During the last few decades, there has been a tremendous improvement in the treatment of cancer. There is evidence that this trend is continuing, based on the achievements re sulting from the combined efforts of clinicians and basic re search workers. This book is an example of such interaction and collaboration. It was prepared by authors representing both areas of work. Most of the work reported in this book is not merely theoretical, but has been experimentally successfully tested and sometimes applied clinically. This work has, however, not yet been generalized and practiced on a wide scale. Some of the results reported here relate to new aspects and open new horizons for future progress. This book will be of great value for both clinicians and basic research workers. VICC Treatment and Rehabilitation Programme ISMAIL ELSEBAI Chairman Preface The three main approaches to the treatment of cancer are surgery, radiotherapy, and chemotherapy. Today, all malignant neoplasms are managed by one or more of these modalities, with varying success rates depending on the type of tumor, its degree of spread, and the knowl edge and skill with which the treatment plan has been designed and executed. In the United States of America and in Europe, approximate ly half of all cancer is presently curable, but this has been the case for approximately 20 years."

This book is intended as an introduction to the drug treatment of cancer. It is almost ten years since the last edition was written. In the intervening time, there have been numerous developments in cancer chemotherapy and in order to cover these the majority of the text has been completely revised and rewritten. In addition, two new chapters have been introduced, one on the safe handling of cytotoxic drugs and the other on biological response modifiers. In order to incorporate this new information without any undue increase in the length of the text the chapters on a combined approach to treatment have been omitted. This is not because interdisciplinary collaboration is no longer considered important but is a reflection of the fact that, in most centres, it has become the norm in cancer management and its central role in successful treatment no longer needs to be stressed quite so strongly. The four chapters in the last edition which dealt with the team approach to cancer therapy have been replaced by a single chapter on the place of chemotherapy in the overall treatment of cancer. Unfortunately, despite all the innovations of the last decade, it has become increasingly clear that much of the promise offered by drug treatment during the 1960s and 1970s has not been fulfilled.

During the past decade, a significant amount of research has been conducted on phytopharmaceuticals. Today, a growing body of evidence demonstrates the efficacy of a wide variety of natural products and affirms their potential in the treatment of cancer. Phytopharmaceuticals in Cancer Chemoprevention focuses on the role of natural supplements in cancer prevention and therapy. The first section covers cancer epidemiology, as well as cancer statistics, current therapies, and potential toxicities involved with existing cancer drugs. The second section begins by discussing the pathophysiology of cancer including mechanistic and molecular aspects of cancer biology, and then explains the etiology of breast cancer, lung cancer, prostate cancer, tobacco and cancer, and gastrointestinal tract cancers, and concludes with the various risk factors related to obesity, exercise and aging. The third section covers phytopharmaceuticals and focuses on cancer health risk factors and the protective abilities of various natural products. The final section features commentary on cancer susceptibility and the value of natural remedies for healthy living. With contributions from a diverse panel of renowned scientists and cancer biologists, this book covers a broad spectrum of phytopharmaceuticals in relation to their prospective roles in the future of cancer prevention and treatment. It is a valuable resource for nutrition scientists, oncologists, and dietitians in their efforts to conquer the challenge of cancer.

Handbook of Supportive Oncology and Palliative Care is a practical guide to providing evidence-based and value-based care to adult and pediatric cancer patients experiencing severe symptoms and stressors due to cancer diagnosis, cancer treatment, and comorbid conditions. This accessible reference provides the art and science behind the whole-person and family approach to care by delivering the best practices to relieving a cancer patient's symptoms across physical, psychosocial, and spiritual dimensions. Unlike other resources, this book covers all dimensions of palliative care but with a special emphasis on primary palliative care. Part One of the handbook provides the essential background and principles of supportive oncology and palliative care, including chapters on understanding the adult and pediatric patient and family illness experience, the roles and responsibilities of the palliative care team, and the art of the palliative care assessment interview. Part Two covers symptom management and includes ten chapters considering the major physical and psychosocial symptoms a cancer patient may face-neurologic, cardiac, respiratory, gastrointestinal, genitourinary, psychiatric, sleep and fatigue, pain, and psychosocial and spiritual distress. Part Three addresses special considerations and issues that an oncologist, physician, nurse or other healthcare provider often face in these settings, including chapters on intimacy, sexuality, and fertility issues, grief and bereavement, running a family meeting, care for the caregiver, and survivorship.Written by expert clinicians, this state-of-the-art handbook is a necessary resource for any oncologist, nurse, primary care physician, psychosocial expert, or related practitioner who endeavors to improve quality of life and provide healing to those suffering from cancer and its treatment. Key Features: Provides the binding principles of palliative care for pediatrics, adults and families from diverse cultures and spiritual beliefs Easy-to-read format makes extracting content fast and convenient for both the clinical and educational setting Guides the clinician and practitioner through the palliative care assessment process, including the appropriate questions for the palliative care interview Interdisciplinary team approach to psychosocial and spiritual care Includes access to the fully searchable downloadable eBook

Malignant pleural mesothelioma, a malignancy due largely to asbestos exposure, represents an increasingly common challenge to clinical and medical oncologists, respiratory physicians, and cardiothoracic surgeons, as well as researchers in the field. The disease has yet to reach its peak and is expected to kill over 100,000 people worldwide. As malignant pleural mesothelioma gains in profile, Kenneth O'Byrne and Valerie Rusch present a comprehensive overview of the subject, aimed at all health care professionals who come into contact with patients with the disease. The book includes chapters on epidemiology, diagnosis, histopathology, radiology, surgery, chemotherapy, immune therapy, radiotherapy, and palliative medicine, written by an international team of contributors. A molecular biology section focuses on the carcinogenic effects of asbestos fibres and simian virus 40, angiogenesis and angiogenic growth factors, the immune response, and genetic abnormalities detected in the disease. Future therapies are also covered, as is a perspective on the distinct legal issues related to the disease. This highly-illustrated, full colour book provides the ultimate, timely resource on this devastating disease.

Drug resistance in cancer, whereby a proportion of cancer cells evades chemotherapy, poses a profound and continuing challenge for the effective treatment of cancer. The principles underlying the biological mechanisms behind this phenomenon are clearly understood and explained in this volume. However, a deeper understanding of drug resistance requires a quantitative appreciation of the dynamic forces that shape tumour growth, including spontaneous mutation and selection processes. The authors seek to explain and to simplify these complex mechanisms, and to place them in a clinical context. Clearly explained mathematical models are used to illustrate the biological principles and provide an insight into tumour development and the effectiveness and limitations of drug treatment. It is suitable for those with a non-mathematical background and aims to enhance the effectiveness of cancer therapy.

The development of drug-resistant cancers is considered to be the most significant obstacle to the cure of cancer today. Nearly half of all patients with cancer suffer from tumours that are intrinsically resistant to chemotherapy, and most of the remaining half develop drug resistance during the course of their treatment. This book reviews the mechanisms and clinical implications of drug resistance in cancer with unrivalled authority. Chapters cover topics of current clinical concern, including multiple drug resistance and its reversal, topoisomerase drugs, apoptosis, dose intensity and escalation, gene therapy and haematopoietic support. The authors are among the leading clinicians and investigators in the field. These authoritative volumes in this series are intended for a wide audience of clinicians and researchers with an interest in the applications of biomedical science to the understanding and management of cancer.

This is the fourth volume of our series Progress in Anti-cancer Therapy. For the past four years we have taken the challenge to select each year, some of the most interesting topics on the wide field of oncology. As usual, this volume continues the tradition and covers five cancers (breast, prostate, bladder, lym phoma and ovarian), the role of HIV and HTLV in cancer, as well as some deve lopmental pharmacology and behavioral issues. This year, we have particularly focused our attention on one of the most com mon (although rarely addressed) cancer accounting for more than 315,00 newly diagnosed cases and 41,000 cancer-related deaths annually (Landis SH et al., 1999): prostate cancer. Five chapters address some of the issues concerning this disease. The chap ter by Schroder describes the hopes and pitfalls of early detection of prostate cancer. It reviews the literature on screening studies that have been performed both in the US and in Europe. These studies suggest that cancer mortality could be reduced by screening for prostate cancer, mostly through PSA testing. However, the effectiveness of early detection still needs to be definitely confir med and ongoing randomized studies are described, the results of which will probably help the medical community determine the worth of PSA-based scree ning for prostate cancer. On the same hand, the paper from von Eschenbach is reviewing the clinical problems that are related this disease."

Metal-based anticancer drugs are among the most successful therapeutic agents, as evidenced by the frequent prescription of selected platinum and arsenic compounds to patients. Metal-based Anticancer Agents covers the interdisciplinary world of inorganic drug discovery and development by introducing the most prominent compound classes based on different transition metals, discussing emerging concepts and enabling methods, as well as presenting key pre-clinical and clinical aspects. Recent progress on the unique features of next-generation targeted metal-based anticancer agents, including supramolecular coordination complexes used for both therapy and drug delivery, promise a bright future beyond the benefits of pure cytotoxic activity. With contributions from global leaders in the field, this book will serve as a useful reference to established researchers as well as a practical guide to those new to metallodrugs, and postgraduate students of medicinal chemistry and metallobiology.

The immune system plays an essential part to maintaining the homeostasis of the organism. It is responsible for tolerance towards self antigens and for recognition and elimination of infectious invaders and cancer cells. Immunomodulating agents constitute a wide family of therapeutic products for the treatment and prevention of human disease and pathophysiological situations with immunological imbalances. This Forum on immunomodulators represents a selection of important examples of immunomodulating agents readily usable in human therapy. Several potential applications of cytokines as well as synthetic products are also presented.

A high proportion of drugs currently coming to market exert their action in the body by inhibiting a target enzyme involved in a particular body function or in a bacterium, protozoon, or virus causing an infection. This book extends the previous volume in providing a comprehensive coverage of< br> more recently recognized target enzymes and their known inhibitors and, within this framework of knowledge, demonstrates how the drug designer uses all available information to develop a specific therapeutic agent. Drug design is an interdisciplinary art; this text illustrates the pathway followed< br> from the initial design concept and synthesis of an inhibitor, through its in vitro and in vivo assessments, to clinical trial -- a process involving chemists, biochemists, pharmacologists, and clinicians.