Carl Pochedly, editor PEDIATRIC CANCER THERAPY Baltimore: University Park Press, 1979, 302 pp., $29.50.
Dr. Pochedly has become a prolific editor of materials covering the range of problems in the held of pediatric oncology. Although his own clinical service is small, he has reached Out and skillfully coordinated the experience and expertise of colleagues from all parts of the country. This book is typical of his efforts to produce a compendium of current information for ready access to the primary physicians who work with children. The print is large, and the consistency in writing styles makes the book easy to read. Most of the authors are established authorities, and their summaries of the state of the art are quite adequate.
As in any multiauthor publication, there are peaks and valleys. For example, a disproportionately large space is given to bone tumors (44 pages and two chapters), as against 29 pages for acute lymphoid leukemia. There is too much detailed material, and Dr. Gerald Rosen's comments on page 94 about "skip areas" are confusing. For this publication, a broader discussion of childhood acute lymphoid leukemia, rather than discussion limited to the experience of one institution, would have seemed more appropriate. However, the concepts are similar, so this is no great detraction.
As a rule, the more junior contributors have provided a broad review of their assignments whereas the more senior participants adhere to their personal experiences. But this is not detrimental and is probably less relevant in a field where changes are occurring rapidly.
Regarding the various chapters, Dr. Thomas F. Necheles, who wrote on acute nonlymphoid leukemia, mentioned a cost of $25,000 for a bone-marrow transplant. He might have balanced this against the cost of treating a patient with chemotherapy; the latter may be considerably higher, with less adequate results. One might quibble with Dt. Abdelsaiam H. Ragab on the use of an inferior venacavogram in Hodgkin's disease, particularly since he omits mention of die value of radioisotope studies. He might also have reported on die current results of dierapy for the Stage I-III patients.
Dr. Pochedly's chapter on neonatal Wilms' tumor and neuroblastoma appears to be out of line with the rest of die book, but it is provocative. I am not sure that everyone would agree with Dr. Sergio A. DeLamerans (who wrote the chapter on management of Wilms' tumor) mat all children with bilateral Wilms' tumor should receive total abdominal radiotherapy. There is room for individualization.
Dr. Sirgay Sanger's psychiatric overview is well done, except that he does his colleagues a disservice by quoting a meager "20 percent" cure rate for childhood malignancies. It is probably closer to 60 percent in terms of fiveyear survival.
Dr. Arthur Levine's emphasis on hand washing (in his chapter on managing infections in children with cancer) should be placed in capital letters! How did we stray from the basics?
A few minor complaints: Dr. Paula Groncy, the first author of the chapter on neuroblastoma, was omitted in the list identifying senior contributors although her coauthor, Dr. Jerry Z. Finklestein is mentioned. The caption for the picture of the child with a unilateral lid lag in the chapter on acute lymphoid leukemia (page 11) probably was mistakenly titled "3rd nerve" instead of "7th" cranial nerve as the text indicates. And Dr. Pochedly, who does a fine job of editing, I am sure will tolerate one gig: Resection means "partial removal of an organ or tissue." Some of his authors have used the cliché "complete resection." Why is it that we succumb to jargon so easily?
In summary, I agree with Dr. J. S. Malpas, who comments in the Foreword that this is a useful review for the targeted audience. It is not a reference text and was not meant to be. It has one prevailing message: the therapy of children with cancer has become sophisticated and more successful, and access to a qualified multidisciplinary team is vital. Fortunately for children, pediatricians are among the first to seek the best help they can get.They deserve kudos for that.
Dr. Pochedly with young patient receiving intravenous chemotherapy for acute myeloid leukemia.