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covering aspects of physical, psychological and psycho-social rehabilitation. This section is full of valuable detail integrating the knowledge and focus of many health care professionals including physiotherapists, speech and occupational thera- pists and emphasizes the importance of a well- managed rehabilitation programme in maximising patient quality of life.

The criticisms are minor. There is a definite bias towards U.S. practice, not surprising as there is only a handful of non-Americans on the contribu- tors list, and more discussion of Medicare and health insurance than a text-book warrants. This book is aimed at a wide readership and the completeness with which a topic is covered at times makes the writing style irritatingly inconsist- ent, where within one chapter there are simplistic instructions on performance of a basic procedure and wide ranging discussion of implications of recent trial results.

Though this is a large book. it is well indexed and information is easy to find. It is an excellent reference text, not only for the oncologist but also for any professional treating patients with cancer.

ANN O'CALLAGHAN CRC Clinical Research Fellow,

Wessex Medical Oncologev Unit, CF99, Southampton General Hospital,

Southampton SO16 6 YD, U. K.

CAMBRIDGE MEDICAL REVIEWS: HAEMATOLOGICAL ONCOLOGY, Vol. 4. Armitage, Newland, Keating, Burnett (Eds). Cambridge University Press. 1995. i55.00 (hardback). ISBN 0 521 46169 3.

This book is the fourth in a series of review volumes whose purpose is to evaluate and com- ment on the growth of knowledge in Hemato- logical Oncology. The series is aimed at the requirements of both clinicians and research workers. These laudable aims are clearly stated in the frontispiece page. What is however not at all obvious from this or subsequent introductory pages is that this volume is almost exclusively about recent progress in lymphoproliferative disorders (especially non-Hodgkin lymphoma (NHL)).

The book opens with an excellent review of the link between the Epstein-Barr virus and Hodgkin's disease. The next chapter suggests that Hodgkins disease in sub-Saharan Africa carries a worse prognosis than in more developed countries, but I was left wondering if this might simply be due to differing standards of health

care, rather than a more fundamental epidemio- logical reason. Following are a useful classifica- tion of AIDS-associated NHL, and accounts of the pathology of MALTomas and their close relatives, Ki- 1 positive lymphoma, and splenic lymphoma with villous lymphocytes. Further con- tributions deal with prognostic factors in NHL, CHOP as the gold standard of therapy for large cell NHL, and the rapidly expanding use of mag- netic resonance imaging to visualize lymphoma in the marrow. The practical difficulties of blood stem cell harvesting are discussed, emphasizing that some patients are not amenable to this approach, probably because of intrinsic marrow damage rather than any defect in the mobilization schedule. The final chapter summarizes the well-reviewed topic of the use of immunological and molecular features in the diagnosis of hematological malignancy.

The contributions are in general well written, and as up-to-date as any volume of this type ever is (an important omission is a discussion of the recent REAL classification for lymphomas). An underlying theme emerging from several chapters was the need for corroborative clinical data to validate the importance of pathologically defined disease entities. The book will indeed be of interest to anyone with a clinical or laboratory interest in lymphoproliferative disease.

RICHARD E. CLARK Senior LecturerlConsultant Haematologist,

The University of Liverpool, Department of Haematology.

Duncan Building, Liverpool L69 3BX, U IC

HANDBOOK OF CANCER CHEMOTHERAPY, 4th edn. Roland T. Skeel and Neil A. Lachant (Eds). Little, Brown and Company, Boston. 1995. No. of pages: 560 (paperback). Price: f32.95.

For those who are just starting out in the care of patients with cancer, a concise handbook detailing the approaches to treatment of common malignancies, the management of the toxicities of treatment and the complications of malignancy can be an invaluable aid.

Handbook of Cancer Chemotherapy is a revised version of a multi-authored text which attempts in fact to be a pocket sized textbook of oncology. It is divided into four sections. The first, Basic Principles and Considerations of Rational Chemotherapy has nine chapters. There are brief summaries of the biological and pharmacological

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basis of cancer chemotherapy and biologic response modifiers, complex subjects which are not dealt with well. Next follows a chapter on high dose chemotherapy and the role of progenitor cell and cytokine support which seemed out of place. The principles of surgical and radiation oncology are then covered, followed by sections on ethical considerations in cancer chemotherapy and the use of quality of life and cost utility assessments in cancer treatment decisions. Finally there is an overview of the general assessment of the cancer patient and criteria for selection of appropriate treatment. The second section, Chemotherapeutic and Biologic Agents is an excellent summary of the mechanisms of action, primary indications, usual dose and schedule and toxicities of all of the commonly used antineoplastic drugs and biologic response modifiers. The third section, Chemo- therapy of Human Cancer has 19 chapters on the major tumour groups, metastatic cancer of unknown origin and HIV-associated malignancies with a summary of the diagnosis, staging, and treatment approaches. Commonly used chemo- therapy regimens are given together with treat- ment recommendations, some of which have not been very thoroughly updated. The final section, Selected Aspects of Supportive Care of Patients with Cancer has 11 chapters which cover most of the common complications of cancer and side-effects of treatment and is an excellent reference for those problems which require acute management.

My major criticism of this book is that it includes some subjects which are out of place in a text which is basically designed to be ready refer- ence and it could thus have been smaller and easier to carry. The organization is generally logical and the sections on antineoplastic drugs and supportive care of patients with cancer are excellent and make this book a potentially useful resource for junior doctors involved in the care of patients with cancer.

PETER SIMMONDS Senior Registrar in Medical Oncology, CRC Wessex Medical Oncology Unit,

Southampton, U. K.

MANUAL OF CLINICAL ONCOLOGY, 3rd edn. D. A. Casciato and B. B. Loweitz (Eds). Little, Brown and Company.

This spiral bound manual is an updated version of the Manual of Bedside Oncology

originally written by the editors in 1983. The aim of the text is to provide a current overview of information essential for the bedside manage- ment of patients with malignancy. It is directed at oncology trainees and contains contributions from oncologists practising in the United States. The text is split into four sections, each of which are well presented with headings and numerous tables. The first section addresses the principles of diagnosis and treatment of cancer which is mainly covered by a very brief introductory chapter. It contains some bizarre statements, for example, comparing the death rate of lung cancer with the number of lives lost in Bosnia. There then follows a useful, but somehow misplaced, account of the diagnostic role of nuclear medicine. Standard reviews of chemo- therapeutic drugs, symptom control and radia- tion therapy are also included. Finally, there is a well written section on the psychosocial issues of malignancy.

Sections 2 and 3 cover the management of solid tumours and hematological malignancy. Each chapter covers the epidemiology, path- ology, symptoms, investigation and management options. At the end of each chapter there is a useful reference list for further reading. In some areas the management advice is a little dogmatic, for example, in the management of stage 111 ovarian cancer. However, these chapters are gen- erally well balanced and convey sufficient detail to allow the reader to appreciate some of the issues and controversies.

The final section covers the complications of cancer. There is a good review of the sexual and reproductive consequences of malignancy. Metabolic, anatomical, hematological and infec- tious complications are also adequately presented. Finally, there is a useful resume of AIDS and AIDS-related malignancy.

No manual could possibly cover every aspect of cancer. For example, cancer genetics as relevant to clinical practice is one area that is under- represented in this manual. However, in my opinion this text has made a successful attempt at presenting a broad range of clinically relevant detail useful to cancer physicians in training. Its style lends itself well to a quick reference text which would be well thumbed if sited on the ward.

BASS HASSAN Senior Registrar,

Wessex Medical Oncology Unit, Royal South Hants Hospital.

Southampton, U. K.