Clinical Haematology and Oncology: Presentation, Diagnosis and Treatment

Reviewed by:

Details:

B Furie et al (eds)
Published by Churchill Livingstone (2003)
Distributed in Australia by Elsevier
ISBN: 0-4430-6556-X 1260 pages plus index
RRP: A$215.60


Review

The intention with this book is to provide a clinically useful, readily accessible guide to the diagnosis and management of patients with haematologic and neoplastic diseases. The authors believe they fill “the niche between the encyclopedic textbooks on haematology and medical oncology and the broad textbooks of internal medicine by maintaining a clinical focus throughout”. It is apparently intended for a wide audience.

There are 122 chapters and just over 1200 pages. The authors are drawn from a broad selection of major American academic and clinical institutions. The approach is therefore much more North American than Australian. The colour plates are of reasonable value. The book is divided into five sections: presentations; therapeutics; evaluation and treatment of haematologic and oncologic diseases; special considerations (e.g. febrile neutropenia, thrombo-embolic complications of cancer, tumour lysis syndrome), and supportive care (screening and genetic counselling, unorthodox approaches, psychosocial issues, sexual dysfunction, symptom management). 

The chapters on presentations tend to be short. There is a clear attempt to cover general medical causes (e.g. differential diagnosis of peripheral neuropathy or hypercalcaemia) before getting on to cancer-related causes. But the differential diagnoses seem to be a little too limited. For example, causes of all neuropathies are limited to a list of 20 possibilities. By way of comparison, my treasured copy of Hurst’s Medicine for the Practicing Physician lists 36 causes for symmetric distal polyneuropathy, 11 causes for mononeuropathy multiplex, and seven causes for a motor predominant-neuropathy.

In the disease-related sections, the broad and complex topic of lymphomas is spread across six chapters. The WHO classification is discussed in chapter 64 and yet chapter 67 persists in referring to intermediate and high-grade lymphomas, using the superseded terminology from the REAL classification. 

In the treatment of intermediate grade non-Hodgkin’s lymphomas, the results of the Fisher et al intergroup study of 1993 and PALMA study are quite rightly given preference; there is no discussion of the results of the GELA study here.  Thus, the principal advances of the last five years in the treatment of lymphoma are not included,  although paradoxically some of the early trials of MabThera in follicular lymphoma are.
The discussion on breast cancer appears reasonably extensive.

A chapter on Symptom Management covers a number of central areas in palliative care too quickly, with a strong emphasis upon pharmacological intervention. The chapter on Unorthodox Approaches to Cancer Therapy also does quite a thorough job of discussing what (little) is known about, in particular, herbal mixtures and dietary supplements.

Overall though, the book suffers from being too cursory for anyone seeking detailed information. It is probably better considered as a broad introductory text. It may well suit some departments as a readily accessible text for junior medical staff and other health professionals seeking slightly more information on a particular topic. A senior nurse colleague studying for a post-graduate degree finds it very useful.

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