Surviving the Cancer System
An Empowering guide to taking control of your care
Mark R. Fesen, MD FACP

Hardcover/328 pages
ISBN: 0-8144-1356-0
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". . . a straightforward guide through a complex system."

Warning: If you are unlucky enough to develop cancer and require treatment, you need a fat wallet, an uncomplicated form of the disease and shouldn't feel inclined to file a lawsuit says Dr. Mark Fesen in his new guidebook, Surviving the Cancer System. It's shocking, but probably not surprising, to learn that oncologists can pick and choose their patients, choosing mostly based on one's ability to pay.

Cancer care “is a highly sophisticated, multifaceted, multibillion dollar system” like a musical production in which you are at the mercy of highly skilled performers” led by an oncologist conductor,” writes Fesen, an oncologist with fifteen years experience.

While he unveils the dark side of the system, he also provides no-nonsense ways to maneuver through this “poorly organized and frequently chaotic” organization of corporate oncologists, cancer centers and pharmaceutical industries whose primarily focus is on reimbursement. A patient with a common cancer could end up paying $80,000 a month for treatment plus $1,000 a week for medication.

The first step in this journey is to “empower yourself” according to Fesen. He urges patients to study their pathology report thoroughly, communicate honestly with the oncologist and learn about different cancer treatments available. It is normal to panic and fall into denial, but those pitfalls waste valuable time. Educating yourself is “like starting a class in physics the night before a big job interview,” Fesen says.

This is not a technical medical book about cancer care. It is a straightforward guide through a complex system. By referencing patients’ own personal experiences in short vignettes, along with his own experience, Fesen offers understandable summaries of different forms of cancer, treatments, insurance coverage and cancer centers. He attempts to dispel myths such as the horrors of treatment side effects that discourage people from seeking treatment.

Fesen, who treats patients with difficult cancers and problems with insurance coverage, provides a public service in writing this guide as most of us at some point, either ourselves or a member of our family, will no doubt have to maneuver through the maze of America’s cancer-care programs.


Reviewer: Kate Padilla