Mesothelioma

This book should be of interest to those taking care of patients with
mesothelioma, and would make a good addition to the library of
professionals concerned with occupational lung disease.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.

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