CRC TRTMNT CANC PDF

Preface

Cancer is an increasingly common problem; by the year 2020, it is likely that one in two of the global population will develop the disease at some time. This striking increase is mainly due to an increasingly ageing population. The treatment of cancer is therefore a vital component of modern healthcare provision.

Oncology crosses the traditional boundaries in which medicine is taught, researched and practiced, thereby providing a great challenge for those involved in its treatment. It is a truly multidisciplinary subject. One of the current dogmas, almost a cliché, is the importance of integration and teamwork between those involved in its management: surgeons, radiotherapists, medical oncologists and a myriad of other organ-based specialists. But the most exciting discoveries of the past two decades have been in the laboratory. Our understanding of the process of growth control and its deregulation has gone through a remarkable transformation, with the discovery of oncogenes, tumour suppressor genes and their encoded products. Coupled with the tremendous advances in imaging and the likely explosion in our understanding of the genome, we are set for a dramatic improvement in cancer therapy over the next decade.

This book attempts to synthesize in one place scientific discoveries together with the best of current practice. Tumours of all kinds, common and esoteric, are considered so that authoritative help on how bet to manage an individual patient can be found rapidly. Our authors come from many disciplines, to paint as broad a canvas as possible of oncological knowledge. Many are associated in some way with Hammersmith Hospital, but we have also invited colleagues from the UK and abroad to share with us their special expertise. In many cases, we have teamed a surgeon with an oncologist to give a complete overview of the management of an individual tumour type.

The book is divided into three parts. The first section considers the principles of cancer treatment and the likely developments that will take place over the next decade. The contributors here are active participants in current research programmes in their area. The second and main part – practice – is an extensive series of chapters covering every individual class of tumour. They represent the distillation of considerable experience from senior clinicians. For many tumours, such as early carcinoma of the larynx, treatment has become standardized as well as successful. For others, such as breast cancer, there is considerable controversy. We have given more space to those tumours where controversy reigns, for it is here that difficulties in management are most likely to arise. We have used some diplomatic editing, with the agreement of the authors, to make their management plans widely applicable. In this way, we hope the book will provide sufficient guidance to point the way to the best contemporary treatment protocols for individual patient care throughout the world.

The final section - management – gives further essential detail on the general problems of caring for the cancer patient. Here we consider medical problems that commonly arise, and also the development of continuing care philosophies, which have revolutionized the management of those patients for whom no cure is yet available. We consider radiotherapy planning techniques as well as new developments in conformal planning. We review medical audit and clinical trials, both essential tools of progress in an emerging discipline. We also consider complementary medicine and cancer, for the first time, we believe, in an orthodox oncology text.

We have been greatly helped by the expertise and writing skills of our authors who have produced truly excellent manuscripts. We hope that this unique, multiauthor text will continue to educate a new generation of oncologists at a time of considerable progress. Delivering optimal care requires far more teamwork than ever before and the integration of many specialities. The success of modern cancer treatment is transforming the lives of many of our patients. We hope that this contribution will help to do this.