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Big Comfort from a Small Book

Women, imagine you are at a nice lunch with seven of your closest female friends.  Everyone is having a great time and the food is excellent. Now, think about the fact that one in the group, not excluding you, will be diagnosed with breast cancer. The scenario no longer seems so delightful, does it?

One in eight – that is how many women in the United States will be diagnosed with breast cancer, according to Madhulika Sikka’s A Breast Cancer Alphabet, published in 2014 by Crown. Sikka, an executive editor at NPR News, was one of those eight when she was diagnosed with breast cancer in late 2010. She sought treatment and decided that a mastectomy, chemotherapy and reconstruction were right for her. She lost a breast but her humor and practicality remain intact, if her book is any indicator.

A Breast Cancer Alphabet is a small, elegantly designed and illustrated book. The first page of each section features a stylized illustration that corresponds to that section’s subject; e.g., “A is for Anxiety,” “B is for Breasts” and so on through “Z is for Zzz’s.” Each section imparts Sikka’s been-there-done-that advice and sometimes funny commentary that makes her cancer experience sound like an empathetic telephone call from your best friend.

As a best friend should, Sikka tells the hard truth about breast cancer while still remaining upbeat and urging readers to get real about themselves and the disease. For instance, in “D is for Drugs,” Sikka discusses chemotherapy and other medicines used to fight cancer. Lest the reader become alarmed about the vast amount of drugs that might be needed, Sikka ends the section by saying. “...some of these drugs will make you feel awful, some will make you feel better, and others will help take the edge off. You have to work with your doctor to get it just right for you…you have to be stoic about so many other things, you don’t need to get all holier than thou about the drugs…”

As in “D is for Drugs,” all of the sections contain real-world information described in user-friendly language that conveys and validates the emotional and physical turmoil that besets the 250,000 newly diagnosed with breast cancer in the United States each year. In “F is for Fashion Accessories,” Sikka is very direct, saying that “If you undergo chemotherapy, you will soon come to terms with the fact that you are bald…” While that sentence is sobering, she then mentions her use of knitted caps to help deal with her cold, bald head and admitting that “…most of the time I looked like a lumberjack…or a cat burglar!” Sikka discusses the pros and cons of different head coverings and encourages the use of another fashion staple if a patient chooses not to cover the head. The notion that it is optional to go bald is an empowering reminder of choice for a cancer patient to whom it might seem that the disease is making all of the decisions.

Sikka’s candid, amusing and intimate tone make the small A Breast Cancer Alphabet a big winner for the newly diagnosed or veteran breast cancer patient who wants advice but not meaningless platitudes, from a woman who had the disease and does not consider it a pink-hued “journey.” From the introduction to the bibliography, Sikka’s book tells the truth and encourages readers to be their own advocate for the most desirable outcome of their cancer. To that end, there are a few pages of lined paper after the bibliography for readers to make notes – a thoughtful inclusion to a straightforward, useful book.

While A Breast Cancer Alphabet is written primarily for women, I am surprised that it does not mention the incidence of breast cancer in men. Yes, the large majority of breast cancer diagnoses are in women. However, a search on the American Cancer Society website estimates that in the United States in 2014, “… about 2,360 new cases of invasive breast cancer [in men] will be diagnosed” and “about 430 men will die from breast cancer.” Those numbers are small but they should have been included in the book.

Despite the lack of statistics for male breast cancer in the USA, A Breast Cancer Alphabet contains helpful information in short chapters that do not overwhelm the reader yet give a sense of order and hope to those afflicted with the disease.