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This book is a practical guide on how best to incorporate advanced radiation therapy techniques into the multimodality treatment of a wide range of gastrointestinal tumors, including esophageal cancer, gastric cancer, hepatobiliary malignancies (primary and metastatic liver tumors, intrahepatic, perihilar, and extrahepatic cholangiocarcinomas, and gallbladder cancer), pancreatic cancer, colorectal cancer, and carcinoma of the anal canal. Practical considerations when treating patients with external beam radiation therapy, intensity-modulated radiation therapy, particle therapy, and stereotactic body radiation therapy are clearly explained. Detailed attention is devoted to the safety and efficacy of radiotherapy in combination with current and emerging systemic therapies (chemotherapy, immunotherapy, and biologic agents), surgery, and ablative therapy, and the advantages and disadvantages of alternative treatment approaches for different tumor types are carefully evaluated. The book will benefit radiation oncologists, medical and surgical oncologists, medical physicists, medical dosimetrists, and other oncology professionals.
Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.
"The WHO Classification of Tumours of the Digestive System presented in this book reflects the views of a Working Group that convened for an Editorial and Consensus Conference at the International Agency for Research on Cancer (IARC), Lyon, December 10-12, 2009"--P. [5].
Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.
One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.
This textbook discusses core principles and practices in gastrointestinal oncology and covers a wide range of practice areas such as pathology and radiologic images, epidemiology, genetics, staging, multidisciplinary management of specific gastrointestinal cancer, and pathology for each primary tumor site. The comprehensive coverage makes Textbook of Gastrointestinal Oncology a useful resource for the practitioner wishing to gain a greater understanding of the principles of managing malignant gastrointestinal disease, as well as medical oncology fellows, surgeons, radiation oncologists, gastroenterologists and fellows, and residents.
Although there has been a slow but steady decrease in incidence, gastric cancer remains the second leading cause of cancer death worldwide. Several aspects of the oncological and surgical management are still controversial and so gastric cancer represents a challenge for the surgeon. This book aims to delineate the state of the art in the surgical and oncological treatment of gastric cancer, describing the new TNM staging system, the extent of visceral resection and lymphadenectomy focusing on the different open and minimally invasive surgical techniques and discussing intraoperative chemohyperthermia and neoadjuvant and adjuvant treatment. Operative endoscopy and endoscopic ultrasonography are also discussed, as these now have an important role in both diagnostic work-up and palliative care of gastric cancer patients. Only a multidisciplinary approach involving the surgeon, gastroenterologist, and oncologist can produce the comprehensive and integrated overview that today constitutes a winning strategy for the optimization of results.What we hope we have achieved is a flexible, up-to-date, exhaustive publication, rich in illustrations and consistent with evidence-based medicine.
Hepatobiliary Cancer addresses the field with contributions from talented practitioners from around the world in surgery, chemotherapy, radiation therapy, medical oncology, and integrative medicine. The text approaches these cancers by type – biliary and liver tumors – and in terms of diagnostic techniques and therapies: surgical, ablative, systemic and regional chemotherapies, biologic, and complementary. Hepatobiliary Cancer is essential reading for anyone expert in, or engaged in learning about, treating hepatobiliary cancers. Heavily illustrated with photomicrographs, photographs, drawings, and tables to support and illuminate the text, it is a concise, yet comprehensive guide to hepatobiliary cancer diagnosis and treatment.
As aging trends in the United States and Europe in particular are strongly suggestive of increasingly older society, it would be prudent for health care providers to better prepare for such changes. By including physiology, disease, nutrition, pharmacology, pathology, radiology and other relevant associated topics, Geriatric Gastroenterology fills the void in the literature for a volume devoted specifically to gastrointestinal illness in the elderly. This unique volume includes provision of training for current and future generations of physicians to deal with the health problems of older adults. It will also serve as a comprehensive guide to practicing physicians for ease of reference. Relevant to the geriatric age group, the volume covers epidemiology, physiology of aging, gastrointestinal physiology, pharmacology, radiology, pathology, motility disorders, luminal disorders, hepato-biliary disease, systemic manifestations, neoplastic disorders, gastrointestinal bleeding, cancer and medication related interactions and adverse events, all extremely common in older adults; these are often hard to evaluate and judge, especially considering the complex aging physiology. All have become important components of modern medicine. Special emphasis is be given to nutrition and related disorders. Capsule endoscopy and its utility in the geriatric population is also covered. Presented in simple, easy to read style, the volume includes numerous tables, figures and key points enabling ease of understanding. Chapters on imaging and pathology are profusely illustrated. All chapters are written by specialists and include up to date scientific information. Geriatric Gastroenterology is of great utility to residents in internal medicine, fellows in gastroenterology and geriatric medicine as well as gastroenterologists, geriatricians and practicing physicians including primary care physicians caring for older adults.
Morson and Dawson's Gastrointestinal Pathology is one of the 'Gold Standards' of pathology textbooks. It has been completely revised to incorporate the latest advances in this rapidly evolving field including the developments in gastric cancer and Helicobacter pylori and the revised classification of other common gastrointestinal conditions. This new edition features a wealth of new material presented in full colour for the first time.