This book provides a reasonably thorough introduction to an enormous topic. The development of cancer is described at a general level with examples and an introduction to oncogenetics; its treatment, again necessarily at a general level but explaining the main treatment methods and examining approaches for different cancers; ongoing areas of research and implicit problems in choosing priorities; and the size and economics of cancer's impact globally and in specific countries. James devotes a chapter to alternative and complementary medicine. James takes a fresh approach, is objective and, through the currency and extent of his expertise, is appropriately cynical about some disparities, even inequities, in the priorities and contradictions in the treatment of cancer in some jurisdictions. He drills down through statistics to identify important trends, some unexpected, across geographic regions, countries and cultures. His reporting of the evident importance of Vitamin D in cancer prevention may be worth the price of the book many times over. Contrary to the views of alternative medicine advocates, Vitamin C fares less well. Many pharmaceutical products are demystified.
Slight criticisms of this format would include the illegibility of some early tables which have been reduced in size and are now black and white. One can piece together some of what the tables are saying by crossing back to the supporting text a few times but, alas, that is not how supporting tables are meant to work.
I was expecting James, a representative of the medical establishment, to pay short shrift to alternative and complementary medicines. He devotes a chapter to these approaches which, given the other areas he had to cover, is generous but nevertheless will make him a target for those who would have the balance the other way. Fortunately, there are many resources on non-medical treatments available. While dismissing some quackery, James is generally fair and evidence-based, importantly highlighting the high risk that can exist if a complementary medicine confounds other treatments. This approach seems reasonable and the reader may consider his points in the context of the disparities, contradictions and trans-border inequities that James identifies in national treatment and pharmaceutical support regimes, and in the context of the commercial priorities of pharmaceutical companies when they try to dovetail with these regimes and appease investors and shareholders. While alternative and complementary approaches have potential risks and drawbacks, the reader is left thinking that it may be preferable to assess them more broadly against the scientific method than against expensive, complex and bureaucratic systems tailored for drug companies and their products. James may not share this view, but the strength of his book is that it provides a sound introduction so that readers may think around the topic as I have.
James has made very good use of the Very Short Introduction format. There are many topics that he has not touched upon but the reader will be better prepared to undertake further reading, to make sense of media, commercial, bureaucratic, even political, statements about cancer treatment. Most importantly, there is information to help manage personal risk and to talk to experts if necessary.