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 radiation principles.
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 field.
A 52-year-old man presented with an erythematous lesion in the axilla of unknown duration. Surgical excision was performed. What is your diagnosis?
