A Lung Cancer: Principles and Practice
A Lung Cancer: Principles and Practice
Editor by:
Harvey I Pass
David P Carbone
David H Johnson
John D Minna
Andrew T Turrisi
A Lung Cancer: Principles and Practice
Lung cancer remains the leading cause of cancer-related death in men, and in women it has surpassed even breast cancer. The primary cause of lung cancer in up to 90 percent of patients is smoking, and it is estimated that bronchiogenic carcinoma will develop in 10 to 15 percent of all smokers. Environmental factors -- for example, passive smoke, occupational exposure to asbestos or chromium, and air pollution -- as well as genetic predisposition in a multistep carcinogenic process may both play a part. Nevertheless, cessation of cigarette smoking is the most effective, most easily achievable, and least expensive intervention in reducing the risk of lung cancer.
Despite marked progress in the treatment of lung cancer, most patients still die of their disease within several months to a few years. Some patients and physicians have a nihilistic perception of the treatment of lung cancer, and adequate treatment is often delayed or not even considered. However, even locally advanced disease can be cured in many patients with the appropriate multimodal therapy. Patients with a suspected or confirmed diagnosis of lung cancer are best evaluated by a team of lung-cancer specialists consisting of thoracic surgeons, medical oncologists, radiation therapists, pneumologists, radiologists, and pathologists.A Lung Cancer: Principles and Practice.
Lung Cancer: Principles and Practice reflects this multidisciplinary approach to a common disease. Lung cancer should be suspected in any patient who presents with persistent cough or hemoptysis or with deep venous thrombosis, without other clinical explanations or constitutional symptoms. A simple chest radiograph may reveal a pulmonary mass, and subsequent computed tomography of the chest and upper abdomen will allow rapid assessment of any extension of the tumor into the mediastinum and of any metastases to the liver and adrenals. Tissue diagnosis should then be performed by the most appropriate means
Most patients in whom treatment can be administered with curative intent present with locally advanced disease. In these patients, monotherapy (surgery alone) is rarely sufficient, and a multimodal approach to treatment should be considered. Although adjuvant chemotherapy has failed to offer a survival advantage, modern combination chemotherapy has shown promise as neoadjuvant therapy before surgery or radiation. The indications and limitations of adjuvant radiotherapy after complete resection of non-small-cell lung cancer are discussed, and current controversies are highlighted. The reader will find precise answers to most relevant clinical questions. Rare topics, such as the occurrence of multiple primary tumors and the difficulty and occasional impossibility of distinguishing them from metastases, are also addressed. The role of surgery in patients with stage T4 primary tumors with infiltration of the superior vena cava is critically reviewed.
An issue rarely discussed in clinical textbooks is cost effectiveness. Here, methods are briefly reviewed, and the cost effectiveness of some therapeutic interventions, in contrast to screening programs, is emphasized. Despite the proven cost effectiveness of palliative chemotherapy in comparison with the best supportive care, global budget restrictions may not allow this treatment to be offered to all patients. Given the growing importance of health care expenditures and limited resources, an even more extensive review of this subject would be welcome in a future edition.
The first section of this textbook is devoted to the biology and molecular genetics of lung cancer. Potential targets for future therapeutic interventions, such as ras and erbB2, epidermal growth-factor receptors, telomerase, and angiogenesis, are appropriately reviewed. The difficulties, challenges, limitations, and opportunities of studying lung cancer in experimental models are highlighted. This information, together with the sections on clinical issues, makes Lung Cancer: Principles and Practice a truly comprehensive and valuable textbook on a common and often ultimately fatal disease.
A Lung Cancer: Principles and Practice Books Details
Hardcover: 1000 pages
Publisher: Lippincott Williams & Wilkins;
Third Edition edition (December 1, 2004)
Language: English
ISBN-10: 0781746205
ISBN-13: 978-078174620
A Lung Cancer: Principles and Practice
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