Author to address `devastating diagnosis'.

Byline: Karen McCowan The Register-Guard

Chances are, most people reading these words will someday need Jessie Gruman's book.

One in 10 U.S. households will confront a cancer diagnosis. Others will face other life-threatening conditions, from AIDS and Alzheimer's to muscular dystrophy and multiple sclerosis.

The former Eugene resident will speak here Saturday on "AfterShock: What to Do When the Doctor Gives You - or Someone You Love - a Devastating Diagnosis."

Her book has won raves from people as diverse as journalist Tom Brokaw and Dr. Harold Varmus, the Nobel Prize-winning researcher and president of the Memorial Sloan-Kettering Cancer Center.

Professionally, Gruman is a psychologist who worked for the National Cancer Institute and the National Institutes of Health before founding the nonprofit Center for the Advancement of Health in 1992. The center aims to help people access good scientific information when making health care decisions.

Personally, she has survived a serious heart ailment and three cancer diagnoses - the first as a 20-year-old college student.

Even so, her latest cancer diagnosis following a routine colonoscopy reminded her afresh how powerful a wallop such news packs.

"All of my experience and expertise couldn't protect me from that gale force of emotion you feel when you all the sudden find out you not might live," she said in a phone interview this week.

Her book is aimed at helping people through the first couple of weeks after such a diagnosis.

"That period right afterward is such a no man's land - and so stressful," she said.

First comes the task of absorbing and understanding the news.

"Everything that you thought was true is not," she said. "Everything that you expected has changed. Your plans are shattered."

Meanwhile, the newly diagnosed face the upsetting task of telling those who love them. They must schedule medical appointments and get various specialists communicating with one another. They must make - and act on - complex treatment decisions.

But Gruman draws on her personal experiences with lymphoma, cervical cancer, excess fluid around her heart and colon cancer to offer some reassuring news in her book's first chapter: The initial shock wave usually subsides.

"When you first hear about it, the whole thing seems insurmountable," she said. "But it may be that, within a week or two, once you get into the everydayness of it, it becomes manageable. You'll have a better sense of whether you can continue with life as you planned it."

In many respects, medical advances have improved things since Gruman learned she had Hodgkin's disease as a Vassar College student.

"I was diagnosed with a pretty advanced case and treated very, very aggressively - surgery, radiation, two years of chemo. I was on life support at one point. I went back to college as a frightened, 100-pound waif with no hair."

By the time she woke up from her colonoscopy three years ago to learn that "part of my colon and I were going to go separate directions," she could appreciate advances such as laparoscopic surgery, directed chemotherapy, "wonderful" anti-nausea drugs and laser-focused radiation.

Other advances, however, have served to increase treatment options and thus the decision-making burden following a diagnosis.

"People feel overwhelmed by choices," she said.

Moreover, breakthroughs that relieve treatment side effects have increased pressure for people to carry on with other life responsibilities even as they deal with their disease.

"There used to be a hypothesis that when you were sick, you were kind of excused from a lot of job and family expectations," she said. "Now there's less of a sanction or sanctuary for people who are dealing with really serious illness."

In her free, 3 p.m. talk at the Eugene Public Library, Gruman will discuss strategies for coping with those choices and other decisions.

Her book is peppered with snippets of often contradictory decisions made by more than 100 other people she interviewed for the book.

She deliberately included contrarian perspectives.

"One of the strengths of the book is that you've got to do what you need to do, and there's this huge range of what's possible," she said.

As an example, she pointed to the decision about who to tell.

"One woman told me, `It breaks my heart to tell other people. I can see reflected in their faces their pain at what I'm going through. It's like picking off a scab each time.' "

At the same time, Gruman writes, keeping the news from co-workers or family can be stressful in its own right. Among strategies she suggests: Ask someone else to tell others.

The book also devotes a chapter on how to interact effectively with doctors, including a suggested script for letting your doctor know you want a second opinion.

"Most doctors I know would say you should always get a second opinion before embarking on a treatment course for a life-altering disease," she explained. "But they don't always handle it well when their patients ask for one."

Though she lived here only a year, taking science classes at the University of Oregon in 1977-78, Gruman is a frequent visitor to Eugene because her parents, the Rev. Larry and Ellie Gruman, live here. While she welcomes the chance to speak here and hopes many who attend will buy her book, she doesn't expect most to read it right away.

"I can't imagine reading the whole thing," she said. "There's no way you can prepare ahead of time for something like this. What people need when they're in that very dark place is so very different from what they'll need until they're there. If it were me, I would probably read the introduction and then put the book somewhere in my house so I could give it to someone who needs it - or have it ready if someday I need it myself."