To Dance with the Devil: The New War on Breast Cancer

Overview

Breast cancer takes the life of an American woman every twelve minutes. There is no sure cure for the disease, no known way to prevent it, and no means of predicting whom it will strike next. A community of dogged adversaries stands in opposition to it: mavericks and bureaucrats, brilliant innovators and everyday heroes. Often at passionate odds in temper and technique, they are united in their resolve against an elusive, implacable enemy. To Dance with the Devil is an unprecedented behind-the-scenes account from...
See more details below
Available through our Marketplace sellers.
Other sellers (Hardcover)
  • All (46) from $1.99   
  • New (5) from $2.99   
  • Used (41) from $0.00   
Close
Sort by
Page 1 of 1
Showing All
Note: Marketplace items are not eligible for any BN.com coupons and promotions
$2.99
Seller since 2005

Feedback rating:

(271)

Condition:

New — never opened or used in original packaging.

Like New — packaging may have been opened. A "Like New" item is suitable to give as a gift.

Very Good — may have minor signs of wear on packaging but item works perfectly and has no damage.

Good — item is in good condition but packaging may have signs of shelf wear/aging or torn packaging. All specific defects should be noted in the Comments section associated with each item.

Acceptable — item is in working order but may show signs of wear such as scratches or torn packaging. All specific defects should be noted in the Comments section associated with each item.

Used — An item that has been opened and may show signs of wear. All specific defects should be noted in the Comments section associated with each item.

Refurbished — A used item that has been renewed or updated and verified to be in proper working condition. Not necessarily completed by the original manufacturer.

New
1997 Hard cover New in new dust jacket. Clean and tight-unused copy-Excellent! ! Sewn binding. Cloth over boards. 544 p. Audience: General/trade.

Ships from: Wauwatosa, WI

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
$2.99
Seller since 2014

Feedback rating:

(71)

Condition: New
0385312849 Only 1 copy left! Clean, unmarked copy. Hardcover, with dust jacket- In excellent shape! I can send expedited rate if you chose; otherwise it will promptly be sent ... via media rate. Have any questions? Email me; I'm happy to help! Read more Show Less

Ships from: Los Angeles, CA

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
$10.00
Seller since 2010

Feedback rating:

(22)

Condition: New
1997 Hardcover First Edition New in New dust jacket 0-385-31284-9. Book and DJ are NEW, first edition, ; 1.6 x 9.3 x 7.1 Inches; 518 pages.

Ships from: Lynn, MA

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
$31.49
Seller since 2014

Feedback rating:

(257)

Condition: New
Brand New Item.

Ships from: Chatham, NJ

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
$45.00
Seller since 2014

Feedback rating:

(136)

Condition: New
Brand new.

Ships from: acton, MA

Usually ships in 1-2 business days

  • Standard, 48 States
  • Standard (AK, HI)
Page 1 of 1
Showing All
Close
Sort by
Sending request ...

Overview

Breast cancer takes the life of an American woman every twelve minutes. There is no sure cure for the disease, no known way to prevent it, and no means of predicting whom it will strike next. A community of dogged adversaries stands in opposition to it: mavericks and bureaucrats, brilliant innovators and everyday heroes. Often at passionate odds in temper and technique, they are united in their resolve against an elusive, implacable enemy. To Dance with the Devil is an unprecedented behind-the-scenes account from the war on one of medicine's most pernicious foes. The product of over three years of research, scores of interviews with the nation's top doctors, policymakers, researchers, and activists, and in-depth reporting on the patients and clinicians who invited the author into their lives, To Dance with the Devil is at once an up-to-the-minute report and a gripping human drama. For a year Karen Stabiner was a steady observer at the innovative UCLA Breast Center, following the progress of Dr. Susan Love, the eminent breast surgeon and author, and a number of Love's patients. From UCLA, Stabiner's narrative spirals out to examine the turbulent national scene: partisan politics and budget crises; pioneering research and dire experimental treatments; managed care and the battle to shape its future; high stakes, high society fund-raising; and the brutally competitive race for answers and dollars.

"...this book is a result of three years of research and interviews with the nation's top doctors, activists, researchers, and policy makers...the author also followed the progress of a breast surgeon and her patients along with

Read More Show Less

Editorial Reviews

Publishers Weekly - Publisher's Weekly
Among cancers, breast cancer is one of the least predictable but most pernicious forms. This year, according to journalist Stabiner, "over 182,000 women will get breast cancer, and about 46,000 will die of it." Yet, despite such statistics, before 1990 little effort was made on the part of researchers or health-care professionals to stop the disease. In a compelling book that combines the elements of a medical detective story with political journalism, Stabiner chronicles the developments in breast cancer research in the '90s by tracking cancer patients from diagnosis to treatment and by following a number of doctors and researchers through the maze of cancer research. Stabiner spends more than a year tracking the career of Dr. Susan Love, a preeminent voice in the field of breast cancer research, from her early work with the UCLA Breast Center, one of the country's first centers devoted exclusively to the treatment of breast cancer, to Love's eventual disillusionment with a bureaucratic managed-care system that interfered with her ability to treat patients. Stabiner also reports on the political intrigue and the intense competition of medical research as she covers the race to isolate BRCA-1, the breast cancer gene. Her stories of courageous women dealing with the emotional and physical scars of radical mastectomy and the sometimes terminal nature of their disease are inspiring, but her book is distinguished above all for its disturbing look at a field where cost-benefit analyses have become more important than human life, and for its exhilarating report on ways that ingenious and dedicated scientists have overcome a short-sighted medical bureaucracy.
Library Journal
Like all technology, medicine is entangled in politics and power plays. Stabiner chronicles this political landscape from a journalist's perspective, focusing on the most commonly diagnosed cancer in women: breast cancer. Spending more than a year in behind-the-scenes research, she details "the Dance," the rivalries and alliances created by researchers, government officials, and politicians in dealing with breast cancer. Stabiner accuses "bastions of basic research" of practicing benign neglect in terms of women's health and praises the heroes and heroines of the breast cancer "battlefield," e.g., Iowa Senator Tom Harkin, who maneuvered monies from the military budget into new breast cancer research funds. She concludes with a message of hope. Similar in scope to Randy Shilts's And the Band Played On (LJ 11/15/87), this fascinating account is highly recommended for all women's health collections.Rebecca Cress-Ingebo, Fordham Health Sciences Lib., Wright State Univ., Dayton, Ohio
Kirkus Reviews

A big, sprawling story of the fighters in the war against breast cancer, told by a journalist who seems unable to get a firm grip on her subject.

Stabiner (Inventing Desire: Inside Chiat/Day, 1993, etc.), who has written for the New Yorker and other magazines, provides a revealing profile of the unconventional and headstrong breast surgeon Dr. Susan Love, whose UCLA Breast Center she visited daily from January to September 1994. Stabiner also offers compelling glimpses into the lives of seven of Love's patients. The conflicts between Love, a dedicated and outspoken activist, and her bosses at UCLA, who fear she is not dealing with the money-losing center's real problems, are adeptly outlined. If Stabiner had chosen to write a behind-the-scenes account of the Breast Center, she could claim success. Through her account, we learn a great deal about the unpredictable nature of the disease, the terrible decisions women must make, and the woefully imperfect weapons that doctors are equipped with. When it comes to the larger war on cancer, however, Stabiner skimps. Although she interviewed numerous government officials, clinicians, lobbyists, fund-raisers, and medical researchers, their stories seem oddly disjointed and incomplete. The changes in how breast cancer research is being funded, the search for the breast cancer gene and its therapeutic implications, the impact of managed care on breast cancer treatment—these are issues that deserve more thoughtful consideration in a work that purports to be giving the big picture. Unfortunately, Stabiner seems to be more interested in personalities than in the issues at stake here.

Delivers less than it promises, but the punch it has is still a strong one.

Read More Show Less

Product Details

  • ISBN-13: 9780385312844
  • Publisher: Bantam Doubleday Dell Publishing Group
  • Publication date: 5/1/1997
  • Edition number: 1
  • Pages: 518
  • Product dimensions: 6.51 (w) x 9.58 (h) x 1.82 (d)

Meet the Author

Karen Stabiner
Karen Stabiner
Karen Stabiner, whose work has appeared in the Los Angeles Times, The New York Times, and The New Yorker, is the author of Inventing Desire, an acclaimed portrait of contemporary American advertising, among other books. She lives in Santa Monica, California, with her husband and daughter.
Read More Show Less

Read an Excerpt

October 1993: Washington, D.C.

It took Fran Visco two years to get into the White House. The first time she tried, in 1991, she got only as far as a guarded, locked gate where she loaded boxes containing 140,000 letters onto a conveyor belt. As the boxes were carried away she joked to her friends that they would probably ride straight through, out the back door and into an incinerator. President Bush would never see them.

In fact, no one ever acknowledged that the letters had arrived. She went home to Philadelphia to start over.

On October 18, 1993, she stood in a small room just off the East Room, talking with Health and Human Services Secretary Donna Shalala and Dr. Susan Love, director of the UCLA Breast Center and cofounder of the National Breast Cancer Coalition (NBCC), the two-and-a-half-year-old advocacy group that had twice waged a campaign for a national strategy against breast cancer. They were waiting for President Clinton and the First Lady to arrive, to accept Visco's latest offering. The boxes were piled in a lopsided pyramid at the back of a small stage in the East Room: Petitions that contained 2.6 million signatures, representing the 1.6 million women in the United States who knew they had breast cancer, and the one million who already had the disease but had not yet been diagnosed.

Visco, a forty-five-year-old corporate lawyer, was the president of the National Breast Cancer Coalition. Since May 1991 the Coalition had been fighting for research dollars and a strategy on how best to spend them. In fifteen minutes she would be seated onstage in front of all those boxes, listening to President Clinton outline a planthat was as much Fran's as anyone's.

She and Love had set out to dismantle the civilized conspiracy that had hobbled medicine's progress against breast cancer since the mid-1800s, when American and British surgeons began to define a therapeutic approach. Before that, much of what passed for treatment was based on anecdote and superstition; afterward, on often misguided heroics, as though to compensate for the clumsiness of the past.

It was not a conscious plot; not even willful disregard. It was somehow worse: layer upon layer of silence and neglect, of therapies whose use far outlasted their efficacy, and research budgets that focused almost exclusively on men's diseases. The three most potent threats to a woman's health--heart disease, breast cancer, and osteoporosis--went virtually ignored. There was not enough money to keep women from getting sick, only a desperate scramble to save them once they did.

It did not work. One third of all women who developed breast cancer eventually died of it. That had been true for fifty years--but the Coalition was determined to buy a better future. The National Institutes of Health (NIH), which conducted most of the government's health care research, had to Visco's mind embarrassed itself with paltry breast cancer budgets--$90 million in fiscal 1990, $100 million the next year, and $155 million in fiscal 1992. The Coalition had lobbied until Congress found an additional $210 million for the fiscal 1993 budget, a windfall from the peacetime Department of Defense, which had been led into the fray, kicking and screaming, by Visco and a handful of sympathetic politicians who insisted that breast cancer was a perfectly reasonable topic for army research.

Between the army's two-year program and the NIH, which had managed an $80 million increase in its own breast cancer budget for fiscal 1993, the government had allocated over $400 million in research dollars, almost triple the 1992 budget--enough to jump-start a stalled research effort, the result of too little money and too little imagination. Better still, Visco's proprietary role in the army program had won her the chance to change the way that money was spent. The government's delicate label for patients was "consumers." Fran Visco would be the first consumer to actively participate in the grant review process, which meant that she could help to steer the money away from endless treatment regimens and into more promising work on prevention or cure. The Coalition had won not just money, but authority. Patients had their foot firmly inside a door that had always been closed to them.

The East Room reception was the crowning event of National Breast Cancer Awareness Month, and Visco had organized it down to the last detail. Ronald Perelman, the billionaire owner of the Revlon Group and one of the Coalition's financial angels, had underwritten part of the petition drive, but as usual the effort had depended on volunteer labor and donated supplies, and Visco was determined to acknowledge that contribution. She did not want celebrities like Revlon models Lauren Hutton and Veronica Webb onstage, or even in the front row of the audience, because they would distract the media. She insisted that many of the seats in the East Room be awarded to "just folks" who had collected signatures. If the Coalition was to grow and sustain its effort, she needed people, lots of them, all around the country. Rewarding the volunteers was the best way to ensure that they went home and got back to work.

She knew what she wanted President Clinton to say to them. More than anything, Visco wanted him to refer to breast cancer as an epidemic. An epidemic required a solution, however long that took. If he started using the word it would be easier to get funding next year.

She knew what the resistance was. Visco had debated the linguistic point on countless radio talk shows with scientists who preferred the formal definition of the term. Breast cancer was not a true epidemic like AIDS. It had not exploded out of nowhere, nor did it spread from one person to another, nor was there as dramatic a rise in incidence. Epidemic was a literal distinction, they reminded her, not an emotional state.

Visco was always quick to reply that there was a second definition of epidemic--an ongoing, inexplicable increase in incidence--that certainly applied to breast cancer.

The more she had to explain it the angrier she got. Surely the numbers were convincing without her help: 182,000 women got breast cancer every year and 46,000 died. Between 1990 and 2000 nearly a half million women would die of the disease, the most commonly diagnosed cancer in women and the second most fatal after lung cancer. Among African-American women it was the most lethal cancer because it often was detected at a later stage. A woman's lifetime risk of developing breast cancer--the chance that she would develop the disease if she lived to be eighty-five--was one in eight, up from one in twenty when Visco was born.

Worse yet, there seemed to be nothing a woman could do to improve her odds. Cigarettes caused lung disease, and that simple causal link gave a woman an obvious tool: the best way to avoid lung cancer was to stop smoking or not start. Breast cancer had so far resisted medicine's best hunches about prevention. It claimed vegetarians, women on low-fat diets, women who were fat, women who were thin and fit--anyone.

Other ailments presented a greater statistical danger. A woman's lifetime risk of developing heart disease was one in two; adult-onset diabetes or alcoholism, one in three; a stroke, one in five; a hip fracture, one in seven. But rational fact was no consolation. Women reported that they were more frightened of breast cancer than of heart disease, the most serious health threat they faced, in great part because there was nothing they could do to protect themselves. Life was roulette when it came to breast cancer. As far as Visco was concerned, the government had to make up for lost time and find some answers--if not a cure, which was what she dreamed of, then at least a prevention strategy women could depend on.

Medicine could not even fight breast cancer to a draw. If one in eight did not qualify as an inexplicable increase, what did?


Visco tried to convince the White House speechwriters of her position, but a few days before the reception she got an apologetic call from one of them. Despite her arduous lobbying, the President probably would not refer to breast cancer as an epidemic. There were, the speechwriter said, "political implications" to consider.

It was Visco's one tactical defeat, but she decided to yield rather than alienate the scientific community even further. The people at the NIH were already irritated because the Defense Department controlled $210 million in research money that they believed properly should have gone to the NIH, and cranky about the upstart lawyer who fancied herself a breast cancer expert. Researchers were not used to intruders from the outside world, whether they were army officers or advocates. The NIH had functioned since 1887 in collegial isolation, set apart both by geography--a sprawling 300-acre campus in Bethesda, Maryland--and by the impenetrable nature of its research, which attempted to understand the fundamental rules of the human body, how it stayed healthy and why it fell ill. The National Cancer Institute (NCI), created by a special act of Congress in 1937 and the largest division of the NIH, enjoyed even greater autonomy thanks to a "bypass budget" that circumvented Congress and was signed directly by the President.

These were the bastions of basic research. The native dialect was intimidating, spoken only by an elite corps who believed that answers about specific diseases came not from studying those diseases but by amassing a body of general knowledge. They considered earmarked research, in which scientists spent targeted money on a particular disease, to be a lesser challenge and a potentially dangerous distraction.

Basic researchers insisted that the key to a particular disease could come from anywhere--from the study of how yeast cells behaved, from research into a virus implicated in other ailments. Limiting the scope of a scientist's work was like putting blinders on him, and critics of the Defense Department's earmarked program worried that it might by definition exclude research that would lead to an answer.

As far as Visco was concerned, basic research was nothing more than a polite euphemism for benign neglect. The scientists feared that special interests would dismantle the nation's research effort, steal money from basic research to fund their own agenda. Visco felt the NIH was out of touch with reality, engaged in a grand intellectual exercise while people who needed practical answers suffered and died. The NIH was part of the government, supported by taxpayers' dollars. It was time for scientists to better serve the people who paid them.

She fully intended to live up to their nightmare scenario, to demand even more money and insist on a voice on how it was spent. The NIH had every reason to be upset by the Defense Department program. It was Visco's pet project, a model for an eventual invasion of the inaccessible NIH. The days when researchers and politicians made decisions about women's health--or simply opted to ignore it--were over.
Read More Show Less

Customer Reviews

Be the first to write a review
( 0 )
Rating Distribution

5 Star

(0)

4 Star

(0)

3 Star

(0)

2 Star

(0)

1 Star

(0)

Your Rating:

Your Name: Create a Pen Name or

Barnes & Noble.com Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & Noble.com that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & Noble.com does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at BN.com or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

  • - HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
  • - Time-sensitive information such as tour dates, signings, lectures, etc.
  • - Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
  • - Comments focusing on the author or that may ruin the ending for others
  • - Phone numbers, addresses, URLs
  • - Pricing and availability information or alternative ordering information
  • - Advertisements or commercial solicitation

Reminder:

  • - By submitting a review, you grant to Barnes & Noble.com and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Noble.com Terms of Use.
  • - Barnes & Noble.com reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & Noble.com also reserves the right to remove any review at any time without notice.
  • - See Terms of Use for other conditions and disclaimers.
Search for Products You'd Like to Recommend

Recommend other products that relate to your review. Just search for them below and share!

Create a Pen Name

Your Pen Name is your unique identity on BN.com. It will appear on the reviews you write and other website activities. Your Pen Name cannot be edited, changed or deleted once submitted.

 
Your Pen Name can be any combination of alphanumeric characters (plus - and _), and must be at least two characters long.

Continue Anonymously

    If you find inappropriate content, please report it to Barnes & Noble
    Why is this product inappropriate?
    Comments (optional)