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Late Fragments
Cancer and Society
Chart to help find meals and snacks when experiencing difficulties with eating during treatment Left to right: poor appetite; taste changes, nausea; sore mouth, dry mouth, high energy; and low energy.
treatment when the cookbook idea took off. Her dedication to making food come to life on the page is evident. Smith is keen to highlight the creation as something universally accessible; “This is a book for family and friends— you want to feel useful and this book gives you ideas on how to do that”. It is a book for everyone—the inclusiveness comes from affordable and easy to make recipes that have benefited from expert clinical direction. Healthy eating is the slogan for contemporary living.
Collaborator and contributor, Clare Shaw, who has held the post of Consultant Dietician since 2004 at the Royal Marsden, is involved in dietetic work, teaching, strategic leadership, and research into rehabilitation and survivorship careplans for patients. She told The Lancet Oncology about the significance of nutrition recognised by national recommendations. “All new patients attending the hospital and all inpatient admissions undergo nutrition screening (as per NICE guidance) to identify those who are malnourished or at risk of malnourishment.” The malnourished surgical patient is at greater risk of morbidity or mortality. Shaw explains some of the science behind food in relation to cancer. Studies have shown that unintentional weight loss before or during cancer treatment can have an adverse effect on the toxicity of treatment. This can cause treatment to be interrupted and be further impeded by neutropenia, weakening the body’s ability to fight infection, or mucositis, leading to painful ulcers and mouth sores. Shaw concludes that there is no
special diet but a healthy diet is vital; “Individualised dietary advice from a registered dietician has been shown to improve dietary intake and nutritional status during treatment and to influence longer term outcomes when treatment has finished’’. Most us have either been affected by cancer or know someone who has been. It is hard to know what to do and how to help. The Cancer Cookbook is not aimed to get the patient into the kitchen, but gives family and friends a chance to take part in the recovery process. Take meals round and freeze them, bring round ingredients and cook with the children, create a much-missed dinner for all the family to enjoy. And for the final touch check out the charts at the end of the introduction. Each recipe is broken down into its nutritional value and gives you an indication of what you could eat when battling symptoms that turn food into objects of fear and pain. It is easy to follow when eating is not an easy task.
husband, ‘‘the best looking man I’ve ever kissed’’. Neither an inside look into her professional life during her tenure at Downing Street nor a guide for those living with colon cancer, Late Fragments is an atypical memoir. Instead, Gross writes that her book is to convey to her sons, aged only 3 and a half at her diagnosis, ‘’who I am, what I know and the stories that make up my life’’. This wish to provide her sons she fondly refers to as her ‘‘knights’’, a sense of who she is structures the book and her storytelling. She stresses the importance of friendship and love, calling her friends part of the ‘‘estate’’ left to her sons. Her sense of wonder with life and her attempt to impart this to them is apparent throughout. Moreover, the need to portray herself
accurately to them gives her writing a sense of honesty devoid of the sentimentality endemic in many memoirs. Unexpectedly, Late Fragments provides guidance for those who are dealing with a terminally ill friend or family member. Goss urges them to acknowledge the illness, that after receiving news of a terminal diagnosis, there is nothing they can say to make things worse. She highlights the support needed by those in the periphery to the patient such as siblings and parents. Gross manages to inject humour in an otherwise dark subject and ultimately, Late Fragments is a celebration of the life she lived and her wish to share it.
Jules Morgan
Late Fragments
Late Fragments: Everything I Want to Tell You (About This Magnificent Life) Kate Gross William Collins, 2014 Pp 256 £14.99 ISBN 9780008103453
374
At 32, Kate Gross, author of Late Fragments: Everything I Want To Tell You (About This Magnificent Life) was diagnosed with stage IV colorectal cancer, which she dubs the ‘‘nuisance’’. The pace of her life, which she describes as ‘‘hyper-speed’’, changes completely as she endures therapy to slow the course of her ultimately terminal disease. Reading of Gross’ achievements both professionally and personally, one wonders whether Gross knew she was going to die young. In her 20s, she obtained the coveted position as private secretary and advisor to Tony Blair and by only 30, she founded the Africa Governance Initiative to promote effective governance in Africa. Her personal life was similarly fulfilling with her twin sons and her
Isabel Lokody www.thelancet.com/oncology Vol 16 April 2015
Chart to help find meals and snacks when experiencing difficulties with eating during treatment Left to right: poor appetite; taste changes, nausea; sore mouth, dry mouth, high energy; and low energy.
treatment when the cookbook idea took off. Her dedication to making food come to life on the page is evident. Smith is keen to highlight the creation as something universally accessible; “This is a book for family and friends— you want to feel useful and this book gives you ideas on how to do that”. It is a book for everyone—the inclusiveness comes from affordable and easy to make recipes that have benefited from expert clinical direction. Healthy eating is the slogan for contemporary living.
Collaborator and contributor, Clare Shaw, who has held the post of Consultant Dietician since 2004 at the Royal Marsden, is involved in dietetic work, teaching, strategic leadership, and research into rehabilitation and survivorship careplans for patients. She told The Lancet Oncology about the significance of nutrition recognised by national recommendations. “All new patients attending the hospital and all inpatient admissions undergo nutrition screening (as per NICE guidance) to identify those who are malnourished or at risk of malnourishment.” The malnourished surgical patient is at greater risk of morbidity or mortality. Shaw explains some of the science behind food in relation to cancer. Studies have shown that unintentional weight loss before or during cancer treatment can have an adverse effect on the toxicity of treatment. This can cause treatment to be interrupted and be further impeded by neutropenia, weakening the body’s ability to fight infection, or mucositis, leading to painful ulcers and mouth sores. Shaw concludes that there is no
special diet but a healthy diet is vital; “Individualised dietary advice from a registered dietician has been shown to improve dietary intake and nutritional status during treatment and to influence longer term outcomes when treatment has finished’’. Most us have either been affected by cancer or know someone who has been. It is hard to know what to do and how to help. The Cancer Cookbook is not aimed to get the patient into the kitchen, but gives family and friends a chance to take part in the recovery process. Take meals round and freeze them, bring round ingredients and cook with the children, create a much-missed dinner for all the family to enjoy. And for the final touch check out the charts at the end of the introduction. Each recipe is broken down into its nutritional value and gives you an indication of what you could eat when battling symptoms that turn food into objects of fear and pain. It is easy to follow when eating is not an easy task.
husband, ‘‘the best looking man I’ve ever kissed’’. Neither an inside look into her professional life during her tenure at Downing Street nor a guide for those living with colon cancer, Late Fragments is an atypical memoir. Instead, Gross writes that her book is to convey to her sons, aged only 3 and a half at her diagnosis, ‘’who I am, what I know and the stories that make up my life’’. This wish to provide her sons she fondly refers to as her ‘‘knights’’, a sense of who she is structures the book and her storytelling. She stresses the importance of friendship and love, calling her friends part of the ‘‘estate’’ left to her sons. Her sense of wonder with life and her attempt to impart this to them is apparent throughout. Moreover, the need to portray herself
accurately to them gives her writing a sense of honesty devoid of the sentimentality endemic in many memoirs. Unexpectedly, Late Fragments provides guidance for those who are dealing with a terminally ill friend or family member. Goss urges them to acknowledge the illness, that after receiving news of a terminal diagnosis, there is nothing they can say to make things worse. She highlights the support needed by those in the periphery to the patient such as siblings and parents. Gross manages to inject humour in an otherwise dark subject and ultimately, Late Fragments is a celebration of the life she lived and her wish to share it.
Jules Morgan
Late Fragments
Late Fragments: Everything I Want to Tell You (About This Magnificent Life) Kate Gross William Collins, 2014 Pp 256 £14.99 ISBN 9780008103453
374
At 32, Kate Gross, author of Late Fragments: Everything I Want To Tell You (About This Magnificent Life) was diagnosed with stage IV colorectal cancer, which she dubs the ‘‘nuisance’’. The pace of her life, which she describes as ‘‘hyper-speed’’, changes completely as she endures therapy to slow the course of her ultimately terminal disease. Reading of Gross’ achievements both professionally and personally, one wonders whether Gross knew she was going to die young. In her 20s, she obtained the coveted position as private secretary and advisor to Tony Blair and by only 30, she founded the Africa Governance Initiative to promote effective governance in Africa. Her personal life was similarly fulfilling with her twin sons and her
Isabel Lokody www.thelancet.com/oncology Vol 16 April 2015