FOREWORD BY DR. GELFAND

      Over the past decade there has been a growing movement in the practice of medicine—patient advocacy. Patients are increasingly taking charge of their own health and taking steps to be well informed and active in decisions about their own bodies. The passive patient with a “whatever-you-say-Doc” attitude is becoming the exception rather than the norm. However, in the case of a serious, complex illness like breast cancer, the proactive patient may end up confused, overwhelmed with information, and excessively anxious. The saying that “a little knowledge is dangerous” is apt for these situations. The acquisition of great amounts of technical information by breast cancer patients without medical training—from books or extensive exploring on the Internet—frequently ends up aggravating the anxiety. A lot of the questions that I get asked by breast cancer patients reflect their earnest attempts at self-education but also their minimal understanding of the complexity of the underlying issues, or knowledge of how the information should be organized and utilized.

      Women with breast cancer, and their family and friends, most of all need a balanced approach to this illness. They need a basic road map to help them deal with the up-and-down journey from diagnosis into the world of the “patient” and back to the world of “normalcy”—a map that outlines the major phases of the process, offers guidance and insights along the way, and presents basic technical information in simple, understandable language. Just Get Me Through This! strives for balance through the collaboration of a seasoned professional and an intelligent patient. The result is neither a technical manual to breast cancer, nor a personal biography of overcoming breast cancer. Rather we have blended the perspectives of doctor and patient—enhanced by extensive conversations with other medical professionals, patients, and survivors—to offer readers a well-rounded, straight-from-the-shoulder view of the illness and of appropriate responses. We do not aim to be the only source of information and insight that you will need. We simply offer a foundation on which to build trusting, open dialogue not only with your health care team (e.g., surgeons, oncologists, nurses), but with family, friends, and even coworkers.

      One of the most important and least written about aspects of breast cancer is the degree to which the diagnosis alters one’s life experience. By and large doctors do not prepare patients for more than the technical aspects of treatment. For example, doctors will go to great lengths to explain the powers of today’s highly effective antinausea drugs, but they will rarely help a patient manage the inevitable emotional traumas, anxieties, and practical difficulties of chemotherapy. Few surgeons will discuss the fact that a spouse or significant other might have difficulty coping with the results of a mastectomy or other bodily changes, and recommend ways to improve communication to work through such tough relationship issues. And who warns a patient of the possible coldness and even disappearance of old friends who are terrified by her cancer diagnosis because of their own issues with mortality?

      Yes, it is wonderful and comforting to learn from your doctor that chemotherapy and all the other conventional medical treatments available today are typically well tolerated as long as the symptoms are managed well, and that by and large most women go on to live normal lives in the aftermath of cancer. Yet it is the nonmedical facets, the gestalt of the whole breast cancer experience, that most of the 200,000 women a year diagnosed with breast cancer are unprepared for. We have written Just Get Me Through This! to address that need. It is our hope that when you have turned the last page, you will