Mesothelioma (2003)

BWS Robinson, AP Chahinian, editors. Mesothelioma. London: Martin Dunitz Ltd., 2002. $145.00 Malignant mesothelioma is reportedly newly diagnosed in the U.S. no more than 3000 times per year, and this diagnosis often is conveyed to the patient with unalloyed pessimism regarding prognosis and therapy. Nevertheless, interest in this rare disease continues to rise, not only because of the worldwide asbestos-related occupational safety and public health issues it has raised. Advances in molecular genetics, drug development, and multimodality treatment have injected new enthusiasm and a few measurable successes into the effort to comprehend and combat mesothelioma. The detailed study of mesothelioma requires knowledge of nonclinical as well as clinical disciplines, such as world geography and minerology, epidemiology, and the law. The editors of this work, Drs. Robinson and Chahinian, both have been recognized authorities on mesothelioma for more than 20 years. This broadly conceived work is their informative compilation of essays and reviews by international contributors to many aspects of mesothelioma, with no loss of emphasis on pathogenesis and treatment. The individual submissions vary in style and appear to be grouped into several general categories. I found the sections concerning historic and geographic experiences of mesothelioma in North America, Europe, Australia, and South Africa to be especially enlightening. The diagnosis and clinical management of mesothelioma are broadly covered and include palliative care, pleuroscopy, pathology, surgery, imaging, radiotherapy and chemotherapy, gene therapy, and photodynamic therapy. An essay regarding medicolegal aspects of mesothelioma in Australia and short expositions of asbestos carcinogenesis, simian virus 40 (SV40) cocarcinogenesis, prospects for immunotherapy, and mesothelioma epidemiology complete the volume. The pace of scientific and clinical advances in mesothelioma has grown so rapidly that any multiauthor reference risks being outdated. Therefore, incomplete cases, which comprise approximately 10–15% of all reported cases, are not discussed in this book. Other clinical developments might have merited inclusion, such as pleural effusion management with the Pleurex catheter, or the increasing role of positron emission tomography and computed tomography digital image analysis in quantitating mesothelioma tumor burden. The discussion of chemotherapy does not mention two highly active agents, gemcitabine and permetrexed. In addition, the molecular biologic contributions do not emphasize microarray gene expression, or the detection of peptide antigens in mesothelioma tissues. Nonetheless, a comprehensive overview of the historic and geographic aspects of pleural mesothelioma can be gleaned readily from this volume, as well as an appreciation for the clinical complexities involved in the diagnosis, classification, and treatment of this disease entity. This work is a credit to its editors and contributors, who should be thanked for producing a useful and readable addition to the reference library of practicing oncologists, graduate physicians, scientists, lawyers, and educators.