Book Review

Handbook of Cancer Survivorship

N Engl J Med 2007; 356:2552June 14, 2007

Article

Handbook of Cancer Survivorship
Edited by Michael Feuerstein. 504 pp., illustrated. New York, Springer, 2007. $89.95. ISBN: 978-0-387-34561-1

The victories over cancer in the past three decades have given us much to celebrate. In the United States alone, there are now more than 10.5 million cancer survivors. We have also learned that there can be a cost to curing cancer, and thus the emphasis has shifted from a focus solely on cure to one of maximizing cure as well as minimizing cost. For the past decade or two, investigators have been seeking to better understand the relationship between cancer, cancer therapy, and the subsequent long-term or late effects and health problems faced by survivors. Indeed, the past 4 years have been quite busy for those of us in the trenches, given the release of several important reports: the 2003 Institute of Medicine (IOM) report on survivors of childhood cancer; the 2004 National Action Plan for Cancer Survivorship, developed collaboratively by the Centers for Disease Control and Prevention and the Lance Armstrong Foundation; and the 2005 IOM report on survivors of adult cancer.

What have we learned? What are the physical, psychological, insurance-related, and job-related problems associated with having survived cancer and having gone through chemotherapy, radiation therapy, or surgery? Can we prevent these problems or reduce their effects?

Michael Feuerstein has assembled a distinguished cadre of scientists to answer some of these questions in the Handbook of Cancer Survivorship. To my knowledge, this is the first book that targets health care professionals who work with survivors of adult cancer. Most of the chapters are grouped into three broad sections titled “Burden,” “Common Problems,” and “Secondary Prevention.” Although there are many rich and informative chapters in this book, I found those in the section on secondary prevention to be particularly outstanding. For investigators interested in prevention-focused interventions, this is must-read material. For clinicians involved in developing or enhancing multidisciplinary clinical programs for cancer survivors, this section also includes many excellent and well-founded strategies that could be easily integrated into current practice. The chapters on quality of care and cancer survivorship centers are complementary and will be similarly instructive to the many clinical programs sprouting up in North America and Europe. The two chapters on quality of life are also standouts. Even though I am familiar with this territory, I learned much about the evolution of measuring quality of life in cancer survivors, especially from an excellent section comparing and contrasting the large number of measurement tools now available.

As with any book of this kind, there are trade-offs. The book is superb in its coverage of psychological late effects, of common symptoms such as pain and fatigue, of secondary prevention, and of clinical survivor programs, but there is little information about physiological late effects of cancer therapy, such as heart disease, infertility, and premature menopause, or about second cancers. Indeed, readers who seek to learn more about these conditions are not likely to be satisfied. The title of the book might be misleading to some readers, since the book does not deal with survivors of childhood or adolescent cancers but is instead concerned almost exclusively with survivors of adult cancer. The authors seem unsure of how much information to incorporate from what we have learned about childhood cancer survivors. This problem could have been easily remedied in the introduction by explicitly stating that the focus of the book is on survivors of adult cancer and by instructing the contributors to draw from the literature of childhood cancer survivorship only as it informed the research or care of survivors of adult cancer. Finally, as with many first editions, this book has several typographical errors and could have benefited from combining some of the chapters to avoid redundancy.

These shortcomings aside, there is much to be learned from this book. It will serve as an excellent starting point for future books on survivorship and will provide readers with much information that is useful in both the care of cancer survivors and the study of their health problems.

Kevin C. Oeffinger, M.D.
Memorial Sloan-Kettering Cancer Center, New York, NY 10021
oeffingk@mskcc.org