Gynecologic Tumour Board is considered to be ‘a comprehensive reference on the clinical management of reproductive systems cancer in women’. The format of the book is relatively novel - 60 renowned experts present 21 illustrative cases that reflect commonly and uncommonly encountered clinical scenarios found in the gynaecological oncology clinic. Using a case-based structure, the book intends to provide an instructive guide to how important interdisciplinary care is to the woman with gynaecological cancer and to discuss standards of treatment, seminal trials and the important research questions that remain.
The book comprises four sections: approach to tumours of the ovary; approach to tumours of the uterine corpus; approach to cervical cancer; and approach to vulvar and vaginal cancers. Each section is further divided into a number of chapters which address particular clinical scenarios illustrated by a specific case. For example, the chapter entitled ‘Platinum-resistant recurrent ovarian cancer’ focuses on a 58 year-old woman with stage IIIC ovarian cancer, with a slow normalising CA 125 in response to adjuvant carboplatin and paclitaxel. Each of these cases is presented by a group of clinicians from a particular tertiary institution in the US supported by the literature. Some readers may find the interview based discussion format that each chapter takes logical and comprehensive, while others may find such a format distracting and difficult to read.
Although the book purports to consider management from diagnosis, through treatment to quality of life and long-term care, and equally to incorporate specialists from across the cancer continuum including allied health professionals, many readers will find the cases are not managed in the way in which we in Australia would consider appropriate multidisciplinary care. Each case is considered by a team of medical specialists from a variety of disciplines, but opinion is not sought from other recognised members of the multidisciplinary team, such as the social worker, specialist nurse or psychologist. Aspects such as quality of life, survivorship and palliative care receive limited attention. The chapters on early cervical cancer and cancer of the vulva briefly discuss sexuality, but neither chapter considers other implications of the cancer and its management on the woman, such as bladder and bowel dysfunction or lymphoedema. Equally the chapter on metastatic cervical cancer, although discussing palliative chemotherapy in great detail, makes no reference to the symptom burden that such women experience and the role of specialist palliative care.
In summary the lack of a comprehensive perspective on the care of women with gynaecological cancer will limit the use of this book as a reference to many. The detailed discussion of clinical management, referenced throughout with recent trial data, will make the text a valuable resource to gynae-oncology fellows who are studying for their exam. The book may also serve as a useful teaching and discussion tool for those unable to provide cases from their own clinical setting.