Radical pleurectomy and decortication (P/D) involves the removal of the thickened pleural membrane around the lungs and separation of the pleura from the chest wall. The goal is to allow the lung to expand more easily.  Because it is less likely to remove all of the mesothelioma cells than the more extensive approach known as Extrapleural Pneumonectomy (EPP), some doctors have only considered P/D for patients who would not tolerate lung removal. The debate among the world’s mesothelioma experts continues.

But at the University of Pennsylvania, doctors are achieving notable success in treating mesothelioma with a combination of P/D and adjuvant photodynamic therapy (PDT). Photodynamic therapy involves the treatment of cancer cells with a light-sensitive agent and light in the hopes of disrupting cancer cell DNA. In their newly-published study, 38 patients underwent the two procedures. Thirty-five of the 38 (92%) mesothelioma patients also received systemic chemotherapy. Ninety-seven percent of the patients had stage III/IV mesothelioma and most (82%) had the most common epithelioid variety.

Many newly-diagnosed mesothelioma patients die of the disease within a year. But after radical P/D and PDT, the median survival in the University of Pennsylvania study was 31.7 months for all 38 patients.  Patients with the epithelioid subtype lived even longer with a median survival of 41.2 months. Those with epithelial mesothelioma also had a slower rate of disease progression. Median progression-free survival was. 9.6 percent for all patients and 15.1 percent for the epithelioid group.

In 97 percent of the mesothelioma patients studied, surgeons report “macroscopic complete resection” of the mesothelioma tumor using this lung-sparing technique. Interestingly, although overall survival was longer than usual for patients with epithelial mesothelioma, the time it took for their disease to begin growing again was not.  The researchers conclude that this may be due either to the preservation of the lung and/or to the PDT.

Their study, published in the Annals of Thoracic Surgery, ends with this upbeat summary: “We conclude that the results of this lung-sparing approach are safe, encouraging and warrant further investigation.”

source from:  survivingmesothelioma

The state’s Attorney General has ruled that a property owner in Springfield, Massachusetts put her tenants, and possibly their neighbors, at risk for asbestos caused diseases like mesotheliomacancer by failing to follow state regulations regarding asbestos removal. Asbestos is the primary cause of mesothelioma, a rare malignancy of the mesothelial membrane that is often fatal. It was long used in the U.S. as a building material, and can still be found in the roofs, floors, walls and siding of tens of thousands of older homes and buildings.

Asbestos often disintegrates as it ages, prompting many property owners to have it removed.  Because of its recognized connection to mesothelioma, lung cancer, asbestosis, and other diseases, state laws regulate the removal and disposal of asbestos. These laws are designed to not only protect the workers doing the removal, but also to protect anyone who might come in contact with the removed asbestos later.  Unfortunately, people at risk may not even be aware of it.  For example, mesothelioma symptoms often don’t appear until 20 years or more after asbestos exposure.

Under the Massachusetts Clear Air Act, property owners are required to file a notice of asbestos removal with the state Department of Environmental Protection.  The landlord not only failed to file this notice, but she allegedly paid off two of her tenants to remove asbestos siding themselves from one of her rental properties and store it.  Although state law requires that asbestos removal workers be trained in safe asbestos handling and use special tools for removal, the tenants did not do either.  The asbestos siding was allegedly stored in torn bags in the yard, another violation of state regulations which could pose a mesothelioma risk to even passersby.

“We allege that this defendant put her tenants at risk by having them unsafely remove asbestos from the property and failing to warn them of the dangers involved,” said Massachusetts Attorney General Martha Coakley in a statement last week.  “Our office remains committed to upholding environmental laws to prevent people from taking shortcuts that may endanger the health and safety of others.”

Property owners who wish to remove asbestos should contact certified abatement professionals. In some cases, it may be safer and more cost-effective to contain and seal the crumbling asbestos rather than remove it. Mesothelioma claims an estimated 2,500 lives in the U.S. each year.  There are two major types of mesothelioma – pleural mesothelioma and peritoneal mesothelioma.  Both are caused by exposure to asbestos.

source from:  survivingmesothelioma

The World Trade Center Scientific and Technical Advisory Committee has added a list of cancers – including mesothelioma – to the list of illnesses they feel should be covered by the Zadroga Act.  Passed by Congress in 2010, the Zadroga Act provides $4.3 billion to monitor, treat and compensate people affected by the 9/11 attacks.

Although cancer was not on the original list of illnesses covered by the act, a number of scientific studies on emerging health effects convinced the Advisory Committee that it should be.  Even before first responders began getting sick, a Mount Sinai School of Medicine analysis of the dust and debris in the rubble of the World Trade Center indicated the presence of many known carcinogens, including asbestos. Asbestos can cause mesothelioma, a virulent cancer of the internal membranes.

People with the greatest exposure to asbestos have the greatest risk of developing mesothelioma, although symptoms may not occur for 20 to 40 years.  This may explain why a 2011 study of firefighters who worked in the rubble did not find higher rates of lung cancer or mesothelioma, although the rates of many other cancers were higher.  The study published in The Lancet found that firefighters who responded are 19 percent more likely to get cancer of all types than the general population.

Although mesothelioma does not originate in the lungs, it often starts with asbestos inhalation and eventually causes symptoms similar to lung cancer.  The sharp fibers found in asbestos make their way to the pleural membrane that encases the lung, where they trigger irritation and inflammation. Eventually, that inflammation can lead to changes at the cellular level and mesothelioma develops.

The 15-member Advisory Committee has passed their recommendation for mesothelioma coverage to the National Institute for Occupational Safety and Health director Dr. John Howard who has 60 days to review their recommendations and make a decision.

source from:  survivingmesothelioma

Mesothelioma, a cancer of the organ linings caused by asbestos exposure, is highly resistant to conventional treatments.  Not only does it grow quickly, but its shape makes detection and removal difficult. Unlike some other types of solid tumors which may grow in a mass, mesothelioma tumors tend to spread out in a sheet-like formation across membranes.

The UK scientists have been experimenting with a new method for targeting and destroying mesothelioma tumors, regardless of their shape. 5T4 is an antigen overexpressed by several kinds of cancer cells. The researchers tested for 5T4 in mesothelioma cells taken from 11 lab-grown cell samples, 21 tumor biopsies, and 11 samples of the pleural fluid of mesothelioma patients. For comparison, they also tested the 5T4 antibody levels in the plasma of healthy donors.

The research team confirmed that 5T4 was overexpressed in all of the mesothelioma cells tested. Next, they exposed samples of mesothelioma cells to 5T4-specific killer T-cells – the same kind of cells produced by the immune system to destroy invaders.  In the lab, the 5T4-targeting killer T-cells were able to kill four out of six of the mesothelioma cell lines tested.

“We conclude that 5T4 is a potential new antigen for targeted therapies such as immunotherapy in MPM, as it is overexpressed on mesothelioma cells and recognized by 5T4-specific Cytotoxic T-cells,” wrote the researchers in a recent published report.  Their findings have since been translated into a Phase II clinical trial using 5T4-targeted therapies in mesothelioma patients.  The patients are being treated with a vaccine called TroVax which activates their killer T-cells to find and destroy mesothelioma cells overexpressing the 5T4 antigen.

The TroVax mesothelioma study is an example of the treatment approach known as immunotherapy. Unlike other types of mesothelioma treatments, such as chemotherapy and radiotherapy, immunotherapy is relatively non-toxic and theoretically capable of killing the targeted cells anywhere in the body. Because it is designed to ‘teach’ the body’s immune system which cells to target, the immune system ‘memory’ may help keep mesothelioma from returning.

New therapeutic agents are particularly important for mesothelioma, because it is so aggressive and because there are so few effective treatment options available. Two to three thousand Americans and 2,000 UK residents are diagnosed with mesothelioma every year.

source from: survivingmesothelioma

Mesothelioma is an aggressive malignancy that spreads across the thin membranes that encase internal organs.  The most common type occurs in the pleura, the lining around the lungs. In most cases, the prognosis is poor; many patients are told they are unlikely to live out the year. But as treatment protocols improve, a growing number of mesothelioma patients are defying the odds and living much longer.

A tri-modal approach including chemotherapy to shrink the mesothelioma, surgery to remove it, and radiotherapy to prevent its return has proven to be an effective strategy for some patients. In a report published in a recent issue of Anticancer Research, Italian doctors describe the case of a young patient admitted to the hospital with shortness of breath and other non-specific symptoms. A CT scan confirmed a diagnosis of pleural mesothelioma.

The woman underwent two cycles of neoadjuvant (prior to surgery) chemotherapy with pemetrexed and cisplatin, the current gold standard for mesothelioma treatment. She then underwent an extrapleural pneumonectomy, a controversial and radical surgery that involves removing not only the cancerous membrane, but also other membranes, the closest lung, and often the diaphragm.  After 6 months, the patient received external beam radiation to her left hemithorax.

A combination of Positron Emission Tomography (PET) and CT scanning have been used to watch for a return of mesothelioma, but so far it has not happened.  In fact, the woman remains in good health and free from mesothelioma four years later.

“This clinical case shows a disease-free survival interval of 4 years for malignant pleural mesothelioma,” observe the researchers. “A good staging system and a combined treatment involving surgery, neoadjuvant chemotherapy and adjuvant radiation therapy represents a useful strategy not only to contain local disease progression, but even to increase disease-free survival in pleural mesothelioma.”

Other studies have confirmed that, the younger a patient is at the time of diagnosis, the more likely he or she is to survive mesothelioma.  Overall health, length of asbestos exposure, and smoking history also may have an impact.

source from: survivingmesothelioma

That is the message of a recent University of Pennsylvania study on pain management.  The study gathered information on pain and pain control from patients with mesothelioma or lung cancer between 2005 and 2008. Participants were asked to fill out an Internet-based questionnaire that included 22 questions designed to assess their symptoms, evaluate their pain, and appraise their attitudes toward pain medication.

Of the ninety people who filled out the survey, nine percent had mesothelioma, a rare cancer of the lining of the chest or abdominal cavity.  The other 91 percent had either small-cell or non-small-cell lung cancer. Most were men and 89 percent were Caucasian.  Almost half of the survey respondents had undergone surgery for their mesothelioma or lung cancer, 58 percent were treated with chemotherapy and 44 percent had had radiotherapy.

When malignant mesothelioma starts in the pleural cavity around the lungs, patients often report mild pain in the chest or back. Mesothelioma in the abdominal cavity may trigger pelvic pain. Mesothelioma pain often progresses and can become severe and chronic in the later stages of the disease. Ninety-two percent of the patients in the University of Pennsylvania study reported pain. Fifty-two percent attributed their pain to their disease while 38 percent said the treatment was the cause. Sixty-seven percent of respondents said they were unsure of the primary cause.

But the most disturbing news for the pain researchers was that, among the patients reporting pain, a full third were not using pain medications to control it.  When asked why not, 76 percent said they were worried about becoming dependent on them and 56 percent said they were not able to pay for the medication.  But in 71 percent of cases, patients said their healthcare providers had not even recommended medication.  Many mesothelioma and lung cancer patients were using physical therapy or other alternative therapies to manage their pain.

The study’s authors say their findings suggest inadequate provider concern for symptom palliation, even though multiple studies have cited uncontrolled cancer pain as having a detrimental effect on quality of life. They recommend that providers caring for patients with mesothelioma or lung cancer “make pain management a priority and regularly discuss pain symptoms and pain management with patients” since pain control needs may change over time.

source from: survivingmesothelioma

A new Japanese study on future health trends projects that the incidence of mesothelioma won’t peak in Japan until 2027.  In the meantime, tens of thousands of Japanese workers are expected to die of mesothelioma.  Based on considerations such as the number of workers in industrial jobs and the likelihood of asbestos exposure, the study projects the mesothelioma death toll to reach 66,327 people ages 50 to 89 between 2003 and 2050.

Although a 2009 study of Japanese mesothelioma risk predicted a maximum of just 37,000 deaths by 2070, the new study’s authors say their prediction method is likely to be a more accurate – albeit grim – picture of mesothelioma in Japan than previous age-cohort models. “Our approach is based on a risk function that links mesothelioma mortality combined with data pertaining to the population, size of the labor force, and quantity of asbestos imports,” write the authors in a summary of their findings in the journal Industrial Health.

But the report is not all bad news.  The Hamamatsu University School of Medicine researchers say their data suggests that the number of mesothelioma deaths in Japan could be “significantly reduced” if more workplaces were brought into compliance with government guidelines for asbestos exposure.

The careless use of asbestos by inadequately-protected workers has sparked a worldwide mesothelioma epidemic in recent years, particularly in underdeveloped countries where asbestos is used as a low-cost building product. The World Health Organization (WHO) has designated asbestos as a known human carcinogen, although several country’s that use or export asbestos – including Canada, Russia and the U.S. – have thwarted attempts at an outright ban.

source from: survivingmesothelioma

The method, called chemoprevention, involves using low doses of targeted toxins to seek out and kill cells that have the potential of turning into mesothelioma.  Ideally, these agents are designed to latch onto compounds that are only produced by pre-cancerous cells, minimizing the risk to healthy cells.

This idea may be particularly valuable for malignant mesothelioma.  Although the cause – asbestos exposure – is well-known,  there is no way to keep exposed individuals from developing the disease. And because the early symptoms of mesothelioma are typically mild and may mimic other, less serious, conditions, mesothelioma is frequently diagnosed in its late stages when treatment is often less effective.  Since it is relatively easy to identify people at high risk for mesothelioma, the Italian researchers say prevention may be the best way to save lives.

“Exposed individuals may be offered medical surveillance or compensation, but nothing is currently being done to lower their specific cancer (mesothelioma) risk,” the team writes in a new report in Anticancer Research.

In an effort to determine the status of research into chemoprevention of mesothelioma, the team compiled a list of all the studies that have been done on the method.  They found forty-six articles on five projects but were surprised to find that no new chemoprevention trials have been set up for mesothelioma for twenty years, despite what they call “considerable advances” in the area of chemoprevention.

Their report concludes, “A reconsideration of possibilities offered by chemoprevention should be encouraged. New trials based on the most recently characterized molecules should be planned.”

The drug ranpirnase (Onconase), a chemotherapy agent with low toxicity, is believed to be one of the best candidates for chemoprevention of mesothelioma.  Derived from the egg cells of the northern leopard frog, Onconase received orphan drug status from the FDA in 2007. It works by disrupting the RNA and preventing reproduction in targeted cells. Noted mesothelioma researcher Michelle Carbone, MD, of the University of Hawaii’s Cancer Research Center, who has conducted clinical trials on Onconase, has called the drug’s mesothelioma prevention potential an “exciting development.”

More than 25 million people worldwide are exposed to asbestos, which is still being mined and used, despite its toxicity. Every year, over 2,500 people are diagnosed with mesothelioma in the U.S.

source from: survivingmesothelioma

Fifty-six year old Lincoln Hall had climbed many of the world’s highest peaks, including Mt. Everest in 2006.  But when he developed serious symptoms of oxygen deprivation on the way down, he was left for dead by his climbing team. An American guide and his two clients found Hall the next day and sacrificed their own summit experience to save his life.  After treatment in a Nepal hospital for a chest infection, fluid on his brain and frostbite, Hall eventually returned to Australia where he was hailed as a hero.

Despite the risks Hall took in his life, including his brush with death on Everest, it was the mineral asbestos that proved to be his most dangerous encounter. Asbestos is the primary cause of the rare malignancy called mesothelioma.  According to the Associated Press, Hall came in contact with asbestos while doing construction work early in his life. Once asbestos is inhaled or ingested, the sharp fibers stay in the body indefinitely, causing chronic irritation that can lead to mesothelioma as many as 40 or 50 year later.

Because of the heavy use of asbestos in building products, especially those manufactured before the 1980’s, construction workers make up a large portion of the world’s mesothelioma victims. Like Hall, many did not even work in the industry for very long. Late last year, Australian actor Harold Hopkins died of mesothelioma, which he also believed was the result of construction work in his teens. The same was true for American actors Merlin Olsen, who died of mesothelioma in 2009, and Steve McQueen, who was just 50 years old when he died of mesothelioma in 1980.

There is some evidence that the early exposure to asbestos in all of these cases may have put these men at higher risk of mesothelioma later in life.  A French population study published in 2011 found that the risk of mesothelioma was lower for subjects who were first exposed to asbestos after the age of 20.  The study tracked more than 2,466 asbestos-exposed men and was published in the European Respiratory Journal.

Lincoln Hall wrote books and articles about his climbing experiences and has photos published in climbing magazines. He also established the Australian Himalayan Foundation which raised money for schools in the Himalayas and was devoted to the caused until he died.  He was represented by the Australian mesothelioma law firm of Maurice Blackburn Pty Limited in his asbestos-mesothelioma lawsuit.  Hall is survived by his wife and two sons.

source from: survivingmesothelioma

Produced by Australia’s ABC network and starring some of the country’s most respected actors, “The Devils Dust” tells the story of mesothelioma victim Bernie Banton.  Banton was a long time employee of James Hardie, an Australian manufacturer of fiber cement building products.  For years, the company added asbestos to its cement to increase its strength and durability.  After Banton was diagnosed with pleural mesothelioma in 1999, he became an advocate for mesothelioma sufferers throughout the country.

Although mesothelioma cases like Banton’s are tragically common in Australia, Banton’s case was brought into the national spotlight largely because of the book “Killer Company”, by journalist Matt Peacock.  It was Peacock who exposed the fact that James Hardie knew about the mesothelioma/asbestos link more than 20 years before it ever warned employees or the public of the danger. “Killer Company” is the basis for the upcoming miniseries.

When asbestos is inhaled or ingested, as it clearly was by hundreds of James Hardie employees like Banton, shards of the fibrous mineral become imbedded in the thin tissue that surrounds the lungs or abdominal cavity. Over time, the continual irritation and inflammation caused by these shards can bring about cellular changes that lead to mesothelioma. Mesothelioma is a highly aggressive cancer with a poor prognosis. Australia continues to have one of the highest per capita rates of mesothelioma in the world with 3 new cases per 100,000 people. According to the ABC network, 60,000 Australians are expected to die of asbestos diseases like mesothelioma by 2030.

In “Killer Company”, Peacock not only relates Banton’s personal struggle with mesothelioma and his work as a victim’s advocate, but graphically illustrates many incidents of careless asbestos exposure in and around James Hardie. Workers reportedly ate their lunches near the asbestos they worked with and neighborhood children played in the asbestos waste dumped outside.

The Bernie Banton Foundation continues Banton’s legacy of advocacy in Australia. “The Devil’s Dust” miniseries begins production this week.

source from: survivingmesothelioma