Book Review

Clinical Oncology

N Engl J Med 1995; 333:809September 21, 1995

Article

Clinical Oncology
Edited by Martin D. Abeloff, James O. Armitage, Allen S. Lichter, and John E. Niederhuber. 2350 pp., illustrated. new York, Churchill Livingstone, 1995. $199. ISBN: 0-443-08941-8

At 2350 pages, this book is in every sense substantial. It attempts to address the interests and needs of students, general physicians, and cancer specialists in all disciplines. Meeting this goal is a formidable challenge, since it requires the presentation of both fundamental scientific material and clinical applications. The authors have been generally successful in achieving their aim.

The book has four sections, the first of which summarizes aspects of basic cancer biology and genetics concisely (in about 350 pages) and in a comprehensible manner. Nevertheless, no one textbook can fully present the vast, diverse, and dynamic body of information on cellular and molecular biology. Although some newer topics are missing (such as telomerase function), this section gives a solid foundation. The second section addresses general issues of medical care and patient support.

The bulk of the book (more than 800 pages) is a system-by-system, disease-by-disease discussion of specific cancers, including their epidemiology, prevention, diagnosis, and treatment. Useful clinical algorithms are frequently presented, and although individual preferences may vary, these clinical paths are generally acceptable. Occasionally, there is an insufficient distinction between different (competing) therapeutic options. They are assigned equal weight even though national standards of care (such as options for patients with stage I or II breast cancer or stage III colon cancer) have been articulated at Consensus Development Conferences sponsored by the National Institutes of Health. There is a final, brief section on rehabilitation.

This book has many of the strengths and a few of the weaknesses of a comprehensive multiauthored work. The more than 200 contributors are distinguished, authoritative, and articulate. Most of the clinical chapters benefit from the collaboration of authors from different disciplines. Careful editing has minimized overlaps and gaps. Other positive features are the attractive graphics and the thoughtful summary tables and charts (such as lexicons for medical, economic, and biologic terms that may be unfamiliar to some readers). The editors have also tried to incorporate a variety of timely topics, such as new therapeutic agents, issues of medical economics, and recently introduced technical devices.

The description of chemotherapy agents is simple and straightforward but contains only rudimentary information on mechanisms of action, pharmacology, and toxicity. Readers looking for more detailed information (such as the precise dose, schedule, or route of administration or quantitative information on toxic effects) will not find it. Since this book is not intended to be a treatment manual, authoritative sources and appropriate citations are abundant.

Michael Friedman, M.D.
National Cancer Institute, Bethesda, MD 20892