In its fifth edition, Cancer Medicine has been named eponymously to honor its founding editors James F. Holland and Emil Frei III, two giants of medical oncology. The Holland-Frei Cancer Medicine reflects their dedication to innovative, comprehensive, and multidisciplinary care of cancer patients, as well as their belief in the importance of grounding such care in a more fundamental understanding of cancer biology. It is to their vision and the example that they have established over the last four decades that this book is dedicated.

From edition to edition, Cancer Medicine has appeared at increasingly shorter intervals. The fifth edition follows the fourth by just three and one half years, reflecting the remarkable pace at which new knowledge is being developed and emphasizing the importance of having the latest information to plan the care of cancer patients. In future editions we will strive to update the work at least as frequently.

The current edition also marks a new collaboration with the American Cancer Society. The completed volume bears the ACS logo and will appear electronically on an ACS website to permit ready access to information. Dr. Ted Gansler of the ACS deserves special thanks as a talented Associate Editor who has reviewed the entire volume for accuracy and clarity and has helped to achieve both.

All chapters have been updated and new references cited. As in the previous edition, clinical chapters have been written primarily by surgical, radiation, and medical oncologists to assure a multidisciplinary approach to each disease. Gynecologists, urologists, orthopedists, and otolaryngologic oncologists have contributed in their specialty areas. Psycho-oncology, nursing oncology, and rehabilitation medicine are all represented. They emphasize the importance that oncology must attach to the quality of life. Pathology and the imaging specialties are specifically included as individual contributions and as parts of the chapters on various diseases. We are fortunate in having been able to attract preeminent clinicians to these tasks. Diagnostic imaging has become more and more important in the management of patients with cancer. Dr. Richard Steckel has once again made a major contribution by coordinating the chapters on diagnostic imaging. This edition has also reorganized the coverage of pediatric oncology, in large part because the editors believe that there are many lessons to be learned from these neoplasms. We are grateful to Dr. Michael Weiner for his invaluable help with this section.

Over the last decade, our knowledge of cancer biology has continued to increase at an exponential rate. Progress has continued in the clinic, but at a more gradual pace. The challenge for the new century is to accelerate the pace of clinical investigation to translate new insights into cancer prevention, detection and therapy. This will require clinicians who understand cellular and molecular biology as well as laboratory investigators who will perform clinically relevant experiments. In this edition we have updated chapters regarding cancer biology and have added disease specific material to the discussion of each form of cancer. We have enjoyed the cooperation of some of the world’s great scientists in this endeavor. This edition again offers the clinician up-to-date information that underlies contemporary practice and offers the laboratory investigator an avenue to appreciate the relationship of his or her research focus to the broad perspective of cancer research and human cancer.

A companion volume has been published in a question format that serves to increase the educational value of this treatise. In addition, quarterly updates are planned to supplement and to update material at even more frequent intervals.

We have worked to make Cancer Medicine the most authoritative and effective resource available for the student of oncology at all levels. If we have succeeded, it is because of the knowledge and devotion of our authors and their response to our critiques. We are grateful to Adrienne Mattea for her expert assistance in producing this edition. We thank our colleagues and students for provocative inquiry and advice. We are exceptionally pleased with our new publisher B.C. Decker, whose commitment, talent, foresight, and experience have energized the entire process of creating, editing, publishing, and distributing this volume. In particular, Paula Presutti, Cynthia Miller, and Norman Reid deserve mention for their work in producing the book.

We are grateful to our institutions and departments for the continuing support that has enabled our study of cancer. We are mindful of the forbearance and love of our families who tolerated the incursions on personal time necessary for the completion of this edition. We are optimistic that this book will contribute to the continuing education of a variety of health professionals and will aid in the care of patients with cancer to whom all of our efforts are dedicated.

The Editors