Mesothelioma Hardcover – January
Mesothelioma is a multiauthored book that aims to provide a
comprehensive overview of the epidemiology, biology, diagnosis, and
treatment of malignant pleural mesothelioma. Edited by Drs. Bruce
Robinson and Philippe Chahinian (from Perth, Australia, and New York
City, respectively), the book brings together an international group of
authors, most of whom are acknowledged experts on this disease. The
selection of authors highlights the fact that mesothelioma, though an
uncommon disease in many countries, is a considerable problem
internationally. The strongest focus of the book is on the epidemiology
of malignant pleural mesothelioma. Of the 20 chapters, 7 discuss the
epidemiology and history of the disease in North America, Europe,
Australia, South Africa, and Japan. One of these chapters chronicles how
its author, Christopher Wagner, now deceased, and his colleagues
established the link between exposure to asbestos and mesothelioma in
South Africa circa 1960, despite initial skepticism from physicians
elsewhere. Chapters devoted to the pathology of mesothelioma and to
staging and surgery, gene therapy, photodynamic therapy, molecular
pathogenesis (including the role of simian virus 40), and immunotherapy
are well written, generally accurate, and thorough. A chapter on the
medicolegal aspects of mesothelioma is a useful and highly relevant part
of the book in the light of the large volume of litigation concerning
asbestos that is related to mesothelioma. In contrast, chapters on
clinical and palliative care and on imaging are not so well organized
and lack detail. More attention could have been given to descriptions of
the clinical and radiologic presentation according to disease stage,
and the discussion of the comparative merits of computed tomographic and
magnetic resonance imaging could have been enhanced with additional
illustrations. The discussion of palliative care is cursory and would
have benefited from an expert discussion of the methods of pain
management. Although the role of pleuroscopy is addressed in a chapter
by C. Boutin, a leader in this technique, current clinical practice in
North America does not parallel this European experience, and some
comment in that regard would have been beneficial. Radiation therapy and
chemotherapy are grouped together in a single chapter written by
Chahinian, a medical oncologist. A full chapter on radiation techniques
and results written by a radiation oncologist would have been
worthwhile. Finally, the organization of the chapters is puzzling.
Chapters on epidemiology are placed at both the beginning and the end of
the book, and the progression of the chapters in between is not
entirely logical. As is true of all textbooks, this book is not
absolutely current because of the inherent delay between the writing of
the individual chapters and publication. Although a decade ago this
delay would not have made a difference for a book dealing with
mesothelioma, today it does. Advances in biology and clinical care are
now occurring at a rapid pace in this disease, and therefore some of the
information presented is subtly out of date. Overall, however, this
book provides an excellent review for the practicing clinician. There
are few textbooks addressing mesothelioma, and this one is a welcome
addition to the literature.
Valerie W. Rusch, M.D.Copyright ©
2004 Massachusetts Medical Society. All rights reserved. The New
England Journal of Medicine is a registered trademark of the MMS.
Mesothelioma Hardcover – January
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