Dr. Frederick Levenson has, in this recent volume, offered his theories for the causation, prevention and treatment of cancer. He postulates that an underlying cause of cancer is psychological, and he offers his psychoanalytical interpretation of its induction.

He does acknowledge that physical causes of cancer do exist. These include the actions of physical and chemical carcinogens, and he notes that smoking and exposure to radiation in certain settings can lead to increased incidences of cancer. These facts, of course, are widely acknowledged.

Levenson believes that emotional stress can be a cause of "irritation," which can lead to cancer. He believes that an unfortunate chain of psychological events begins in infancy in some persons.

For example, an infant, when crying or screaming, will splay out its arms and legs. This discharges tension and its consequent irritation. He then points out that the voluntary muscles of the fingers and toes are relatively rarely the primary site of cancer, because they discharge their "irritants" in exercise. The precise nature of the "irritants" and the way in which they are discharged is not stated.

Levenson finds noteworthy a report that if an individual suffered from extensive emotional trauma during the first seven years of life and then also lost a satisfying relationship during young adulthood, cancer followed within six months to eight years. The imprecision of these observations and the fact that they are of a post-hoc nature are readily apparent.

"Psychologically," Levenson says, "cancer may be viewed as the ultimate primative psychosomatic representation of an extreme separation of the self-contained positive and negative forces motivating our lives. It is a resistance to the integration of the basic biologically determined drives of aggression and libido (destructive forces and constructive forces). Cancer is blantantly a narcissistic dysfunction (a self-contained problem), which is evidence of the conflict of these most primative drives. It is an attack upon the self in which the forces of life are overwhelmed by the person's unconscious self-destructive needs."

This theory of cancer causation is presumably more understandable to those individuals who are psychoanalytically attuned than to this reviewer. The author presents no valid scientific information to support this postulate.

Levenson also describes his psychoanalytic treatment of the advanced cancer patient. The implication is that these approaches are designed not only to aid in the psychological management of the patient but also to control the physical growth of the cancer. No data are offered to attest to the efficacy of this approach.

There is, at present, no valid scientific evidence that psychotherapy can arrest the development of cancer. If Levenson has such data, it is incumbent upon him to publish it in an accredited scientific manner so that his treatment methods can be appropriately evaluated by his peers.

All those who care for cancer patients know that the emotional impact which this disease creates on patients and family is great. Further research into improving methods for the emotional support of these patients is highly desirable. Unfortunately, this volume does nothing to advance this field of study.

It makes claims that psychoanalytical mechanisms are important in cancer casuation and that analytical approaches to these mechanisms can check tumor growth. By making these claims, which cannot be substantiated, the author directs attention away from the potentially great contribution the psychologist can make to the emotional support of the cancer patient and his family.