Preventive Strikes: Women, Precancer, and Prophylactic Surgery

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Overview

Modern scientific tools can identify a genetic predisposition to cancer before any disease is detectable. Some women will never develop breast or ovarian cancer, but they nevertheless must decide, as a result of genetic testing, whether to have their breasts and ovaries removed to avoid the possibility of disease. The striking contrast between the sophistication of diagnosis and the crudeness of preventive surgery forms the basis of historian Ilana Löwy’s important study.

Löwy traces the history of prophylactic amputations through a century of preventive treatment and back to a long tradition of surgical management of gynecological problems. In the early twentieth century, surgeons came to believe that removing precancerous lesions—a term difficult to define even today—averted the danger of malignancy. This practice, Löwy finds, later led to surgical interventions for women with a hereditary predisposition to cancer but no detectable disease.

Richly detailed stories of patients and surgeons in the United States, France, and the United Kingdom allow Löwy to compare the evolution of medical thought and practice—and personal choice—in these different cultures.

Preventive Strikes aims to improve our understanding of professional, social, and cultural responses to cancer in the twenty-first century and to inform our reflections about how values are incorporated into routine medical practices.Ilana Löwy

Johns Hopkins University Press

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Editorial Reviews

Doody Reviews
Reviewer: Mary Katherine B. Zanin, PhD (The Citadel)
Description: Using data from research studies and anecdotal evidence from patients and doctors, this book discusses the effectiveness of prophylactic surgery for the prevention of cancers in women.
Purpose: In the introduction, the author describes her goals: to explain the history of preventive surgery for cancer, to identify the scientific justification for prophylactic surgery, and to explain why women are the main targets of this radical approach. In her book, she successfully addresses most of her objectives in a sophisticated manner. Women who have experienced a cancer diagnosis or who know they have a genetic predisposition for cancer may find this book interesting and informative.
Audience: The author is academically qualified and presents the history and science of cancer in a clear, accurate manner, but her language is often quite technical and intellectual, which may limit the audience. The book probably will appeal mostly to highly-educated women who are currently struggling to decide how to best proceed with their own cancer or precancer treatment. It also may appeal to physicians who are striving to offer their cancer patients the best advice about how to make those decisions.
Features: In her effort to provide a complete account of the historical methods of diagnosis and treatment of cancer in women, the author can be redundant and wordy in some places, but often the repetition comes in the form of specific stories from various patients and doctors, which may be pertinent to various readers. The book also offers the pros and cons of prophylactic surgery for women at high risk for cancers of the colon, breasts, ovaries, uterus, and cervix. In the final analysis, Lowy makes it clear that preventive surgery is rarely definitively right or wrong and that often the best decision a woman can make is one that gives her, personally, a sense of well-being.
Assessment: Women who want a deeper understanding of the complexity of cancer treatment options will benefit from reading this book.
Medical History
Splendid... This is a major study for doctors and historians alike.
Lancet
Elegantly captures the history of the medicine and the politics, showing how they are interlinked.
Doody's Review Service
Reviewer: Mary Katherine B. Zanin, PhD (The Citadel)
Description: Using data from research studies and anecdotal evidence from patients and doctors, this book discusses the effectiveness of prophylactic surgery for the prevention of cancers in women.
Purpose: In the introduction, the author describes her goals: to explain the history of preventive surgery for cancer, to identify the scientific justification for prophylactic surgery, and to explain why women are the main targets of this radical approach. In her book, she successfully addresses most of her objectives in a sophisticated manner. Women who have experienced a cancer diagnosis or who know they have a genetic predisposition for cancer may find this book interesting and informative.
Audience: The author is academically qualified and presents the history and science of cancer in a clear, accurate manner, but her language is often quite technical and intellectual, which may limit the audience. The book probably will appeal mostly to highly-educated women who are currently struggling to decide how to best proceed with their own cancer or precancer treatment. It also may appeal to physicians who are striving to offer their cancer patients the best advice about how to make those decisions.
Features: In her effort to provide a complete account of the historical methods of diagnosis and treatment of cancer in women, the author can be redundant and wordy in some places, but often the repetition comes in the form of specific stories from various patients and doctors, which may be pertinent to various readers. The book also offers the pros and cons of prophylactic surgery for women at high risk for cancers of the colon, breasts, ovaries, uterus, and cervix. In the final analysis, Lowy makes it clear that preventive surgery is rarely definitively right or wrong and that often the best decision a woman can make is one that gives her, personally, a sense of well-being.
Assessment: Women who want a deeper understanding of the complexity of cancer treatment options will benefit from reading this book.
Nuncius
A valuable contribution to the historical scholarship on risk, surgery and cancer, and one can only wish that it will influence current discussions around the topic.

— Thomas Schlich

Social History of Medicine
Löwy makes very clear the price that patients continue to pay for medicine's ignorance of the lessons of its history. She has done us all a service.

— Iona Heath

American Historical Review
This book deserves a broad audience beyond the historians of medicine and health policy to which it is most clearly addressed... The questions [Löwy] tackles are of considerable importance both to the history of twentieth-century medicine and to contemporary medical policy.

— Margaret Marsh

Reviews in History
Clearly of relevance to scholars in a number of fields, certainly beyond that of medical history.
Isis - Carsten Timmerman
This is how contemporary history of medicine—and the role of science in medicine—should be written.
International Journal of Epidemiology - Iona Heath
Löwy makes very clear the price that patients continue to pay for medicine's ignorance of the lessons of its history. She has done us all a service.
Nuncius - Thomas Schlich
A valuable contribution to the historical scholarship on risk, surgery and cancer, and one can only wish that it will influence current discussions around the topic.
Social History of Medicine - James S. Olson
Preventive Strikes, the work of a gifted scholar, is an ambitious contribution to cancer history.
Medical History - Christopher Lawrence
Penetrating, witty... A major study for doctors and historians alike.
Lancet - Sander L. Gilman
Preventive Strikes: Women, Precancer, and Prophylactic Surgery elegantly captures the history of the medicine and the politics.
American Historical Review - Margaret Marsh
This book deserves a broad audience beyond the historians of medicine and health policy to which it is most clearly addressed... The questions [Löwy] tackles are of considerable importance both to the history of twentieth-century medicine and to contemporary medical policy.
Reviews in History - Yolanda Eraso
Point[s] to a much deeper understanding of the complex interdependencies that exist between womens' bodies, medicine, technologies, policy makers, health activists, the health industry, and the press... clearly of relevance to scholars in a number of fields, certainly beyond that of medical history.
Bulletin of the History of Medicine
Ambitious, insightful, and invaluable.
From The Critics
Reviewer:Women who want a deeper understanding of the complexity of cancer treatment options will benefit from reading this book.
Description:
Purpose:Using data from research studies and anecdotal evidence from patients and doctors, this book discusses the effectiveness of prophylactic surgery for the prevention of cancers in women.
Audience:In the introduction, the author describes her goals: to explain the history of preventive surgery for cancer, to identify the scientific justification for prophylactic surgery, and to explain why women are the main targets of this radical approach. In her book, she successfully addresses most of her objectives in a sophisticated manner. Women who have experienced a cancer diagnosis or who know they have a genetic predisposition for cancer may find this book interesting and informative.
Features:The author is academically qualified and presents the history and science of cancer in a clear, accurate manner, but her language is often quite technical and intellectual, which may limit the audience. The book probably will appeal mostly to highly-educated women who are currently struggling to decide how to best proceed with their own cancer or precancer treatment. It also may appeal to physicians who are striving to offer their cancer patients the best advice about how to make those decisions.
Assessment:In her effort to provide a complete account of the historical methods of diagnosis and treatment of cancer in women, the author can be redundant and wordy in some places, but often the repetition comes in the form of specific stories from various patients and doctors, which may be pertinent to various readers. The book also offers the pros and cons of prophylactic surgery for women at high risk for cancers of the colon, breasts, ovaries, uterus, and cervix. In the final analysis, Lowy makes it clear that preventive surgery is rarely definitively right or wrong and that often the best decision a woman can make is one that gives her, personally, a sense of well-being.
Lancet

Elegantly captures the history of the medicine and the politics, showing how they are interlinked.

Medical History

Splendid... This is a major study for doctors and historians alike.

Read More Show Less

Product Details

  • ISBN-13: 9780801893643
  • Publisher: Johns Hopkins University Press
  • Publication date: 12/29/2009
  • Pages: 344
  • Product dimensions: 6.10 (w) x 9.10 (h) x 1.30 (d)

Meet the Author

Ilana Löwy is a senior researcher at the French National Institute of Health and Medical Science.

Johns Hopkins University Press

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