Book Review

Cancer Supportive Care: Advances in Therapeutic Strategies

N Engl J Med 2008; 359:2299-2300November 20, 2008

Article

Cancer Supportive Care: Advances in Therapeutic Strategies
(Translational Medicine Series. 5.) Edited by Gary H. Lyman and Jeffrey Crawford. 395 pp., illustrated. New York, Informa Healthcare, 2008. $269.95. ISBN: 978-1-4200-5289-3

Supportive care for patients with cancer is not a new concept — the Multinational Association of Supportive Care in Cancer had its 21st international symposium earlier this year. However, both the nature of the problems encountered by patients with complications of cancer and its treatment and the therapeutic options available have changed dramatically over the years. Initial meetings and publications on supportive care for patients with cancer were focused mostly on the management of neutropenic fever, intravenous access, pain control, and emesis that is induced by chemotherapy. Although some challenges remain in these areas, our ability to take care of these problems has greatly improved. In recent years, a number of major challenges have arisen because of the increasing complexity of cancer treatments such as aggressive combined chemoradiation and targeted therapies. Increased recognition of the need to deliver better palliative care to patients with advanced cancer, as well as the increasing number of cancer survivors, has also raised new challenges.

The editors of this book do an excellent job of addressing the traditional as well as the emerging challenges and opportunities in the provision of supportive care for patients with cancer. The book is concise and easy to read. Its 20 chapters are not grouped into sections, an appropriate choice given the relatively short length of the book and the fact that both the table of contents and the index are user-friendly. The foreword and the preface are both worth reading; they helped me understand how the book was conceived and organized.

The book begins with an excellent overview of the conceptual framework for the assessment of symptoms and other aspects of quality of life that are related to health, as well as useful considerations for clinical trials. The assessment of symptoms is also emphasized in some of the more specific chapters, such as those on fatigue and pain.

Anemia is a particularly difficult area to address in a book on supportive care because of the rapidly changing knowledge about the safety of drugs that are used in its treatment. There are currently much stronger restrictions on the use of erythropoiesis-stimulating agents — because of the serious risks of thromboembolic disease and decreased survival — than those that are outlined in this book. The chapter on anemia is otherwise very well written.

It is nearly impossible to provide a homogeneous level of editing in a book that covers such a wide range of subjects. The variability in the number of references for each chapter — ranging from 184 in the chapter on anemia to 22 in the chapter on anxiety and depression — can be at least partially attributed to the wide variation in the number of peer-reviewed publications in different subject areas. There are fewer journals in areas in which access to industry-sponsored research is more limited. Nonetheless, I found the book quite enjoyable and easy to read, and I think it will benefit many readers.

Eduardo Bruera, M.D.
University of Texas M.D. Anderson Cancer Center, Houston, TX 77030
ebruera@mdanderson.org