Lung cancer for rookies

Dx/Rx: lung cancer.

Christopher G Azzoli. Massachusetts: Jones and Bartlett, 2006 (viii + 134 pp). ISBN 0 7637 2641 9.

This small, single-author American text in pocket-book format provides a succinct but comprehensive overview of lung cancer including its epidemiology, diagnosis and treatment. There are also brief sections on mesothelioma and thymoma.

Reflecting the author’s specialty, the content is heavily skewed towards medical oncology. Surgical and radiation oncology aspects are given limited coverage.

The style and level of detail suggest that this book would be most useful for medical students and junior hospital doctors, or even lay consumers with some scientific background. The information is presented as dot points — hardly literature, but readable. A brief list of up-to-date key references is provided at the end of each chapter.

In general, the information presented is accurate, although there are a few howlers:

“Asbestos is ... used as inflammable building material”.

“Anyone with a first degree relative with a smoking related cancer should not smoke cigarettes.”

It is irritating to see myths perpetuated, such as “carcinoid tumours are highly resistant to chemotherapy and radiotherapy” and “large cell neuroendocrine tumours carry a poor prognosis compared with other types of non-small cell lung cancer”. What is the evidence for these statements?

There are good practical hints on the management of complications of lung malignancy (these would be most useful for junior hospital doctors). There is, however, no mention of the use of lasers or stents for the treatment of major airway obstruction.

So, in summary, a concise and contemporary overview, but too superficial for the practising clinician managing lung cancer. If the reader requires an evidence-based manual that contains statistics and treatment recommendations more relevant to Australian practice, I would suggest the NHMRC-endorsed Clinical practice guidelines for the prevention, diagnosis and management of lung cancer, recently published by the Australian Cancer Network.

David L Ball Chair of Lung Service and Radiation Oncologist, Peter MacCallum Cancer Institute, Melbourne, VIC