Chemo, Craziness and Comfort: a parent's field guide

Chemo, Craziness and Comfort: My Book About Childhood Cancer is a short, practical handbook. Nancy Keene wrote it. She is a parent whose own daughter was treated for acute lymphoblastic leukemia. It is not a memoir in the usual sense, though Keene's family experience runs through it. It reads more like a field manual, written by someone who has already made most of the mistakes a new cancer parent is about to make.

Keene has written or co-written several books in this space. Her body of work is built the same way each time: her own experience, plus contributions and quotes gathered from many other parents who lived through the same territory. This one is aimed squarely at a parent in the earliest, most disoriented weeks of a child's diagnosis. That is when the volume of new information is overwhelming, and the emotional load is heavier still.

It does not attempt to explain oncology. There is no meaningful discussion of specific diagnoses, staging, or treatment protocols. It is not trying to compete with that kind of reference. Its subject is the daily work of getting a family through treatment, such as:

• What a clinic day actually involves.
• How to talk to a young child about a port or a needle.
• What siblings need.
• How to get through a 3 a.m. fever call.

The tone throughout is unsentimental. Keene does not dress up how hard the early weeks are. The book does not promise that following its advice will make the experience manageable in any complete sense. It promises only that a reader will not face each problem alone. That holds whether it is the school reentry conversation, the insurance phone tree, or the sibling who has started acting out. Other families have already walked that path and left a map.

It is short and written in plain, direct language. It works less like a book to read cover to cover and more like a resource to keep on a shelf, opened to whatever chapter matches the week's problem.

The book is organized by the practical problem a parent is facing, not by diagnosis or treatment phase. Chapters group around themes such as:

• Coping with the diagnosis itself.
• Managing clinic and hospital visits.
• Handling the physical side effects a child experiences.
• Keeping siblings included and supported.
• Managing the parents' own exhaustion and marriage strain.

Within each section, the material tends to be short entries. A paragraph or two covers a specific problem, often followed by a quote or tip from another parent who solved that exact problem in their own way. This gives the book a chorus-like structure, rather than a single authorial voice throughout, even though Keene is the one assembling and writing it.

There is no clinical glossary, no drug reference, and no attempt at a comprehensive list of childhood cancer types. There is also no nutrition-data appendix or recipe section. Food-related content, where it appears, is about coping with a child's appetite changes and food aversions during chemotherapy. It is not about meal planning.

The book also touches, briefly, on the practical machinery of a family's life during treatment that rarely gets mentioned elsewhere. This includes how to talk to an employer and what to say to a school administrator. It also covers how to keep track of the sheer volume of appointments, forms and phone numbers a diagnosis generates almost immediately. None of it is exhaustive. But it is mentioned at all, drawn from other parents who lived it. That is part of what makes the book feel written by someone who has actually done this. It does not read like someone theorizing about it.

The book is strongest exactly where a purely clinical resource is weakest: the emotional and logistical texture of the experience.

It is honest about the ugly parts most people do not say out loud. These include resentment, exhaustion, and the strain a serious childhood illness puts on a marriage and on other children in the house. Because so much of the content comes from other parents, not from Keene alone, it captures a range of coping strategies rather than a single prescribed approach. That matters, because families vary enormously in what actually helps them.

It is also useful simply as reassurance. It shows that a given reaction, such as panic, numbness, or anger, is common. It is not a sign something is wrong with the parent having it.

That reassurance function should not be undervalued. A parent in the early weeks of a child's cancer diagnosis is often isolated in a very particular way. They are surrounded by people who want to help, but have no framework for what is actually happening. A book built from many other parents' voices can function as a kind of substitute community. That matters during a period when joining an actual support group may not yet feel possible.

Any specific drug name, dosing detail, or treatment sequence mentioned in a book from this period should be treated as historical color, not current practice. Pediatric oncology protocols are revised through ongoing clinical trials. A specific regimen described from one family's experience two decades ago will not necessarily match what a child is offered today.

The book is also, by design, diagnosis-agnostic. That is a limitation as much as a strength. A parent whose child has a brain tumor, and a parent whose child has leukemia, face genuinely different treatment courses. This book will not distinguish between them in any clinical depth. It is a companion to, not a substitute for, information specific to a child's own diagnosis.

The book draws on one family's era and one set of contributing parents. So its assumptions about hospital systems, insurance navigation, and available support services reflect an earlier and largely US healthcare landscape. Some of that logistical detail, unlike the emotional content, has aged less well.

This is the part a comfort-and-coping book like this one does not attempt, and it is worth putting next to it.

The American Cancer Society projected about 9,550 new cancer cases among children ages 0 to 14 in the United States in 2025. It projected about 1,050 deaths in that age group. Annual case and death projections like these are produced by the ACS, not by NCI, though NCI republishes them. Cancer remains, NCI notes, the leading disease-related cause of death in children, even though the numbers are small relative to adult cancer.

The trend line is the more important number for a newly diagnosed family to hold onto. NCI reports that childhood cancer death rates declined 70 percent from 1970 through 2020. As of 2020, NCI estimated about 496,000 childhood cancer survivors were living in the United States. That figure did not exist at this scale when Keene was writing.

The most common childhood cancers, per NCI, are leukemias, brain and central nervous system tumors, and lymphomas. Treatment for children differs from adult cancer care. NCI notes that children typically receive more intensive treatment regimens than adults. Pediatric cancer teams also plan long-term follow-up for late effects, so ask your child's team what that will look like.

For a fuller picture of what childhood cancer treatment involves today, see childhood cancer overview. For the questions this page's own team suggests asking early, see questions to ask about childhood cancer treatment.

One area where Keene's book and current clinical guidance genuinely overlap is appetite and eating during a child's treatment. Chemotherapy's effect on a child's appetite has not changed, even as the drugs have.

A comfort-and-coping book offers practical, non-medical strategies. These include small frequent meals and not turning mealtime into a battle. They also include letting a child eat what appeals to them even if it is not a balanced plate on a bad week. These line up with how pediatric oncology teams generally talk about the same problem. They see it as something to manage day to day, with a dietitian's involvement, not as something with a single fixed solution. Cancer Explained's own page on this problem covers it in more current, diagnosis-relevant detail: feeding and appetite changes in childhood cancer.

It suits a parent in the first disorienting weeks after a child's diagnosis. That parent needs something short and plain, full of other parents' voices, rather than another clinical document. It also suits a parent who wants permission to feel the ugly feelings, and practical tricks for surviving a clinic day, a hospital night, or a sibling's jealousy.

It does not suit a parent looking for current, diagnosis-specific medical information, drug names, or protocol details. It should not be used that way. It also is not the right book for a parent who wants a single narrative arc. Its chorus-of-voices structure works against reading it front to back as a story.

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• NCI — Childhood Cancers
• NCI — Nutrition in Cancer Care (PDQ)
• Childhood cancer overview (Cancer Explained)

This page discusses Chemo, Craziness and Comfort for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care.