Tuesday, April 13, 2010

Australia Faces Spike in Mesothelioma Cases

Authorities in Australia are speculating that over the next 15 years the number of mesothelioma cases diagnosed there will rise from the current 500 cases per year to more than900 diagnosed cases annually. A professor from the London School of Hygiene and Tropical Medicine using World Health Organization statistics found that the United Kingdom and Australia lead the world in mesothelioma–related deaths each year.


Researchers at the Cancer Research UK Epidemiology and Genetics Group theorize that the death rate from asbestos related diseases in men over the age of 40 will become nearly 100 times more likely to die by the age of 80. The same research found that there have been more than 10,000 mesothelioma deaths since the 1980s. Australia has relied heavily in the past on asbestos materials and products. During the 1970s, for instance, almost 22 million pounds of asbestos was imported to aid in the country’s construction industry.


In the United States, Chrysotile is the most commonly used type of asbestos in the construction and equipment industry, and it is responsible for the majority of US mesothelioma cases. Brown, blue, and white asbestos are the most common types of asbestos that were in use during the 1970s and 1980s, and since have been banned in Australia. The commercial mining of asbestos in Australia continued until the 1980s when information about the dangers of asbestos exposure became public, causing a multitude of regulations and laws being passed to protect individuals from the harmful effects.


The rise in Australian mesothelioma cases mirrors the growth of related medical facilities, organizations, and foundations around the country. These include As a result of the increasing cases of mesothelioma being diagnosed in Australia, and due to the suspected increase in death rates in the future, many mesothelioma and cancer related medical facilities have been growing in number around the country. Organizations and foundations are also on the rise in Australia, groups like the Asbestos Diseases Foundation of Australia and the Queensland Asbestos Related Disease Support Society.

Mesothelioma Clinical Trial Will Use Two-Drug Chemotherapy Method

In a clinical trial being conducted at Brigham and Women’s Hospital, the effectiveness and correct dosage of a two-drug chemotherapy method is being tested on mesothelioma patients who have undergone surgery.


Mesothelioma is a rare form of cancer that most commonly develops in the lining of the lungs. The primary cause of mesothelioma is exposure to asbestos and symptoms can take as long as 20 to 50 years to arise after initial exposure. For this reason, people often unknowingly develop the cancer and are diagnosed when it has already reached the advanced stages of development.


A total of 36 malignant mesothelioma patients are being enrolled for the study. One of the chemotherapy drugs being used is cisplatin, which has become a recognized treatment option for mesothelioma. The clinical trial will also be testing the chemotherapy drug gemcitabine to see if the addition of the drug can be accomplished safely and can improve treatment.


Dr. David Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital, is the lead investigator for the trial. Much of his research has been centered on malignant pleural mesothelioma and he is most noted for his multi-modal approach to combating the cancer.


Current treatment options for this cancer are limited and researchers are still looking for a cure. Most methods of treatment offered to patients are palliative and do not attempt to cure the cancer. Nonetheless, clinical trials like the one being carried out at Brigham and Women’s Hospital are providing answers for researchers looking for a cure.

Mesothelioma May Benefit From Immuno-Gene Therapy

Gene therapy is a promising treatment for mesothelioma, but it has been slow to make its way into clinical use because delivering enough therapeutic genes to effectively kill large numbers of cancer cells has proved challenging. Recently, mesothelioma researchers have been focusing on a method called immuno-gene therapy, which transfers just enough genetic material to trigger the patient’s own immune system to fight the cancer, according to a recent review published in the American Journal of Respiratory Cell and Molecular Biology.


Researchers have been investigating the use of gene therapy – introducing a gene or genes into the body that kill cancer cells or make those cells more sensitive to the effects of anticancer drugs – for approximately two decades. According to the review, mesothelioma is a particularly good target for gene therapy, because no treatment used so far (surgery, chemotherapy, radiation) has been able to effectively treat the disease, and because mesothelioma tumors tend to stay in one place until the late stages of the disease—making them good targets.


For a gene to be introduced into the body to kill mesothelioma or another cancer, it needs a vehicle—or vector—to help it reach the tumor cells. Gene therapy for mesothelioma can be administered using viruses (most commonly adenoviruses that have been altered in a lab so that they are unable to replicate), and coated DNA. Yet both methods have their limitations.


“The problem with viruses is that the body rejects the infectious cells very quickly,” explains the review’s author, Steven M. Albelda, MD, Professor of Medicine at the University of Pennsylvania School of Medicine, and Vice Chief of the Pulmonary, Allergy, and Critical Care Division. “The problem with coated DNA is that it’s very inefficient. The technology hasn’t really been able to infect the majority of tumor cells.”


When either viruses or DNA is injected by vein (which is how most drugs are administered), only a small amount of the vector actually reaches the mesothelioma cells. “The small amount that gets there doesn’t express the gene for very long,” Dr. Albelda says. When gene therapies are unable to reach large numbers of cancer cells, they need a strong “bystander effect,” which means that the cancer cells affected by treatment send out signals that also kill neighboring cells.


Given the challenges in reaching large numbers of mesothelioma cells, the focus of gene therapy has shifted to inciting the body’s own immune response against the cancer. The idea behind immuno-gene therapy is to inject just enough of the gene—for example, using a vaccine or cytokines (chemical messengers released by the immune system)—to stimulate an immune response powerful enough to trigger a strong bystander effect. “Now you’re just using the gene therapy to trigger the immune system, and most of the killing will be done by the body’s own immune system,” Dr. Albelda says.


Treatments that stimulate the patient’s immune system can be administered in two ways. One method is to create an off-the-shelf drug that can be injected into any patient. The other is to develop a highly personalized therapy using cells (such as dendritic cells or lymphocytes) taken from the patient’s own body. Those cells are then altered in a lab so that once injected back into the patient, they will attack mesothelioma cells.


Even immuno-gene therapy is limited in its ability to destroy large tumors such as advanced mesothelioma, which is why researchers are investigating combination approaches that pair up traditional therapies such as surgery and chemotherapy with immunotherapy. When researchers administer gene therapy after chemotherapy, the combination may heighten the response against the cancer.


“The other thing we’ve been working on which works really nicely is combining immunotherapy with surgery,” Dr. Albelda says. “The problem with surgery is it always leaves some cells behind. Our idea is that if we induce an immune response and we get rid of 95 percent of cancer cells with surgery, the immune system can clean up the remaining cells.”


The question that remains is how best to incorporate these therapies. “I think we have to learn how to integrate immuno-gene therapy with chemotherapy, radiation, and surgery in the right way,” says Dr. Albelda. As study results continue to improve, researchers are going to be able to initiate combination therapies earlier and earlier in the course of the disease, making these treatments more likely to be effective in mesothelioma in the future.

Sunday, April 11, 2010

Coping With Mesothelioma Diagnosis

Dealing with a mesothelioma or lung cancer diagnosis is one of the hardest things imaginable. Not only does one have to wrestle with their own mortality and get their affairs in order, they also have to help family members and loved ones cope with the news. Family members often feel helpless because they believe there is nothing they can do to help. One thing we can all do to help is try to raise awareness regarding the science behind trying to find a cure. The number of studies and clinical trials on mesothelioma is rapidly growing. One interesting study is called, “Plasma lipid peroxides among workers exposed to silica or asbestos dusts.” By Kamal AA, Gomaa A, el Khafif M, Hammad AS. - Environ Res. 1989 Aug;49(2):173-80. - Department of Community, Environmental and Occupational Medicine, Ein Shams University, Cairo, Egypt.


Here is an excerpt: “Plasma malondialdehyde (MDA) (an indicator of lipid peroxidation) was determined in random samples of workers (age range 25-60 years) exposed to silica dust (n = 31, mean exposure duration 21.3 +/- 8.3 years) or asbestos dust (n = 59, mean exposure duration 15.6 +/- 4.5 years) and in 52 age-matched healthy male controls. MDA levels of both exposed groups were significantly higher than that of the controls and were significantly higher among workers exposed to asbestos than among those exposed to silica dusts. Neither age nor smoking was related to MDA levels among both controls and exposed workers; among the latter group MDA was not significantly correlated with duration of exposure. Mean MDA levels of exposed workers with radiographic signs of lung fibrosis or pleural thickening and of those without such signs were not significantly different, except in the case of asbestos-exposed workers where it was significantly less than that of those without such signs. Differences between mean durations of dust exposure of workers with radiographic signs of lung fibrosis and those without such signs were statistically insignificant. The results suggest the possible involvement of lipid peroxidation on exposure to silica or asbestos dusts in humans and possible development of antioxidant mechanism(s) on prolonged dust exposure and support the opinion that development of pneumoconiosis depends on susceptibility factor(s).”


A second study worth looking at is called, “Surface charge and asbestos toxicity” by


W. G. LIGHT & E. T. WEI - Nature 265, 537 - 539 (10 February 1977); doi:10.1038/265537a0 - Department of Biomedical and Environmental Health Sciences, School of Public Health, University of California, Berkeley, California 94720.


Here is an excerpt: “Asbestos is a serious occupational and environmental hazard because of its fibrogenic and carcinogenic actions on the lung. Asbestos fibres exist in various physical forms, all of which are toxic. It is not known, however, which form is the most hazardous or which fibre property is the most important for inducing the toxic effects. It is thus important to examine relationships between the structure of the fibres and their biological activity. We have investigated the relationship between the surface charge and the haemolytic activity (ability to rupture the erythrocyte membrane) of asbestos. We report here that different forms of asbestos can be activated or inactivated by surface charge alterations.”


If you found either of these excerpts interesting, please read the studies in their entirety and urge others to do so as well.

Vaccine for mesothelioma

According to a new study to be published in an upcoming print version of the American Journal of Respiratory and Critical Care Medicine, scientists have developed an investigational vaccine for mesothelioma, a type of cancer caused by exposure to asbestos. When researchers from the Netherlands tested the vaccine on 10 patients, they found that it “infuses a patient’s own dendritic cells with antigen from the patient’s tumor”-and “that it induced an immune T-cell response against mesothelioma tumors.”


The American Cancer Society reports that 2,000 to 3,000 new cases of mesothelioma arise each year; the scientists who developed the cancer vaccine hope that this new treatment will save thousands of lives, as reported by Bloomberg Business Week. The disease usually attacks the lungs first and can then spread to the tissues of other human organs. The typical survival rate after a diagnosis of mesothelioma is around 12 months, with standard chemotherapy treatments usually extending survival time by only three months. Scientists believe that new mesothelioma cases will continue to climb until 2020.


Researcher Dr. Joachim Aerts stated, “We hope that by further development of our method it will be possible to increase survival in patients with mesothelioma and eventually vaccinate persons who have been in contact with asbestos to prevent them from getting asbestos related diseases.”

Mesothelioma Cancer Prognosis

Generally, the most important variable in determining the prognosis and life expectancy of a patient mesothelioma cancer stage at diagnosis. Unfortunately, mesothelioma is more difficult to "stage" than other cancers. This is true for two reasons:


1) because its quite rare, and
2) because its initial symptoms are subtle, it is often advanced when diagnosed, it is difficult to stage.


Peritoneal mesothelioma in particular can be difficult to stage because, while pleural mesothelioma has multiple classification systems, pathologists have not yet developed a system of staging for peritoneal mesothelioma. Both pleural and peritoneal mesothelioma are very serious conditions and are not good prospects.


Since mesothelioma is usually diagnosed at an advanced stage, the statistics of five-year survival for early stage mesothelioma are generally unreliable. He also can not say with certainty which of the two types is a bad diagnostic peritoneal mesothelioma or pleural mesothelioma. Numerous studies show that peritoneal is more deadly and rapidly spreading mesothelioma pleural mesothelioma, but these studies are often contradicted by scholars who argue pleural mesothelioma is the most dangerous and difficult to deal with both. Usually, patients diagnosed with mesothelioma is peritoneal or pleural said they may have less than a year to live. However, according to researchers at major research centers around the world this is not necessarily the case. More recent studies indicate that patients with mesothelioma may, in some cases, have a better appearance than previously thought.


These studies suggest that about 10% of all mesothelioma patients will be alive 3 years later and about 5% will be alive 5 years later. However, if mesothelioma is detected early and treated, 50% survive 2 years and 20% of people survive 5 years.


In a clinical trial involving 120 patients with different types of pleural mesothelioma, all patients underwent pleural pneumonectomy (removal of the lung and pleura), followed by radiotherapy and chemotherapy. 45% were alive two years later and 20% were still alive five years later.


In the same study, patients with sarcomatoid and mixed mesothelioma was not as well. Only 20% of these patients were alive two years later, and none of them have survived five years.


However, patients who had no cancer in the lymph nodes and tumors of epithelioid type is much better. Nearly 75% survived more than two years and nearly 40% were alive after five years.


Another larger study conducted in Italy examined the records of 4.5 million people diagnosed with mesothelioma. The survival rates were as follows: 24% of people with pleural mesothelioma and 34% diagnosed with peritoneal mesothelioma were still alive one year after diagnosis. Two other important studies, in addition to examination of comparable populations, also revealed similar results.


Another variable that is extremely important for a patient is seeing his general health at the time of diagnosis. In general, the health of a patient, the better he or she will react to treatments against cancer, and the chances of longer survival. Doctor's have a method of classifying patients' health and to give each patient a score at diagnosis. This method of classification is called a patient's condition "performance" (PS). The best score is 0 and indicates a patient can normally take care of himself or with the help of. A performance index of 1 indicates that the patient can do things, but may need assistance. The more deteriorated health of the patient, the higher the number.


The patient must always keep in mind that statistics such as those mentioned here are by no means definitive. Survival has much to do with a number of different factors, including health, the type of mesothelioma, the choice of treatment, and even a moral patient. The statistics listed here are too general for patients to get an accurate idea of their own look.


Patients should consider taking part in clinical trials. Although nobody can say exactly why patients who are treated in clinical trials do better on average than those treated conventionally. Maybe with all the testing and monitoring that is done, patients become more confident that everything that can possibly be done is done.

Mesothelioma Definition

Mesothelioma is a type of cancer caused by the inhalation of asbestos, which is a seemingly useless material ignored by most people. It is called mesothelioma cancer because it affects the outer covering of vital organs, the mesothelium. Examples are the peritoneal, pericardial and pleural membranes


The signs and symptoms usually appear decades after the onset of the cancer itself, and is sometimes taken for granted because its symptoms are mostly the same with less serious illnesses.


Diagnosis of mesothelioma


The progress of mesothelioma depends on the distance of the metastasis from the point of origin. Diagnosis is done through biopsy of the patient's infected part. It is screened through the determination of serum osteopontin level and significant amounts could indicate mesothelioma.


There are three types of mesothelioma, the most common type is the pleural mesothelioma which involves the lining of the lungs. This is caused by asbestos exposure. The workers of a manufacturing company dealing with asbestos are the first victims due to direct contact and inhalation of its fibers. This type of cancer is more common in males than in females. This causes chronic inflammation that will develop into malignant tumors after years.


The second is the Peritoneal mesothelioma. This type of mesothelioma affects the peritoneum and the last is pericardial mesothelioma which affects the covering of the heart or the pericardium.


Some studies imply that the development of mesothelioma in one individual is affected by SV40 or Simin Virus 40. In rare cases, mesothelioma cancer definition is associated with irradiation and inhalation of fibrous silicates. Mesothelioma is not a smoking-associated cancer like in lung cancer but it can aggravate the risk of asbestos-induced cancers.


Some of the treatments available nowadays are chemotherapy, irradiation therapy and surgery. But the most effective way on how to avoid cancer is prevention from acquiring it.


Mesothelioma cancer definition can be ambiguous because of the lack of proper diagnosis during the early stages of the disease. This type of cancer is uncommon and people working in an asbestos-procuring or manufacturing company should be aware of the hazards of their job so they can implement proper action to solve the problem.

Malcolm McLaren – Passes away from Mesothelioma

Malcolm McLaren, the man who brought us The Sex Pistols and a pillar of the British Punk Movement of the late 70’s and 80’s has died at the age of 64. He also managed The New York Dolls.


Malcolm McLaren died of Mesothelioma in Switzerland earlier this week. He’s being flown back to England for funeral.