Book Review

Current Research and Clinical Management of Melanoma (Cancer Treatment and Research Volume 65)

Malignant Melanoma: Medical and Surgical Management

N Engl J Med 1994; 331:1246November 3, 1994

Article

Current Research and Clinical Management of Melanoma (Cancer Treatment and Research Volume 65)
Edited by Larry Nathanson. 388 pp., illustrated. Boston, Kluwer Academic, 1993. $195. ISBN: 0-7923-2152-9

Malignant Melanoma: Medical and Surgical Management
Edited by Ferdy J. Lejeune, Prabir K. Chaudhuri, and Tapas K. Das Gupta. 383 pp., illustrated. New York, McGraw-Hill, 1994. $35. ISBN: 0-07-105421-9

Although cutaneous malignant melanoma accounts for only 3 percent of all neoplasms, its incidence has risen more rapidly than that of any other cancer, with an 83 percent increase between 1973 and 1987. If this trend continues, it is estimated that the lifetime risk of melanoma, which is 1 in 1600 for a person born in 1950, will be 1 in 90 for someone born in the year 2000. The growing importance of melanoma is illustrated by a Medline search showing that in 1992 alone there were 969 medical-journal articles on the topic. It is therefore not surprising to encounter two new books presenting state-of-the-art knowledge about melanoma.

The first book under review is a multiauthored work all but one of whose contributors is American. It covers numerous recent advances in our knowledge of melanoma, is well edited, and has a pleasant uniformity of style. Each chapter has copious tables and figures, including a few in color, and an extensive and up-to-date bibliography. Controversial topics are well presented, and the areas in which our knowledge is incomplete are indicated.

The second book is poorly named, since only approximately half of it deals with the treatment of melanoma. The remainder covers the topics discussed in the first book, and others, such as the biology of the melanin pigmentary system and methods of conducting and assessing clinical trials. There is even a chapter on experimental melanoma in fish. Like the first book, the second has good coverage of controversial topics and draws our attention to areas for further study. There are numerous tables, references, and illustrations. A particularly valuable aspect of the book is the excellent color photographs showing benign lesions from which melanoma must be differentiated, varieties of clinical melanoma, histopathological and immunohistochemical preparations, and response of lesions to isolation perfusion or chemoembolization.

This book was also written by multiple authorities on melanoma, but the cast of characters is much broader than in the first book, with distinguished authors from several European countries, Canada, the United States, Lebanon, and Australia. There is some unevenness, with an occasional chapter suffering from verbosity or clumsy use of the English language. A few chapters will be of particular value to readers who are well versed in micropathology, dermatology, or genetics but may prove difficult for the neophyte.

Both books cover recent advances, including the broad array of molecular disturbances in malignant melanoma and new immunotherapeutic agents, such as the interferons, interleukin-2, melanoma vaccines, and tumor necrosis factor.

Both books have some overlap among chapters. For the most part, this serves to drive home important points, but sometimes the repetition is a bit tedious. For example, the second book devotes three chapters to isolated limb perfusion, a topic also mentioned in other chapters. The two books share a minor flaw in the frequent use of such unnecessary phrases as “It is interesting to note that,” “It should not be forgotten that,” and “It is useful to bear in mind that.” In the second book Figure 2-1 and 2-3 and plate 65 are mislabeled, and Figure 25-1, a radiograph, is printed sideways.

Despite minor defects, both books provide valuable summaries of a vast amount of knowledge pertaining to virtually every aspect of melanoma. They emphasize the need for ongoing multicenter clinical trials to resolve controversial issues. These books will serve to educate physicians and other health care workers -- and, indirectly, the general public -- about the need for early recognition and treatment of melanoma. Either book can be read profitably by basic scientists and clinicians interested in this fascinating and at times unpredictable cancer.

Israel Penn, M.D.
University of Cincinnati Medical Center, Cincinnati, OH 45267