The Survey and Results

71

16

10

1

91

4

2

1

52

22

17

1

2

4

61

11

14

2

4

4

69

14

13

1

63

17

12

1

4

48

29

18

2

29

58

8

90

2

5

• The chapter on psychosocial care needs to be fuller, going deeper as you write the book for GPs and the primary health care personnel.
• Each chapter on specific cancers should be illustrated at the end by a typical case described fully during the disease and including the terminal clinical problems.

• to introduce the statistical data concerning my country (in each cancer localization)
• to unificate general terminology.

1. to include much more black/white pictures (particularly schemes);
2. to differentiate the shape and dimensions of the letters/titles, subtitles etc., should be stressed by type face; some specially important words or definitions could be framed;
3. the left-hand pages in part B are very useful for self-assessment, but to keep the price low they could be perhaps omitted in the book and edited separately in form of a cheap brochure containing many listed dispositions or questions;
4. the introduction to everyone of 30 specific chapters of part B contains the short formulated main didactic goals with respect to problem-oriented subchapters, which should be however signed with page numbers.

• oral & oropharynx
• nasal cavity and sinuses
• larynx
• thyroid + salivary glands

• Medical students and general practitioners need to know more about preventive oncology and also the predisposing conditions to cancer.
• Not all the malignant diseases are classified in the TNM staging system, i.e. leukemia (indicated), lymphoma, childhood malignant tumors.

• epidemiologic differences because of geographic difference
• cheapest treatment
• especially more psychosocial facets which is necessary for the bad communication between patient and doctor.
• the rights of a doctor, and his/her obligations.

• Subject depth should be increased little more to broaden the view of the practitioner.
• More commonly encountered cancer sites should be covered in the patient problem section.

1. In SE Asia, much of our clinical practice will involve nasopharyngeal cancer and hepatoma. The former has been described succinctly but only rates one paragraph and the latter is not mentioned, emphasising that this is a very Western-orientated book!
2. There was no mention of the side-effects of chemotherapy, which again represent a large part of the practice of medical oncology. Several of these, such as signs, diagnosis and management of neutropaenic sepsis, nausea and vomiting and hair loss, are important to all involved in cancer care.
3. It is worth mentioning other oncological emergencies such as spinal cord compression, the early recognition of which is relevant to the primary care worker.
4. Some of the statements about prognosis are unnecessarily vague. For example, in the case of Pancreatic Cancer, we are told of the 5 year survival for a very rare variant of the tumour, but no precise figure is given for the great majority of the patients, except that it is "very poor". Such statements are not much of help to practitioner or patient.
5. Cancer screening in general practice deserves more discussion, especially regarding the use of tumour markers and screening tests for cancers in the "grey area" such as stool for occult blood for colorectal cancer, PSA for prostate cancer, CA-125 for ovarian cancer, etc, and the problem of dealing with false positive results.
6. Unconventional methods of cancer treatment is an issue of significant magnitude. May be worth at least a brief note: can be seen from the viewpoint of the patient as a consumer: unfair to the consumer if incorrect or misleading information is provided about the "product".
7. The topic "Nutrition and Cancer" could be discussed with reference to typical clinical situations, instead of on a more general theoretical basis: total parenteral nutrition for the pre-op oesophagus cancer patient; dietary advice for patients undergoing chemotherapy; the patient with head & neck cancer undergoing radiotherapy; the patient with pelvic malignancy undergoing radiotherapy; problems in the patient with terminal illness: should gastrostomy be used? should tube-feeding or intravenous fluid be given to the semiconscious patient? the role of appetite-stimulants (steroid, medroxy-progesterone acetate). Last but not least: what dietary advise should be given to the normal individual to minimise the cancer risk (a controversial topic).
8. The use of more subheadings would be contributive to the presentation.

1. for head & neck tumours, it might be better if salivary and thyroid gland tumors be separated from mucous membrane & aero-digestive tract tumours (for systematically purpose)
2. in part D (patient problems), breast problems must be increased (more cases)
3. in part D examples of cancer pain management should be more (this is problem in developing countries)

1. Cost consideration will be paramount. Soft cover, better page management and maybe part D can be enlarged and presented as a separate volume of case histories.
2. The style of English will need to be changed to our local styles. Even some medical terms are not common here, e.g. Pollakisuria (p. 183). Others include Soudan (p 151) for Sudan.
3. The name will need to be changed to better reflect the target population.

• There are some areas where I feel some more information would be of help but on the whole, as you have put it quite succinctly, most of the information is up to date to 1994.
• There are some typographical errors as well as words that are used more commonly in the English speaking world, which I have noted down on a separate sheet for you.
• In the section on breast cancer, I think it would be wise to state that axillary lymph node dissection is being done for pathological staging, so that patients can be entered into adjuvant treatment protocols.
• At the end of you textbook, you have presented 42 problem cases in a very succinct manner, with provision of logarithm as how the patient should be managed. This should be extremely helpful to the general practitioner.
• In summary, I think this textbook will serve a very useful purpose for the practising family physician. I also think it will be of great help to medical students, as well as residents interested in Oncology. I am going to recommend its use to the latter group of residents at McGill University. I sincerely hope that your textbook will sell well in Europe and North America.
  (Separate sheets with corrections were enclosed.)

1. more information on basic oncology (ex: I couldn't see any reference to ongoing and now .. (illegible) of women in asking information about breast cancer prevention and BRCAI-Z)
2. more information on cancer prevention
3. more information on palliative care

• Some subjects are too superficial (hematological malignancies).
• Dedicated chapter on prevention (nutrition, carcinogens, radiation, smoking, .... ).
• Self-assessment at the end of the chapter, and text on both sides, saving space.
• Using paper which is not glossy. It is tiring reading the book because of the reflection.
• Comparative table of cancer types around the world.
• Chapter on tumour-immunology and etiology.

• diagnosis
• photos; references
• tumour markers
• details of chemotherapy; comparative studies.

• I would prefer the term hematologic malignancies for leukemias and lymphomas instead of systemic disease since most of advanced stage/advanced grade solid tumors tend to spread systematically (especially in children).
• Medical students and general practitioners need to know more about preventive oncology and also the predisposing conditions to cancer.
• Not all the malignant disease are classified in the TNM staging system, i.e. leukemia (indicated), lymphoma, childhood malignant tumors.]

• integration between the basic medical and clinical sciences and health services
• genetic mapping, gene therapy
• vaccines against neoplasms? immunotherapy
• addressing multi-ethic, multicultural environment, etc

• Less detail.
• An algorhythmic approach that can easily be followed.]

1. molecular genetics (familiar predisposition, brief summary
2. sections of Epidemiology and Etiology
3. infections in cancer patients
4. care for terminally ill patients
5. developments in oncological therapy - changes in prognosis

• more pictures, graphics and using different colours could make the understanding easier
• a broader symptomatology and non-surgical therapy
• more interesting patient problems: seen in another country
• emergency
• after each chapter some questions for understanding the aim of the book.

1. Epidemiology of cancer: most frequent cancer, sex distribution, age distribution, causes of cancer, risk factors
2. Biology of cancer: development of cancer, growth of cancer (exponential, Gompertian), doubling time
3. Classification of cancer: clinically and pathologically
4. When to think about cancer: signs and symptoms
5. Prevention of cancer: method and measures to be taken
6. Detection of cancer: method and measures to be taken.

1. diagram of staging (TNM) in every specific tumours briefly illustrated;
2. more pictures (like head & neck section) to draw more attention.

1. The contents of this book seems to be oversimplified, and the readers may have prejudice for controversial problems under hot discussion.
2. This book has no references and does not provide guidance to the readers for the study of points of their interest.
3. The left-hand pages have too much space and it may be used for more pictures, tables, etc

1. Use of different type-face to reflect subheadings.
2. List of objectives at beginning of chapters is too long.
3. Citation for further reading at the end of chapters.
4. Integration of some basic molecular biology.
5. The section on basic principles, follow-up, community and home based care needs to be expanded.

1. This book lacks conformity in respect to TNM classification. In a few sections TNM has been "stage grouped" while in many this is not the case.
2. Epidemiology does not configure in relation to developing countries.
3. Kaposi's sarcoma and dermatofibrosarcoma protuberans does not configure in spite that KS occurs in about 20% of AIDS patients in the West, while DFSP is one of the Differential Diagnosis of hypertrophied scars in African countries.
4. Bibliography would enhance the standard of the book. (References enclosed of six own publications)