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Cancer in Pregnancy: Therapeutic Guidelines
Book Reviews radiologic, and chemotherapeutic recommendations are furnished. The chapter on gestational trophoblastic disease is excellent. It covers the basic problems well, presents appropriate treatment protocols, describes follow-up procedures, and has the most current bibliography in the entire book. Absent from the text are chapters on lung and brain cancers, even though the former is becoming a major problem in women in their reproductive years. This publication is the best available text on cancer in pregnancy. It should be read by all obstetricians and anyone who provides medical care for women during their reproductive years.
Cancer in Pregnancy: Therapeutic Guidelines, edited by H. Hugh Allen and Jeffrey A. Nisker, 291 pp, with illus, $32.50, Mount Kisco, New York, Futura Publishing Company, 1986 Older statistics indicated that cancer occurred in approximately 1 in 1,000 pregnant women; because women now often wait until later years to have children, an increase in the number of pregnant women with cancer might be expected. This book deals with the problems of most of the common malignant lesions seen during pregnancy. The first section of the book addresses Immunologie mechanisms in pregnancy. A basic review of immunologic changes in pregnant women and in patients with malignant lesions is clearly presented. The simple conclusion is that until assays for each of the regulator and effector cell types are available, determining whether similar mechanisms are responsible for failure of rejection of the fetus and for the persistence and growth of tumor cells will be difficult. The sections on irradiation and chemotherapy review the basic knowledge in these areas, the risks to the fetus, and the basic changes that might be seen (1) in the reproductive ability of the man or woman who receives such therapy, (2) in the fetus as an immediate effect, and (3) in the fetus as long-term effects. The sections on the management of tumors of the breast, cervix, thyroid gland, ovary, colon, and rectum are well presented; a balanced evaluation of therapy and the potential associated risks is included. The authors offer specific recommendations for particular tumors; in general, the fundamental approaches to therapy are advocated. The discussion on evaluation of the abnormal Papanicolaou smear in pregnant women describes current approaches in detail and provides specific suggestions for treatment and follow-up. The topics of lymphomas and leukemias are the most thoroughly detailed and well-presented part of the book. Specific recommendations are provided for evaluation, staging, therapy, and, most importantly, commonsense supportive care of the pregnant woman during treatment. In brief chapters, malignant melanoma and ovarian cancer are reviewed. Reasonable surgical, Mayo Clin Proc 61:677, 1986
George D. Malkasian, Jr., M.D. Department of Obstetrics and Gynecology Complications in Orthopaedic Surgery, 2nd ed (in 2 vols), edited by Charles H. Epps, Jr., 1,527 pp, with illus, $138, Philadelphia, J. B. Lippincott Company, 1986 This second edition is the revised and expanded version of Complications in Orthopaedic Surgery, which was first published in 1978. Obviously, numerous complications can potentially occur in the field of orthopedic surgery; this vast potential is reflected in the fact that the textbook consists of two volumes. In the first part of the first volume, general considerations are addressed, including such topics as complications related to anesthesia, complications of infections, and other common complications of general surgical procedures. Part 2 discusses complications of trauma; this large area extends into the second volume. Part 3 considers complications of arthroplasty and total joint replacement. Part 4 describes complications of reconstructive surgical procedures other than arthroplasty. In the second edition, several new chapters have been included: complications of external fixation, complications of functional bracing and cast bracing, complications of microvascular surgery, complications of multiple trauma, and complications of allografting proce-
677
Cancer in Pregnancy: Therapeutic Guidelines, edited by H. Hugh Allen and Jeffrey A. Nisker, 291 pp, with illus, $32.50, Mount Kisco, New York, Futura Publishing Company, 1986 Older statistics indicated that cancer occurred in approximately 1 in 1,000 pregnant women; because women now often wait until later years to have children, an increase in the number of pregnant women with cancer might be expected. This book deals with the problems of most of the common malignant lesions seen during pregnancy. The first section of the book addresses Immunologie mechanisms in pregnancy. A basic review of immunologic changes in pregnant women and in patients with malignant lesions is clearly presented. The simple conclusion is that until assays for each of the regulator and effector cell types are available, determining whether similar mechanisms are responsible for failure of rejection of the fetus and for the persistence and growth of tumor cells will be difficult. The sections on irradiation and chemotherapy review the basic knowledge in these areas, the risks to the fetus, and the basic changes that might be seen (1) in the reproductive ability of the man or woman who receives such therapy, (2) in the fetus as an immediate effect, and (3) in the fetus as long-term effects. The sections on the management of tumors of the breast, cervix, thyroid gland, ovary, colon, and rectum are well presented; a balanced evaluation of therapy and the potential associated risks is included. The authors offer specific recommendations for particular tumors; in general, the fundamental approaches to therapy are advocated. The discussion on evaluation of the abnormal Papanicolaou smear in pregnant women describes current approaches in detail and provides specific suggestions for treatment and follow-up. The topics of lymphomas and leukemias are the most thoroughly detailed and well-presented part of the book. Specific recommendations are provided for evaluation, staging, therapy, and, most importantly, commonsense supportive care of the pregnant woman during treatment. In brief chapters, malignant melanoma and ovarian cancer are reviewed. Reasonable surgical, Mayo Clin Proc 61:677, 1986
George D. Malkasian, Jr., M.D. Department of Obstetrics and Gynecology Complications in Orthopaedic Surgery, 2nd ed (in 2 vols), edited by Charles H. Epps, Jr., 1,527 pp, with illus, $138, Philadelphia, J. B. Lippincott Company, 1986 This second edition is the revised and expanded version of Complications in Orthopaedic Surgery, which was first published in 1978. Obviously, numerous complications can potentially occur in the field of orthopedic surgery; this vast potential is reflected in the fact that the textbook consists of two volumes. In the first part of the first volume, general considerations are addressed, including such topics as complications related to anesthesia, complications of infections, and other common complications of general surgical procedures. Part 2 discusses complications of trauma; this large area extends into the second volume. Part 3 considers complications of arthroplasty and total joint replacement. Part 4 describes complications of reconstructive surgical procedures other than arthroplasty. In the second edition, several new chapters have been included: complications of external fixation, complications of functional bracing and cast bracing, complications of microvascular surgery, complications of multiple trauma, and complications of allografting proce-
677