This book is a real gem. The author not only knows his medicine inside out but is also a brilliant writer. This is a rare combination indeed, and the result is a book that challenges all the received wisdom of the medical profession in a way that both draws the reader in and imparts knowledge effortlessly.

As a society we have come to accept that breast cancer must be treated by surgery, chemotherapy and radiation, or some combination of the three. Rare indeed is the woman who escapes with simple lumpectomy, no lymph node dissection and no adjuvant treatment with radiation or chemotherapy. Yet after reading this book it becomes inescapably apparent that this protocol is founded on nothing but habit and medical vanity; it is certainly not founded on science, and, as the author demonstrates with great clarity, it has done absolutely nothing to extend life expectancy, nor to enhance quality of remaining life. To the contrary: lymph node dissection is disfiguring and potentially disabling, and is not correlated with increased survival time. Neither is chemotherapy, nor radiation. These statements are not mere rhetoric: the author cites medical literature and studies to back every one of these conclusions up, and the result is a book that is as empowering as it is revolutionary. Everyone should read this book, not just those women who are unlucky enough to be dealing with breast cancer. It is an education in its own right, and it begs many questions which the medical profession might rather were left unbegged. The author deserves huge acclaim for having combined an astute knowledge of medicine (he is a malpractice lawyer) with great literary skill. What a treasure - and thank you, Amazon, for bringing this book to my attention: I would never have found it otherwise.

Every woman diagnosed with breast cancer should have access to this book BEFORE making treatment decisions. Clearly written, understandable even to the reader without a scientific background, this well-documented book offers a critique of the standard and routine treatments for early breast cancer. It helps prepare the woman with breast cancer to make truly informed choices about treatment best for her alone rather than accepting the one-size-fits-all treatment program for the "average" patient.
Too often, authority figures lead women to believe that they must accept sometimes seriously debilitating treatments or be accused of being a difficult patient, or perhaps of having a "death wish." This book, with its extraordinary complete set of footnotes, provides sound information with which to respond.
Enough Already was a labor of love and compassion by a Harvard Law graduate whose wife was diagnosed with breast cancer. She was presented with the routine array of treatment options--lumpectomy vs. mastectomy, axillary dissection, radiation, chemotherapy and hormone replacement. When she asked for references to the medical literature, she was given a copy of Bernie Siegel's Love, Medicine and Miracles--a book of inspirational prose, poetry and crayon drawings that has helped some women cope with breast cancer (and angered others) but which does not even begin to address the safety or efficacy of routinely prescribed treatment. Where could the Goldbergs find the latest findings about these treatments, their chances of success and their side effects?
Not, they soon learned from the books that breast cancer doctors write for the general public, their customer pool. They typically give as much pertinent, impartial information as a glossy brochure from a car dealership assuring prospective buyers that the cars offered are the greatest vehicles every made. Any negative studies showing totally inadequate brakes or horrific repair records are glossed over or ignored. Buyers often must rely on consumer magazines for the truth.

Unfortunately, there are no consumer magazines dedicated to researching and reporting their informed findings to women with breast cancer. Most of the information comes directly from the cancer industry. The surgeon who recommends an axillary dissection will probably never mention, if he discusses it all, that it may permanently impair arm function or even result in the extremely debilitating, incurable condition--lymphedema--gross swelling of the arm. Axillary dissection is routine and is used only for staging the cancer. If women were aware of how damaging this procedure can be, many would likely refuse. After a century of damaging axillary lymph node dissections, the cancer industry is just beginning to make little peeps about the possibility of extracting only one node--the sentinel node. Long, long overdue.
The radiation therapist will never warn in publications written for women with breast cancer that the radiation they receive will be ten times that suffered by victims of the Hiroshima atomic bombing and that it may burn their skin and damage their heart. Nor will the chemotherapist admit, as one did when diagnosed with cancer, that he would never accept chemotherapy himself.
Women may elect to accept any of the treatments described above but they need truly informed consent. Goldberg makes clear in a chapter entitled "Your Tumor or Your Life" that he feels that surgery to remove at least the tumor and enough healthy tissue to assure safe margins is a sound decision. And the other treatments? It all depends. If there is one area where one size does not fit all, it is the treatment of breast cancer.
It is easier for the cancer industry personnel to give all women in certain "stages" the same treatment rather than individual treatment. This practice has continued for decades because women are poorly informed about their options and physicians are somewhat in a bind because of potential malpractice suits. One can never be sued for giving too much treatment, only for omitting some treatment that some specialist is willing to testify should have been given. Thus, many doctors order up whatever is available and conventional. If they have serious doubts, they almost never communicate these doubts to the women receiving the treatment.
For our own protection, then, we must know as much as we can about the choices we will face if we are among the 1 in 9 American women who will someday be diagnosed with breast cancer. The figures really are astonishing.

Every year, millions of women undergo mammograms (another subject for serious exploration). Some 800,000 of these x-rays of the breast will contain areas sufficiently suspicious as to require biopsies. Of these, 180,000+ will be found to be malignant. Each of these women, with information supplied primarily by the cancer industry, will usually be given a week or two to decide what treatments to accept or reject; treatments that will seriously affect the quality of her life and perhaps even its duration.
Can a women with breast cancer do the necessary research in a week or two? Of course not! It took Goldberg, a former trial lawyer and law professor, accustomed to preparing flat-out, around-the-clock briefs, a full year to gather and analyze the vast body of clinical literature available on-line and in the National Library of Medicine in Betheseda, Maryland. Then he added the reality check of reported medical malpractice cases (with citations) in which real women report (under oath) what was done to them by real doctors in the real world.
Like me, Ms. Goldberg chose only surgery and said "No, thank you" to all the rest. It has been three years since her diagnosis and everything is fine. For me, I have had same-side recurrences and additional surgery only (never axilla lymph node excision). I eat no animal products (vegan) exercise regularly and I have enjoyed almost ten years of very high quality life. I am, however, fully aware that micro-metastasis is totally unpredictable (no matter what "treatment" is chosen) and that my future is, therefore, unpredictable.
George Goldberg's book and extensively cited research will help women to discuss the options for treatment or non-treatment with their medical providers in their native tongue--citing the studies. The decisions to be made could seriously affect each woman's entire life. Knowledge can translate into powerful, real participation in the medical decision-making process.