By Kathy LaTour

After Cancer Treatment: Heal Faster, Better, Stronger
[Johns Hopkins Press, October 2006]
By Julie K. Silver, MD

I generally don’t review books that are not out yet, but this is one you need to get ready for. Julie Silver, MD, is a physiatrist, a medical professional in the field of rehabilitation, not a subspecialty we hear about very often since there are only 8,000 in the United States. In addition, Dr. Silver, in her position as medical director of Spaulding Rehabilitation Hospital’s outpatient center in Framingham, Massachusetts, directs a program called RESTORE that helps cancer patients heal physically.

Because of her very specialized background, Dr. Silver was well equipped to create a health plan when she was diagnosed with breast cancer at age 38. But there isn’t the tone of “this is how a professional would do it.” In fact, I applaud her willingness to show us how debilitated she was. Early on in the book she describes getting ready to go back to work and how she ceremonially gave her old clothes to a charity and bought new clothes to signify her new life after cancer. (Most women I know call that retail therapy, but her definition works too.) But she admits it did little to conceal how she felt as she returned to work—bald, gaunt, tired, not eating well and in pain from neuropathy in her hands and feet. We can all identify.

She recognized that returning from cancer meant building a new life based on some losses and some gains, quoting philosopher Joseph Campbell: “We must be willing to give up the life we planned, so as to have the life that is waiting for us.”

In creating her post-cancer life, Dr. Silver had skills most cancer survivors don’t—training and personal experience with patients about how to mindfully create a plan to heal. As she began creating her own plan, she became aware that it was a plan that could be used by all cancer patients, prompting her to create a holistic approach to healing in this book. But After Cancer Treatment is more than a plan to get back on your feet. It gives specifics on what to expect and how to cope with common issues of survivorship.

Not surprisingly, the book begins with understanding what has happened to your body as a result of treatment. But Dr. Silver is not one to accept those who use the old “I’m taking it one day at a time” line to allow no progress. She embraces planning and making goals toward healing that include the three areas she sees as critical: exercise, a healthy diet and proper rest.

Highlighting the benefits of exercise, Dr. Silver details how to build and grow a reasonable and helpful exercise regimen. She provides adaptations for medical problems, such as arthritis, diabetes and back pain, while explaining the differences between cardio training, strength training and flexibility. Moving on to nutrition, she breaks out carbs, proteins and fats, and explores some of the controversy around supplements and vitamins. She also has a section on ways to fight fatigue with food. The book also looks at issues such as pain, anxiety, spirituality, the ability to adjust to setbacks and maintaining hope for the future.

Dr. Silver does a wonderful job of looking at Western medicine as well as complementary medicine. Because of her training, she offers excellent descriptions of mind-body treatments with helpful tables that condense and define. I like that she understands that those who have gone through cancer have often opened a channel to accepting new approaches and definitions of being whole and happy.