Evolution of Cancer

the education and training of the staff who will be involved in cytotoxic reconstitution which is followed by an invaluable chapter on the management of extrasavation of cytotoxic drugs. Section two of the book is likely to be a constant source of reference. It comprises a valuable alphabetical listing of monograhs of individual drugs that are used intravenously. Each monograph has been prepared by a named member of the working group according to a common structure. There is a section on nomenclature which includes the names of manufacturers and suppliers in the UK. There follows sections on chemistry, stability profile, clinical usage, details of how individual drugs are prepared for injection or infusion together with handling precautions. The final section considers how residual drug and contaminated articles should be destroyed. It should be emphasised that the working group has deliberately refrained from providing details of 'standard protocols for various indications'. In summary this is a book that should be read by any members of the 'Oncology Team' involved in setting up a reconstitution service. It should also be available in the departmental library of all Oncology Departments and all Pharmacies where any cytotoxic drugs are reconstituted and administered. This is a highly provocative book, written by two clinical radiotherapists, on the evolution of cancer. The authors base their approach to the treatment of cancer on the hypothesis that cancer represents a process of evolution in reverse, which they call 'devolution'. This concept is applied to develop theories on carcinogenesis, epidemiology, diagnosis and especially the strategy of cancer treatment. Fanconi's anaemia is cited as an evolutionary experiment of nature on carcinogenesis. The tumours described in patients with the DNA repair syndrome were classified according to their epithelial,-non-epithelial and gonadal origin. The early manifestation of non-malignancies and the later occurrence of epithelial tumours is considered as a support for the evolution theory. The cancer incidence in Japan following the explosion of the atomic bombs would also support this evolution theory. The parallel evolution of biology with the physicochemical alterations on earth are also cited in support of the evolution theory of cancer. Such arguments are then used for the formulation of a therapeutic strategy, starting with the repair of DNA damage, via carbohydrate biochemistry to immunotherapy and antiviral therapy. A large variety of arguments are used to formulate a strategy in surgery, radiotherapy, chemotherapy and immuno-therapy. For most readers of this book …