The 1995 Cancer Treatment edited by Dr. Charles Haskell is the fourth edition of his original textbook published in 1980. Cancer Treatment has kept pace with advances in oncology over these 15 years, and the fourth edition includes new chapters on cancer prevention, cancer screening, biologic therapy, gene therapy, clinical trial design, cancer and pregnancy, hematologic complications of treatment, local-regional therapy of lung and liver metastases, and AIDS-related lymphoma. The 1995 edition also includes 68 new authors.
Dr. Haskell dedicates his book to "postgraduate physicians training to become medical oncologists." This is gratifying recognition for those physicians- in-training who diligently work to enroll and treat patients in clinical trials, which are essential to advances in oncologic research and care. As in previous editions, the emphasis of the book is on critical review of state-of-the-art cancer treatment, with practical recommendations for cancer management.
The text is divided into two parts, the first covering general topics and the second, the diagnosis and treatment of specific neoplasms. The general topics in part 1 include discussions of the increasingly important areas of cancer prevention, molecular biology, and translational research. The chapter on antineoplastic agents is a good reference source. It lists drugs alphabetically, rather than according to common mechanisms of action.
On the negative side, two statements in the pain management chapter-"for good reason we have seen the growth of the Hemlock Society, the emergence of Dr. Kevorkian, and repeated attempts to legalize euthanasia . . ." (page 227), and "[physician fears of legal prosecution for providing opiate analgesia prescription] are fostered by the witch-hunt mentality pervading some states' medical board personnel" (page 228)-are value judgements. Rather than improving pain control for cancer patients, this adversarial approach may have just the opposite effect.
The chapter on paraneoplastic syndromes and the section on investigational therapy are well written.
Part 2 on specific neoplasms is the primary emphasis of the text, and sections are organized according to organ system, with chapters devoted to the diagnosis and treatment of neoplasms within each system. Individual chapters are succinct, easily readable, and frequently summarize the molecular biology, histology, staging, diagnosis, treatment, and clinical trials pertinent to the malignancy in table and figure format.
Particularly useful are the "Summary of Treatment" and "Summary of Treatment by Stage of Disease" paragraphs at the end of most chapters, which distill the medical literature into standard-of-care options and recommendations for disease management. If a standard of care has not been established, this is acknowledged fully, and the author's personal or institutional approach to the disease is presented.
Chapters are also well referenced and include editorial suggestions for additional reading. Noteworthy sections include those on breast cancer, which include seven chapters exploring its natural history, in situ disease, local surgical and radiation treatment, adjuvant therapy, and treatment of metastatic disease; neoplasms of the gastrointestinal system; myeloid neoplasms; and lymphoid neoplasms.
Cancer Treatment, 4th Edition, fills a niche between simple medical oncology handbooks limited by their brevity and all-encompassing textbooks limited by their thoroughness. It is a valuable resource for all health-care professionals involved in the prevention, diagnosis, and treatment of malignancy.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
