Book Review

Cancer Survivorship: Today and Tomorrow

N Engl J Med 2007; 357:2209-2210November 22, 2007

Article

Cancer Survivorship: Today and Tomorrow
Edited by Patricia A. Ganz. 304 pp. New York, Springer, 2007. $79.95. ISBN: 978-0-387-34349-5

During the past decade, reporting of the health problems and health care needs of cancer survivors has grown considerably. The number of peer-reviewed articles published in this area in the past 5 years is more than double the number published in the preceding 5 years, which was more than double the number published in all previous years combined. With all this activity, our understanding of survivorship has evolved substantially. Many physicians feel overwhelmed by the new information in this field and by the relative lack of composite or general resources available to clinicians and scientists who provide health care to cancer survivors or investigate their health problems and needs.

Patricia Ganz, the editor of Cancer Survivorship, is one of the leaders in survivorship research; her interest in the quality of life and the health of cancer survivors dates back to the 1980s. She was a primary contributor to the 2006 Institute of Medicine report on cancer survivors (From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: National Academies Press), and she coedited with Julia Rowland and Maria Hewitt a special 11-article issue of the Journal of Clinical Oncology (2006;24[32]) that was devoted to the expansion of knowledge in this area and highlighted the challenges of delivering quality care to survivors of cancer. With this breadth of experience, Ganz has assembled a topflight group of authors and edited a superb and much-needed book.

In an era of “one size fits all,” it is difficult to write a medical book that serves different audiences with different needs. This invaluable book succeeds in appealing to a broad group of health care professionals and will be appreciated by clinicians in academic or private practice settings. In particular, clinicians in private practice or community settings, including oncologists and primary care physicians, will find that this book fills a gap in their libraries and provides practical and up-to-date information that can facilitate their care of cancer survivors.

The format of the book is user friendly, with most chapters presented in the style of a review article and with excellent use of tables and figures. The first three chapters provide a historical perspective from the viewpoints of physicians, nurses, and social workers. Next are three outstanding chapters on survivorship research, surveillance after primary therapy, and late effects of cancer treatments, written by Julia Rowland, Craig Earle, and Noreen Aziz, respectively. Rowland, the director of the Office of Cancer Survivorship (OCS) at the National Cancer Institute, and Aziz, a senior program director at the same office, have long been vocal and effective advocates for the funding of survivorship research. Their chapters reflect a special understanding of the key issues in the area. Defining late effects and describing key outcomes within a single chapter can be a daunting task; Aziz has succeeded in assembling a wealth of information in a readable and understandable format. Earle, a physician-scientist who is well known in the community of survivorship researchers and clinicians, has contributed a succinct and thoughtful rationale for the surveillance of cancer survivors.

The nucleus of the book consists of 10 stellar chapters that concern survivors of specific types of cancer, starting with survivors of pediatric cancer, proceeding to survivors of Hodgkin's disease and the most common adult cancers (testicular, gynecologic, breast, prostate, lung, and colorectal cancers), and ending with survivors who have undergone hematopoietic stem-cell transplantation and survivors who were 65 years of age or older when they were given a diagnosis of cancer. Each chapter includes a discussion of the medical and psychosocial outcomes and key research questions for that particular group of survivors. The integrated discussion of medical and psychosocial health problems and the needs of the population is very effective and reflects the collaboration and insights of some of the most respected investigators in their fields.

Following these mini-treatises are chapters on themes that cut across various issues, including second cancers, psychosocial rehabilitation, reproductive complications and sexual dysfunction, concerns about employment and insurance, and cancer advocacy. Each chapter is extremely well written and reflects a current understanding of these common issues. Suggestions about where future research should lead are also included.

The last chapter is perhaps the most important. Now that we have a reasonable understanding of the health problems that develop in cancer survivors and the potential for focused health care to reduce disease, premature death, and diminished quality of life in these patients, how can we improve on the appalling state of current care for cancer survivors in North America? Earle and Ganz, along with Deborah Schrag and Steven Woolf, advocate the preparation of a treatment summary for all cancer survivors and call for improved communication between oncologists and primary care clinicians about the care of these survivors.

This superb book will be used frequently by health care professionals from many backgrounds. Perhaps the greatest difficulty faced in preparing a book such as this one is the rapid evolution of our understanding of cancer survivorship. Indeed, findings within the past year have greatly expanded our knowledge of long-term outcomes for survivors. This book, with its review-style format, lends itself to frequent new editions that could keep pace with the expanding knowledge base and prevent the resource from becoming out of date. Knowing the energy and commitment of Ganz and her distinguished group of collaborators, I look forward to the next edition.

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

Citing Articles (1)

Citing Articles

1. 1

   Anne Grinyer. (2010) The late effects of mantle field radiotherapy: The information and support needs of women survivors of Hodgkin's disease. European Journal of Oncology Nursing 14:3, 183-189
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