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Book reviews |
It was with some trepidation that I accepted the challenge of reviewing the book Prostate Cancer Biology, Diagnosis and Management by Konstantinos Syrigos. There is currently a very large amount printed about diagnosis, management and basic information on prostate cancer both in large multi-author textbooks of oncology and also as monographs. However, once I started reading this book I found there was much to commend it both to the specialists and to the general oncologists. The editor has gathered together an impressive author list with many leading proponents of prostate cancer management included. The book plans to undertake a comprehensive review of prostate cancer management with sections devoted to the basic anatomy and physiology of the prostate, aetiology and early prostate cancer models, clinical presentation investigation of prostate cancer, the management of localized prostate cancer, the management of more advanced disease, quality of life and symptomatic management and also prostate cancer prevention and epidemiology.
Particular strengths of this book are the sections on the prostate itself and the prostate cancer biology with comprehensive review of these important areas. If there was any niggle in these sections is that there is a degree of overlap between some of the sections, exclusion of which could make a slighter short read.
There are also useful chapters on the epidemiology and aetiology of prostate cancer and an interesting discussion on the potential role of screening of prostate cancer along with a separate chapter on the use of PSA itself. The screening chapter in particular would be a useful basis for physicians interested in this area although the focus is rather North American and rather positive about the role of screening which is not always supported by the evidence. There then follows a number of chapters on the local management of prostate cancer with an excellent review particularly of radiotherapy treatment. It was also good to see new modalities of treatment of prostate cancer getting a significant airing, in particular, the use of cryosurgery and HIFU areas which are not widely discussed. I was disappointed that discussions on the role of neoadjuvant therapy, and indeed, adjuvant therapy was restricted to a single section within the radiotherapy chapter and to discussion of the use of neoadjuvant treatment with prostectomy, whereas most evidence points to the use of the neoadjuvant therapy alongside radiotherapy treatment. A greater focus on this I think would have improved this section. As the localized treatment of prostate cancer is an area of great controversy. It was interesting that the editor tried to address this by having a chapter discussing therapy decision making and localized prostate cancer. The fact that this chapter does not quite come off I think reflects more the difficulty in producing a high quality objective account rather than reflecting on the skills of the writer.
Perhaps most disappointing for me was the section on the systemic treatment of prostate cancer. There is a chapter on hormonal therapy written by Prof. Labrie, one of the leaders in this area, but for me the chapter does not deliver the authority of review I would have liked and partly in the way that the chapter is diverted into other areas such as screening and non-hormonal forms of treatment. The chapter on the management of hormonal resistant prostate cancer was useful but overly brief for such a large and complicated area. Discussion of the role of chemotherapy in this setting was limited to a single page and the isotope management of patients with this disease to a mere paragraph, whilst there was no discussion of the possible role of bisphosphonates at any point. In contrast, the subsequent chapter on gene therapy runs to a 12 page comprehensive overview. If some areas of the management of hormonal-resistant prostate cancer had been managed in this fashion this book would have been significantly strengthened.
My overall impression? A very good effort to describe the current state of play with prostate cancer. Strengths are its information on the biology and biology of prostate cancer. Anyone looking for a detailed review regarding the systemic management or the use of neoadjuvant and adjuvant therapy for prostate cancer may have to look elsewhere.
Who would gain from reading this book? This is more difficult. I certainly learned much and found many of the chapters interesting in reviewing the book may be helpful for specialist oncologists in urological cancer and for those oncologists who want to know more about prostate and prostate cancer biology.
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