ASBESTOS NEWS DAILY - MESOTHELIOMA TREATMENTS
Mesothelioma Treatment – Asbestos Exposure – Asbestos Related Diseases
by Dave Barker
The Department of Veterans Affairs has stated there are currently 25 million Americans who have served in the armed forces of theUnited States. Possible millions of theseAmerican veterans were exposed to toxic asbestos during their military or naval service. Asbestos was used by every military branch.As asbestos was highly regarded for its heat resistance and fireproofing capabilities. Asbestos was so valued that the military andNavy mandated widespread usage before it was phased out during the 1970’s.
Most used the asbestos products for insulation purposes, as than 300 products containing asbestos were used by primarily by the Navy from the 1930’s through the 1970’s. Every ship and shipyard built by the Navy before themid-70’s was fitted with numerous asbestos containing materials. To a lesser degree the Army and Air Force used asbestos.
What were the levels of risk for asbestos exposure on ourNaval vessels? In a word, high! The asbestos products were extensively used in engine and boiler rooms and other areas below deck for fire safety purposes. Navy personnel who worked below deck were heavily exposed to asbestos, but all sailors are at risk, as this deadly compound was used in navigation rooms, sleeping quarters, and mess halls, as decks and pipe coverings all contained asbestos.
It must be understood, no portion of a Naval ship was asbestos free between the 1930’s and mid 1970’s, making Navy veterans and shipyard workers one of the most at risk groups for developing asbestos related diseases. I have had clients who were told by the VA rating specialists that other than engineering rates were not exposed, that is simply not true. In multiple cases I have shown where deck rates wore asbestos gloves when their duty was hotshellman on the gun mounts, or asbestos suits on damage control duties.
Of all occupations exposed to asbestos, veterans account for 30% of allmesothelioma cancer patients. Thus more than 30% of Americans suffering withmesothelioma (a cancer of the internal lining of the lungs, abdomen, and heart) were exposed to asbestos during their military or naval service.
Veterans who served between up to the 1970’s have a great risk of developing asbestosis, cancer and other related disease. Navy personnel and workers employed in shipyards through the 1970’s hold a greatpossiblity of developing a disease caused by asbestos exposure.
Veterans with an asbestos related illness should contact a veteran’s service officer and file their claims. It is important you select a VSO who will think outside of the VA box, especially on these type conditions.
The veteran must provide proof that their disease is asbestos related and that exposure occurred during military service. The burden of proof is always on the veteran, in this case, due to mind sets, the proof is difficult even though it is totally obvious.
The Department of Veteran Affairs recognizes asbestos as well asmesothelioma as a service connected disability.
Even when diagnosed withmesothelioma which all cases are caused by asbestos exposure, the VA does not consider is a presumptive, nor always approve the claim for disability compensation. The veteran must provide evidence themesothelioma ‘is as likely as not’ to have been caused by exposure to asbestos while in service.
Diagnosis of asbestos related diseases is difficult as many symptoms are identical with other disorders. Symptoms range from respiratory problems as well as chest pain, thus asbestos related conditions are frequently misdiagnosed. This causes the condition to spread. Similar pleuralmesothelioma a common form of asbestos cancers, has symptoms such as a chronic cough, night sweats, and fever, which are frequently misdiagnosed as pneumonia or the flu. As a result the cancer becomes active and spreads.
Mesothelioma treatment is available at the VAMC. VA physicians and clinicians are specialty trained. The local VA may have to send the veterans to another facility, but they will make sure the condition is monitored and treated properly.
You may find valuable information on my website:
Mesothelioma Treatments – Asbestos Medical – Mesothelioma Cancer
Study Warns: CarbonNanotubes Behave Like Asbestos, could Cause Mesothelioma Cancer
Tuesday, January 26, 2010 by: Charlie Troubadour, citizen journalist
(NaturalNews) The scientific community is warning of the risk carbonnanotubes pose as a trigger formesothelioma cancer, a disease the American medical establishment has failed to cure and continues to fear. While much attention is focused on this potential environmental hazard, medical professionals and scientists continue to ignore plant-basedmesothelioma treatments that exist which could ease the suffering ofcancer patients.
The substance which scientists are focusing on, carbonnanotubes, is thought to be a miracle material which is lighter than plastic and stronger than steel, and is currently being developed for use in everything from pharmaceutical drugs to high-tech electronics. However, a recent study appearing inNature Nanotechnology suggests certain carbonnanotubes may be as dangerous as asbestos.
Asbestos exposure, the leading cause of malignantmesothelioma, produced one ofAmerica`s worst occupational health catastrophes when industrial workers were exposed to asbestos particles in flooring, roofing, insulation, and a variety of other materials.
However, this health disaster has for decades been exacerbated by the traditional medicalestablishment`s stubborn struggle to treat malignantmesothelioma in the United States. For years, doctors and health professionals have relied primarily on chemotherapy and radiation therapies with little-to-no success. However, a variety of plant-based treatments widespread in Europe which have shown amazing results have been largely ignored by doctors inAmerica.
The most promising example, mistletoe extract, can be injected into the bloodstream, and has been responsible for some amazing recoveries. The most recent documented case involves Debbie Brewer, a 49 year-old English woman who developedmesothelioma from asbestos exposure. Given months to live, she eschewed chemotherapy and chose instead to rely solely on mistletoe injections provided by The University Clinic inFrankfurt,Germany.
Today, Brewer is cancer-free, and her case is raising the profile of natural, plant-based cancer treatments inEurope. More research is being done inAmerica on finding the environmental causes ofmesothelioma. This might explain why so much attention has suddenly been placed on carbonnanotube technology, which is projected to be a $2 billion industry in less than three years. Scientists are worried a new environmental trigger is about to be introduced.
Of course, finding environmental dangers is an important function of any environmental researcher. However, finding and recognizing natural cures that exist in the environment should be just as important. Yet, barely any attention has been given to mistletoe extract in the American scientific community at a time when the recent study ofnanotubes has been widely tracked.
There`s no denying thatnanotubes may present a serious health risk. Asbestos fibers are dangerous because of their extremely long, thin construction, which makes it easy for them to become lodged in the lining of the lungs after being inhaled. Researchers at theUniversity ofEdinburgh in theUK found long, thin carbonnanotubes to behave identically to asbestos in clinical experiments.
However, one of the reasons scientists are so alarmed by the behavior of carbonnanotubes is because they fearmesothelioma, a cancer for which mainstream science has yet to find a suitable treatment or cure (as chemotherapy and radiation therapy have produced less-than-hopeful results).
When scientists, in researching ways to treatmesothelioma, will decide they can no longer afford to ignore plant-based treatments such as mistletoe extract is a question which remains.
Hypnosis Can Be Useful for Pain Management in Mesothelioma
Friday, November 27, 2009
Mesothelioma can be a painful cancer. Over half of the pleural mesothelioma patients experience pain in the chest which can be intense and severe enough to require narcotics to alleviate the pain and discomfort.
Not willing to take any more drugs, some mesothelioma patients are turning to hypnosis as a way to manage their pain. Hypnosis, once shunned by the medical profession, is becoming more popular in clinical settings helping people stop smoking, lose weight, and now, deal with pain.
Hpynotherapy, when performed by a trained specialist, can be a powerful and effective procedure. A hypnotist brings a patient to a state of high concentration allowing him to have a strict focus. The person then "projects" himself to another place or state where he can block pain awareness or substitute other sensations for painful ones.
Hypnosis is considered an unconventional therapy and is often used with other holistic treatments including yoga and meditation. Hypnosis is not effective for everyone.
© Surviving Mesothelioma and Cancer Monthly. All rights reserved.
Image-Guided Radiation Therapy (IGRT)
Image-guided radiation therapy (IGRT) is a leading-edge cancer treatment used at Mayo Clinic. It uses advanced imaging immediately before and during radiation therapy to improve its accuracy and delivery.
Highly trained specialists in the Department of Radiation Oncology work closely with medical oncologists, surgeons and other physicians to coordinate the most appropriate care plan for each cancer patient.
Cancer patients benefit from treatment at Mayo, which provides care for a large number of patients and has special expertise in cancer care. Collectively, Mayo Clinic treats more than 19,500 new cancer patients each year, making it one of the largest cancer treatment facilities in the nation. The National Cancer Institute has designatedMayoClinicCancerCenter as a comprehensive cancer center for its excellence in cancer research.
How It Works
In IGRT, a physician uses high-quality three-dimensional images to pinpoint tumor sites and adjust the patient's position during treatment to precisely target the tumor. IGRT provides the patient with a more accurate and precise treatment than traditionally possible.
Before a patient starts standard radiation treatments, a CT scan is performed to allow the physician to see the patient's internal anatomy. After the CT scan, small tattoos are placed on the patient's skin so the radiation beams can be aimed at the tumor. Other imaging, such as MRI or PET scans, may be used in the planning. Before each treatment, digital imaging systems view the patient from multiple angles, and computer analysis of the images allows the treatment team to bring the patient into better alignment with the radiation beams. The use of IGRT adds two to three minutes to each radiation treatment.
If a standard image cannot show the tumor's location, the physician may insert tiny gold markers in the tumor so it appears in the images. In other instances, the treatment system may rotate around the patient, acquiring a cone beam CT scan that allows the treatment team to better position the patient before treatment.
Advantages of IGRT
IGRT improves the accuracy of radiation treatment delivery. Radiation oncologists consider IGRT ideal for tumors that are very close to sensitive structures and organs. The skilled specialists at Mayo Clinic will determine whether IGRT is the most appropriate form of treatment for each patient.
The advantages of IGRT include:
- Decreased radiation exposure to normal tissue surrounding the tumor
- Enhanced views to locate a tumor and detect any movement
- The possibility of higher radiation dosage to cancer cells
- Precise radiation delivery
- Increased likelihood of destroying cancer cells
Mesothelioma Virus-Based Therapy is Promising
Posted on Monday, November 23, 2009
A potential new therapy for mesothelioma could come in the form of a cancer-targeting virus that selectively destroys cancer cells while sparing healthy cells. Triggering that virus to express the antiviral protein, interferon-beta, could further enhance the immune response against the cancer, and reduce the risk of treatment side effects, according to a study of mice published in the October 1 issue of Cancer Research.
The viruses used in the study are called oncolytic viruses, and their potential lies in their ability to specifically target cancer cells without harming healthy cells. “The viruses that we use have a preferential tropism for cancer cells over normal cells. That is, they replicate in mesothelioma cells much more potently than they do in normal cells,” explains lead author Richard Vile, PhD, Professor of Immunology and Richard M. Schulze Family Foundation Professor at the Mayo Clinic.
When normal, healthy cells come into contact with a virus, they respond by producing high levels of the antiviral protein, interferon. The interferon shuts down that cell, as well as neighboring cells, before the virus has a chance to replicate. “In contrast, many mesothelioma cells are defective in their response to interferon, so even though the virus infects them, those cells no longer shut down viral replication like normal cells do,” Dr. Vile explains. This means that, unlike chemotherapy drugs, which destroy cancerous and healthy cells alike, oncolytic viruses destroy cancer cells specifically and are less likely to trigger harmful side effects.
To target mesothelioma cells in the study, Dr. Vile and his colleagues used vesicular stomatitis virus (VSV), which is in the same virus family as rabies. The VSV they used was designed to express interferon-beta.
The researchers injected either VSV-expressing interferon-B or a control substance into mesothelioma tumors in mice. Tumors shrank significantly in mice that received the VSV treatment. Four of eight mice were cured of their tumors, compared with zero of eight mice in the control group. What’s more, all of the surviving mice rejected a later challenge when they were again injected with mesothelioma cells, indicating that the virus conferred long-term protection.
Triggering the virus to express interferon-beta enhanced the immune-stimulating activity involved in killing tumor cells, the researchers discovered. It also further protected healthy cells from the virus, preventing adverse side effects.
Dr. Vile cautions that the results of animal studies often do not translate into human benefits, but he says his team is pleased with the results thus far. “I think they give us an excellent platform to go into clinical trials and give us reason to believe that we will have an effect in human patients,” he says.
The next step in his research is to determine the best vector platform to target mesothelioma. This study used VSV, but Dr. Vile’s collaborator, Steven Albelda at theUniversity ofPennsylvania, has been working with an adenovirus that also expresses interferon-beta. “One of our next preclinical steps is to see which platform is most effective in animals, and develop whichever one is clinically likely to be most potent,” Dr. Vile says.
Willmon CL, Saloura V, Fridlender ZG, Wongthida P, Diaz RM, Thompson J, Kottke T, Federspiel M, Barber G, Albelda SM, Vile RG. Expression of IFN-beta enhances both efficacy and safety of oncolytic vesicular stomatitis virus for therapy of mesothelioma. Cancer Res. 2009;69:7713-7720.
© Surviving Mesothelioma and Cancer Monthly. All rights reserved.
View Original Article: http://www.survivingmesothelioma.com/news/view.asp?ID=0081
Study Reveals Mesothelioma Therapy Risks and Benefits
Posted on Wednesday, November 18, 2009
Treating mesothelioma aggressively with a combination of surgery, chemotherapy, and radiation (trimodality therapy, or TMT) might improve survival in a small number of patients, but it may not be the best option for those with more advanced cancer. Imaging tests alone can’t identify the most appropriate candidates for surgery, and as a result, many patients may be unnecessarily undergoing a risky procedure that won’t improve their odds of survival, according to a recent study in the ANZ Journal of Surgery.
David Sugarbaker, MD, of the Brigham and Women’s Hospital inBoston has reported positive results from combining extrapleural pneumonectomy (EPP—surgery to remove the diseased lung, as well as the diaphragm and the membrane covering the heart and lung), followed by chemotherapy and radiation. However, another study noted that mesothelioma returns in more than 50% of patients who are treated with TMT.
John M. Alvarez, FRACS, Clinical Associate Professor at theUniversity ofWestern Australia, wondered whether some patients who are undergoing TMT might have hidden mesothelioma that isn’t being detected on imaging scans. If that were the case, these patients would be undergoing risky surgery with little chance for improvement in long-term survival.
“Put simply, there is no point resecting a lung if there is a tumor in the other lung,” says Dr. Alvarez. Pneumonectomy carries a mortality of 5 to 10%, and there is no benefit to removing a lung when there is mesothelioma in the other lung or abdomen, he adds.
Dr. Alvarez and his colleagues wanted to determine whether CT scan, MRI, and other traditional imaging studies used to stage mesothelioma before surgery might be missing later-stage cancers. Their study included 30 patients who had been referred for TMT.
The researchers staged these patients’ cancer using CT, MRI, and PET scans, but they also added bilateral thoracoscopy (examining the inside of the chest with a scope), mediastinoscopy (examining the tissue between the lungs), and laparoscopy (examining the abdominal cavity) to confirm that the mesothelioma had not spread beyond one side of the chest. Tissue was removed during these procedures and put through histological studies to look for microscopic evidence of mesothelioma.
Tissue biopsies revealed what imaging tests hadn’t—that the mesothelioma had spread in eight patients (26%), making them ineligible for TMT. “Even if PET, MRI, and CT scans say there is no tumor there, we have shown that by taking samples of what may appear to be normal tissue, the histology comes back as positive for mesothelioma,” Dr. Alvarez says.
The 19 patients who were found to be eligible underwent TMT with EPP (three declined to undergo the surgery), followed by chemotherapy and radiation. Yet Dr. Alvarez found no difference in one-year survival between mesothelioma patients who received TMT and those who did not. Patients who were found to have advanced-stage disease had a poor prognosis—half of them died from mesothelioma by one year, and all of them died by two years, suggesting that they would not have benefited from TMT.
TMT remains an unproven therapy, according to Dr. Alvarez, and any benefit may be limited to only the most appropriate patients. He says his study underscores the importance of carefully staging mesothelioma patients before putting them through the rigors of surgery.
“If a surgeon does an EPP and does not do a surgical staging procedure and relies solely on PET, MRI, and CT…then there is a 20 to 30% chance that the surgery is futile, as the mesothelioma is widespread,” Dr. Alvarez says. “In essence, we would be putting patients through a treatment of unproven benefit, but in this group of patients there would be no benefit at all and a real significant risk.”
Alvarez JM, Hasani A, Segal A, Sterret G, Millward M, Nowak A, Musk W, Bydder S. Bilateral thoracoscopy, mediastinoscopy and laparoscopy, in addition to CT, MRI and PET imaging, are essential to correctly stage and treat patients with mesothelioma prior to trimodality therapy. ANJ Journal of Surgery. 2009;79:734-738.
Baldini EH, Recht A, Strauss Gm, DeCamp Jr. MM, Swanson SJ, Liptay MJ, Mentzer SJ, Sugarbaker DJ. Patterns of failure after trimodality therapy for malignant pleural mesothelioma. The Annals of Thoracic Surgery. 1997;63:334-338.
Sugarbaker DJ, Flores RM,JaklitschMT, et al. Resection margins, extra-pleural node status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma – results in 183 patients. J Thorac Cardiovasc Surg. 1999;117:54-63.
© Surviving Mesothelioma and Cancer Monthly. All rights reserved.
Mesothelioma Surgery: A Closer Look
Saturday, September 26, 2009 at 7:05pm
Learning of a mesothelioma diagnosis may result in feelings of confusion, anger and vulnerability. Once a patient understands more about the cancer, treatment options are often explored and surgery may be considered if a patient is a candidate.
In terms of mesothelioma treatment, surgery is divided into three main categories depending on the purpose of the procedure. Prior to diagnosis, diagnostic surgery is completed to determine whether or not mesothelioma is present in the body. Palliative surgery is performed to provide a patient with relief from mesothelioma symptoms while curative surgery involves removing cancerous cells and tissue in hopes of curing the patient (though no known cure for mesothelioma currently exists).
Following a mesothelioma diagnosis, a variety of surgical procedures may be recommended for mesothelioma patients. Thoracentesis is often used to diagnose mesothelioma in patients where pleural mesothelioma is suspected. The procedure is also used as a palliative treatment option and involves the insertion of a long and hollow needle into certain spaces in the lung where fluid in the area is extracted.
Another palliative treatment option that may be available to mesothelioma patients includes pleurodesis which involves the draining of pleural spaces in the lungs before treating the area with a chemical that causes inflammation. This is done to cause the spaces to close up and prevent future fluid buildup.
A pneumonectomy is performed to remove a patient’s infected lung, though this procedure is typically not performed unless the patient is in otherwise good health. Paracentesis is a palliative procedure that patients with peritoneal mesothelioma may elect to undergo to remove fluid buildup in the abdominal cavity using a long, hollow needle.
Though the surgeries mentioned above are the options typically explored by mesothelioma patients who are candidates for surgery, additional procedures and treatments may be recommended to combat the cancer.
Commonly used treatment options include chemotherapy and radiation, which may also be recommended following surgery. Alternative therapies such as massage, acupuncture and the use of supplements are also explored by many mesothelioma patients.
Additional information about mesothelioma and mesothelioma treatments may be found through theMesotheliomaCenter.
Genetic test offers hope of better therapy for cancer patients
By David Derbyshire - 10th September 2009
New hope: Scientists have uncovered a genetic test which they say helps indicate the control the dosages of drugs to give to cancer patients, like those on a course of chemotherapy
A new genetic test that could dramatically improve the chances of cancer patients and reduce the side effects of chemotherapy is being developed by British scientists.
The technique uses DNA extracted from a tiny blood sample to predict how each patient will respond to cancer drugs.
Doctors can use the results to lower doses and reduce the side effects for some patients or treat the disease more aggressively for others.
If the pilot trial of the test now underway is a success, it could be used in just five years – bringing doctors a step closer to 'tailor made' drug treatments for cancer.
Chemotherapy works by killing cancer cells or stopping them from dividing and spreading. But despite its success in treating cancers, it is often a 'blunt instrument' that damages healthy cells and causes unpleasant side effects.
Every person reacts differently to cancer drugs making it tricky for doctors to get the dose right.
Treatment can cause hair loss, nausea and upset stomachs, while some patients can be left with kidney damage or permanent nerve damage.
The new test being developed at Loughborough and Leicester universities is designed to see how individual patients response to platinum based cancer drugs.
These are given to around two thirds of cancer patients, and are used to treat testicular, bowel and ovarian cancer.
Dr Barry Sharp, of the Centre for Analytical Science,LoughboroughUniversity, said: 'The purpose of those clinical trials ultimately is to move us to a position where we can personalise chemotherapy programmes for individual patients.
'At the moment when you go into clinic you get a standardised treatment.
'It is not based on your individual response to the drugs you are gong to receive and the outcome of that treatment is largely unknown to that clinician at the start of the treatment cycle.'
The new genetic test could mean less harmful side-effects from cancer treatment for suffers like reality TV star Jade Goody who died from the disease in March
The test should make the outcome of chemotherapy 'more predictable', improving the chances for patients and saving the NHS money, he told the British Science Festival atSurreyUniversity inGuildford.
In the pilot trial, doctors will take a 20ml blood sample from patients after their first round of treatment with a platinum based drug such as such as cisplatin and carboplatin.
The drugs work by binding to the DNA in cancer cells and stopping them from dividing and spreading.
The test looks at the how much platinum is becoming attached to the DNA of white blood cells. The more platinum is bound to the DNA, the more effective the drug will be.
The test has only become possible in the last few years because of advances in DNA testing.
The first clinical trial will investigate whether the blood test works in practice. The results will not be used to change a patient’s chemotherapy.
Even if the results are promising, Dr Sharp said it could be years before tailored chemotherapy is available.
'It’s a long way from basic laboratory science being successful to a body like Nice being able to say that it is recommended part of treatment.'
He added: 'Some people could be saved the trauma of these very aggressive treatments and some people could have a better prognosis with more aggressive treatments – but the clinician doesn’t know at the point of care how the individual patient is going to respond.'
Earlier Detection of Mesothelioma Possible from Telltale Protein, Researchers Say
Friday, September 4, 2009
Researchers atOxfordUniversity say they have developed a test that may allow earlier detection of mesothelioma in patients, giving doctors valuable time to treat the rare asbestos-related cancer.
Dr. Helen Davies, who worked on the research, told the British Broadcasting Corp. that the research suggested a way for physicians to more readily identify mesothelioma from the start. “An earlier diagnosis … allows speedier interventions to relieve symptoms as well as initiation of other treatments such as chemotherapty or radiotherapy if appropriate,” Davies said.
According to an article published in the American Journal of Respiratory Critical Care Medicine, the test analyzes levels of a protein closely linked to mesothlelioma that is found in fluid around the lungs. A number of conditions may cause excess fluid in the lining of the lungs. But nine out of 10 people with mesothelioma suffer from the condition which cause difficult breathing and chest pain.
Researchers looked at levels of the protein meothelin which is released in high qualities in the pleural fluid of most mesothelioma patients. They found that levels of the protein were almost six times higher in patients with mesothelioma than in patients with lung cancer that had spread from other parts of the body, and 10 times greater than those with benign condictions, making it a useful indicator protein of the presence of mesothelioma.
Four-Gene Expression Ratio Test for Survival in Patients Undergoing Surgery for Mesothelioma
Gavin J. Gordon, Lingsheng Dong, Beow Y. Yeap, William G. Richards, Jonathan N. Glickman, Heather Edenfield, Madhubalan Mani, Richard Colquitt, Gautam Maulik, Branden Van Oss, David J. Sugarbaker, Raphael Bueno
Affiliations of authors: Department of Surgery, Division of Thoracic Surgery, Harvard Medical School (GJG, LD, WGR, HE, MM, RC, GM, BVO, DJS, RB) and Department of Pathology (JNG), Brigham and Women’s Hospital, Boston, MA; Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (BYY)
Correspondence to: Raphael Bueno, MD, Department of Surgery, Division of Thoracic Surgery, Harvard Medical School and Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (e-mail: email@example.com
Background: Malignant pleural mesothelioma has few effective treatments,one being cytoreductive surgery. We previously developed a generatio test to predict outcome of malignant pleural mesotheliomapatients undergoing surgery. In this study, we investigatedthe predictive value and technical assay performance of thistest in patients with malignant pleural mesothelioma.
Methods: Clinical data were obtained prospectively from 120 consecutivepatients with malignant pleural mesothelioma who were scheduledfor debulking surgery at one institution. Specimens were obtainedat surgery or by pleural biopsy examination. Expression datafor four genes were collected from tumor specimens, and threeratios of gene expression (TM4SF1/PKM2, TM4SF1/ARHGDIA, andCOBLL1/ARHGDIA) were determined by quantitative reverse transcriptase–polymerasechain reaction. Patients were assigned to good or poor outcomegroups by the gene ratio test. Survival was estimated by theKaplan–Meier method and the log-rank test in univariateanalyses. A multivariable Cox proportional hazards model wasused to control for prognostic factors. Technical robustnesswas determined by using up to 30 specimens per patient, twobiopsy techniques, and two performance sites. All statisticaltests were two-sided.
Results: The test predicted overall survival (P < .001) and cancer-specificsurvival (P = .007) in univariate analysis and overall survivalin multivariable analysis (hazard ratio for death = 2.09, 95%confidence interval [CI] = 1.27 to 3.45,P = .004). The testwas reproducible within patients and repeatable between twodeterminations for specimens with widely varying tumor cellcontents. Repeatability between two determinations was 88.5%(95% CI = 84.0% to 92.2%) or, when technically unacceptabletest values were excluded, 91.9% (95% CI = 87.4% to 95.1%).Reproducibility between two determinations was 96.1% (95% CI= 86.5% to 99.5%). Combining the gene ratio test and other prognosticfactors allowed prospective discrimination between patientsat high risk (median survival = 6.9 months, 95% CI = 2.6 to8.9 months; 3-year survival = 0%) and low risk (median survival= 31.9 months, 95% CI = 21.9 to 41.7 months; 3-year survival= 42%).
Conclusion: The gene ratio test for survival of patients with malignantpleural mesothelioma has robust predictive value and technicalassay performance.
CONTEXT AND CAVEATS
Malignant pleural mesothelioma has few effectivetreatments, except for Chemotherapy and cytoreductive surgery.
Clinical data were obtained before surgery from patientswith malignant pleural mesothelioma. Tumor specimens were obtainedat surgery or by pleural biopsy examination, and gene expressiondata were obtained for four genes. A gene ratio test was usedto assign patients to good or poor prognosis groups, and theirsurvival was analyzed. Robustness was determined by using manyspecimens per patient, two biopsy techniques, and two performancesites.
The gene ratio test for survival of patientswith malignant pleural mesothelioma has robust predictive valueand technical assay performance.
The gene ratiotest should be further evaluated with patient specimens collectedbefore clinical intervention to determine whether its resultscan be incorporated into decision making for patient treatment.
Patientshad to agree to undergo aggressive surgery at enrollment andpatients who did not were excluded. Consequently, the resultsmay not apply to patients who are older or less fit.
Mesothelioma Treatment Alert: National Cancer Institute to Begin New Phase of Mesothelioma Drug Trial
Study drug targets proteins that aid in tumor growth
Syracuse,New York 9/11/2009 07:43 PM GMT (FINDITT)
The National Cancer Institute inBethesda,Maryland is enrolling participants in a Phase II clinical trial to determine the efficacy of the cancer drug gefitinib in treating patients with malignant mesothelioma cancer.
In this study, researchers involved in the multi-center study will be evaluating several factors, including the activity of the drug in terms of failure-free survival, as well as the response rate, toxicity levels, and overall survival rates in patients treated with gefitinib.
Marketed under the trade name Iressa, gefitinib specifically targets the proteins in malignant cells, inhibiting cellular growth.
Currently, gefitinib is only indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC), and who have undergone previous chemotherapy. Researchers believe the drug may also be effective in mesothelioma treatment, as well as the treatment of other cancers involving the protein molecule known as the epidermal growth factor receptor, or EGFR.
During the trial, researchers plan to enroll 40 patients with histologically confirmed malignant mesothelioma that is not amenable to curative surgery or radiotherapy. In addition, patients must have measurable lesions and no known brain metastases.
Patients involved in the study will receive daily doses of oral gefitinib for alternating periods until progression of the cancer is halted, or unacceptable toxicity levels are reached. Clinicians will follow study participants for up to four years.
Mesothelioma is a rare form of cancer that attacks the mesothelium, the protective membrane that surrounds the body’s internal organs. The disease is caused by exposure to asbestos, a material once commonly found in many materials used in the construction, shipbuilding, heating and ventilation, and other industries. Asbestos is present in thousands of buildings across the country, including residential, office, industrial, and government and public buildings.
Asbestos is a common silica-based mineral, once highly prized for its resistance to heat and moisture, as well as its fibrous nature, which allowed it to be formed into many products ideal for construction, industrial, and other applications. In its pristine state, asbestos is harmless. However, over time the asbestos fibers become dry and brittle, and when disturbed are easily released into the air where they can be ingested or inhaled. Once in the body, these tiny fibers become permanently lodged in the tissue of the mesothelium where they cause abnormal cellular growth.
Although the use of asbestos in manufacturing was banned in theUnited States in the late 1970s, millions of homes and other buildings constructed prior to the early 1980s contain the material in various forms. Simple projects, such as renovations and duct cleaning, can result in asbestos fibers being released into the air.
It can take up to 50 years for the symptoms of mesothelioma to become evident. The initial symptoms of mesothelioma may mimic those of flu or other respiratory ailments, and may include persistent cough, shortness of breath, and chest or abdominal pain or swelling. Mesothelioma diagnosis is made following a complete physical exam, thorough health history to determine potential asbestos exposure, and chest X-rays or other medical imaging procedures.
Currently, mesothelioma prognosis is grim, with no known cure. Treatments focus on amelioration of symptoms for those affected with the condition.
Mesothelioma patients and their families seeking additional information about the latest advances in mesothelioma treatment and care can contact Dr. Raphael Bueno of Brigham and Women’s Hospital inBoston. As associate chief of the Division of Thoracic Surgery, Dr. Bueno is uniquely positioned to offer guidance regarding the most current treatment modalities available for patients who suffer from Mesothelioma
Mesothelioma multimodality therapy gaining favor
Combining treatments shows promise
HOUSTON 8/07/2009 02:00 PM GMT (TransWorldNews)
Oncologists are increasingly using multimodality therapy to treat mesothelioma, as this approach has been used for other types of malignancies. Cancer specialists have created new therapy routines using multimodality methods for lung cancer, pancreatic cancer, rectal cancer and malignant mesothelioma. Multimodality therapy is defined as the application of two or more processes of cancer treatment intended to deal with certain types of cancer. These methods may include radiation therapy, surgery, gene therapy, chemotherapy, or immunotherapy. Treatment regimens can use a wide range of combinations. Some plans include radiation therapy before surgery to shrink the tumor, while others employ post-surgical chemotherapy to deal with follow-up symptoms. Multimodality is typically personalized to the patient’s disease, symptoms, and responses to conventional treatment. These therapies are also dependent on the stage and type of the patient's cancer. Advocates of the multimodal approach think that the multifaceted plan of attack provides the patient the highest probability of receiving full benefits from treatment.
In the 1970’s, oncologists and cancer researchers started considering the uses and benefits of a multimodal approach to cancer therapy. During those early studies, scientists noted a marked degree of success in treating cancers in lab animals with multimodal techniques. From there, they also saw notable improvements when using the same ideas to treat certain childhood cancers. As effective as these initial tests were, however, the cancer community has still not reached complete agreement on the effectiveness of multimodal therapy routines. Some clinical studies have not shown a noticeable difference in benefits between patients undergoing multimodal therapy versus those experiencing conventional treatments. Other research efforts have established that multimodal therapies can both decrease the incidence of symptoms of the disease as well as increase a patient’s quality of life. Since the idea of multimodal therapy is relatively new to the cancer treatment landscape, more research is underway to determine the efficacy of this approach.
Proponents of this course of action state that multimodality treatment is the best path in terms of both confronting the primary malignant tumor as well as precluding the metastasizing of the disease. The reasoning behind these ideas comes from the fact that particular modes of treatment, such as tumorectomy surgery and radiation therapy, are intended to remove the main cancer site, though other methods, such as chemotherapy, are meant to keep the cancer from spreading throughout the body.
An added benefit of multimodality therapy is that it assures a smaller amount of impairment on the patient's long-term health prospects. Not long ago, surgery was the best cancer treatment option available, with the stated end of withdrawing malignant cells so as to keep the cancer in check. When other modes of treatment, such as radiation and chemotherapy, are applied along with surgery, the patient typically enjoys a much better prognosis. Surgeons understand that they do not need to remove as much tissue, which implies that, by the usage of multimodality therapy, it becomes a possibility for modern cancer patients to save organs and limbs that could potentially have been lost if they had solely undergone surgical treatments. Reports have demonstrated that recurrence rates and mortality rates are both lower with multimodality therapy as compared to surgery alone.
As much promise as the multimodal theory has shown, the nature of the disease and how it varies among individuals creates many difficulties in making a blanket determination on the approach’s effectiveness. Two patients could have the same disease at the same stage and receive the same set of treatments, but could have completely different reactions. The physical demands of undergoing surgery, chemotherapy, radiation and other treatments simultaneously can take a severe toll on some patient populations, such as older patients or those in advanced stages of their disease. These combinations of treatments can also take a financial toll on patients and their families. Mesothelioma clinical trials that are in the process of studying these approaches can alleviate some of the costs involved in using these new treatment avenues and the research staff can tailor the necessary treatments to the patient’s needs.
New hope for asbestos cancer sufferers
Reporter: Jan Harwood
Date online: 08/01/2009
Sufferers of mesothelioma, the asbestos related cancer, have been given new hope through the development of a groundbreaking treatment inGermany.
Rochdale has one of the highest proportions of mesothelioma sufferers in the country. The town was once home to world's largest asbestos factory, Turner & Newall inSpoddenValley.
Nationally, figures for the cancer continue to rise as sufferers only show signs of the disease decades after first contracting it.
German Professor Thomas Vogl has been studying the use of Chemoembolization, a procedure that is most commonly used in theUK for liver cancer, with Mesothelioma and has had some success.
47-year old Debbie Brewer was told she had 6-9 months to live in November 2006.
She started to take Mistletoe in April last year, a therapy used to boost the immune system and educate it to fight the tumor, and a month later had her first trip to Germany to meet the Professor with the hope he could help her.
He performed the treatment in May and Debbie returned in June for a second treatment and was told the tumor had shrunk 10%.
After five treatments her tumor has so far shrunk 53% and she has been given a partial remission diagnosis and has been told the tumor may not return.
Many now feel that this treatment should be available in theUK as the treatments for Mesothelioma are limited to chemotherapy, radiotherapy or a major operation to remove the damaged lung.
There is currently a campaign to get trials started in theUK.
How hospice gave a cancer patient a new lease of life
4:29pm Wednesday 3rd June 2009
A TERMINAL cancer patient paid tribute to a hospice which he says has given him a new lease of life.
David Shirra was diagnosed with Mesothelioma, a cancer of the lungs linked to the asbestos he worked with as a young docker, in late 2007.
He said St Helena's hospice day care centre atJackson Road,Clacton, has taught him how to cope with his condition, and allowed him to enjoy his remaining time.
The 71-year-old, ofPrinces Road,Holland, said: “I am sure that a lot of people out there think of a hospice as a place to go to die, but it is not.
“They have been a lifesaver to me.
“If I hadn't come to the hospice, I don't think I would be so happy and relaxed, I think I think I would have given up the ghost.”
David admitted when he first heard the news of his cancer, it struck him and his wife Doreen like “a bolt out of the blue”.
But his family was also hit hard by the news. His granddaughter, who was in her early teenage years, initially found his illness very hard to accept, but came to terms with it after she took part in an art therapy course at the hospice.
For David, there was practical help in dealing with his cancer, which causes trouble breathing.
He said: “I used to to lie down at night at it would be like drowning, but since they showed me how to breathe, I have had no trouble.”
“They also had courses in controlling your stress, living with an incurable disease.”
Just as important the the medical advice has been the chance to meet other people in the same situation.
Waving towards the day room where the hospice’s patients were talking together, David said: “Most of the people out there have incurable diseases and we have a good chat.
“I talk to people outside and they say how are you, but you can't go too deep into your problems. Here, most of us have the same sort of problems so we just relax and talk to each other.
“The staff are really interested in you as well, it is not just a check-list.
“It is like a second family here. Nothing is too much trouble. They are like guardian angels.”
He concluded: “I could not praise it enough. It has given me a new lease of life.”
And with the support of the hospice, he says he is ready to fight his cancer all the way.
He said: “When the time comes to go, I shall kick and scream, but at least I shall be happy that I had 70-odd years.
“I might break world records and live for another 20-odd years – at least we can try!”
This week is the first annual St Helena Hospice Awareness Week, to promote their work.
If you would like to support the hospice, contact their fundraising team on 01206 791 740.
Ranpirnase Added to Doxorubicin Improves Survival in Pretreated Patients With Malignant Mesothelioma: Presented at ASCO
By Emma Hitt, PhD
ORLANDO, Fla -- June 2, 2009 -- Ranpirnase added to doxorubicin improves survival in pretreated patients with malignant mesothelioma, according to findings from a phase 3 trial presented here on June 1 at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO).
According to the researchers, a previous study has demonstrated that ranpirnase, a novel ribonuclease, resulted in a 1-year survival rate of 42% in a multicentre phase 2 trial in chemotherapy-naïve and pretreated patients.
Martin Reck, MD, Hospital Grosshansdorf,Hamburg,Germany, and colleagues compared the efficacy and safety of doxorubicin with or without ranpirnase. Patients (n = 413) had unresectable malignant mesothelioma and an Eastern Cooperative Oncology Group performance status of 0 to 1, and they were allowed to have up to 1 previous line of treatment. Mean age was approximately 62 years.
An intent-to-treat analysis found no significant difference in median overall survival. With doxorubicin plus ranpirnase, the median survival was 11.1 versus 10.7 months for doxorubicin plus placebo (hazard ratio [HR] = 1.02; 95% confidence interval [CI], 0.82-1.26).
However, in a preplanned analysis of 130 patients who had been pretreated with chemotherapy, a significant advantage in survival in favour of doxorubicin plus ranpirnase was noted, with a median survival of 10.5 months for ranpirnase versus 9 months for placebo (HR = 1.49; 95% CI, 1.02-2.17).
No adverse safety issues were observed with the addition of ranpirnase. The most common side effects were associated with doxorubicin and included nausea, fatigue, and alopecia. Other side effects included neutropenia, oedema, arthralgia, and peripheral neuropathy.
The researchers concluded that the treatment is safe and feasible and may result in a significant impact on survival compared with doxorubicin alone for pretreated patients.
"Further evaluation of ranpirnase in combination with pemetrexed and confirmation of second-line efficacy will be of interest," Dr. Reck said during the presentation.
[Presentation title: Randomized, Multicenter Phase III Study of Ranpirnase Plus Doxorubicin (DOX) Versus DOX in Patients With Unresectable Malignant Mesothelioma (MM). Abstract 7507]
Malignant mesothelioma risk increased after radiation treatment for HL
PostedMay 28, 2009
Patients with Hodgkin’s lymphoma who have been treated with radiation may be at an increased risk for malignant mesothelioma.
Although malignant mesothelioma is relatively uncommon, previous research indicated it may be associated with radiation exposure.
Results of several recent epidemiological studies showed that radiation for lymphoma may be linked with an increased risk for malignant mesothelioma. However, these studies involved only a small number of patients and the results needed to be confirmed in larger studies.
For this study, the researchers examined risk for malignant mesothelioma in 2,567 patients who had reached at least five-year survival after treatment for Hodgkin’s lymphoma.
Patients included in the study had been treated with radiation alone, chemotherapy alone or a combination of both.
Median follow-up period was 18.1 years. At this time, 13 patients had malignant mesothelioma at least five years after being treated for Hodgkin’s lymphoma.
Five-year survivors of Hodgkin’s lymphoma were about 26 times more likely than the general population to develop malignant mesothelioma, according to the results. Those treated with radiation alone were about 30 times more likely to develop malignant mesothelioma.
There were no cases of the disease among the 232 patients treated with chemotherapy alone, but patients treated with both radiation and chemotherapy were almost 44 times more likely to develop malignant mesothelioma.
De Bruin ML.Blood. 2009;113:3679-3681.
Seminal studies by Scripps Research Institute investigators demonstrated that asbestos with high-iron content (as opposed to low-Fe level asbestos) was more likely to cause mesotheliomas in miners. In vitro iron-asbestos promoted oxygen radical generation that altered DNA, providing rationale for the epidemiologic studies. The combination of radiation-mediated oxygen radicals plus lung iron asbestos (or tobacco-mediated iron deposition) may underlie these findings.
– Harry S. Jacob, MD
HemOnc TodayChief Medical Editor
Medics may Target Mesothelin to Treat Mesothelioma
Posted on May 21st, 2009
by Deon Scott in All News
It has been reported that medics may start to target the protein mesothelin in order to try and treat the asbestos related cancer, mesothelioma, as well as to make a more effective diagnosis of other forms of cancer, according to a recent report.
The report was recently printed in the Molecular Cancer Therapeutics journal. According to the report researchers have found that mesothelin could prove to be an effective therapeutic target because of the way that this protein is distributed in the body.
This protein is found in only small quantities in the lung, abdominal, and heart lining in healthy patients, but in those with mesothelioma and certain other cancers the protein is found in much higher quantities. In order to try and treat these cancers researchers are looking at antibodies that will bypass normal cells and target mesothelin.
However, there are concerns about the side effects of the treatment. Yang Feng, PhD, a biologist with the Center for Cancer Research Nanobiology Program of the National Cancer Institute, said: “This reaction by the immune system is a severe side effect, and makes it risky to re-administer the treatment agent to patients.”
Surgery portion of new mesothelioma treatment plan found effective
Asbestos inhilation diagram. Image courtesy of theMesotheliomaCancerCenter
Pleurectomy/decortication, a type of surgery involving the removal of the outermost lining surrounding the lungs, was assessed in a study presented at the 2009 European Multidisciplinary Conference in Thoracic Oncology.
A particular kind of surgery performed as a part of a treatment plan intended for patients with malignant mesothelioma was considered successful preceding chemotherapy treatment in a study presented May 3 at the 2009 European Multidisciplinary Conference in Thoracic Oncology.
The surgical method known as a pleurectomy/decortication (a type of surgery involving the removal of the outermost lining surrounding the lungs) was assessed in the study. The study observed the procedure in combination with chemotherapy and radiation in a three-fold treatment approach.
A group of experts, including Dr. Servet Bölükbas and Dr. Horst Schmidt Kliniken, devised the study to check the efficiency of pleurectomy/decortication as the surgical component in malignant pleural mesothelioma treatment rather than pneumonectomy (removal of a lung).
Malignant mesothelioma is a rare cancer caused almost exclusively by asbestos exposure. Patients usually exhibit mesothelioma symptoms several decades following initial exposure, permitting the cancer to progress to later developmental stages. A multimodal therapy method using two or more methods of treatment is frequently suggested for mesothelioma patients.
Thirty-five patients with malignant pleural mesothelioma were enrolled in the study over a five-year period from November 2002 through October 2007. Patients underwent the pleurectomy/decortications procedure prior to four chemotherapy sessions (using cisplatin and pemetrexed) and radiation to the chest wall and mediastinum (a group of structures in the thorax) roughly four to six weeks following the surgery. Approximately 94 percent of the patients finished the treatment regimen.
The one year survival rate was 75 percent with a median survival rate of 33.2 months. The two year survival rate was 61 percent with the three year survival rate reported at 43 percent.
The researchers concluded that the use of pleurectomy/decortication as the surgical component in a multimodal treatment plan using chemotherapy and radiation demonstrated positive survival results and morbidity calls for extra testing.
New Cancer Treatment Achieves First Mesothelioma Success
After standard treatments failed to stop or slow the progression of her cancer, the first mesothelioma patient treated with a new protocol has shown a highly favorable response. These early results are similar to the investigative protocol's success against several other very aggressive cancers.
These are early results from one patient, so no conclusions can be drawn yet. Mesothelioma is so relentless and uniformly fatal, though, that being able to stop its growth and spread is very exciting. Most importantly, it's a major victory for this patient. It mirrors the success we're seeing for the great majority of our patients with other cancers, as well.
The key to moving from the lab to success in humans has been taking a fresh look and finding the right medicines to combine. When we have administered a precisely timed regimen of low-dose interferon with lovastatin, the results have been surprising.
Nashville,Tenn. (Vocus/PRWEB ) May 14, 2009 -- After standard treatments failed to stop or slow the progression of her cancer, the first mesothelioma patient treated with a new protocol has shown a highly favorable response. These early results are similar to the investigative protocol's success against several other very aggressive cancers.
The first mesothelioma patient is a woman in her late forties who was exposed to asbestos in childhood. When her cancer was diagnosed in 2008, it already had filled most of the chest space where her right lung had been. She received the approved treatments for the cancer. As is typical for mesothelioma, however, it continued to grow steadily. Realizing that the usual chemotherapy regimen is never able to stop this cancer, she visited NeoPlas Innovation'sNashville clinic and began the new outpatient treatment.
Two months later, CT scans showed that the cancer had stabilized, and the largest of the tumors actually had regressed significantly in size. Improvement in her clinical condition correlated with the findings. NeoPlas Innovation Director of Research Dr. Stephen B. Cantrell commented, "These are early results from one patient, so no conclusions can be drawn yet. Mesothelioma is so relentless and uniformly fatal, though, that being able to stop its growth and spread is very exciting. Most importantly, it's a major victory for this patient. It mirrors the success we're seeing for the great majority of our patients with other cancers, as well." The protocol is offered for qualifying patients with colon cancer, renal (kidney) cancer, pancreatic cancer, melanoma and certain sarcomas. It can be considered for other patients on a case-by-case basis.
The new treatment is simply an "off-label" combination of two existing medicines: lovastatin, typically used as a cholesterol lowering agent, and interferon. In 1998 Dr. Jeffrey Rubins and colleagues inMinneapolis demonstrated that lovastatin had a significant effect against mesothelioma cells in laboratory cultures. According to Dr. Cantrell, "The key to moving from the lab to success in humans has been taking a fresh look and finding the right medicines to combine. When we have administered a precisely timed regimen of low-dose interferon with lovastatin, the results have been surprising." NeoPlas Innovation patients often have seen the arrest of their cancers' growth and spread in as few as eight weeks of treatment. In many cases, patients have experienced active regression of tumors.
Fatigue is the most notable side effect of NeoPlas Innovation's cancer treatment. Most patients never experience effects commonly affiliated with chemotherapy or radiation (nausea, vomiting, hair loss, bone marrow suppression or immune system suppression). An experienced physician prescribes and monitors the outpatient treatment.
NeoPlas Innovation's web site, www.neoplas.org, provides complete information and an interactive screening tool for patients who are considering this treatment. The clinic can be reached at (615) 371-8100.
For an interview with Dr. Cantrell, call 615-371-8100.
INNOVATIONS IN MEDICINE
Video-Assisted Surgery Helps Lung Cancer Patients
(NAPSI)-Lung cancer is the second-most commonly diagnosed cancer in both men and women, and the leading cause of cancer death. Many of the estimated 180,000 Americans who will be diagnosed with non-small cell lung cancer-the most common form of lung cancer-this year may be able to breathe easier thanks to innovative treatments that make the disease a little easier to deal with.
The sooner cancer is treated, the better the outcome is likely to be. Below are some of the top causes of and risks for lung cancer. If any of the following applies to you or someone you know, you may want to speak with your physician about your risks and options:
1) Smoking. Smoking and secondhand smoke are responsible for 87 percent of lung cancer cases.
2) Radon exposure. Radon is an inert gas that can be present in soil and water and seep into any dwelling.
3) On-the-job exposure to carcinogens such as asbestos, uranium and arsenic.
5) Family history of lung cancer.
Often, when lung cancer is detected, surgically removing the cancerous portion of the lung can increase survival rates. For more than a decade, doctors have been able to perform a kind of lung cancer surgery that gets patients with clinical stage one, non-small cell lung cancer feeling better faster, may improve the time to full activity, and make delivery of planned chemotherapy more feasible. It's called VATS, for video-assisted thoracic surgery. Unlike open surgery, which requires a large incision in the chest, VATS uses three or four small incisions, and the surgeon performs the procedure using a video camera and endoscope.
Clinical evidence supports several advantages over open surgery, said Scott J. Swanson, M.D., director, minimally invasive thoracic surgery at Brigham and Women's Hospital inMassachusetts.
"Compared with open surgery, VATS results in far less trauma and patients may return to work and daily activities as soon as a week after surgery. Ordinary surgery may require four to six weeks of recovery time. The procedure can also be used to take tissue samples to determine the presence of disease," said Dr. Swanson.
Doctors, lung cancer patients and people who care about them can learn more at www.mipinfo.com.
Note ToEditor−included with this release is a list of references:
i American Lung Association: Lung Cancer. Retrieved 11/10/09 from http://www.lungusa.org/lung-disease/lung-cancer/
ii American Cancer Society, "What Are the Key Statistics About Lung Cancer?," Retrieved 11/10/09 from http://www.cancer.org/docroot/CRI/ content/ CRI_2_4_1x_What_Are_the_Key_Statistics_About_Lung_Cancer_15.asp?sitearea
iii American Lung Association: Understanding Lung Cancer. Retrieved 11/10/09 fromhttp://www.lungusa.org/lung-disease/lung-cancer/about-lung-cancer/understanding-lung-cancer.html
iv Mayo Clinic: Lung Cancer Risk Factors. Retried 11/10/09 fromhttp://www.mayoclinic.com/health/lung-cancer/DS00038/DSECTION=risk-factors
v National Cancer Institute. Stage I Non-Small Cell Lung Cancer. Retrieved 12/12/08 fromhttp://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/HealthProfessional/page8
Video-assisted surgery is tough on cancer but easier on patients than traditional surgery.
Mesothelioma Asbestos Claims - Mesothelioma Treatment
If you or a loved one has been just diagnosed with - or a loved one has died from work related mesothelioma or some other asbestos-related disease, please complete the Mesothelioma Attorney Contact Form for a quick reply within 2 -3 hours. The information you submit will be held in total confidence. It will be used exclusively for the purpose of evaluating your case and determining if you may be entitled to a cash settlement. Your privacy is ensured.
The treatment of malignant mesothelioma has proven difficult. Because the disease begins in the pleura and peritoneum, which are the membranes surrounding the chest cavity and abdominal cavity respectively, progression of the malignancy results in spread to the underlying organs. The tumor spread makes complete surgical removal nearly impossible. Furthermore, the effectiveness of different treatments has been difficult to evaluate in large treatment trials because there are relatively few cases of malignant mesothelioma.
Although the general prognosis for malignant mesothelioma is not encouraging - on average, patients live about one year after diagnosis - an early diagnosis and aggressive treatment can improve survival - up to two years in almost 50 percent of cases and five years (or longer) in 20 percent. Some of the factors that affect prognosis are the type of mesothelioma, the stage of disease at diagnosis, the patient's age and the patient's overall health. The prognosis is best when the mesothelioma is the epithelial type and stage I.
Mesothelioma Types of Treatment
The primary treatment options for malignant mesothelioma are surgery, radiation therapy and chemotherapy.
Mesothelioma Surgery : Before any surgery is considered for the treatment of malignant mesothelioma, the patient's overall health is carefully evaluated. Tests are performed to make sure the patient has no metastatic disease (cancer spread to distant sites) and to evaluate the patient's lung and heart function. Lung function often is compromised in patients with pleural mesothelioma for several reasons. The pleural effusion (fluid collection) and the tumor mass caused by mesothelioma can compress the lung. Also, the patient's exposure to asbestos may have decreased lung function, which also decreases with age. In addition, some patients have a history of smoking cigarettes, which further decreases lung function.
Surgery for malignant mesothelioma can be aimed at long-term control (aggressive surgery) or relief of symptoms (palliative procedures).
Aggressive Surgery :Extrapleural pneumonectomy involves removal of the pleura, the lung, the diaphragm and the pericardium. The intent of this very aggressive, complicated surgery is to remove as much of the tumor as possible. Not all centers will perform this procedure because of its complexity and because it carries a high risk of death within 30 days after surgery. Extrapleural pneumonectomy typically is performed only in younger patients in good overall health with stage I disease. Patients are evaluated carefully to determine their ability to tolerate the surgery.
Mesothelioma Palliative Procedures : When malignant mesothelioma is advanced, palliative procedures can be performed to relieve and/or control symptoms such as breathlessness, which are caused by effusion (fluid collection) or by the tumor compressing the lung or other organs. These procedures do not aim to cure the disease.
- Thoracentesis can be used to treat effusion in pleural mesothelioma. A needle is inserted into the chest to drain the fluid, relieving breathlessness and pain. Talc may be introduced into the pleura to limit recurrence of the effusion. Similar procedures are used to treat ascites (fluid collection) in peritoneal mesothelioma.
- Pleurectomy/decortication is the surgical removal of the pleura. This procedure can be performed to reduce pain caused by the tumor mass or to prevent the recurrence of pleural effusion. For peritoneal mesothelioma, surgery generally is aimed at relieving symptoms, such as recurrent ascites or bowel obstruction. As with pleural mesothelioma, complete surgical removal of the entire tumor is unlikely.
Mesothelioma Radiation Therapy
Because of the location of malignant mesothelioma, it is extremely difficult to deliver high enough doses of radiation to kill the tumor without damaging the surrounding organs. Lower doses of radiation can result in some reduction in the disease, but it is unclear whether this reduction actually results in longer survival than does no treatment.
Using radiation therapy after surgery has not been shown to improve survival. However, because surgery is very unlikely to remove the entire tumor, radiation commonly is administered after surgery in the hopes of killing remaining tumor cells. In addition, radiation therapy can be used to relieve symptoms of mesothelioma, including chest pain.
Chemotherapy - the use of medications to treat cancer - has had disappointing results in the treatment of malignant mesothelioma. Some chemotherapy drugs have a partial effect in some patients. Combination chemotherapy (using more than one drug at the same time) may be given in an attempt to improve response. Some combinations have shown some promise, and some new medications are being tried.
Like radiation therapy, chemotherapy may be administered after surgery in an attempt to kill cancer cells that could not be removed during the procedure.
Mesothelioma Treatment by Stage
Pleural mesothelioma can be treated according to stage; there are no standard treatment options by stage for peritoneal mesothelioma.
- Stage I (localized) mesothelioma - If a patient wants aggressive treatment and is deemed fit to undergo surgery, some centers may perform an extrapleural pneumonectomy. Another surgical option is pleurectomy/decortication, which is sometimes performed to alleviate some of the symptoms of mesothelioma. Both of these procedures may be followed by radiation therapy or chemotherapy.
- Stages II, III and IV (advanced) mesothelioma - Pleurectomy/decortication may be performed to relieve symptoms in pleural mesothelioma. Other procedures such as thoracentesis may be performed to drain pleural effusions and prevent them from recurring. Radiation therapy and/or chemotherapy also may be administered for symptom relief.
- Recurrent malignant mesothelioma - There is no standard treatment for recurrent mesothelioma. Generally, treatments are considered that were not used in the first treatment attempt.
Clinical Trials and Future Treatments
New treatments for malignant mesothelioma (and possible preventive measures, such as a vaccine) are being evaluated in clinical trials, and the future holds some promise. Clinical trials are research studies that evaluate new treatments for safety and effectiveness. There are no guarantees that a new treatment will work, and there are some risks. However, a clinical trial is not undertaken unless the researchers believe the treatment may have some value.
Here are some of the treatments for malignant mesothelioma that are being evaluated:
- Combination chemotherapy - Different combinations of chemotherapy drugs have been tried with mixed results. A recent study showed some benefit of combining cisplatin (Platinol) and gemcitabine (Gemzar). The researchers used the combination to treat 21 patients with advanced mesothelioma, of whom 47 percent showed a partial response.
- Intracavitary chemotherapy - Instilling chemotherapy drugs directly into the pleural or peritoneal space is being researched because of its advantage over traditional chemotherapy. Because the drug is instilled directly into the cavity, much greater doses can be given to patients without causing severe side effects. Some studies have shown this therapy to result in control of effusions and reduced tumor size.
- Brachytherapy (intracavitary radiation therapy) - In this treatment, a radioactive substance is placed directly into the pleural or peritoneal space.
- Multimodality therapy - Any combination of surgery, radiation therapy and chemotherapy is multimodality therapy. For example, researchers have combined surgery with intracavitary radiation or chemotherapy and then administered radiation or chemotherapy afterward.
- Gene therapy - In this approach, a virus that has been genetically altered is introduced into the tumor. The virus infects the tumor cells and makes them vulnerable to anticancer drugs.
- Immunotherapy - Treatments that stimulate the body's immune system to fight cancer cells are called immunotherapy.
- Photodynamic therapy - In this treatment, drugs that are sensitive to light are taken up by the tumor cells, which are then exposed to light.
Mesothelioma - When to Call a Professional
Call your doctor promptly if you have any of the symptoms of lung cancer, especially if you have worked in an industry with high exposure to asbestos.
Malignant mesothelioma usually is advanced by the time it is diagnosed and thus has a poor prognosis. On average, the survival time after diagnosis is about one year. However, several factors affect prognosis, including the extent of the tumor and the age and health of the patient. In some cases, survival time can be increased with early detection and aggressive treatment, and improved treatments should be available in the near future.
Freeze therapy gives hope to cancer sufferer Jan Egerton
Mar 1 2009 by James Marley, Sunday Sun
IN a desperate bid to win her battle for life, one North woman jetted across the globe to get ground-breaking treatment.
And now she hopes that her efforts will lead to her beating terminal cancer.
Jan Egerton has spent the last eight years fighting asbestos cancer, mesothelioma.
It seemed there was little that doctors could do for her, as her tumours were too big for radiotherapy.
But the 48-year-old refused to give up, and when she heard of a revolutionary treatment offered by medics in theUS, she was straight on a plane.
Jan and husband Gary, 42, flew toLos Angeles for two sessions of the £5000-a-time treatment last year.
Now she feels better than ever.
“I was told I couldn’t have treatment inEngland because my tumours were bigger than two centimetres,” Jan, of Old Eldon,CountyDurham, explained.
“But I researched on the internet and came across this hospital in LA.
“Within three weeks of sending an email enquiry, I was on the bed about to undergo the first procedure.”
Cryoablation involves freezing and reheating a tumour repeatedly until it dies. It is done non-invasively using needles, and patients can be out of hospital the same day.
It has been used for some time to treat prostate cancer, but UCLA hospital inLos Angeles is pioneering its use for lung cancers like mesothelioma.
Used alongside major surgery to remove the lining of the lung, cryoablation could help to beat cancer in cases too advanced for radiotherapy or chemotherapy.
On her return — and under the recommendation of her American doctor — Jan underwent surgery to remove the lining of her lung.
That was five weeks ago. Now, she is looking forward to a long life in good health. “I’ve got something else I can do to keep me alive now,” Jan said.
“The treatment has made day-to-day life easier. It has stopped me getting so many back aches. And if we manage to clear all the tumours, it will take at least five years for it to grow back, giving me at least five years to live.
“I am a fighter. I am determined to keep battling this cancer.”
Jan was nervous about the procedure. At one point the doctors were working only one millimetre away from major artery the aorta. But the results were worth it.
She said: “They filmed the treatment, and it was amazing to watch it back. You see the cancer turn black and die in front of you. It’s great.”
Jan, who works as a company secretary for Hall Construction Services, inDurham, funded the treatment, and the trips to theUS to get it, completely out of her own pocket.
There is no NHS help available for terminal cancer patients in theUK wanting to undergo new treatments like cryoablation.
Despite her constant struggle with mesothelioma, which Jan believes she caught secondhand due to her father’s job working with asbestos, tireless Jan never stops fighting for other sufferers.
She is keen to spread the word about cryoablation, even saying that she would donate any compensation money she gets from her illness to help others fund trips to theUS for treatment.
But what Jan really wants to see is this sort of procedure being offered in theUK. “I don’t suppose it would ever be available on the NHS,” she said.
“But even if we had to pay for the cryoablation, it would be more affordable if we didn’t have to fund a flight toAmerica as well.
“I hope the Government, or even just a single radiologist in a single hospital, will consider introducing the treatment over here.”
Jan was attending the Mick Knighton Mesothelioma Research Fund annual conference last week inGateshead.
She raised £14,000 for the Wallsend-based cancer fund in 2007 by organising a swanky dinner dance, auction and raffle with her colleagues.
Set up by mesothelioma widow Chris Knighton after the death of husband Mick, the charity has raised more than £500,000. It is currently funding a project to increase the efficiency of chemotherapy drug Alimta, which is said to extend mesothelioma sufferers’ lives by up to three months.
Chris said: “Mesothelioma has affected the lives of many families in the North East, due to the legacy of heavy industries. Recent figures show that many more people will be diagnosed with asbestos in the future.
“This is the perfect opportunity to raise awareness, but we also want to highlight the progress that’s been made to find ways of treating the disease.”
Mesothelioma Treatment Reaches a New Breakthrough Moment
Submitted by MedHeadlines on 4 December, 2008
Researchers from the National Centre for Asbestos Related Diseases atSirCharlesGairdnerHospital
have made an astounding discovery concerning a cure for mesothelioma cancer. The positive results became official when a commercial skin cancer cream was able to cure mice with advancedmesothelioma
Malignant Mesothelioma is a rare form oflung cancer that is almost exclusively caused by asbestos exposure. To date, mesothelioma treatment has predominantly been more palliative than curative due to the extreme latency period associated with the disease.
In fact, manypatients aren’t even aware of having the disease until 30 to 50 years after the initial asbestos exposure occurred. This often results in most cases being diagnosed during the latest stages of development.
However, the new test involving the skin cancer cream may provide patients with some hope for curable treatments. The test required doctors to inject the skin cancer cream Aldara into the mesothelioma tumors of mice. Aldara is typically applied to skin to treat basal cellcarcinomas. In addition, a stimulant drug known as anti-CD40 was also injected into the tumors.
The doctors found that the injections caused the immune systems to produce “killer cells”, which actually searched out and eliminated cancer cells. Researchers Steve Broomfield and Andrew Currie said 50% of the mice in the study were completely cured of the disease.
Dr. Currie later added, “This combination is so attractive because one of these drugs is already commercially available and the other is being tested in clinical trials. The time frame for undertaking our own clinical trial is minimized because the safety of the drugs has already been investigated.”
Professor Bruce Robinson, who heads the hospital’s asbestos diseases centre, said it was the first time doctors had been able to seriously contemplate having a cure for mesothelioma. He expects the new drug therapy to be in use in humans in three to five years time.
These startling findings in mice offer an enormous amount of hope for the thousands of people likely to develop mesothelioma in the future.
For more information on treating mesothelioma, visit theMesotheliomaCancerCenter.
Mesothelioma and Intraperitoneal Chemotherapy
Posted on Thursday, November 13, 2008.
Combining aggressive surgery with chemotherapy delivered directly into the abdominal cavity may significantly extend survival in patients with peritonealmesothelioma, according to a consensus statement of peritoneal mesothelioma specialists published in the September 15 issue of the Journal of Surgical Oncology.
Reaching a consensus on the treatment of peritoneal mesothelioma—a cancer that affects the abdominal lining—has been difficult for doctors, because the disease progresses so quickly and conventional treatments such as surgery and chemotherapy have done little in the past to stall its progress and improve survival. However, new therapies are showing great promise, and are vastly improving the outlook for patients with this cancer.
Among the most promising of these therapies is combining aggressive surgery to remove as much cancer as possible (cytoreduction) with chemotherapy delivered directly into the abdominal cavity (perioperative intraperitoneal chemotherapy -- PIC). Sometimes that chemotherapy is heated (hyperthermic intraperitoneal chemotherapy, or HIPEC).
More than half of patients treated with this combination therapy have lived for at least five years, compared with an average survival of only one year in patients treated with traditional surgery and/or chemotherapy. The experts surveyed for the consensus statement said the most effective intraperitoneal chemotherapy regimen combines the platinum-based chemotherapy drug cisplatin with doxorubicin.
Before patients can undergo any treatment, they should first be evaluated with diagnostic studies such as a CT scan of the abdomen (an x-ray technique that produces detailed images), and a biopsy to analyze the cells for cancer. Knowing the tumor size, location, and subtype can help doctors exclude patients who would not benefit from undergoing potentially risky surgery, says lead study author Marcello Deraco, MD, of the Fondazione IRCCS Istituto Nazionale Tumori Milano inMilan,Italy. Patients whose cancer has spread outside of the abdomen, or whose tumor is larger than 5 centimeters may not be appropriate candidates for surgery.
The study authors mention several new techniques that are helping doctors more accurately diagnose, and more precisely treat peritoneal mesothelioma. Studying tumor genes with genetic microarray techniques is helping doctors better distinguish malignant mesothelioma from lung cancer. Microarrays may also help predict how well patients will respond to drugs.
New treatments such as immunotherapy (which stimulates the patient’s own body to fight off the cancer), gene therapy, and anti-angiogenesis drugs (which prevent the growth of blood vessels that feed cancer) may improve the outlook even more for peritoneal mesothelioma patients in the future.
For now, referring patients to medical centers that specialize in cytoreduction surgery and intraperitoneal chemotherapy can offer the best possible hope for peritoneal mesothelioma patients, Dr. Deraco says.
Deraco M, Bartlett D, Kusamura S, Baratti D. Consensus statement on peritoneal mesothelioma. J Surg Oncol. 2008;98:268-272.