Colorectal cancer is a common disease in all developed nations of the World. Until about 10 to 15 years ago, it was largely a surgical disease, with chemotherapy or radiotherapy having little impact on survival. Few oncologists even treated the disease, and even fewer would admit to specialist interest in a disease that was considered “refractory.” We also had more knowledge of the underlying molecular events in this disease than in most other solid cancers of adults, but this had not been translated into any meaningful clinical interventions. However, the last two decades have seen advances in chemotherapy, radiotherapy, and use of molecular targeted agents that we could not have dreamed of 20 years ago.
In the same timescale, we have made further and important advances in our knowledge and understanding of the genetics, molecular biology, and pathophysiology of this condition. This knowledge has been the driver for some of the clinical advances and promises to be important in the next generation of drugs that we hope will further improve outcomes. For example, it is not unreasonable to hypothesize that the prospect of chemopreventive agents for this disease can be realized within this generation.
Our rapidly expanding knowledge base and the therapeutic advances based on it mean it is hard to keep up-to-date. This applies to both scientists trying to update therapy paradigms and clinicians trying to keep abreast of the molecular aspects. This book was designed to address these issues in a way that was accessible to the specialist as well as the generalist. This is important because some of the advances in colorectal cancer should be applicable to other common malignancies that are currently regarded as “refractory.”
The editorial team is currently based entirely in Europe, but all of us have the experience of practice in other nations and have been intimately involved in international research projects and clinical studies. We felt the time was ripe to produce a textbook that would update all aspects of our understanding in one publication. Thus, the goal was to produce a book that we would all like to own which would equip us enough to have informed discussion and conversation with experts within our own areas of expertise.
This will be the key to making the molecular information that we are gaining at a frightening rate translate into clinical advances. We have collated contributions from world-class clinical and basic scientists in this book.
Each was handpicked to represent their own disciplines and for their ability to describe complex issues in an understandable way. Each was tasked with producing text that was as comprehensive and up-to-date as possible in a rapidly moving field. There was a deliberate effort made to “globalize” the content of this book in order to maintain its relevance throughout a broad-based readership. The scope of the book encompasses risk factors, epidemiology, molecular pathogenesis, surgery, radiotherapy, chemotherapy, and even aspects of palliative care related to colorectal cancer.
This text should serve as a useful and comprehensive reference for all who have an interest in colorectal cancer. In addition, it is designed so that the non-specialist can pick it up and access the topics that were of most interest to them without feeling overwhelmed.
Rebecca A. Barnetson and Malcolm G. Dunlop
Colon Cancer Genetics Group, University of Edinburgh, School of Molecular and Clinical Medicine and MRC Human Genetics Unit, Western General Hospital, Edinburgh, U.K.
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