Oral Cancer: Diagnosis, Management, and Rehabilitation
Edited by John W. Werning, M.D. Pp. 448. Thieme, New York, N.Y., 2007. Price: $129.95.
Cancer of the oral cavity and the treatment required to cure the disease can be among the most debilitating problems in medicine. Whereas early tumors can be handled by limited resections without adjunctive therapy, advanced cancers often require extensive surgery, radiation, and/or chemotherapy. All of these options frequently result in loss of functional swallowing and speech. Dr. Werning and his co-authors have created a comprehensive, detailed review of every significant aspect of oral cancer. While most general texts offer one or two chapters on the oral cavity, this text deals with complexities and substantial differences in each subsite.
The early chapters deal with the usual staging, preoperative evaluations, and epidemiologic and anatomic reviews quite nicely. They take a mundane subject and make a strong attempt to dig into the details and make them relevant to the reader.
The next natural division deals with cancers of the various sites, options for treatment, and the authors’ experiences and recommendations. All of these chapters are written by Drs. Werning and Mendenhall. Although having the same two authors for so much of the book has the potential to result in treatment tunnel vision, I felt it was a positive in this case. The problems are arranged in an organized, consistent format, and the authors effectively deal with the discrete issues in each oral subsite.
The reconstructive chapters are excellent with regard to indications, details to consider in reconstruction, and understanding the issues created in ablation of the various structures of the oral cavity. These chapters are limited in techniques and make no attempt to be a surgical atlas of all details of all possible reconstructive options. They accomplish very well the primary purpose of understanding the enemy and developing strategies to overcome the obstacles created by ablation.
The final chapters of the book deal with various topics related to nonsurgical treatment as well as the consequences of treatment. These chapters, in addition to those on speech therapy, prosthetics, chemoprevention, and newer strategies, tie up every loose end possible in oral cavity cancer treatment. Much more would be needed to cover each of these subjects in the same depth as the evaluation and surgical sections. For instance, there are two chapters dealing with radiation and chemotherapy. They furnish adequate general understanding of the topics for the intended reader, but treatment of head and neck cancer is evolving rapidly and patients treated nonsurgically actually comprise an ever-growing proportion of advanced cases.
The strengths of the book lie in the early and middle chapters dealing with evaluation and surgical management. The latter sections cover their bases and are well done, giving a good overall picture of how to deal with the problems associated with cancer treatment. These latter subjects would be difficult to cover completely within the scope and mission of the book, and a lengthier treatise would not be as effective.
John M. Truelson, M.D.
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