Perhaps the most difficult task for a publisher is to determine a book's intended audience. The outcome is less crucial when a slim, inexpensive volume is at issue. But when heft and price tend toward the upper reaches, the need to identify an appropriate audience becomes critical. Finding a suitably large and homogeneous audience is exceedingly hard. Without such an audience, the levels of content tend to waffle from rudimentary (the early medical school level) to intricately technical (the subspecialist level).
Once the issue of audience is faced, there remains the difficult task of separating general principles from unproved details. The newness of oncological truths and their rapidly changing additions and subtractions make for considerable tension in separating lasting truths worthy of hard book status from the trendy data of the journal genre.
The "Big Book" suffers, as many do, from the financial need to market to every level of
Costanza ME. Principles of Cancer Treatment. JAMA. 1982;247(14):2025. doi:10.1001/jama.1982.03320390083054