Editorial Review: Roads to Meaning and Resilience with Cancer by Morhaf Al Achkar

Editorial Review: Roads to Meaning and Resilience with Cancer by Morhaf Al Achkar

A young general practitioner with lung cancer searches for his identity and for an “answer to my existential struggle”. He facilitates conversations about some of life’s big questions with 39 others with the same diagnosis, “hoping that by developing the language to explain our struggles as cancer patients, others can understand us better, and with that, also better understand themselves.”

Roads to Meaning and Resilience with Cancer is based on the data obtained via a series of short interviews of 60 to 90 minutes with each of the participants, with the responses loosely arranged by topic, including those in the book’s title, plus ‘Health actions”, and within those broad categories further grouped by the type of response. The interpretation of his questions and the reflections received range from the mundane to the visionary as these individuals share parts of their lives, without going into extensive detail.

The author’s unique position as doctor, cancer patient, researcher, professor, teacher, mentor, immigrant, and truth speaker aligns in exploring the consequences of the uncertainty and “the existential threat’ that people find thrust upon themselves when they become cancer patients.

Other than the diagnosis they all have in common, the participants are as disparate as any other group of strangers, and accordingly, at times the book seems like a haphazard collection of thoughts and opinions on the meaning of life when faced with untimely death. However, in giving equal consideration to all opinions, including those that contradict his own, he presents a range of viewpoints that the majority of readers would otherwise not have access to.
The author’s background as a physician and researcher is evident in the style of writing, which vacillates between a dry, clinical representation of data, personal introspection, and something in between. The book would have benefitted from further editing and development.

When Al Achkar does give his own views on the interviewees' responses, there is a lot of sage advice for those on both sides of the cancer fence and it is an expectedly uncomfortable read – “People want to explain this disease and, if possible, find a reason to think they are immune from it.”

The pertinent issue of equitability in access to healthcare is raised, and the consequences of the lack of access such as people unable to afford care having to resort to alternate therapies. He also addresses some detrimental cancer-related clichés and stereotypes, such as the culture of patient-blaming (“Did you smoke?”).

When he does take a firm stand related to certain topics, such as on ‘Nutrition therapy’, his well-constructed, diplomatic and pragmatic deconstructions are worth paying attention to –
”Rebecca wants to help her body fight cancer by making healthy choices. However, the diversity of concrete recommendations may reflect the lack of evidence for any specific one. Maybe that is why most medical doctors would not make any one specific recommendation other than eating a healthy diet in the broader sense of the word.”

Experienced oncology patients might find affirmation of some of their own views here, but likely won’t glean much in the way of new insights or information. However, ‘Mainstreamers’ interested in what it’s like to live with cancer, including doctors, will gain valuable understanding of this isolating disease, and find themselves empowered to interact with cancer patients in more respectful and useful ways.

The last five pages of the book are all one needs to read to appreciate the essence of this project – and it is here, in the closing, that the author’s value, as an altruistic, grounded person with so much to contribute, truly shines through. All in all, the candid insights and sensible advice in Roads to Meaning and Resilience with Cancer provide a framework for honest conversations about cancer.