The study of oncology and the management of patients with cancer are becoming increasingly complex. The amount of information necessary for clinicians to assimilate is staggering. This is particularly true for surgical oncologists, who must not only keep up with the most recent advances in cancer diagnosis and therapy but also with the most up-to-date surgical procedures. Cancer Surgery is a reference that provides this important material in a comprehensive and logically organized format.
A multidisciplinary approach is taken, with an emphasis on the
roles of surgeons, medical oncologists, and radiation oncologists
in the treatment of these complicated patients. Although the text
is geared primarily toward surgical oncologists, it will also
serve as an important reference for medical and radiation oncologists,
because the descriptions of surgical procedures are clearly presented.
Surgeons who are not cancer specialists will also find this text
useful as a guide to the appropriate management of their patients
The scope of the text is impressive; it covers neoplasms from those in the head and neck to those in the sacrum. Each chapter is divided into sections on epidemiology, natural history, detection, and management strategies. For example, the chapter on breast cancer begins with a discussion of incidence and mortality. All relevant and up-to-date statistics are presented. Risk factors are then described, with a detailed discussion of screening and detection. The utility of mammography, breast self-examination, and physical examination by a physician is highlighted, with sections on anatomy, pathology, and staging. Treatment strategies are presented, covering the important points of surgical technique from the initial biopsy to definitive surgical resection. Fine diagrams and illustrations help highlight this technical discussion. The chapter concludes with selected topics on adjuvant therapy; male breast cancer; and special situations, such as breast cancer during pregnancy.
In the chapter on colon cancer, a similar analysis is performed. Data are presented on incidence, mortality, and staging. Detection strategies, including the role of colonoscopy and radiologic studies, are outlined. In addition, the authors offer an in-depth discussion of management approaches, illustrating both traditional and experimental therapies. Immunotherapy involving vaccines and regional management of inoperable metastatic disease are highlighted. Also addressed is the role of surgical metastasectomy for both liver and lung metastases.
Other chapters discuss cancers of the esophagus, stomach, liver, biliary tree, pancreas, and mediastinum. There is a good overview of the diagnosis and management of soft-tissue sarcomas, focusing on the importance of limb-sparing approaches as well as the treatment of metastatic disease. The sections on complicated amputations of the shoulder and pelvis provide detailed descriptions and atlas-quality drawings.
Each chapter is followed by an extensive list of references containing many up-to-date studies and reviews. The illustrations and photographs are excellent and enhance the delivery of information. The organizational style makes it easy to find important facts, figures, and recommendations. As is sometimes the case with a work as broad as Cancer Surgery, some sections are not covered in great detail; however, relevant sources are well cited and can be obtained for a more in-depth review.
For nononcologists, Cancer Surgery is an excellent source of definitions, descriptions, and management suggestions. Students, residents, and fellows will find the operative descriptions and illustrations quite helpful in understanding the more complex procedures. Cancer Surgery is well written and will make a fine addition to any oncologist's library.