OncologyOncology

In the Internet age, with online journals and libraries and Web sites that offer access to the latest medical information and reviews, one can reasonably ask if there continues to be a role for medical textbooks. My answer is still a resounding yes: authoritative texts are still needed to define the state of the art. Any text is around 12 to 14 months out of date at the time of publication, but texts provide a basis of medical knowledge that can be supplemented through journal articles and Web sites. Moreover, some, like this one, provide Web access (at additional cost) for updated information and CD-ROMs to facilitate searching and use of illustrations, among other features.

The third edition of Clinical Oncology, edited by Drs Abeloff, Armitage, Nieberhuber, Kastan, and McKenna, like the previous edition, is well written and organized, easy to read and use. The editors’ goals in all editions have been “to provide a textbook that is the most useful, understandable, attractive and thorough in presenting the principles of clinical oncology . . . a scholarly textbook that is properly balanced among the disciplines of science, clinical medicine, and humanism.” They are to be congratulated in achieving these goals.

As in previous editions, the first of three parts deals with the science of clinical oncology. It is divided into four sections: “Biology and Cancer” (172 pages), “The Genesis of Cancer” (125 pages), “Diagnosing Cancer” (166 pages), and “Preventing and Treating Cancer” (350 pages).

“Biology and Cancer” provides excellent foundations in cancer molecular biology, the biology of metastasis, the cellular microenvironment (which may be as important as the cellular alteration that ultimately leads to the malignant phenotype), stem cell and cellular differentiation, and vascular and interstitial biology.

Excellent chapters in section 2 include “Hereditary Cancer Predisposition Syndromes,” by Offit and Siddiqi, and “Genetic Factors: Finding Cancer Susceptibility Genes,” by Ostrander and Friedrichsen. Section 3 includes excellent chapters on flow cytometry, molecular diagnostics, and imaging. The last section has excellent chapters by Drucker on “The Present and Future of Molecular Targeted Therapy” and Cheung on “Therapeutic Antibodies and Immunologic Conjugates.”

Part 2 focuses on “Problems Common to Cancer and its Therapy.” The first section deals with symptom management and palliative care. The section has been expanded from prior editions and contains excellent chapters on pain management, end-of-life care, and lymphedema. The next three sections deal with hematologic complications, infectious complications, and metabolic and paraneoplastic syndromes. The standout chapter on paraneoplastic neurologic syndromes concisely summarizes recent work on pathogenesis and treatment. Section 5 focuses on surgical complications and section 6 on local complications of cancer, site-specific metastases, pulmonary, cardiac, and reproductive complications, and second malignancies. The final section contains two chapters on cancer in the elderly and cancer complications in pregnancy.

Part 3 deals with specific malignancies in 55 chapters totaling 1784 pages. As in prior editions, there is liberal use of algorithms. The chapters are written by a “multidisciplinary team of authors” who define the state of the art in a comprehensive manner. Many references in these chapters are up to date (2003, occasionally 2004), and the opening chapter summaries present salient points succinctly. The index is comprehensive and easy to use; locating a specific subject is effortless, unlike some other oncology texts.

Overall, my impression of the third edition of Clinical Oncology is the same as when I reviewed the first edition in 1996: “a well-written, authoritative and comprehensive oncology text . . . a usable, readable text that postgraduate trainees in medicine and surgery, fellows, and practicing oncologists will find useful in the care and management of cancer patients.” It is well worth the price.