childhood cancer: a handbook from st. jude children's research hospital

Medical and Pediatric Oncology 36:402±403 (2001)

BOOK REVIEWChildhood Cancer: A Handbook From St. Jude Children's

Research Hospital

Stan F. Whitsett, PhD

Statistics presented in Childhood Cancer: A Hand-book From St. Jude Children's Research Hospital indi-cate that `̀ one in every 300 to 350 American children willdevelop cancer by the time they are 20 years old'' (p. 11).That translates into tens of thousands of parents, siblings,extended family members and friends who will beimmersedÐalong with the patientÐinto the complexworld of pediatric oncology. Many will struggle despe-rately to grasp the meaning of the often-confusingterminology, research results, and clinical practices thatsurround the child's treatment. This book provides anexcellent resource to aid their understanding.

Childhood Cancer is a compilation of chapters writtenby the Faculty and Staff at the world-renowned childhoodcancer center in Memphis, TN. According to the editors,the book is intended for individuals close to a child withcancer. This intention leads to a book written primarilyfor the lay person, but it also provides information ofinterest and value to professionals, not speci®callytrained in pediatric oncology, who seek an overview ofsalient topics in the ®eld.

The book is organized into seven major sectionsentitled `̀ Overview of Childhood Cancer,'' `̀ How Canceris Diagnosed,'' `̀ How Cancer is Treated,'' `̀ How ThePatient is Cared For,'' `̀ The Leukemias and Lympho-mas,'' `̀ The Solid Tumors,'' and `̀ Recovery FromCancer.'' At this level, the organization of the book isvery logical, and provides a sequential presentation ofinformation in much the same way as it tends to arise inactual clinical practice. Thus, parents of a child recentlydiagnosed with cancer could presumably begin readingChapter 1 during the initial stages of treatment, and worktheir way through the remainder of the book as treatmentprogresses.

Unfortunately, the `̀ ¯ow'' of chapters within each ofthe major sections is not always that logical. It seems thattwo problems have contributed to this shortcoming. First,Childhood Cancer attempts to be extremely comprehen-sive in its coverage, and consequently presents atremendous amount of information in a limited space.This leaves certain topics covered brie¯y and perhapssuper®cially; some readers will need a more thoroughpresentation. The chapter entitled `̀ What to Ask Your

Doctor,'' for example, illustrates only a few of the mostpressing questions that parents will need to raise, andthese are treated so super®cially that their discussion mayseem trivial (or demeaning) to parents. Chapter 21(`̀ Future Directions in Cancer Treatments'') is so briefthat it could actually be interpreted as conveying adisheartening outlook for future developments. Second,the chapters seem to have been written as stand-aloneunits, and are often poorly integrated with one another.One recognizes that it is a monumental editorial task totry to harmonize material written by so many authors (atotal of 60 contributed) each individually a leading experton the assigned topic. This challenge has not always beenmet; leading to some of the individual chapters within themajor sections seeming rather fragmented and disjointed.Tables on hereditary syndromes associated with cancerappear in two chapters (5 & 6) in different format andproviding complementary information. One completetable in Chapter 5, cross-referenced in Chapter 6, wouldbe more helpful to the reader despite its interest andrelevance to each. The two chapters on research andclinical trials (18 & 19) will be dif®cult to linkconceptually to the remainder of the chapters subsumedunder the heading `̀ How Cancer Is Treated.''

Despite these shortcomings, the material presentedrepresents the most up-to-date, authoritative and acces-sible information available to nonprofessionals. Thosewho use this text as a research instrument for gaininggreater understanding of the childhood cancer will ®ndprecise and usually comprehensible information regard-ing virtually any topic in the ®eld. Furthermore, becauseSt. Jude is a premier research center for pediatriconcology, chapters are included that are not often foundin texts of this type. Although some readers may be putoff by the technical concepts presented under suchheadings as `̀ The Genetics of Childhood Cancer'' and

ÐÐÐÐÐÐSouthern Alberta Children's Cancer Program, Calgary, Alberta,Canada

*Correspondence to: Stan F. Whitsett, Southern Alberta Children'sCancer Program, Alberta Children's Hospital, 1820 Richmond Rd.S.W., Calgary, AB T2T 5C7.E-mail: stan.whitsett@crha-health.ab.ca

ß 2001 Wiley-Liss, Inc.

`̀ Immune Therapy,'' the importance of these topics tomodern pediatric oncology makes their inclusion essen-tial. Similarly, discussions of the role for and practicesunderlying research in pediatric oncology should encou-rage greater understanding of clinical trials, studyprotocols, and their rationales.

In addition to its breadth of information, there arestrengths to this book that will make it valuable toreaders. The ®nal section, for example, entitled `̀ Recov-ery from Cancer,'' focuses on the impact of a malignantdisease on the child and family after treatment iscomplete. We know that this is a period of great dif®cultyand apprehension for patients and family members alike,but one that is often overlooked among the exigencies of

treatment of the primary disease itself. Childhood Cancerdoes a marvelous job of presenting information regardingphysical, psychological, social and even ®nancial seque-lae to cancer treatment in a forthright yet compassionatemanner.

We have learned in pediatric oncology that aneducated and informed patient (and/or caregiver) makesa valuable member of the treatment team, and facilitatesthe ease and effectiveness of oncology care. The materialprovided in Childhood Cancer, supplemented with theongoing and patient-speci®c information provided byoncologists and others on the medical team, will providemuch of the education and information needed toaccomplish that end.

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