Clinical Oncology, Second Edition

A comprehensive textbook on clinical oncology should have broad appeal to readers from various disciplines, including educators, clinicians, and scientists working with cancer patients. Students of the medical disciplines must also have a reference textbook to guide them in their educational exploration, whether they are in the field of medicine itself or in complementary areas. We look to comprehensive textbooks not only to provide us with the latest updates in different disease entities, but also to guide us by choosing the most relevant areas of study and investigation. The editors who compiled this textbook have met these challenges, while maintaining a readability that is suitable for various levels of expertise and comprehension

The editors of Clinical Oncology asked the authors of their 96 chapters to catalog the multitude of new discoveries since their first edition and to “emphasize their own interpretation of complex data”—an appealing approach to a comprehensive textbook on clinical oncology. There are ample data for the practicing clinical oncologist, with numerous journals and supplements readily available. However, many of these sources can be clouded by the risk of potential bias due to pharmaceutical company sponsorship and omission of potentially relevant data. Therefore, this comprehensive and objective text offers readers the opportunity to have both a thorough review of the data and, at its best, a sophisticated interpretation by respected authorities in each field.

This second edition is a thorough review of the important areas of oncology. It is divided into four major sections, including (1) the science of clinical oncology, (2) problems common to cancer and its therapy, (3) specific malignancies, and (4) rehabilitation of the cancer patient. Each of these sections is subdivided into chapters, totaling 96 in all.

The editors of this textbook include respected clinicians in clinical oncology, radiation oncology, and surgical oncology, who have, in turn, recruited a host of well-qualified and enthusiastic authors for various chapters. A brief survey of the chapters shows topics ranging from the regulation of the cell cycle to management of fever in cancer patients with or without neutropenia, to the evaluation and management of sexual dysfunction in the cancer patient. Clearly, a multidisciplinary approach is at work in this text—a tactic that is vital to understanding the problems cancer patients face from a global point of view.

The first section, on the science of clinical oncology, develops a background and scientific explanation of carcinogenesis and the basic principles for understanding the genetics and immunologic basis of cancer, as well as the appropriate epidemiology and biostatistics necessary for a clinician in oncology. The second section deals specifically with clinical problems associated with cancer from general conditions such as pain and psychological distress, to more specific clinical entities such as thrombotic complications, nausea and vomiting, and neurologic complications.

The third, quite comprehensive part of the book deals with specific malignancies, from central nervous system malignancies through cancers of the various organs, including childhood tumors, human immunodeficiency virus (HIV)-associated malignancies, and the hematologic malignancies. The last section, on rehabilitation of the cancer patient, deals with posttreatment problems and their management.

This organization enables a very thorough and systematic approach to researching common entities in cancer patients. With an extensive index, cross-referencing is easy and convenient, such that a particular problem can be researched through any of the textbook’s four parts.

More specifically, the individual chapters offer the particulars about risk factors, staging, prognosis, and therapy for individual cancers. The text is quite readable and well referenced, with good support from tables, charts, and graphs. I found the flow diagrams to be extremely useful, along with side boxes of text to help review the incidence, differential diagnosis, staging, and primary and secondary therapies for specific cancers. Perhaps an enhanced use of illustrations and pictures, however, would give the less well initiated reader a more basic understanding of the problems encountered in each malignancy. That said, the photographs provided in the color plate section seem to be quite standard—perhaps resembling photographs seen in similar textbooks—but they adequately (if not innovatively) convey the clinical problems pictured with good resolution, color, and legends.

Regarding therapy for specific disease entities, the book contains a very good description of available chemotherapy schedules and dosing, such that a medical oncologist could refer to this volume for specific programs of combination chemotherapy. However, I was less impressed with the description of radiotherapy techniques and schedules. Indeed, this textbook would be less useful as a guide for radiotherapists developing specific treatment strategies or for medical or surgical oncologists seeking to understand the specifics of radiotherapy techniques and dosing. With regard to surgical techniques, some chapters, such as the chapter on bone sarcomas, do an excellent job of illustrating surgical principles and practices, but other chapters are less well illustrated and may prove inadequate for the uninitiated reader.

Overall, this textbook provides readers with an excellent comprehensive overview and specific data on the management options for patients with malignant diagnoses. The text could serve as a primary source of information in dealing with cancer patients, whether from a medical oncologist’s point of view or as a reference text for students or other readers. While other available textbooks offer a comprehensive overview of clinical oncology, it would be difficult to find a text that is more comprehensive or useful as a reference tool or general overview than this textbook.

Similarly, although disease-oriented texts may be more specific and detailed with regard to certain unusual diseases, this volume provides readers with an opportunity to survey, in limited or great detail, the available clinical information on a given clinical entity or presentation. This textbook certainly belongs in every oncology library and clinical oncology practice to provide a well-balanced review of the practice of clinical oncology. It probably also belongs on your own personal bookshelf.