Approximately 25-30% of the Australian population will die from cancer or its various complications and one in four will be diagnosed with cancer by age 75. An understanding of the basics of clinical oncology and of the impact of the major scientific advances in oncology is therefore of critical importance to all practising clinicians. For not only must clinicians suspect, investigate, diagnose and manage cancer - they must also transmit accurate information to patients and their carers in a respectful, empathic and collaborative manner.
Cancer facts is a concise text written by 55 experts in the field, collated and edited by an international authority in clinical and academic oncology. The stated objective of the text is to provide a concise but comprehensive summary of the essentials of oncology and cancer management.
In general terms the text succeeds admirably in achieving its stated aim and provides an accessible, clinically relevant overview of clinical oncology and the related sciences. The book comprises 62 chapters divided into 14 parts covering symptom control and quality of life, lung cancer, breast cancer, gastrointestinal cancer, urogenital cancers, gynaecological cancers, head and neck cancers, melanoma, haematological malignancies, miscellaneous cancers, complications in cancer patients and psychosocial issues in cancer. Each chapter provides an evidence-based synopsis of the field and includes a reading list designed to allow wider, more detailed reading on the essential elements of each chapter.
Cancer facts provides an overview of an extremely broad and complex area of medicine and as such is more likely to be of benefit to the non-oncologist than the specialist oncologist. The structure of the text is generally clear and consistent, but at times seems to be determined more by the organisation of medical specialties than by the need to provide a precise, coherent integration of cancer management. One must wonder whether having separate chapters on the surgical, radiation and chemotherapy management of non-small cell lung cancer would be more ambiguous or confusing to the non-oncologist than a single chapter on non-small cell lung cancer written collaboratively by a radiation oncologist, medical oncologist and surgeon.
The book concludes with nine colour plates of skin cancers, an essential part of any substantive review of cutaneous malignancies. However, aside from a single mammogram, there are no colour illustrations, reproductions of medical imaging or diagrams to help readers gain an understanding of anatomy, pathology or staging. As with all similar multi-authored texts, there is some unevenness in the quality and referencing of the chapters, and inevitably there will be questions raised about those topics omitted from the text. Research and clinical ethics, patient education resources, evidence-based medicine, decision-analysis, oncology on the internet and environmental/occupational oncology could all arguably be included within an expanded text.
For the most part, however, these are minor objections and Cancer facts is likely to find a valued place in many doctors' library or desk. James Bishop has taken on an ambitious task and his text is highly recommended for all oncologists and non-oncologists, be they students, trainees or practising clinicians.
Hunter Haematology Unit, Mater Misericordiae Hospital, Newcastle, NSW