Pediatric Oncology

Foreword

Hardly any field of pediatrics reflects the medical advances of the past three decades as dramatically as pediatric oncology. Thirty years ago, when I began my pediatric training, three quarters of all children with malignancies died of their disease. Today 80% are healed. Three reasons for this can be delineated. First, therapy optimization studies have led to constant improvement through adaptation of treatment to individual cases. Second, new drugs, new combinations and new dosages have been developed and tolerance to therapy has been improved by supportive measures. Finally, molecular biological research has increased our fundamental understanding. We now broadly know what molecular mechanisms cause malignant growth and use this knowledge in therapeutic decision-making. We cannot yet – with certain exceptions – intervene specifically in the aberrant regulation of malignant growth, but the foundations have been laid.

Pediatric oncology is, rightly, viewed as a clinical and scientific subspecialty of pediatrics. This does not mean it need not interest the general pediatrician or specialists in other areas of pediatrics. On the contrary: in the early stages of a malignant disease the symptoms are often nonspecific. Although one may primarily suspect a tumor or leukemia, other diseases cannot be excluded. Conversely, the vague general symptoms that can be caused by a malignancy may lead themselves to misinterpretation. Furthermore, a whole team is required to care for the patients: pediatricians, pediatric or specialist surgeons, specialized nurses, psychologists, social workers and chaplains. Pediatric oncology is holistic, integrated medicine in the true sense of the word. And with regard to medical training, nowhere in pediatrics can one gain a closer experience with treatment of infections and other particular topics than in pediatric oncology. Oncology has an undisputed place in the training of every pediatrician. Equally, comprehensive general pediatric training is important for every future specialist.

There are a number of excellent, exhaustive textbooks on oncology that are indispensable in training. However, there is also a need for a compact guide offering rapid orientation in the situations encountered by all who work in pediatric oncology. Precisely that is provided by this book by Paul Imbach and Thomas Kühne. I wish them the success they deserve.

v