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Mesothelioma FREE TO VIEW

Charles F. Thomas, Jr, MD, FCCP
Chest. 2004;126(1):322. doi:10.1378/chest.126.1.322
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By Bruce W. S. Robinson and A. Philippe Chahinian, eds. London: Taylor & Francis, A Martin Dunitz Book, 2002; 366 pp, $145.00

Malignant pleural mesothelioma is a disease of the industrialized age. Intimately associated with asbestos exposure, the incidence of this cancer has been steadily increasing worldwide. Treatment options for patients are not straightforward, and are best evaluated by a multidisciplinary team involving pulmonologists, thoracic surgeons, medical oncologists, radiation oncologists, and hospice-care practitioners. Unfortunately, no treatment has conclusively improved survival beyond supportive care. As such, many patients will require symptom palliation or end-of-life care. Given the association with asbestos, some patients or their families will explore litigation for compensation. To this complex scenario, the multiauthored book Mesothelioma contributes a comprehensive review of the history and epidemiology of mesothelioma, clinical material on diagnosis, pathophysiology and therapy, and medicolegal aspects of the disease.

A global perspective of the problem of mesothelioma is presented to the reader in several chapters of the book, and gives important insights into mesothelioma in Europe, Australia, Japan, South Africa, and the United States and Canada. The selection of international authors makes these sections of the book informative and interesting. Indeed, the thoroughly discussed material on the global epidemiology of this disease stands out as the strongest part of the book. The chapter on the medicolegal aspects of mesothelioma is highly relevant and very interesting; however, the discussion focuses on litigation history and issues solely in Australia. A more global view of asbestos litigations in Europe, North America, Asia, and Africa would be of more general interest.

The overall organization of the book is somewhat haphazard, with chapters discussing the epidemiology of mesothelioma both at the beginning and end of the book. Likewise, the sections on pathology, molecular pathogenesis, and mechanistic insights into mesothelial cell reactions to asbestos fibers are not grouped together. Given that treatment options for many patients involve symptom palliation and hospice care, this section of the book is quite cursory, and an enhanced discussion of techniques for pain management would have made this chapter more informative. Although brief, the discussion of managing malignant effusion for symptomatic control is sufficient. Overall, the chapters discussing the diagnosis, pathophysiology, and therapy of pleural mesothelioma are thorough and well written. The chapter on radiographic imaging of mesothelioma, however, has images of chest radiographs and CT scans that are not reproduced with adequate quality.

Mesothelioma is a comprehensive volume from recognized experts in dealing with this difficult disease. Although not without minor deficiencies, 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 diseases.




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