Abstract
How would you rate this book? (5 star means excellent book useful for all GPs in training—a must have item; 1 star means poor book that you would not buy yourself)
What is good about this book?
What is the correct syringe driver prescription for the terminally ill? From where is a bone marrow biopsy taken? Who is eligible for Carer's Allowance?
This little book is like a colourful slimline Oxford Handbook written to assist GPs in their community-based role in cancer management. Written by oncologists, and given a primary care focus by InnovAIT editor Chantal Simon, this book is an essential reference for all UK GPs and Associates in Training (AiTs).
Intelligent formatting is used to guide the reader through key clinical points in context, while presenting practical tips on how to enhance the quality of cancer care in line with the cancer-related Quality and Outcomes Framework (QOF) outcomes. Frequently faced clinical questions are addressed, with simple graphics to aid explanations to patients, and further high-quality sources of information sign posted. Cancer types are covered intuitively using pathological, clinical and prognostic information, and the identification and management of oncological emergencies are highlighted for quick reference.
After a clear concise orientation to key UK cancer trends, the authors discuss prevention and screening in enough detail to remind you of the public health principles of cancer prevention and the structure of UK screening programmes. This leaves you equipped to answer patient questions and address concerns regarding abnormal prostate-specific antigen (PSA) results, the arrival of a bowel cancer screening kit or the implications of a borderline smear.
They adeptly orientate the reader to the complex process of cancer diagnosis and to the principles behind oncologists' decisions when choosing between the multiple modalities of cancer management. Before tackling each cancer individually, they detail red flag symptoms, linking these with the most appropriate and timely investigation and clarifying common points of confusion to help avoid costly delays.
To assist the GP's supportive role, there is concise explanatory information on, for example, the process of radiotherapy planning, the necessity for chemotherapy following curative surgery, how to best manage the side effects of the myriad of cytotoxic drugs and of the eligibility criteria for the wide range of support and benefits available for patients and carers. The refreshing emphasis on the palliative approach provides reassurance for GPs without a special interest in domiciliary end-of-life care and an accessible quick reference for the GP with a special interest (GPwSI) in providing patient-centred palliation.
What is bad about this book?
There are two suggested areas for further focus in future editions. While there is a useful section on children with cancer, young people (aged 16–24 years) also deserve special mention. They are identified as a group providing a diagnostic dilemma, with non-specific and atypical presentation patterns and unique psychobehavioural needs. The National Institute for Health and Clinical Excellence (NICE) Improving Outcomes guidance recommends a coordinated age-appropriate approach for this transition group, to drive reductions in morbidity and advances in survival.
The number of cancer survivors is increasing following improvements in diagnosis and management. Survivorship provides another challenge to GPs as the long-term side effects of chemotherapy and radiotherapy are poorly understood and symptoms of recurrence are often masked by co-morbidity and abnormal anatomy. As GPs are largely responsible for the care of this growing group, guidance on symptom patterns to watch out for will become increasingly sought.
Overall, there is a lot of useful information packed into this little book but do not let this put you off, it is very easy to read and well indexed. While it probably should not take up valuable space in your doctor's bag, it is a reliable reference text for use in every surgery.
Note: Chantal Simon was not involved in the review process of this book review.