I had the pleasure of reviewing the 8th edition of
Philip Rubin’s Clinical Oncology: A Multidisciplinary Approach for Physicians
and Students. This is another in a long line of excellent clinical textbooks
edited by Dr. Rubin and associate editor Jacqueline P. Williams, PhD. Dr. Rubin
is a pioneer in oncology and, in particular, radiation oncology. The current
edition consists of 34 chapters authored by 95 contributors spanning all
oncologic specialties and numerous institutions.
The original edition of this textbook, entitled Clinical Oncology for Medical
Students, was published by Dr. Rubin in 1963. This early text emphasized
radiation therapy, with a second edition published in 1965. In 1967, the title
was changed to Clinical Oncology for Medical Students: A Multidisciplinary
Approach, with updates appearing in 1970 and 1971. The next three editions were
sponsored by the American Cancer Society and authored by members of the
University of Rochester Cancer Center Faculty. For those of us who were medical
students at that time, these textbooks proved to be valuable educational tools.
Unique to the current 8th edition is the multi-institutional authorship.
The textbook is divided into general chapters and site-specific chapters. The
first 15 chapters provide both the medical student and the practicing physician
with a solid foundation for understanding the principles of cancer and cancer
therapy. The first chapter, with Dr. Rubin as the lead author, is entitled
"Statement of the Clinical Oncologic Problem." It contains general
information on cancer, for example, reviewing the epidemiologic aspects of
cancer, as well as the principles of detection, staging, and treatment.
The second chapter, entitled "The Biology of Cancer," describes the
molecular basis of tumor development. The chapter discusses the particularly
relevant principles of cancer development in this era of molecularly targeted
therapies. Chapter 3 reviews the pathology of cancer, and chapter 4 reviews the
principles of surgical oncology. Chapters 5 through 7 reflect Dr. Rubin’s
expertise in radiotherapy in their discussion of the principles of this field.
These three chapters provide a solid background on all aspects of radiation
involved in the treatment of cancer, including radiobiology, physics, and basic
The next chapter explores chemotherapy and medical oncology, and this is
followed by a discussion of the basic concepts guiding drug development and
clinical trials, which will be especially useful for medical students. Textbooks
often report the results of clinical trials, but they rarely describe the
process behind trial development and reporting. I frequently ask students the
difference between phase I, II, III, and IV trials and, more often than not,
receive an incorrect response. This chapter provides a concise, complete summary
of relevant information.
The non-site-specific chapters include discussions of gene therapy and
immunologic therapy. Also included are chapters on HIV-related malignancies and
oncologic emergencies. The latter chapter is divided into different types of
emergencies. Each section begins with a background paragraph, which is followed
by a consideration of diagnosis and therapy. I found this to be a useful,
straightforward presentation of the data.
Another chapter is devoted to the principles of psychosocial oncology. Those
of us involved in the care of oncology patients understand the importance of
this aspect of management, which can be a large part of day-to-day practice.
This section of the book does a good job of reviewing an often underappreciated