Current multidisciplinary oncology series

Cancers of the colon and the rectum is as its subtitle states, A Multidisciplinary Approach to Diagnosis and Management. Successful treatment of colorectal cancer (CRC) relies on the conjunction of several medical disciplines. This book, part of the series “Current Multidisciplinary Oncology”, represents an excellent introduction to the integrative care of colorectal cancers. From prevention and diagnosis to treatment strategies and future directions, this text summarizes most of the angles to take into account in the management of CRC. Nonetheless, it is worth mentioning the United States market orientation of this text as issues such as chapters like “Navigation programs”, “Models of Care Delivery” and “Patient Advocacy” are of limited usefulness outside the US health system.

The first six chapters of the book focus on prevention, screening and diagnosis. Particularly, the chapter “Prevention and Screening” is an extensive review of the risk factors involved in the development of CRC cancer as well as the screening techniques and recommendations. Of especial interest within this chapter is the comprehensive summary of the chemoprevention agents and trials. Also of note is the “Preoperative Staging: Imaging and Endoscopic Approaches” chapter, that offers the readers a very graphic compendium in the endoscopic approaches to colon cancer.

The molecular pathways involved in colorectal carcinogenesis and progression are described within some chapters like “Pathology and Molecular diagnosis”. However, given the enormous importance of the molecular basis to understand and treat this disease, a chapter dedicated to this subject would have been highly interesting.

The main body of the book comprises of nine chapters dedicated to the treatment of CRC ranging from surgical treatment to palliative care. Regarding surgery, basic information on the standard surgical procedures for resection of the primary tumor is provided. In addition, special surgical considerations are described in more detail for liver and lung metastases as well as for pelvic recurrences.

The topic on systemic chemotherapy is divided into two chapters giving a thorough description of the main trials that have influenced clinical practice. The authors successfully address specific relevant matters in chemotherapy usage, by formulating questions or headings followed by concise answers describing the available data. Nonetheless, probably due to the rapidly evolving nature of the oncological field, the information on the available predictive and prognostic biomarkers is limited to those well established and, the text does not delve deeper into the more recently identified biomarkers.

The management of the toxicity derived from the systemic therapy is outlined thoroughly in a separate chapter. Although it is restricted to some of the most common side effects, this can be exactly what clinicians need in the everyday practice.

The contribution of the palliative care to the management of CRC cancers is approached from the radiotherapy angle, with specific focus on the palliative treatment of stage IV rectal cancer symptoms. Importantly, there is a chapter on “Multidisciplinary Approach to Quality of Life”, many times forgotten yet so important for the CRC patient’s care.

The last chapters are focused on the future directions of CRC cancer research with special emphasis on gene expression and its contribution to the finding of prognostic and predictive biomarkers. Furthermore, promising novel targeted therapies are described, along with an interesting overview on the methodology for the design of biomarker-driven clinical trials.

Overall, “Cancers of the Colon and Rectum” represents a truly multidisciplinary compendium of the management of these tumors that will be of value both for any physician involved in providing care for CRC patients as well as for trainees of many medical disciplines.

Acknowledgements

Disclosure: The authors declare no conflict of interest.