Book Review

Tumors of the Chest: Biology, Diagnosis and Management

N Engl J Med 2007; 356:1188-1189March 15, 2007

Article

Tumors of the Chest: Biology, Diagnosis and Management
Edited by Konstantinos N. Syrigos, Chris M. Nutting, and Charis Roussos. 687 pp., illustrated. Berlin, Springer, 2006. $199. ISBN: 978-3-540-31039-6

Advances in the molecular, diagnostic, and therapeutic aspects of lung cancer during the past two decades make it challenging to compile a book that encompasses all aspects of the management of this disease. Tumors of the Chest offers clinicians a systematic overview of developments in the field, ranging from basic science to prevention, diagnosis, and treatment. Included is an overview of mesotheliomas, with a brief mention of some of the rare tumors of the chest, including sarcomas, lymphomas, and melanomas.

The first three sections of the book introduce the reader to the epidemiology of lung cancer and risk factors for the disease, including a detailed discussion of the effects of tobacco smoking. There is a well-illustrated review of the clinical presentation and evaluation of lung cancer, which includes surgical techniques and imaging methods now used in North America. Two comprehensive chapters discuss experimental models of lung cancer and the molecular biology, pathogenesis, pathology, and genetics of lung cancer. Detailed illustrations and schematics aid the reader's understanding of these topics.

A major portion of the book deals with the multidisciplinary management of lung cancer. There is considerable overlap among the chapters in this section, and some authors seem to overemphasize the results at their own centers or institutions. These chapters are brief, but the concise content is supported by an extensive list of up-to-date references for those seeking additional clarification.

A particular strength of the book is the material devoted to treatment of the elderly (approximately 40% of patients with lung cancer are 70 years old or more at the time of diagnosis) and to palliative care. Given that two thirds of patients with lung cancer present with locally advanced or metastatic disease, the attention given to palliation is extremely important. Included in the section on palliative care are chapters dealing with diverse issues ranging from using cryotherapy for endobronchial lesions to breaking bad news to patients and their families.

The direct medical costs of lung cancer in North America are estimated at more than $5 billion per year. As these costs continue to increase, limited health care resources and financial constraints will demand that economics play a larger role when treatment decisions are made. The chapter on finances addresses the costs of prevention, screening, and treatment, highlighting inadequacies and the need for improvement in care for patients with lung cancer. This chapter is complemented in the final section by a chapter on smoking cessation, which includes a discussion of public health policies and a comprehensive table that lists Web sites from around the world that provide treatment guidelines.

Tumors of the Chest is at times uneven and can lack depth, a problem not uncommon with books of this magnitude. Nonetheless, it will serve as a useful overview for junior oncologists and physicians interested in the management of cancers of the thorax.

Alan Sandler, M.D.
Leora Horn, M.D.
Vanderbilt–Ingram Cancer Center, Nashville, TN 37232
alan.sandler@vanderbilt.edu

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   Mohammad Chakra, Jean Louis Pujol, Pierre-Jean Lamy, Marie Cecile Bozonnat, Xavier Quantin, William Jacot, Jean-Pierre Daurès. (2008) Circulating Serum Vascular Endothelial Growth Factor is Not a Prognostic Factor of Non-small Cell Lung Cancer. Journal of Thoracic Oncology 3:10, 1119-1126
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