- Email: [email protected]
Cancer and the kidney
Media Watch
binding and index. It is, rather, a disjointed collection of essays and other material, nearly all of which were previously published in the International Journal of Health Services. Indeed, many of these journal articles, in whole or part, were previously delivered as speeches or press releases. Epstein tells us straight out that the International Journal of Health Services, which is published by the same outfit that publishes CancerGate, is “unarguably the world’s leading peer-reviewed public health journal”. Arguably, one might point out that the International Journal of Remote Sensing and the International Journal of Bifurcation and Chaos in Applied Sciences and Engineering had greater “impact” on the medical and scientific community, according to 2003 figures from Thomson ISI. But then, that would be argumentative. In considering the relevance of Epstein’s tracts, however, more important than where they were published is when. Over half of the so-called chapters were originally put in print more than a decade ago (seven of them in 1990). And no doubt a few felt dated even then. In one chapter, Epstein dissects the alleged criminal behaviour of a US chemical manufacturer, Velsicol, which had marketed the now-banned carcinogenic pesticide chlordane. The story would be compelling—were it not for the fact that the apparent bad behaviour happened circa 1975. What makes Cancer-Gate so disappointing is that its flaws obscure an otherwise critically important message. Epstein
is right that the age-adjusted incidence of many cancers have soared over the past few decades. He is absolutely right that the cancer community has trivialised industrial chemicals and urban air pollution as important contributors to various cancers. He is right that we ought to spend more energy and resources identifying such carcinogens and, as he writes, “reducing them to the very lowest levels attainable within the earliest possible time”. And, sadly, he is right that the cancer community often seems blinded to these facts. Despite the successes of the US Environmental Protection Agency’s Toxic Release Inventory programme, in accounting for and reducing dangerous chemical exposures, there is simply too much we don’t know about the chemicals we make and use. In 2000, a mere 20% of the reported 78 598 chemicals used in global commerce had been assessed for risks and had appropriate controls put in place. For decades, Epstein has been a passionate and often persuasive proponent for cancer prevention by way of environmental protection. He has been a friend to industrial workers in harm’s way. It is a pity that Cancer-Gate doesn’t do that record justice.
Clifton Leaf [email protected] Clifton Leaf, author of Fortune’s 2004 cover story, Why We’re Losing the War on Cancer (and How to Win It), is currently writing a book on the subject
Cancer and the kidney This book highlights the complex association between the kidney and cancer. Chapters address the manifestations of solid and haemopoietic tumours, and the effects of various cytotoxic and biological treatments on the physiological functions of the kidney. Clinical scenarios are part of every chapter and emphasise the practical features of disease and treatment. Most figures complement the text, and the tables are a useful quick reference for clinical problems such as types of malignant disease and associated glomerulonephropathies. In general, the contents of the book seem to be directed to the nephrologist rather than the oncologist. Early chapters concisely review various features of kidney function and laboratory measurements, and are useful for physicians who care for patients with cancer. However, several issues such as hypercalcaemia and hypophosphataemia are addressed in more than one section. The figures in these chapters tend to be less useful, especially in their black and white presentation. A chapter on myeloma and other paraprotein disorders gives a good overview of clinical presentation, pathology, and management. However, treatment discussions are neither comprehensive nor current: for example, data for the use of proteasome inhibitors are not mentioned. The tables that list diagnostic criteria are likely to be more useful to nephrologists rather than oncologists. http://oncology.thelancet.com Vol 6 August 2005
The topic of nephrotoxicity of chemotherapeutic agents and their use in kidney disease is an excellent concise discussion for both oncologists and nephrologists. The toxic effects of commonly used agents are presented in the context of a clinical scenario and are well referenced. The reference list includes new agents such as oxaliplatin but does not include others such as bevacizumab, which might be a result of the availability of data when the chapter was written. Urinary obstruction in patients with cancer is a topic that is rightfully given its own chapter because this common disorder necessitates such a discussion. The ultrasonography images are of little help to the non-radiologist, although the tables are useful. Various stents used in the relief of obstruction are described in detail, but a figure accompanying this section would have been helpful. Overall, Cohen succeeds in bringing together a group of articles into a textbook that hold in common the kidney and its relation with cancer. The book is a useful reference for many practising oncologists or nephrologists rather than for clinical or translational scientists. Such an achievement is unique for a book that is fewer than 1000 pages.
Cancer and the Kidney Eric P Cohen (Ed) Oxford University Press, 2005 £65·00 (US$114·93, €94·30), pp 276 ISBN 0 19 852644 X
Yoo-Joung Ko [email protected]
555
binding and index. It is, rather, a disjointed collection of essays and other material, nearly all of which were previously published in the International Journal of Health Services. Indeed, many of these journal articles, in whole or part, were previously delivered as speeches or press releases. Epstein tells us straight out that the International Journal of Health Services, which is published by the same outfit that publishes CancerGate, is “unarguably the world’s leading peer-reviewed public health journal”. Arguably, one might point out that the International Journal of Remote Sensing and the International Journal of Bifurcation and Chaos in Applied Sciences and Engineering had greater “impact” on the medical and scientific community, according to 2003 figures from Thomson ISI. But then, that would be argumentative. In considering the relevance of Epstein’s tracts, however, more important than where they were published is when. Over half of the so-called chapters were originally put in print more than a decade ago (seven of them in 1990). And no doubt a few felt dated even then. In one chapter, Epstein dissects the alleged criminal behaviour of a US chemical manufacturer, Velsicol, which had marketed the now-banned carcinogenic pesticide chlordane. The story would be compelling—were it not for the fact that the apparent bad behaviour happened circa 1975. What makes Cancer-Gate so disappointing is that its flaws obscure an otherwise critically important message. Epstein
is right that the age-adjusted incidence of many cancers have soared over the past few decades. He is absolutely right that the cancer community has trivialised industrial chemicals and urban air pollution as important contributors to various cancers. He is right that we ought to spend more energy and resources identifying such carcinogens and, as he writes, “reducing them to the very lowest levels attainable within the earliest possible time”. And, sadly, he is right that the cancer community often seems blinded to these facts. Despite the successes of the US Environmental Protection Agency’s Toxic Release Inventory programme, in accounting for and reducing dangerous chemical exposures, there is simply too much we don’t know about the chemicals we make and use. In 2000, a mere 20% of the reported 78 598 chemicals used in global commerce had been assessed for risks and had appropriate controls put in place. For decades, Epstein has been a passionate and often persuasive proponent for cancer prevention by way of environmental protection. He has been a friend to industrial workers in harm’s way. It is a pity that Cancer-Gate doesn’t do that record justice.
Clifton Leaf [email protected] Clifton Leaf, author of Fortune’s 2004 cover story, Why We’re Losing the War on Cancer (and How to Win It), is currently writing a book on the subject
Cancer and the kidney This book highlights the complex association between the kidney and cancer. Chapters address the manifestations of solid and haemopoietic tumours, and the effects of various cytotoxic and biological treatments on the physiological functions of the kidney. Clinical scenarios are part of every chapter and emphasise the practical features of disease and treatment. Most figures complement the text, and the tables are a useful quick reference for clinical problems such as types of malignant disease and associated glomerulonephropathies. In general, the contents of the book seem to be directed to the nephrologist rather than the oncologist. Early chapters concisely review various features of kidney function and laboratory measurements, and are useful for physicians who care for patients with cancer. However, several issues such as hypercalcaemia and hypophosphataemia are addressed in more than one section. The figures in these chapters tend to be less useful, especially in their black and white presentation. A chapter on myeloma and other paraprotein disorders gives a good overview of clinical presentation, pathology, and management. However, treatment discussions are neither comprehensive nor current: for example, data for the use of proteasome inhibitors are not mentioned. The tables that list diagnostic criteria are likely to be more useful to nephrologists rather than oncologists. http://oncology.thelancet.com Vol 6 August 2005
The topic of nephrotoxicity of chemotherapeutic agents and their use in kidney disease is an excellent concise discussion for both oncologists and nephrologists. The toxic effects of commonly used agents are presented in the context of a clinical scenario and are well referenced. The reference list includes new agents such as oxaliplatin but does not include others such as bevacizumab, which might be a result of the availability of data when the chapter was written. Urinary obstruction in patients with cancer is a topic that is rightfully given its own chapter because this common disorder necessitates such a discussion. The ultrasonography images are of little help to the non-radiologist, although the tables are useful. Various stents used in the relief of obstruction are described in detail, but a figure accompanying this section would have been helpful. Overall, Cohen succeeds in bringing together a group of articles into a textbook that hold in common the kidney and its relation with cancer. The book is a useful reference for many practising oncologists or nephrologists rather than for clinical or translational scientists. Such an achievement is unique for a book that is fewer than 1000 pages.
Cancer and the Kidney Eric P Cohen (Ed) Oxford University Press, 2005 £65·00 (US$114·93, €94·30), pp 276 ISBN 0 19 852644 X
Yoo-Joung Ko [email protected]
555