Clinical Oncology (Book with CD-ROM for Windows & Macintosh)
The major challenges facing the field of cancer research are its epidemiologic study, the technology revolution, and the incremental gains in survival flowing from increasingly complex and lengthy treatments. There is the danger that our focus on treatment will overshadow prevention and early detection. This book is refreshing in that it takes these two elements as its starting point. It is a mine of valuable information about the "big picture" of cancer. In 1913, a group of 10 physicians and 5 laypersons met in New York City to found the American Society for the Control of Cancer. Later renamed the American Cancer Society, it is a community-based organization comprising over 2 million volunteers. The goal for 2015 is a 50 percent reduction in cancer-associated mortality and a 25 percent reduction in the incidence of cancer. This is reminiscent of the United Kingdom's National Cancer Plan: ambitious and laudable. The American Cancer Society's textbook on cancer is a resource for students, primary care physicians, and those it describes as "responsible for creating medical care plans." The chapter on prevention points out that this goal assumes collaboration of the entire cancer-prevention and cancer-control constituency, yet few cancers have such a clear prevention strategy as tobacco and lung cancer. This project was overseen by the three senior editors and a nine-member editorial board, and more than 100 authors served as volunteers without payment or honoraria. The accompanying CD-ROM includes the full text and color images, organized according to chapter. They include both clinical and pathological images, most of site-specific cancers, and they greatly enhance the value of the book as a teaching resource. In places the CD-ROM makes a good clinical overview, such as the chapter on breast cancer, come alive. The text also directs the reader toward reliable electronic data bases and Web sites, which are becoming increasingly important as the pace of progress quickens. The book has three sections. The first includes chapters on the biology, causes, prevention, and detection of cancer. It provides nonspecialists with insight into the scale of the problem and its ramifications for health care systems and society. The third section consists of chapters on pain, nutrition, rehabilitation, survivorship, and other effects of cancer. The jam in the sandwich is the second section of the book, which focuses on specific groups of cancers and occupies more than half the book. The length of the chapters and the level of detail are not always consistent, and at times a surgical rather than a medical perspective is favored. This section is ideal for use as a reference, but reading its chapters consecutively can be confusing because of the lack of a consistent approach to key headings and the layout of the references. For experts, there is insufficient detail, but comprehensive detail is not the aim of the book. The disease-specific chapters are too short and, occasionally, too superficial to be more than an introduction for specialists or trainees in oncology. However, the book offers students a broad view of the principles of the management of cancer. A reflection on the progress in the field is that in places the book is (understandably) out of date, as books usually are when compared with journals. In many places the chapters have important take-home messages. The diversity and character of the authors make for a lively read. For example, the excellent chapter on etiology is comprehensive yet succinct, full of well-justified caveats and supported by extensive references. The chapter on complementary and alternative medicine is a forthright and honest review of the subject and does not retreat from discussing research-based evidence or its absence. It propounds the view that complementary and alternative therapies warrant scientifically accepted research methods and provides an arresting polemic on biased reporting on such therapies in the media. Since 1990, for the first time in recent decades, the age-adjusted rates of death from cancer have declined. The American Cancer Society aspires to "help health care providers adopt practices to encourage prevention and early detection" and "to return the cancer patient to as productive and healthy a life as possible." The motto of the American Cancer Society -- "Hope. Progress. Answers." -- may at last justify the optimism of this book.Hilary Thomas, M.D.Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.