Clinical Hematology and Oncology: Presentation, Diagnosis and Treatment, 1e
In a field characterized by much competition, Clinical Hematology and Oncology is unique. First, this multiauthored book combines clinical cancer medicine with a guide through all aspects of hematology, including coagulation disorders and transfusion medicine. Second, unlike most oncology textbooks, it opens with a survey of the differential diagnosis of typical signs and symptoms in patients with cancer and the diagnostic strategies that are appropriate for tackling them. This part of the book is particularly appealing, since often our patients do not walk through the door with an established diagnosis but, rather, with a swollen lymph node or a lump in the breast that was seen on mammography. While preparing a lecture called "Patients with Enlarged Lymph Nodes," I browsed through section I of the book and found much useful, concise information, albeit split among several chapters, on patients with lymphadenopathy. (In a future edition, a single chapter on this topic might be considered.) Splenomegaly is comprehensively (but not too extensively) discussed in a single chapter, whereas a chapter dealing specifically with the patient with an enlarged liver (surely no rare problem) is missing. Recently, two of my patients with cancer presented with increasing dyspnea and ascites, respectively. I found a chapter on each of these two common problems, with helpful discussions that are neat and to the point. The rest of the book is more standard in its design. It provides short overviews on therapeutics (section II) and a systematic discussion of all types of cancers and hematologic disorders (section III). Section IV, "Special Considerations in the Treatment of Cancer Patients," is good, but I wish it had included a chapter on emergencies. Supportive care is discussed in section V. Thus, the bulk of the book competes directly with existing major textbooks on oncology. On the whole, it does not compare badly. Its chief appeal is its successful delivery of concise information on all aspects of a given type of cancer: epidemiology, screening (where appropriate), clinical evaluation, and treatment. In most chapters, short boxes embedded in the text offer summaries, which are welcome eye-catchers for the hasty reader. References are understandably selected to include mainly other textbooks but also important original research articles, which include "modern classics" such as recent papers on adjuvant treatment of breast cancer with aromatase inhibitors. The editors opted for an integrative presentation of clinical oncology and hematology, and by and large their point is well taken. This feature renders the textbook particularly interesting for medical students and trainees in oncology and hematology. However, I wonder whether "pure" hematologists will be ideally served, since discussions of nonmalignant hematologic disorders are scattered among many pages devoted to oncology. Clinical oncologists will find the book very helpful, and they should not ignore the specific value of section I, which covers the differential diagnosis and management of many common clinical problems.Martin F. Fey, M.D.Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.