Annals of Oncology 14:174, 2003
© 2003 European Society for Medical Oncology
Book Review |
B.W.S. Robinson, A.P. Chahinian (eds). Mesothelioma
Rotterdam, The Netherlands
B.W.S. Robinson, A.P. Chahinian (eds). Martin Dunitz Ltd, London, 2002, 380 pp, £95.00, US$145.00
The incidence of mesothelioma is approaching its peak, and the prognosis for this cancer remains extremely poor. The impossibility of predicting cancer appearance after asbestos exposure, the difficulty of early diagnosis and the lack of an effective therapy, combine to cause the great confusion among mesothelioma patients and asbestos exposed populations. More than ever, it seems crucial that the medical community clarifies its attitude towards the care of this disease. The purpose of this book is to summarize the current knowledge of all aspects of mesothelioma disease. Most of the authors invited to write the chapters are recognized experts in this pathology.
Epidemiology constitutes an important part of the volume, with five chapters describing both asbestos exposure and mesothelioma epidemics in several of the highest exposure regions of the world (Australia, South Africa, North America and Europe). All authors, and in particular J. C. Wagner who describes some of his pioneering work, remind readers of the initial doubts of both medical and political communities about the existence of this primitive pleural cancer and its causative link with asbestos exposure.
Progress in the understanding of mesothelioma etiopathogenesis and oncogenesis are extensively described, with critical discussions of the etiologic role of nonasbestos-related factors. Difficulties of cytological and histological diagnosis and the importance of immunohistochemistry are detailed. The role of imaging and thoracoscopy in diagnosis, staging and treatment are described in specific chapters.
Concerning therapies, the limited positive results of classic anticancer treatments (surgery, radiotherapy, chemotherapy) are clearly exposed, with discussion of the most recent results based on therapeutic combinations in selected patients. Results of intrapleural treatments (chemo-, immuno- or photodynamic therapies) together with more experimental therapies, such as gene- and immunotherapies, are discussed in specific chapters with clear explanations of their scientific relevance and early reports of their clinical efficacy in animal models and human patients. Finally, the legal aspects associated with the disease are introduced in an original and interesting chapter (written by a lawyer) reviewing the slow and difficult legal battle of asbestos victims in Australia.
The field covered by this book is exhaustive and clearly written, even so, one could regret the brevity of the chapters dedicated to the clinical, palliative care and radiological aspects of the disease, as well as the absence of a discussion on the means of surveillance in the asbestos exposed population. At the least, this book concerns all health professionals involved in the care of mesothelioma patients, and provides a useful summary of the current knowledge about this disease.
M. Bard
Rotterdam, The Netherlands
DOI: 10.1093/annonc/mdg025
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