Anthropology & Aging Quarterly  2010: 31 (1-2) 36

Book Reviews

Abel, Emily & Subramanian, Saskia. After 
the Cure: The Untold Stories of Breast Cancer 
Survivors. New York University Press. 
2008. ISBN 13: 978-0-814-0725-8. 183 Pages
$22.95 (Hardcover)

After the Cure: The Untold Stories 
of Breast Cancer Survivors is a collection 
of post cancer ethnographies of women 
who are breast cancer survivors. The 
book details the physical and emotional 
side effects of contemporary breast 
cancer treatment (surgery, radiation 
and chemotherapy).  Central to these 
ethnographies is a chronicle of the lack of 
recognition by the biomedical community 
of post cancer treatment side effects.  Abel 
and Subramanian make clear that there 
is an urgent need for post operative and 
post chemotherapy aftercare therapies for 
women otherwise “cured” of breast cancer.  
The book draws from a study of thirty-six 
African American and thirty-eight white 
women, both young and middle aged, who 
were interviewed from one to three hours 
(Abel and Subramanian 3).  The stories 
reveal how unexpectedly life altering 
cancer treatments as well as the post 
treatment side effects (lymphedema, loss of 
short-term and long-term memory, other 
cognitive dysfunctions, and debilitating 
fatigue) can be, even after cancer recedes 
(Abel and Subramanian 33-34). 

The authors are succinct in 
answering a difficult question: how can 
medical practitioners who treat hundreds 
of breast cancer patients annually fail 
to recognize a pattern in recurring post 
treatment complaints?  The authors write, 
“Readers may wonder why symptoms 
with such profound implications for 
survivors’ lives may lie in the way drugs 
are tested” (Abel and Subramanian 5).  
They suggest that this is, in part, motivated 
by pharmaceutical companies who wish 
to get Food and Drug Administration 
(FDA) approval for drugs must first prove 
these drugs are both safe and effective.  
Clinical trials of chemotherapeutic agents 
tend to focus on survival rates rather 
than side effects (Abel and Subramanian 
5).  The book was written from a critical 
perspective, but also one that reflects the 

personal life trajectories of its authors.   
Six months after breast cancer surgery, 
chemotherapy, and radiation in 1993, Abel 
experienced severe side effects from the 
treatments.  When she shared her problems 
with other survivors, several expressed 
their own difficulties.  When Abel, a 
historian of medicine and public health, 
met Subramanian, a medical sociologist 
and a women’s studies scholar whose own 
mother had died of breast cancer, they 
began to converse about breast cancer, its 
treatments and side effects.  Ultimately, 
Abel suggested they collaborate on a 
study to examine how women who have 
completed breast cancer chemotherapy 
and radiation cope with ongoing problems 
doctors failed to take seriously (Abel and 
Subramanian 2).  Many of the women they 
talk to were never told of the possibility 
of chronic, life altering side effects – a 
problem that seemed unreal in the face of 
the medical community’s obsession with 
informed consent. 

The authors faced the challenge of 
epidemiologically describing the problem 
while simultaneously “legitimizing” 
individual women’s complaints of side 
effects.  The study, however, became 
unwieldy. The authors write, “even if a 
study identified a population, how could 
we know whether it was caused by the 
cancer in a particular case?” (Abel and 
Subramanian 3). Their attention turned 
towards the women’s stories themselves.  
Abel and Subramanian are effective in 
conveying the suffering felt by individual 
women, however one weakness of the 
book is its lack of focus on the important 
role of the nursing profession in aftercare. 
For example, when one of the women 
in the study is given information from a 
doctor about lymphedema, the patient 
says, “he told me well you got to soak it 
[the arm] in warm water.” The patient 
continues, “I stopped by to chat with the 
nurse, and thank goodness, she was there. 
Hearing the doctor’s recommendation, the 
nurse exclaimed no, no, no!” (Abel and 
Subramanian 58).  Given the centrality 
of the nursing role in the context of 
cancer aftercare, it seems something that 
needs even further careful analytical 

consideration.  The authors do point out 
the gendered aspects of care, and why it 
is important to think in–depth about how 
this dynamic matters in understanding this 
particular healthcare context.

Race and gender seem to be two 
(sometimes competing) axes in the book. 
Given this, sometimes the ethnographies 
in the book could benefit from longer 
engagement, and more in depth analyses.   
One story that stood out was a conversation 
with Ida Jaffe, a fifty-eight year old African 
American woman, who stated, “she did not 
know that black women got cancer.”  The 
statement by Jaffe shows how difficult it 
is to reconcile morbidity rates in African 
American women with the realities of being 
diagnosed with breast cancer.   It did seem 
odd, however, with the detail (both physical 
and social) the authors offered to describe 
white women (eye color, dress, affect, 
etc.) and the lack of the same detail when 
describing African American women.  

With these critiques in mind, it 
is important to point out that Abel and 
Subramanian have taken on an ambitious 
and important topic, and do so in a highly 
thoughtful manner.  A few chapters that 
stand out as the most thought provoking 
are “Like Talking to a Wall” and “Narrowed 
Lives.”  Both chapters demonstrate the long 
haul that breast cancer treatment really is. In 
these chapters, the authors stress the need 
for repositioning the idea of a former cancer-
free self with a new notion of the cancer 
survivor – a process that can be as grueling 
as the cancer therapies themselves.  In After 
the Cure: The Untold Stories of Breast Cancer 
Survivors, Abel and Subramanian show 
us not only that breast cancer patients are 
surviving, but also what survival looks like 
far from public view. For those interested in 
anthropology and aging, the topic of how 
women deal with breast cancer and its side 
effects over time is highly relevant. As more 
women live longer and experience breast 
cancer and aging post breast cancer, this 
book has much new information to offer on 
that critical topic.
Mary Hollens
Development Administrator, School of Law
Anthropology Student
Wayne State University



Anthropology & Aging Quarterly  2010: 31 (1-2) 37

Book Reviews

Dagg Innis, Anne. The Social Behavior 
of Older Animals. The John Hopkins 
University Press. 2009.  ISBN 
13:978-0-8018-9050-5, 240 Pages, $35 
(Hardcover).

The Social Behavior of Older 
Animals, by Anne Innis Dagg, 
addresses the various effects of 
aging on older animals that live 
within social groups. Focusing on 
large mammals and birds, the book 
discusses the differing roles that 
older animals can play within their 
social groups.  It considers how the 
remaining presence of these animals, 
after the age of reproduction, is 
probably due to their contribution 
to the survival of their species.  
Dagg makes the argument that 
older animals are, for some species, 
imperative to their survival, and for 
others they still play a significant role 
in their social groups. Dagg briefly 
mentions the difficulty in finding 
supportive information on older 
animals, attributing this to older 
animals being overlooked in past 
research studies. She also points out 
that older animals in the wild, either 
on land or in the water, were often 
poached or hunted out of existence. 
However, the older animals that do 
exist in the wild are considered to be 
“winners, because most of their peers 
have long since died” (Dagg 2009, 
11). Dagg supports this statement 
with several reasons such as, genetic 
inheritance in terms of reproductive 
success and behavior within the social 
group, and a lifetime of knowledge 
about the environment they live in. 

Other reasons that older 
animals may remain in a social 
group, when they have passed the 
age of reproduction and the purposes 
served are further explained. For 
example, Dagg  discusses several 
ways that older animals participate 
in the success and survival of their 
species which include being leaders 
and teachers in behavior. They 
may act in important ways such as 
calming a group down, and serve as 

a source of past knowledge therefore 
deciding where to best find resources.  
Interestingly, these points may seem 
quite familiar to those who are aware 
of the gerontological literature that 
has advanced similar ideas about the 
roles of older humans specifically. 
Dagg addresses the stages of older life 
looking at changes in reproductive 
success, social interactions, aggression 
and behavior, and death and dying. 
The arguments Dagg made for the 
role of older animals, certainly offer 
a possible explanation for their 
remaining in their social group long 
after reproductive age. In short, much 
documentation is offered throughout 
to show how older adults play an 
important role in the continuation of 
their species through their usefulness 
as leaders, owners of important 
knowledge and life lessons, and by 
lending a “helping hand” in their 
social groups. 

Throughout this book, the 
examples given for older animals in 
social groups are very enlightening 
and it is hard to understand how 
we have truly overlooked such an 
important aspect of animal behavior. 
The many interesting and revealing 
stories of the complex nature of 
animals and also the similarities that 
we humans share with them are truly 
eye-opening. With so many other 
species on this planet, it is important 
to see the similarities that we have 
as a reminder that we are not all 
knowing about animals, and that they 
are, just as humans are, very diverse 
and complex.  This book fits into the 
study of gerontology by covering 
important changes in older animals 
socially, physically, and mentally – as 
well as contemplating the roles they 
play in their social groups. 

Georgia Richardson-Melody, M.A. 
Student
Department of Anthropology
Wayne State University