Richard R. Barakat, MD

The article by Kim et al is a comprehensive summary of several decades of research in the management of cervical and vulvar cancer. It describes the current status of treatment and possible future trials.

Handbook of Gynecologic Oncology, edited by Drs. Barakat, Bevers, Gershenson, and Hoskins, is a first-edition clinical handbook formulated primarily for fellows in gynecologic oncology as well as for interested fellows in medical oncology and radiation oncology. The textbook presents concise summaries of the critical issues in the care of gynecologic cancer patients and would also be of interest to residents preparing for their gynecologic oncology rotations, obstetrician/gynecologists, other physicians who care for gynecologic cancer patients, and practicing gynecologic oncologists.

The aging population poses new challenges to all fields of medicine and to gynecologic oncology in particular. In gynecologic oncology, issues that are germane to general medicine, cancer chemotherapy, radical surgery, and routine gynecology are all encountered on a regular basis. In clinical practice, the "very old" are often thought to tolerate standard treatments poorly. While comorbid conditions may be more prevalent, management decisions should be based on an assessment of individual function and not solely on numerical age. In the article by Mirhashemi and colleagues, this theme is conveyed throughout, as they describe the current management of gynecologic malignancies in older women.

For nearly 20 years, tamoxifen has been successfully used in the management of breast cancer. Tamoxifen is a mixed estrogen agonist/antagonist that has a proliferative effect on the endometrium. The drug has been

An expert panel of nine international cancer researchers and practicing oncologists met in Boston to discuss the past, present, and future uses of antiestrogens in the treatment of breast cancer. The first article in this series, based on the symposium presentations, focused on the optimal duration of tamoxifen use (October 1996). This month, the panel explores the noncancer benefits of tamoxifen, as well as the potential risk of endometrial cancer. The symposium was sponsored by Zeneca Pharmaceuticals.

In their comprehensive review of changing concepts in the management of endometrial cancer, Drs. Karasek and Faul highlight the contemporary approach to the management of patients with endometrial adenocarcinoma. The authors stress the evolution

Tamoxifen (Nolvadex), a nonsteroidal antiestrogen, was first approved by the FDA for the treatment of patients with breast cancer in 1978. Large clinical trials have demonstrated a recurrence-free and overall survival benefit