age. In human discourse, it is the epithet for all that is demonic, mysterious and implacable in the experience of man and society. Given this aura of dread, these two serious books of medical popularization--the first is subtitled The Inspiring Stories of People Who Conquered Cancer and How They Did It, the second is an account of a pioneering leukemia treatment--represent significant acts of demystification.

By dispensing the good tidings of ever more effective treatment, both books serve to dispel the paralyzing terror that the very word cancer engenders. As Curtis Bill Pepper points out, for early detection people must shed their fears sufficiently to go for routine cancer checkups. Once a diagnosis of malignancy has been made, the afflicted may have to take aggressive action. This could involve collisions between the patient and his family doctor and a tough-minded struggle for an appointment with an appropriate oncologist at one of the "comprehensive cancer centers" such as New York City's Memorial Sloan-Kettering and the Dana-Farber Cancer Institute in Boston.

The patient may be obliged to assume this responsibility, says Pepper, because "there is no other area of medicine with so great a gap between daily practice and the theoretical possibility of available treatment." Many doctors who do not specialize in cancer fail to keep up with the latest treatment strategies and often lack the connections needed for speedy referral to a cancer center. Some subscribe to the principle "let them die in peace," thus discouraging patients from seeking care that may prolong their lives.

An attentive and compassionate listener, Pepper has constructed his book around interviews with former cancer patients at Memorial. These survivors offer considerable testimony of bad or even potentially fatal medical advice proffered by the physicians they saw first. Estelle Marsicano was scoffed at by her family doctor. "My liver is large too--want to feel it?" he asked. When John Alexion consulted a prominent urologist about his prostate cancer, the patient recalled, "the elderly doctor proceeded to lay a bomb on me. The only procedure he would consider was surgical castration and radical removal of the prostate. I thought, 'Jesus... they're going to turn me into a 6-ft. eunuch!' " At Memorial, however, a surgeon decided on an experimental procedure: inserting capsules of radioactive iodine into Alexion's prostate instead of removing the gland. It worked.

For his book Life and Death on 10 West, Eric Lax ventures to the other side of the consulting room. Working with physicians, Lax explains the complexities of a radical bone-marrow transplant technique that is now proving 50% effective in treating some types of leukemia. The result is a model of medical writing for the layman. The astonishing procedure, used by Dr. Robert Gale and his colleagues at the U.C.L.A. Medical Center, is described with uncommon clarity, as is the ordeal of a young woman whose cancer was obliterated but who later died of another disease. More neutral and less self-consciously uplifting than Pepper's book, Life and Death on 10 West often strikes at the heart and informs the intellect with more force than We the Victors. Both works, however, have splendidly succeeded in substituting the human reality for the demonic metaphor.

--By Patricia Blake