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In Britain, around 20,000 men are diagnosed with prostate cancer and 10,000 men die from prostate cancer each year, making this disease the second most common carcinoma after lung cancer. The aetiology of the disease has long been unclear but a modern view is that it, like lung cancer, is initiated in early puberty and develops over a 30- to 50-year life under varying endocrinological, dietary, infectious and chemical/radiation exposures. Interestingly, about 5-10% of patients presenting with disease demonstrate a family history and recent studies indicated that such disposition is likely to be mediated through both highly penetrant and lower penetrance genes with linkage studies having suggested multiple locations for high-risk prostate cancer genes including chromosome 1q24 (HPC1), 1q42, 1p36 and Xq.
The epidemiology and genetics of prostate cancer are thoroughly reviewed in Part 1 of this volume, with Part 2 providing a detailed discussion of the so-called 'window of opportunity' for curative intervention in early, organ-confined, low-grade disease, and how rapid diagnosis and fast tracking of the patient for appropriate procedures can be practically organised in institutions providing routine care.
Part 3 provides a comprehensive exposition of the scientific evidence and expert opinion base for clinical intervention in established disease through a collection of exceptionally detailed reviews of the benefits and advantages of prostatectomy, external beam radiotherapy and neoadjuvant hormone treatment, brachytherapy and medical intervention in early and late stage disease more generally. The book ends, in Part 4, with a discussion of a range of issues of central relevance to the clinical governance of prostate cancer services, including the structure and function of the multidisciplinary clinical team and the role of the nurse specialist in service co-ordination and patient information provision. A detailed review of the economics of service provision and an enumeration of the challenges that face colleagues engaged in the provision of high-quality clinical services concludes the text.
This extremely thorough and completely state-of-the-art review of prostate cancer is therefore highly recommended as part of continuing professional development to consultants in urology, clinical and medical oncology and their trainees, and to clinical nurse specialists and planners and commissioners of cancer services. |
