Cancer in young adults: through parents’ eyes.

A cancer diagnosis with all its potential sequelae can be devastating at any age. Cancer in young adults is a rare event, and the particular needs of this group of patients have been poorly explored and documented in the literature. This account of parents’ narratives goes some way to redressing this balance. The book was inspired by the life of George as told by his mother Helen. Each chapter begins with George’s story and provides the context for the analysis of the accounts of other parents. Hence we learn of George’s loss of independence and how this affects family dynamics, issues of sexuality and fertility, and about medical decision making. Whilst often moving, the data presented are a combination of Harry Enfield’s Kevin the teenager meets the medical establishment, with the expected and predictable outcome. There are exceptions to this, for example one mother’s story of her willingness to procure the services of a sympathetic prostitute so that her son didn’t die a virgin. The book reinforced what I expected: yes, it is complex; no, we don’t always get it right; yes, patients and their families do often know best and need more information and support than they currently receive. Narrative approaches are becoming very popular, and this book is a good example of why this is so; it is compulsively readable. However, the parents’ accounts were often written as part of a grieving process or as a celebration of a life; at times this stifled a search for deeper meaning or understanding in the data in a way that non-narrative approaches can overcome. I was also a little frustrated by the lack of heterogeneity in the sampling frame. Most of the families whose care I have been involved in would neither have wanted to, nor been able to participate in this kind of research. As a GP involved in the occasional and usually peripheral care of young adults with cancer and their families, I found this readable and useful. However, I remain unclear where the main aim of the book lies. It is not academic enough as a weighty sociological tome, it is too academic to have more popular appeal and it is not a practical guide. I have no doubt though that it will be valued by some of those involved in the care of young adults with cancer and their families and quite possibly young adult cancer patients themselves. How they will interpret the accounts of parents remains to be seen.