Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated. Unfortunately, mesothelioma is often found at a stage in which a cure is unobtainable. Many will succumb to the disease within one year of diagnosis.
Mesothelioma treatment options (traditional and new treatments being studied)
Treatment options are determined by the stage of mesothelioma (the extent to which the tumor has spread in the body). There are three staging systems currently in use, and each one measures somewhat different variables.
The oldest staging system and the one most often used is the Butchart system, which is based mainly on the extent of primary tumor mass and divides mesotheliomas into four stages.
Butchart system extent of primary tumor mass
Stage I: Mesothelioma is present in the right or left pleura and may also involve the diaphragm on the same side.
Stage II: Mesothelioma invades the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may also be involved.
Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.
The more recent TNM system considers variables of tumor in mass and spread, lymph node involvement, and metastasis.
TNM system: variables of T (tumor), N (lymph nodes), and M (metastasis)
Stage I: Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.
Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
Stage III: Mesothelioma is now in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side with or without spread to lymph nodes on the same side as the primary tumor.
Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, extended to the pleura or lung on the opposite side, or directly extended into organs in the abdominal cavity or neck. Any distant metastases is included in this stage.
The Brigham system is the latest system and stages mesothelioma according to resectability (the ability to surgically remove the tumor) and lymph node involvement.
Brigham system: variables of tumor resectability and nodal status
Stage I: resectable mesothelioma and no lymph node involvement
Stage II: resectable mesothelioma but with lymph node involvement
Stage III: unresectable mesothelioma extending into chest wall, heart, or through diaphragm, peritoneum; with or without extrathoracic lymph-node involvement
Stage IV: distant metastatic disease
Wednesday, September 2, 2009
What is the treatment for mesothelioma?
There are three traditional kinds of treatment for patients with malignant mesothelioma. Often two or more of these are combined in the course of treatment:
surgery (taking out the cancer),
radiation therapy (using high-dose X-rays or other high-energy rays to kill cancer cells), and
chemotherapy (using drugs to fight the cancer).
Additional information
Surgery: There are several types of surgery used in treating mesothelioma.
A pleurectomy is the removal of part of the chest or abdomen lining and some of the tissue around it.
Depending on how far the cancer has spread, a lung also may be removed in an operation called a pneumonectomy.
In an extrapleural pneumonectomy, the lung is removed along with the lining and diaphragm (the muscle that helps you breathe) on the affected side. In this surgery, the lining around the heart is also removed.
Sometimes a pleurectomy/decortication is performed. In this surgery, the lining of the lung is removed along with as much of the tumor as possible.
Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).
If fluid has collected in the chest or abdomen, your doctor may drain the fluid out of your body by putting in a needle into the chest or abdomen and using gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed from the abdomen, this is called paracentesis. Your doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be administered by pill, or it may be put into the body by a needle in the vein or muscle.
Chemotherapeutic agents can be administered either systemically (through the bloodstream) or intrapleurally (in the pleural cavity). When it is administered intrapleurally, the treatment is localized at the site of the tumor. These drugs are generally very toxic and you should discuss their use very carefully with your physician.
surgery (taking out the cancer),
radiation therapy (using high-dose X-rays or other high-energy rays to kill cancer cells), and
chemotherapy (using drugs to fight the cancer).
Additional information
Surgery: There are several types of surgery used in treating mesothelioma.
A pleurectomy is the removal of part of the chest or abdomen lining and some of the tissue around it.
Depending on how far the cancer has spread, a lung also may be removed in an operation called a pneumonectomy.
In an extrapleural pneumonectomy, the lung is removed along with the lining and diaphragm (the muscle that helps you breathe) on the affected side. In this surgery, the lining around the heart is also removed.
Sometimes a pleurectomy/decortication is performed. In this surgery, the lining of the lung is removed along with as much of the tumor as possible.
Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).
If fluid has collected in the chest or abdomen, your doctor may drain the fluid out of your body by putting in a needle into the chest or abdomen and using gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed from the abdomen, this is called paracentesis. Your doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be administered by pill, or it may be put into the body by a needle in the vein or muscle.
Chemotherapeutic agents can be administered either systemically (through the bloodstream) or intrapleurally (in the pleural cavity). When it is administered intrapleurally, the treatment is localized at the site of the tumor. These drugs are generally very toxic and you should discuss their use very carefully with your physician.
Is there any promising research or are there promising drugs for mesothelioma?
New approaches being studiedNew approaches to treat malignant mesothelioma are currently being tested. They often combine traditional treatments or include something entirely new. They include
Promising drugs
L-NDDP (Platar): Intrapleural administration of this platinum product is designed to overcome the toxicity and drug resistance currently limiting the usefulness of platinum drugs like Cisplatin. NOTE: A recent trial produced remission in two patients.
Endostatin has been shown to work with angiostatin in destroying a tumors' ability to grow blood vessels without harming normal cells.
Lovastatin is a cholesterol drug shown in a recent study to potentially inhibit mesothelioma cancer cell growth.
Intrapleural interferon gamma is the direct administration of the anti-cancer drug interferon gamma.
Photodynamic therapy kills cancer cells using the energy of light.
Immunotherapy treats cancer by helping the immune system fight the disease.
Gene therapy treats cancer by correcting the genetic deficits that allow tumors to develop. A September 1999 study found that interferon interleukin prevented the growth of mesothelioma cells in mice.
Research is being conducted at various cancer centers all over the United States.
A recent study involving L-NDDP produced two cases of remission in mesothelioma patients. Another study found that a drug known as Lovastatin may hold promise for mesothelioma patients.
To learn more about mesothelioma clinical studies and journal medical journal articles, visit the Mesothelioma Web (http://www.mesotheliomaweb.org).
Promising drugs
L-NDDP (Platar): Intrapleural administration of this platinum product is designed to overcome the toxicity and drug resistance currently limiting the usefulness of platinum drugs like Cisplatin. NOTE: A recent trial produced remission in two patients.
Endostatin has been shown to work with angiostatin in destroying a tumors' ability to grow blood vessels without harming normal cells.
Lovastatin is a cholesterol drug shown in a recent study to potentially inhibit mesothelioma cancer cell growth.
Intrapleural interferon gamma is the direct administration of the anti-cancer drug interferon gamma.
Photodynamic therapy kills cancer cells using the energy of light.
Immunotherapy treats cancer by helping the immune system fight the disease.
Gene therapy treats cancer by correcting the genetic deficits that allow tumors to develop. A September 1999 study found that interferon interleukin prevented the growth of mesothelioma cells in mice.
Research is being conducted at various cancer centers all over the United States.
A recent study involving L-NDDP produced two cases of remission in mesothelioma patients. Another study found that a drug known as Lovastatin may hold promise for mesothelioma patients.
To learn more about mesothelioma clinical studies and journal medical journal articles, visit the Mesothelioma Web (http://www.mesotheliomaweb.org).
Mesothelioma At A Glance
Mesothelioma is a cancer that arises from the cells lining the chest or abdominal cavities.
Mesothelioma typically results from exposure to asbestos.
When mesothelioma affects the chest, the doctor may look inside the chest cavity with a special instrument called a thoracoscope.
When mesothelioma affects the abdomen, the doctor may look inside the abdomen with a special tool called a peritoneoscope.
Mesothelioma is diagnosed by a biopsy.
The outlook for patients with mesothelioma depends on how early the disease is detected and how aggressively it is treated.
Mesothelioma typically results from exposure to asbestos.
When mesothelioma affects the chest, the doctor may look inside the chest cavity with a special instrument called a thoracoscope.
When mesothelioma affects the abdomen, the doctor may look inside the abdomen with a special tool called a peritoneoscope.
Mesothelioma is diagnosed by a biopsy.
The outlook for patients with mesothelioma depends on how early the disease is detected and how aggressively it is treated.
How is mesothelioma diagnosed?
Mesothelioma is diagnosed by pathological examination from a biopsy. Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid buildup around the lungs (pleural effusions), shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an X-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:
ThoracoscopyFor pleural mesothelioma, the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital using a local anesthetic or painkiller.If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and using gentle suction to remove the fluid. This is called thoracentesis.
PeritoneoscopyFor peritoneal mesothelioma, the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
BiopsyIf abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.Unfortunately, in some cases, tumor cells can grow along the tract where the biopsy is taken. This can be minimized with the use of radiation to the area.
ThoracoscopyFor pleural mesothelioma, the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital using a local anesthetic or painkiller.If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and using gentle suction to remove the fluid. This is called thoracentesis.
PeritoneoscopyFor peritoneal mesothelioma, the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
BiopsyIf abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.Unfortunately, in some cases, tumor cells can grow along the tract where the biopsy is taken. This can be minimized with the use of radiation to the area.
What causes mesothelioma?
Most people with malignant mesothelioma have worked on jobs where they breathed asbestos. Usually, this involves men over 40 years of age. Others have been exposed to asbestos in a household environment, often without knowing it. Interestingly, the number of new cases of mesothelioma has been relatively stable since 1983, the same time that the restrictions on asbestos were instituted by the U.S. Occupational Safety and Health Administration (OSHA). In Europe, the number of new cases of mesothelioma continues to rise.
What are the symptoms of mesothelioma?
Most people present with complaints of shortness of breath. They also can have complaints of chest pain. Surprisingly, this pain is often not pleuritic; that is, it does not get worse with deep breathing. This is surprising in that the pleura (outer surface of the lung) is often involved in this disease, and most other diseases involving the pleura are often associated with pleuritic pain (pain that worsens with deep breathing). Patients may also be asymptomatic, with the disease discovered by physical exam or an abnormal chest X-ray.
As the disease progresses, shortness of breath increases, and weight loss, decreased appetite, and night sweats can develop. Local invasion by the tumor can result in changing of voice, loss of function of the diaphragm, and symptoms specific to the area and involvement of adjacent structures.
As the disease progresses, shortness of breath increases, and weight loss, decreased appetite, and night sweats can develop. Local invasion by the tumor can result in changing of voice, loss of function of the diaphragm, and symptoms specific to the area and involvement of adjacent structures.
What is mesothelioma?
Mesothelioma is a rare form of cancer (malignancy) that most frequently arises from the cells lining the sacs of the chest (the pleura) or the abdomen (the peritoneum). Pleural mesothelioma is the most common form, often presenting with symptoms in the chest area. Peritoneal mesothelioma is much less common. This can effect the organs in the abdomen, and its symptoms are related to this area of the body, that is, abdominal swelling, nausea, vomiting, and bowel obstruction. The rarest form of mesothelioma is pericardial mesothelioma, which involves the sac surrounding the heart.
There are two major cell types of mesothelioma, epithelial and sarcomatoid. Sometimes both of these cell types can be present. The sarcomatoid type is rarer and occurs in only about 15% of cases; it portends a poorer prognosis. In very rare cases, mesothelioma can originate from benign, non-malignant cells. This so-called benign mesothelioma can be cured surgically.
There are two major cell types of mesothelioma, epithelial and sarcomatoid. Sometimes both of these cell types can be present. The sarcomatoid type is rarer and occurs in only about 15% of cases; it portends a poorer prognosis. In very rare cases, mesothelioma can originate from benign, non-malignant cells. This so-called benign mesothelioma can be cured surgically.
Saturday, August 1, 2009
TIP30 Inhibits Lung Cancer Metastasis, Study Suggests
They report these findings in the May 2009 issue of The American Journal of Pathology.
TIP30 is a putative tumor suppressor with decreased expression in numerous cancers including melanoma, breast cancer, and colon cancer. Lung cancer is the most common cancer worldwide, both in terms of incidence and of mortality.
To determine if TIP30 plays a role in lung cancer progression and metastasis, Tong et al examined TIP30 expression in paired cancerous and non-cancerous lung tissue. TIP30 expression was decreased in a third of non-small cell lung cancers compared with normal controls, and reduced TIP30 expression correlated with lymph node metastasis. In addition, inhibition of TIP30 expression promoted lung cancer metastasis and angiogenesis in mice,
Tong et al conclude that "TIP30 may function as a tumor suppressor gene and play important roles in suppressing the progression and metastasis of lung cancer." These findings highlight TIP30 as a potential new therapeutic for metastatic lung cancer.
TIP30 is a putative tumor suppressor with decreased expression in numerous cancers including melanoma, breast cancer, and colon cancer. Lung cancer is the most common cancer worldwide, both in terms of incidence and of mortality.
To determine if TIP30 plays a role in lung cancer progression and metastasis, Tong et al examined TIP30 expression in paired cancerous and non-cancerous lung tissue. TIP30 expression was decreased in a third of non-small cell lung cancers compared with normal controls, and reduced TIP30 expression correlated with lymph node metastasis. In addition, inhibition of TIP30 expression promoted lung cancer metastasis and angiogenesis in mice,
Tong et al conclude that "TIP30 may function as a tumor suppressor gene and play important roles in suppressing the progression and metastasis of lung cancer." These findings highlight TIP30 as a potential new therapeutic for metastatic lung cancer.
One Of The Mechanisms That Prevents Spread Of Colon Cancer Discovered
Researchers at IRB Barcelona under the direction of Eduard Batlle, ICREA researcher and head of IRB Barcelona's Oncology Programme, have discovered a new mechanism by which the benign tumour cells receive instructions to grow in confined compartments, and no to invade other areas of the tissue. The description of this new tumour suppression mechanism is reported in the scientific journal Nature Genetics.
The scientists observed that adenomatous tumour cells have special surface receptors, called EphB2 and EphB3, which detect the presence of certain ligands in the healthy tissue that surround them. These receptors and their ligands serve to organize the structure of intestinal tissue. Thanks to the activity of EphB2 and EphB3, the tumour cells are forced to "listen to" the signals that they receive from their environment.
These signals make the benign tumours grow in a confined space, from which they are unable to spread. "We knew that these receptors worked as tumour suppressors, but we did not know how. Now we have been able to observe that they compartmentalize the tumour, thereby preventing its spread", explains Batlle.
Until the tumour cells learn to deactivate these receptors, they cannot invade other tissue outside the compartment. Batlle goes on to say, "as the tumour cells progress to become malignant, their genetic programme is refined and they remove the signals that block their growth, including these two receptors, which impose positional information".
This study explains one of the key mechanisms of how a benign tumour transforms into a malignant one during the onset of colon cancer. Using experiments performed with animal models and in vitro cells, the scientists determined that the loss of compartmentalization, that is to say, the loss-of-function of these two receptors, is one of the vital factors in the development of adenoma-derived colon cancer.
It is estimated that between 30 and 50% of people over 60 years of age may develop one of these benign adenomas. Cancer of the colon ranks first in the list of the most common cancers in Spain, with more than 25,000 causes diagnosed each year. Last year alone, more than half a million people worldwide died as a result of this disease.
The scientists observed that adenomatous tumour cells have special surface receptors, called EphB2 and EphB3, which detect the presence of certain ligands in the healthy tissue that surround them. These receptors and their ligands serve to organize the structure of intestinal tissue. Thanks to the activity of EphB2 and EphB3, the tumour cells are forced to "listen to" the signals that they receive from their environment.
These signals make the benign tumours grow in a confined space, from which they are unable to spread. "We knew that these receptors worked as tumour suppressors, but we did not know how. Now we have been able to observe that they compartmentalize the tumour, thereby preventing its spread", explains Batlle.
Until the tumour cells learn to deactivate these receptors, they cannot invade other tissue outside the compartment. Batlle goes on to say, "as the tumour cells progress to become malignant, their genetic programme is refined and they remove the signals that block their growth, including these two receptors, which impose positional information".
This study explains one of the key mechanisms of how a benign tumour transforms into a malignant one during the onset of colon cancer. Using experiments performed with animal models and in vitro cells, the scientists determined that the loss of compartmentalization, that is to say, the loss-of-function of these two receptors, is one of the vital factors in the development of adenoma-derived colon cancer.
It is estimated that between 30 and 50% of people over 60 years of age may develop one of these benign adenomas. Cancer of the colon ranks first in the list of the most common cancers in Spain, with more than 25,000 causes diagnosed each year. Last year alone, more than half a million people worldwide died as a result of this disease.
Inflammatory Biomarker Helps Identify Progressive Precancerous Lesions In The Lung
The results appear in the first issue for March 2005 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Stephen Lam, M.D., F.R.C.P.C., of the Lung Tumour Group, British Columbia Cancer Agency at the University of British Columbia in Vancouver, Canada, and three associates measured CRP, lung function and other inflammatory markers in 65 individuals. All participants had at least one abnormal cell site in their lungs (bronchial dysplasia) greater than 1.2 millimeters in size, which was biopsied at the start of the study and re-examined 6 months later.
Of the study cohort, 49 individuals (75 percent) were men, with 48 classified as current smokers. On average, study participants were 57 years old and had 52 pack-years of smoking history.
"Lung cancer is a worldwide epidemic," said Dr. Lam. "More than 300 million people die of this disease annually. In the United States alone, 170,000 new cases of lung cancer are reported each year. Most of these are non-small cell lung cancer and the overall prognosis once diagnosed is dismal. The only reasonable chance of cure is surgical resection for early stage tumors. However, most patients with early lung cancer are asymptomatic. Symptoms usually develop after the tumors become invasive or disseminated and curative resection is infeasible."
Consequently, researchers have been working to find novel non-invasive or semi-invasive methods of identifying individuals who harbor progressive precancerous lesions. If detected early, these lesions might be treated with a chemopreventive agent to impede progress to invasive carcinoma.
In the study, the level of CRP only differed between individuals who either did or did not develop progression in their bronchial lesions.
"The odds of developing progressive disease were 9.6 fold higher in the group that had CRP greater than 0.5 mg per liter compared with the group less than this threshold," said Dr. Lam.
There were 32 subjects whose bronchial lesions had progressed to a more abnormal state when biopsied after 6 months.
"These data are consistent with the prevailing hypothesis that squamous cell carcinoma arises from preinvasive lesions in stepwise fashion, which is called the sequential theory of cancer development," said Dr. Lam. "This hypothesis is supported by animal experiments mimicking human carcinogenesis."
The authors believe that these results will be helpful in designing future chemopreventive and early detection studies by identifying high-risk subjects for non-small cell lung cancer.
Stephen Lam, M.D., F.R.C.P.C., of the Lung Tumour Group, British Columbia Cancer Agency at the University of British Columbia in Vancouver, Canada, and three associates measured CRP, lung function and other inflammatory markers in 65 individuals. All participants had at least one abnormal cell site in their lungs (bronchial dysplasia) greater than 1.2 millimeters in size, which was biopsied at the start of the study and re-examined 6 months later.
Of the study cohort, 49 individuals (75 percent) were men, with 48 classified as current smokers. On average, study participants were 57 years old and had 52 pack-years of smoking history.
"Lung cancer is a worldwide epidemic," said Dr. Lam. "More than 300 million people die of this disease annually. In the United States alone, 170,000 new cases of lung cancer are reported each year. Most of these are non-small cell lung cancer and the overall prognosis once diagnosed is dismal. The only reasonable chance of cure is surgical resection for early stage tumors. However, most patients with early lung cancer are asymptomatic. Symptoms usually develop after the tumors become invasive or disseminated and curative resection is infeasible."
Consequently, researchers have been working to find novel non-invasive or semi-invasive methods of identifying individuals who harbor progressive precancerous lesions. If detected early, these lesions might be treated with a chemopreventive agent to impede progress to invasive carcinoma.
In the study, the level of CRP only differed between individuals who either did or did not develop progression in their bronchial lesions.
"The odds of developing progressive disease were 9.6 fold higher in the group that had CRP greater than 0.5 mg per liter compared with the group less than this threshold," said Dr. Lam.
There were 32 subjects whose bronchial lesions had progressed to a more abnormal state when biopsied after 6 months.
"These data are consistent with the prevailing hypothesis that squamous cell carcinoma arises from preinvasive lesions in stepwise fashion, which is called the sequential theory of cancer development," said Dr. Lam. "This hypothesis is supported by animal experiments mimicking human carcinogenesis."
The authors believe that these results will be helpful in designing future chemopreventive and early detection studies by identifying high-risk subjects for non-small cell lung cancer.
Chest Scans May Help Monitor Spread Of Head And Neck Cancer In High-risk Patients
Developing a second, distant cancer (a metastasis or a new primary cancer) is an important factor affecting survival of patients with head and neck squamous cell carcinoma, which accounts for most head and neck cancers, according to background information in the article. The most common site at which such patients develop new metastases is the lungs, with an incidence of 8 percent to 15 percent. Chest X-rays are the most commonly used screening tool for detecting these malignancies but do not always identify early abnormalities.
Yen-Bin Hsu, M.D., of Taipei Veterans General Hospital, Taiwan, and colleagues evaluated 270 screening chest CT scans performed over 42 months in 192 patients with head and neck squamous cell carcinoma. The scans were categorized as new cases, follow-up cases or recurrent cases, and results classified as normal or abnormal.
Of the 270 scans, 79 (29.3 percent) were considered abnormal, including 54 (20 percent) that identified a malignant neoplasm of the lung and 25 (9.3 percent) showing indeterminate abnormalities. "The rate of an abnormal scan was significantly higher in the follow-up case group (44.2 percent) than in the new case group (14.2 percent)," the authors write. Patients whose cancer was classified as stage N2 or N3 (indicating some degree of lymph node involvement), who had stage IV disease (in which the cancer has spread to another organ), who had recurrent disease or who had a distant metastasis in another site were more likely to have a malignant neoplasm of the lung.
"Indeterminate lesions were common on chest CT in our study, and special attention should be paid to them," the authors write. "Based on the progressive changes in follow-up scans, 44 percent of indeterminate lesions were eventually considered a malignant neoplasm of the lung. We also found that small (less than 1 centimeter) solitary nodules, which were usually resectable [operable], carried significantly higher chances (66.7 percent) of being a malignant neoplasm."
"For patients with head and neck squamous cell carcinoma, chest diagnosis is crucial and may influence their treatment plan," they continue. "In conclusion, chest CT is recommended for high-risk patients, especially every six months for the first two years during the follow-up period, although its role is controversial for patients newly diagnosed as having head and neck squamous cell carcinoma. High-risk patients include those with N2 or N3 disease, stage IV disease or locoregional recurrence. For patients with indeterminate small (less than 1 centimeter) solitary pulmonary nodules, aggressive evaluation and management are imperative because of the high rate of a malignant neoplasm of the lung."
Yen-Bin Hsu, M.D., of Taipei Veterans General Hospital, Taiwan, and colleagues evaluated 270 screening chest CT scans performed over 42 months in 192 patients with head and neck squamous cell carcinoma. The scans were categorized as new cases, follow-up cases or recurrent cases, and results classified as normal or abnormal.
Of the 270 scans, 79 (29.3 percent) were considered abnormal, including 54 (20 percent) that identified a malignant neoplasm of the lung and 25 (9.3 percent) showing indeterminate abnormalities. "The rate of an abnormal scan was significantly higher in the follow-up case group (44.2 percent) than in the new case group (14.2 percent)," the authors write. Patients whose cancer was classified as stage N2 or N3 (indicating some degree of lymph node involvement), who had stage IV disease (in which the cancer has spread to another organ), who had recurrent disease or who had a distant metastasis in another site were more likely to have a malignant neoplasm of the lung.
"Indeterminate lesions were common on chest CT in our study, and special attention should be paid to them," the authors write. "Based on the progressive changes in follow-up scans, 44 percent of indeterminate lesions were eventually considered a malignant neoplasm of the lung. We also found that small (less than 1 centimeter) solitary nodules, which were usually resectable [operable], carried significantly higher chances (66.7 percent) of being a malignant neoplasm."
"For patients with head and neck squamous cell carcinoma, chest diagnosis is crucial and may influence their treatment plan," they continue. "In conclusion, chest CT is recommended for high-risk patients, especially every six months for the first two years during the follow-up period, although its role is controversial for patients newly diagnosed as having head and neck squamous cell carcinoma. High-risk patients include those with N2 or N3 disease, stage IV disease or locoregional recurrence. For patients with indeterminate small (less than 1 centimeter) solitary pulmonary nodules, aggressive evaluation and management are imperative because of the high rate of a malignant neoplasm of the lung."
Early Detection Of Lung Cancer
Lung cancer is the leading cause of cancer deaths worldwide and also in Europe. One of the reasons for this is that symptoms of lung cancer are very often lacking or occur only late in the course of the disease," said Prof Rudolf M. Huber from the University of Munich in Germany.
"The prognosis of lung cancer patients is very dependent on how advanced their disease is. In stage I for example, where the tumour has not yet spread, 5-year-survival rates are about 70%; whereas in stage IV, where it has metastasised to other parts of the body, survival is about 1%. Even for patients with locally advanced tumours, survival over 5 years is only about 10%. Therefore every effort should be undertaken to diagnose early in the course of the disease."
"Developing better tools for distinguishing between lung cancer and other lung diseases will help us offer greater hope for patients," added Prof Huber.
In one study presented at the conference, Italian researchers compare two computed tomography techniques for diagnosing indeterminate lung lesions, finding that a form of single-photon emission computed tomography could offer an alternative method in situations where positron emission tomography is not available.
In another abstract, UK scientists report that a new approach to diagnosis that ensures a patient has had a chest CT scan before they attend a clinic has the potential to reduce the time between their first abnormal chest X-ray and final diagnosis.
Also during the conference, Greek investigators suggest that they may have found a new factor that will help indicate a patient's prognosis at the time of diagnosis. Their work indicates that the expression of specific cell surface molecules on tumour cells correlates with clinical parameters. The results "could comprise a promising prognostic factor in lung carcinomas, thus presenting exciting possibilities for the future."
"The prognosis of lung cancer patients is very dependent on how advanced their disease is. In stage I for example, where the tumour has not yet spread, 5-year-survival rates are about 70%; whereas in stage IV, where it has metastasised to other parts of the body, survival is about 1%. Even for patients with locally advanced tumours, survival over 5 years is only about 10%. Therefore every effort should be undertaken to diagnose early in the course of the disease."
"Developing better tools for distinguishing between lung cancer and other lung diseases will help us offer greater hope for patients," added Prof Huber.
In one study presented at the conference, Italian researchers compare two computed tomography techniques for diagnosing indeterminate lung lesions, finding that a form of single-photon emission computed tomography could offer an alternative method in situations where positron emission tomography is not available.
In another abstract, UK scientists report that a new approach to diagnosis that ensures a patient has had a chest CT scan before they attend a clinic has the potential to reduce the time between their first abnormal chest X-ray and final diagnosis.
Also during the conference, Greek investigators suggest that they may have found a new factor that will help indicate a patient's prognosis at the time of diagnosis. Their work indicates that the expression of specific cell surface molecules on tumour cells correlates with clinical parameters. The results "could comprise a promising prognostic factor in lung carcinomas, thus presenting exciting possibilities for the future."
Carbon Nanotubes That Look Like Asbestos, Behave Like Asbestos, Could Lead To Asbestos-related Disease
A major study published in Nature Nanotechnology suggests some forms of carbon nanotubes -- a poster child for the "nanotechnology revolution" -- could be as harmful as asbestos if inhaled in sufficient quantities.
The study used established methods to see if specific types of nanotubes have the potential to cause mesothelioma -- a cancer of the lung lining that can take 30-40 years to appear following exposure. The results show that long, thin multi-walled carbon nanotubes that look like asbestos fibers, behave like asbestos fibers.
Discovered nearly 20 years ago, carbon nanotubes have been described as the wonder material of the 21st Century. Light as plastic and stronger that steel, they are being developed for use in new drugs, energy-efficient batteries and futuristic electronics. But since their discovery, questions have been raised about whether some of these nanoscale materials may cause harm and undermine a nascent market for all types of carbon nanotubes, including multi- and single-walled carbon nanotubes. Leading forecasting firms say sales of all nanotubes could reach $2 billion annually within the next four to seven years, according to an article in the U.S. publication Chemical & Engineering News.
"This study is exactly the kind of strategic, highly focused research needed to ensure the safe and responsible development of nanotechnology," says Andrew Maynard, Chief Science Advisor to the Project on Emerging Nanotechnologies and a co-author on the paper. "It looks at a specific nanoscale material expected to have widespread commercial applications and asks specific questions about a specific health hazard. Even though scientists have been raising concerns about the safety of long, thin carbon nanotubes for over a decade, none of the research needs in the current U.S. federal nanotechnology environment, health and safety risk research strategy address this question."
Widespread exposure to asbestos has been described as the worst occupational health disaster in U.S. history and the cost of asbestos-related disease is expected to exceed $200 billion, according to major U.S. think tank RAND Corporation.
Anthony Seaton, MD, a co-author on the paper and a professor emeritus at the University of Aberdeen in the United Kingdom, says, "The toll of asbestos-related cancer, first noticed in the 1950s and 1960s, is likely to continue for several more decades even though usage reduced rapidly some 25 years ago. While there are reasons to suppose that nanotubes can be used safely, this will depend on appropriate steps being taken to prevent them from being inhaled in the places they are manufactured, used and ultimately disposed of. Such steps should be based on research into exposure and risk prevention, leading to regulation of their use. Following this study, the results of which were foreseen by the Royal Society in the U.K. in 2004, we can no longer delay investing in such research."
Researchers, led by Professor Kenneth Donaldson at the University of Edinburgh in the United Kingdom, examined the potential for long and short carbon nanotubes, long and short asbestos fibers, and carbon black to cause pathological responses known to be precursors of mesothelioma. Material was injected into the abdominal cavity of mice -- a sensitive predictor of long fiber response in the lung lining.
"The results were clear," says Donaldson. "Long, thin carbon nanotubes showed the same effects as long, thin asbestos fibers."
Asbestos fibers are harmful because they are thin enough to penetrate deep into the lungs, but sufficiently long to confound the lungs' built-in clearance mechanisms for getting rid of particles.
Donaldson stresses there are still pieces of the puzzle to fill in. "We still don't know whether carbon nanotubes will become airborne and be inhaled, or whether, if they do reach the lungs, they can work their way to the sensitive outer lining. But if they do get there in sufficient quantity, there is a chance that some people will develop cancer--perhaps decades after breathing the stuff," states Donaldson.
There is a silver lining to this research. According to Donaldson, "Short or curly carbon nanotubes did not behave like asbestos, and by knowing the possible dangers of long, thin carbon nanotubes, we can work to control them. It's a good news story, not a bad one. It shows that carbon nanotubes and their products could be made to be safe."
But Donaldson added that the present study only tested for fiber-like behavior and did not exonerate carbon nanotubes from damaging the lungs in other ways. "More research is still needed if we are to understand how to use these materials as safely as possible," he notes.
Carbon nanotubes are atom-thick sheets of graphite formed into cylinders. They may be formed from a single layer of graphite or they may consist of multiple concentric layers of graphite, resulting in multi-walled carbon nanotubes. While the diameter of a nanotube can vary from a few nanometers up to tens of nanometers, they can be hundreds or even thousands of nanometers long. Carbon nanotubes come in many forms, with different shapes, different atomic arrangements, and varying amounts and types of added chemicals--all of which affect their properties and might influence their impact on human health and the environment.
"This is a wakeup call for nanotechnology in general and carbon nanotubes in particular," says Maynard. "As a society, we cannot afford not to exploit this incredible material, but neither can we afford to get it wrong--as we did with asbestos."
The study used established methods to see if specific types of nanotubes have the potential to cause mesothelioma -- a cancer of the lung lining that can take 30-40 years to appear following exposure. The results show that long, thin multi-walled carbon nanotubes that look like asbestos fibers, behave like asbestos fibers.
Discovered nearly 20 years ago, carbon nanotubes have been described as the wonder material of the 21st Century. Light as plastic and stronger that steel, they are being developed for use in new drugs, energy-efficient batteries and futuristic electronics. But since their discovery, questions have been raised about whether some of these nanoscale materials may cause harm and undermine a nascent market for all types of carbon nanotubes, including multi- and single-walled carbon nanotubes. Leading forecasting firms say sales of all nanotubes could reach $2 billion annually within the next four to seven years, according to an article in the U.S. publication Chemical & Engineering News.
"This study is exactly the kind of strategic, highly focused research needed to ensure the safe and responsible development of nanotechnology," says Andrew Maynard, Chief Science Advisor to the Project on Emerging Nanotechnologies and a co-author on the paper. "It looks at a specific nanoscale material expected to have widespread commercial applications and asks specific questions about a specific health hazard. Even though scientists have been raising concerns about the safety of long, thin carbon nanotubes for over a decade, none of the research needs in the current U.S. federal nanotechnology environment, health and safety risk research strategy address this question."
Widespread exposure to asbestos has been described as the worst occupational health disaster in U.S. history and the cost of asbestos-related disease is expected to exceed $200 billion, according to major U.S. think tank RAND Corporation.
Anthony Seaton, MD, a co-author on the paper and a professor emeritus at the University of Aberdeen in the United Kingdom, says, "The toll of asbestos-related cancer, first noticed in the 1950s and 1960s, is likely to continue for several more decades even though usage reduced rapidly some 25 years ago. While there are reasons to suppose that nanotubes can be used safely, this will depend on appropriate steps being taken to prevent them from being inhaled in the places they are manufactured, used and ultimately disposed of. Such steps should be based on research into exposure and risk prevention, leading to regulation of their use. Following this study, the results of which were foreseen by the Royal Society in the U.K. in 2004, we can no longer delay investing in such research."
Researchers, led by Professor Kenneth Donaldson at the University of Edinburgh in the United Kingdom, examined the potential for long and short carbon nanotubes, long and short asbestos fibers, and carbon black to cause pathological responses known to be precursors of mesothelioma. Material was injected into the abdominal cavity of mice -- a sensitive predictor of long fiber response in the lung lining.
"The results were clear," says Donaldson. "Long, thin carbon nanotubes showed the same effects as long, thin asbestos fibers."
Asbestos fibers are harmful because they are thin enough to penetrate deep into the lungs, but sufficiently long to confound the lungs' built-in clearance mechanisms for getting rid of particles.
Donaldson stresses there are still pieces of the puzzle to fill in. "We still don't know whether carbon nanotubes will become airborne and be inhaled, or whether, if they do reach the lungs, they can work their way to the sensitive outer lining. But if they do get there in sufficient quantity, there is a chance that some people will develop cancer--perhaps decades after breathing the stuff," states Donaldson.
There is a silver lining to this research. According to Donaldson, "Short or curly carbon nanotubes did not behave like asbestos, and by knowing the possible dangers of long, thin carbon nanotubes, we can work to control them. It's a good news story, not a bad one. It shows that carbon nanotubes and their products could be made to be safe."
But Donaldson added that the present study only tested for fiber-like behavior and did not exonerate carbon nanotubes from damaging the lungs in other ways. "More research is still needed if we are to understand how to use these materials as safely as possible," he notes.
Carbon nanotubes are atom-thick sheets of graphite formed into cylinders. They may be formed from a single layer of graphite or they may consist of multiple concentric layers of graphite, resulting in multi-walled carbon nanotubes. While the diameter of a nanotube can vary from a few nanometers up to tens of nanometers, they can be hundreds or even thousands of nanometers long. Carbon nanotubes come in many forms, with different shapes, different atomic arrangements, and varying amounts and types of added chemicals--all of which affect their properties and might influence their impact on human health and the environment.
"This is a wakeup call for nanotechnology in general and carbon nanotubes in particular," says Maynard. "As a society, we cannot afford not to exploit this incredible material, but neither can we afford to get it wrong--as we did with asbestos."
Naturally Occurring Asbestos Linked To Lung Cancer
The study - the largest to examine the question - will be published this fall in the American Journal of Respiratory and Critical Care Medicine.
Exposure to asbestos in the workplace, particularly in shipyards, has long been recognized as a risk factor for mesothelioma, a rare form of cancer affecting the lining of the lung. But in the new study, researchers found a consistent and dose-dependent association between mesothelioma and residential proximity to ultramafic rock, the predominant source of naturally occurring asbestos.
"Our findings indicate that the risks from exposure to naturally occurring asbestos, while low, are real and should be taken seriously," said Marc Schenker, professor and chair of the UC Davis Department of Public Health Sciences and the study's senior author. "This study provides important supportive evidence that naturally occurring asbestos causes mesothelioma - and public efforts should now shift to understanding the risk and how we can protect people from this preventable malignancy."
To put the mesothelioma risk in perspective, the disease kills about the same number of Americans each year as passive smoking. About 2,500 people a year die from mesothelioma in the United States, according to National Institute of Occupational Safety and Health statistics. About 3,000 deaths a year are attributed to exposure to secondhand tobacco smoke, according to U.S. Environmental Protection Agency statistics.
Ultramafic rock is distributed throughout the Sierra Nevada, Coast Ranges and Klamath Mountains in Northern and Central California, and has been a source of increasing concern as new housing developments cut through these areas. Of most concern are the areas of ultramafic rock associated with tremolite asbestos.
In their ambitious study, Schenker and his colleagues used California Cancer Registry data to identify 2,908 cases of malignant mesothelioma diagnosed between 1988 and 1997 in adults ages 35 and older. In most cases, the registry also provided occupational history. As a control group, an equal number of age- and gender-matched pancreatic cancer cases was selected (since pancreatic cancer has no known association to asbestos exposure). For both the mesothelioma and pancreatic cancer cases, the researchers employed sophisticated geographic information system mapping to pinpoint home or street addresses for every diagnosed individual. A map from the California Department of Conservation, Division of Mines and Geology, served as the reference for ultramafic rock deposits. Finally, statistical adjustments were made for sex, occupational asbestos exposure and age at diagnosis.
The researchers found that the risk of developing malignant mesothelioma was directly related to residential proximity to a source of ultramafic rock. Specifically, the odds of having mesothelioma fell by 6.3 percent for every 10 kilometers (about 6.2 miles) farther a person lived from the nearest asbestos source. The association was strongest in men, but was also seen in women. No such association showed up in the pancreatic cancer group. The study was not designed to determine the "ground zero" risk for those living closest to an asbestos source - only to test for a relationship between proximity and risk.
"This is very creative, painstaking epidemiology," said Jerrold L. Abraham, professor and director of environmental and occupational pathology at SUNY Upstate Medical University in Syracuse, New York, and a leading authority on mesothelioma. "The UC Davis researchers have shown a significant association between living near deposits of naturally occurring asbestos and mesothelioma. This is the strongest evidence possible without conducting one-on-one interviews with each diagnosed mesothelioma patient or his or her family."
Laurel Beckett, professor and vice chair of the UC Davis Department of Public Health Sciences and a study co-author, said the findings are important. "We showed that breathing asbestos in your community is not magically different from breathing asbestos in an industrial setting. It would have been a surprise to find otherwise."
Similarly, she said, it was no real surprise to scientists when passive smoking was found to cause lung cancer. "Like smoking, exposure to asbestos appears to be very dose-dependent," Beckett said. "Day-in, day-out occupational exposures are more dangerous than intermittent exposures in the community. But the more you can do to reduce your personal exposure, the safer you will be."
While the overall mesothelioma rate was about one case per 100,000 people per year in the California study, the rate varied markedly by gender and age. For white males, the rate was 2.29 cases per 100,000. For white females, it was 0.49. People over age 60 had ten times the rate of those ages 40 to 59.
Worldwide, epidemiological studies of mesothelioma have found occupational causes for most but not all cases of the disease. In some undeveloped areas of the world, including parts of Greece and Turkey, mesothelioma cases have been linked to use of naturally occurring asbestos in household materials such as whitewash. The UC Davis study suggests naturally occurring asbestos also causes mesothelioma in developed countries, through incidental, non-occupational exposures.
California has required statewide cancer reporting since 1985 and established the California Cancer Registry in 1988. One of the largest cancer databases in the world, the registry is responsible for collecting cancer incidence and mortality statistics for more than one tenth of the United States population. An estimated 98.9 percent of all mesothelioma cases diagnosed in California are reported to the registry.
The registry's size enabled researchers to identify an association that might not have been apparent in a smaller study.
Needed now are field studies to more accurately characterize determinants of exposure to asbestos fibers among residents in areas with naturally occurring asbestos, Schenker said. In addition, he said more must be learned about the types and size of fibers in asbestos deposits, the types of human activities that disturb asbestos fibers and the determinants of cancer risk in exposed populations.
"Because mesothelioma takes 20 to 30 years to develop, what we learn today will allow us to protect Californians from this preventable cancer decades into the future," Schenker said.
Exposure to asbestos in the workplace, particularly in shipyards, has long been recognized as a risk factor for mesothelioma, a rare form of cancer affecting the lining of the lung. But in the new study, researchers found a consistent and dose-dependent association between mesothelioma and residential proximity to ultramafic rock, the predominant source of naturally occurring asbestos.
"Our findings indicate that the risks from exposure to naturally occurring asbestos, while low, are real and should be taken seriously," said Marc Schenker, professor and chair of the UC Davis Department of Public Health Sciences and the study's senior author. "This study provides important supportive evidence that naturally occurring asbestos causes mesothelioma - and public efforts should now shift to understanding the risk and how we can protect people from this preventable malignancy."
To put the mesothelioma risk in perspective, the disease kills about the same number of Americans each year as passive smoking. About 2,500 people a year die from mesothelioma in the United States, according to National Institute of Occupational Safety and Health statistics. About 3,000 deaths a year are attributed to exposure to secondhand tobacco smoke, according to U.S. Environmental Protection Agency statistics.
Ultramafic rock is distributed throughout the Sierra Nevada, Coast Ranges and Klamath Mountains in Northern and Central California, and has been a source of increasing concern as new housing developments cut through these areas. Of most concern are the areas of ultramafic rock associated with tremolite asbestos.
In their ambitious study, Schenker and his colleagues used California Cancer Registry data to identify 2,908 cases of malignant mesothelioma diagnosed between 1988 and 1997 in adults ages 35 and older. In most cases, the registry also provided occupational history. As a control group, an equal number of age- and gender-matched pancreatic cancer cases was selected (since pancreatic cancer has no known association to asbestos exposure). For both the mesothelioma and pancreatic cancer cases, the researchers employed sophisticated geographic information system mapping to pinpoint home or street addresses for every diagnosed individual. A map from the California Department of Conservation, Division of Mines and Geology, served as the reference for ultramafic rock deposits. Finally, statistical adjustments were made for sex, occupational asbestos exposure and age at diagnosis.
The researchers found that the risk of developing malignant mesothelioma was directly related to residential proximity to a source of ultramafic rock. Specifically, the odds of having mesothelioma fell by 6.3 percent for every 10 kilometers (about 6.2 miles) farther a person lived from the nearest asbestos source. The association was strongest in men, but was also seen in women. No such association showed up in the pancreatic cancer group. The study was not designed to determine the "ground zero" risk for those living closest to an asbestos source - only to test for a relationship between proximity and risk.
"This is very creative, painstaking epidemiology," said Jerrold L. Abraham, professor and director of environmental and occupational pathology at SUNY Upstate Medical University in Syracuse, New York, and a leading authority on mesothelioma. "The UC Davis researchers have shown a significant association between living near deposits of naturally occurring asbestos and mesothelioma. This is the strongest evidence possible without conducting one-on-one interviews with each diagnosed mesothelioma patient or his or her family."
Laurel Beckett, professor and vice chair of the UC Davis Department of Public Health Sciences and a study co-author, said the findings are important. "We showed that breathing asbestos in your community is not magically different from breathing asbestos in an industrial setting. It would have been a surprise to find otherwise."
Similarly, she said, it was no real surprise to scientists when passive smoking was found to cause lung cancer. "Like smoking, exposure to asbestos appears to be very dose-dependent," Beckett said. "Day-in, day-out occupational exposures are more dangerous than intermittent exposures in the community. But the more you can do to reduce your personal exposure, the safer you will be."
While the overall mesothelioma rate was about one case per 100,000 people per year in the California study, the rate varied markedly by gender and age. For white males, the rate was 2.29 cases per 100,000. For white females, it was 0.49. People over age 60 had ten times the rate of those ages 40 to 59.
Worldwide, epidemiological studies of mesothelioma have found occupational causes for most but not all cases of the disease. In some undeveloped areas of the world, including parts of Greece and Turkey, mesothelioma cases have been linked to use of naturally occurring asbestos in household materials such as whitewash. The UC Davis study suggests naturally occurring asbestos also causes mesothelioma in developed countries, through incidental, non-occupational exposures.
California has required statewide cancer reporting since 1985 and established the California Cancer Registry in 1988. One of the largest cancer databases in the world, the registry is responsible for collecting cancer incidence and mortality statistics for more than one tenth of the United States population. An estimated 98.9 percent of all mesothelioma cases diagnosed in California are reported to the registry.
The registry's size enabled researchers to identify an association that might not have been apparent in a smaller study.
Needed now are field studies to more accurately characterize determinants of exposure to asbestos fibers among residents in areas with naturally occurring asbestos, Schenker said. In addition, he said more must be learned about the types and size of fibers in asbestos deposits, the types of human activities that disturb asbestos fibers and the determinants of cancer risk in exposed populations.
"Because mesothelioma takes 20 to 30 years to develop, what we learn today will allow us to protect Californians from this preventable cancer decades into the future," Schenker said.
Asbestos Disease Projections Too Low
Current predictions of the future incidence of asbestos-related disease have been substantially underestimated, according to new modelling to be presented in Melbourne today by an epidemiologist from The Australian National University.
The analysis by Dr Mark Clements, from the National Centre for Epidemiology and Population Health, and colleagues shows that the peak number of cases of mesothelioma, a deadly cancer caused by asbestos, will occur four years later and the future total incidence may be in excess of 35 per cent higher than existing models would have predicted. The pattern for mesothelioma reflects changes in asbestos exposure and therefore reflects predictions for all asbestos-related diseases, Dr Clements said. These early results have important implications for asbestos-related disease liability schemes, Dr Clements said, although more detailed work is needed to properly integrate other factors related to the actuarial implications.
According to the research, an existing model developed by the auditing firm KPMG gave the peak of mesothelioma cases as occurring in 2010, with 3530 cases in New South Wales men. However, Dr Clements said their own epidemiological model showed that the peak could occur as late as 2017 and see 6430 cases of the deadly disease in NSW men.
“There is reasonable evidence that the peak of mesothelioma incidence is later than 2010. This has far reaching consequences for actuarial predictions, where the number of cases out to 2060 may be in excess of 35 per cent higher than the number predicted by KPMG’s model,” he said.
“It is unclear why the two models give different results. The KPMG modeling may have been influenced by a common belief that peak incidence would be in 2010; in contrast, our epidemiological model is able to predict the peak for incidence.
“Although these results have implications for liability, there are several steps between predicting mesothelioma incidence and calculating liability,” he said. “Moreover, modelling would be required for other asbestos-related diseases.
“I can’t speculate as to the revised level of liability. However based on our modelling of future mesothelioma incidence it’s worrying that the liability may have been substantially under-estimated,” Dr Clements said.
Dr Clements presented this paper at the Accident Compensation Seminar, hosted by the Institute of Actuaries of Australia.
The analysis by Dr Mark Clements, from the National Centre for Epidemiology and Population Health, and colleagues shows that the peak number of cases of mesothelioma, a deadly cancer caused by asbestos, will occur four years later and the future total incidence may be in excess of 35 per cent higher than existing models would have predicted. The pattern for mesothelioma reflects changes in asbestos exposure and therefore reflects predictions for all asbestos-related diseases, Dr Clements said. These early results have important implications for asbestos-related disease liability schemes, Dr Clements said, although more detailed work is needed to properly integrate other factors related to the actuarial implications.
According to the research, an existing model developed by the auditing firm KPMG gave the peak of mesothelioma cases as occurring in 2010, with 3530 cases in New South Wales men. However, Dr Clements said their own epidemiological model showed that the peak could occur as late as 2017 and see 6430 cases of the deadly disease in NSW men.
“There is reasonable evidence that the peak of mesothelioma incidence is later than 2010. This has far reaching consequences for actuarial predictions, where the number of cases out to 2060 may be in excess of 35 per cent higher than the number predicted by KPMG’s model,” he said.
“It is unclear why the two models give different results. The KPMG modeling may have been influenced by a common belief that peak incidence would be in 2010; in contrast, our epidemiological model is able to predict the peak for incidence.
“Although these results have implications for liability, there are several steps between predicting mesothelioma incidence and calculating liability,” he said. “Moreover, modelling would be required for other asbestos-related diseases.
“I can’t speculate as to the revised level of liability. However based on our modelling of future mesothelioma incidence it’s worrying that the liability may have been substantially under-estimated,” Dr Clements said.
Dr Clements presented this paper at the Accident Compensation Seminar, hosted by the Institute of Actuaries of Australia.
Workers Exposed To Libby Vermiculite Ore Have High Rate Of Chest Wall Abnormalities
More than one-quarter of tested workers at an Ohio manufacturing plant historically exposed to asbestos-containing vermiculite ore exhibited signs of scarring of the chest wall lining, a study by researchers from the University of Cincinnati has found.
Researchers examined recent chest X-rays of 236 people who worked at a plant in Marysville, Ohio, that until 1980 used vermiculite ore mined in Libby, Mont., that contained asbestos fibers.
Of the 236 workers tested, 62 (26.3 percent) showed pleural plaques, or scarring of the chest wall lining. The occurrence was as high as 44.1 percent in workers with the largest and heaviest exposure to the vermiculite ore. The percentage of workers with pleural plaques was 5.1 percent in those with the lowest levels of exposure.
Pleural plaques are usually considered markers of previous exposure to asbestos fibers. Because of the previous exposure to asbestos, there is a potential increased risk for other asbestos-related lung changes, including scar tissue within the lungs and certain types of cancer such as mesothelioma.
Preliminary results of the study were presented in San Diego May 24, 2005, at the annual International Conference of the American Thoracic Society.
"Our study shows that cumulative exposure to vermiculite from Libby is associated with a significant increase in pleural changes," said study leader James Lockey, MD, professor of occupational and pulmonary medicine at the University of Cincinnati College of Medicine.
"There is clearly a relationship with increasing exposure, but the pleural changes also were seen in the low-exposed workers," said co-author Amy Rohs, MD, a fellow in occupational and pulmonary medicine at University of Cincinnati.
About 0.2 percent of the general population with minimal history of exposure to respiratory hazards shows signs of pleural plaques, Dr. Lockey noted. "I was surprised at the significant increase in overall pleural changes in this working population from 2 percent in 1980 to 26 percent, based on these preliminary results," he added.
"The public health implications of these preliminary findings are important in view of the national distribution of the Libby vermiculite ore," the authors concluded.
Until 1990, more than 200 sites around the country received shipments of vermiculite from the Libby mine.
Vermiculite is a group of minerals with a flaky, mica-like structure. Vermiculite ore from Libby has been shown to contain high levels of asbestos, which could have become airborne and inhaled when used in manufacturing. Vermiculite is widely used in a variety of applications, including insulation, packing materials, construction materials and gardening products. The Libby mine closed in 1990 and vermiculite ore used now comes from other sources and is not known to contain asbestos.
The X-rays were taken during the past two years, and each was reviewed independently by three board-certified radiologists. Spirometry tests, which measure lung function, and health histories also were taken. Although these were not assessed for this study, they will be reported later when the complete study findings are reviewed and published.
The workers were among a group of 513 employees at the Ohio plant exposed to vermiculite and who took part in a 1980 study. Of these 513 workers, 433 (84 percent) are currently alive. That original study, published by Dr. Lockey in the June 1984 issue of American Review of Respiratory Disease, initially showed that exposure to vermiculite containing asbestos fibers could cause pleural plaques.
Researchers examined recent chest X-rays of 236 people who worked at a plant in Marysville, Ohio, that until 1980 used vermiculite ore mined in Libby, Mont., that contained asbestos fibers.
Of the 236 workers tested, 62 (26.3 percent) showed pleural plaques, or scarring of the chest wall lining. The occurrence was as high as 44.1 percent in workers with the largest and heaviest exposure to the vermiculite ore. The percentage of workers with pleural plaques was 5.1 percent in those with the lowest levels of exposure.
Pleural plaques are usually considered markers of previous exposure to asbestos fibers. Because of the previous exposure to asbestos, there is a potential increased risk for other asbestos-related lung changes, including scar tissue within the lungs and certain types of cancer such as mesothelioma.
Preliminary results of the study were presented in San Diego May 24, 2005, at the annual International Conference of the American Thoracic Society.
"Our study shows that cumulative exposure to vermiculite from Libby is associated with a significant increase in pleural changes," said study leader James Lockey, MD, professor of occupational and pulmonary medicine at the University of Cincinnati College of Medicine.
"There is clearly a relationship with increasing exposure, but the pleural changes also were seen in the low-exposed workers," said co-author Amy Rohs, MD, a fellow in occupational and pulmonary medicine at University of Cincinnati.
About 0.2 percent of the general population with minimal history of exposure to respiratory hazards shows signs of pleural plaques, Dr. Lockey noted. "I was surprised at the significant increase in overall pleural changes in this working population from 2 percent in 1980 to 26 percent, based on these preliminary results," he added.
"The public health implications of these preliminary findings are important in view of the national distribution of the Libby vermiculite ore," the authors concluded.
Until 1990, more than 200 sites around the country received shipments of vermiculite from the Libby mine.
Vermiculite is a group of minerals with a flaky, mica-like structure. Vermiculite ore from Libby has been shown to contain high levels of asbestos, which could have become airborne and inhaled when used in manufacturing. Vermiculite is widely used in a variety of applications, including insulation, packing materials, construction materials and gardening products. The Libby mine closed in 1990 and vermiculite ore used now comes from other sources and is not known to contain asbestos.
The X-rays were taken during the past two years, and each was reviewed independently by three board-certified radiologists. Spirometry tests, which measure lung function, and health histories also were taken. Although these were not assessed for this study, they will be reported later when the complete study findings are reviewed and published.
The workers were among a group of 513 employees at the Ohio plant exposed to vermiculite and who took part in a 1980 study. Of these 513 workers, 433 (84 percent) are currently alive. That original study, published by Dr. Lockey in the June 1984 issue of American Review of Respiratory Disease, initially showed that exposure to vermiculite containing asbestos fibers could cause pleural plaques.
How Asbestos Fibers Trigger Cancer In Human Cells
University scientists believe they are the first in the world to study the molecular underpinnings of cancer by probing individual bonds between an asbestos fiber and human cells.
Though any clinical application is years away, the researchers hope their findings could aid in drug development efforts targeting illnesses caused by excessive exposure to asbestos, including the deadly cancer called mesothelioma.
The researchers use atomic force microscopy to observe how a single asbestos fiber binds with a specific receptor protein on cell surfaces. They suspect that at least one of the more lethal forms of asbestos triggers a cascade of events inside cells that eventually lead to illness, sometimes decades later.
The conditions most commonly associated with long-term exposure to airborne asbestos are lung cancer; asbestosis, a chronic respiratory disease; and mesothelioma, a cancer that forms in the membrane lining most internal organs of the body, including the lungs.
Eric Taylor, a doctoral candidate in earth sciences at Ohio State and a coauthor of the study, describes atomic force microscopy as “Braille on a molecular level,” meaning it allows scientists to feel and observe what’s happening on molecular surfaces.
“We’re looking at what molecules are involved in the chain of events when the fiber touches the cell. Does the binding occur over minutes, or hours? And what processes are triggered?” said Taylor, who presented the research at the American Geophysical Union meeting in San Francisco.
Asbestos comprises six different minerals that naturally occur in both fragment and fibrous forms. Because of its high durability and heat resistance, the fibrous form has been used in many manufacturing products since the late 1800s. Though its use is now highly regulated, asbestos is still present in many materials. The U.S. Department of Labor estimates that 1.3 million employees face significant asbestos exposure on the job. Environmental exposure is also possible because asbestos is a naturally occurring mineral in soils and exposed bedrock.
Crocidolite, or blue asbestos, is part of the amphibole group of asbestos minerals, which were banned in most of the Western world by the mid-1980s. Before that, they were used in such products as ceiling tiles and thermal insulation.
Ohio State researchers have focused so far on the crocidolite form of asbestos, but eventually hope to study how all six forms of asbestos interact with certain proteins on cell surfaces. Some forms of asbestos can dissolve in the lungs if they are inhaled, but others are believed to essentially “stick” to cells, especially at high concentrations, and eventually cause lung diseases.
“For the first time, this will give us data on biological activity that should help policymakers determine which forms of asbestos are the most dangerous,” said Steven Lower, associate professor of earth sciences at Ohio State and a coauthor on the study.
“The hypothesis we’re testing is that binding of cell surface receptors to asbestos fibers triggers a signal event, which initiates the cancer,” said Lower, also a faculty member in the School of Environment and Natural Resources. “There seems to be something intrinsic about certain types of asbestos, blue asbestos in particular, that elicits a unique signal, and it triggers inflammation, the formation of pre-malignant cells and, ultimately, cancer.”
The first protein to be studied is epidermal growth factor receptor, which is present on the surface of every human cell. Understanding the intricacies of the binding process between the mineral and one or more proteins will provide an index of the biological activity of a particular type of asbestos, and might lead the researchers to figure out how to prevent or undo that interaction, Lower said.
Taylor said the driving motivation behind the research is the potential to find a way to intervene and prevent illness even after someone is exposed to asbestos. Mesothelioma symptoms don’t typically appear until 30 to 50 years after exposure. After diagnosis, however, the cancer is difficult to control, and there is no cure.
This work is supported by the National Science Foundation.
Taylor and Lower conducted the research with Ann Wylie of the University of Maryland and Brooke Mossman of the University of Vermont.
Though any clinical application is years away, the researchers hope their findings could aid in drug development efforts targeting illnesses caused by excessive exposure to asbestos, including the deadly cancer called mesothelioma.
The researchers use atomic force microscopy to observe how a single asbestos fiber binds with a specific receptor protein on cell surfaces. They suspect that at least one of the more lethal forms of asbestos triggers a cascade of events inside cells that eventually lead to illness, sometimes decades later.
The conditions most commonly associated with long-term exposure to airborne asbestos are lung cancer; asbestosis, a chronic respiratory disease; and mesothelioma, a cancer that forms in the membrane lining most internal organs of the body, including the lungs.
Eric Taylor, a doctoral candidate in earth sciences at Ohio State and a coauthor of the study, describes atomic force microscopy as “Braille on a molecular level,” meaning it allows scientists to feel and observe what’s happening on molecular surfaces.
“We’re looking at what molecules are involved in the chain of events when the fiber touches the cell. Does the binding occur over minutes, or hours? And what processes are triggered?” said Taylor, who presented the research at the American Geophysical Union meeting in San Francisco.
Asbestos comprises six different minerals that naturally occur in both fragment and fibrous forms. Because of its high durability and heat resistance, the fibrous form has been used in many manufacturing products since the late 1800s. Though its use is now highly regulated, asbestos is still present in many materials. The U.S. Department of Labor estimates that 1.3 million employees face significant asbestos exposure on the job. Environmental exposure is also possible because asbestos is a naturally occurring mineral in soils and exposed bedrock.
Crocidolite, or blue asbestos, is part of the amphibole group of asbestos minerals, which were banned in most of the Western world by the mid-1980s. Before that, they were used in such products as ceiling tiles and thermal insulation.
Ohio State researchers have focused so far on the crocidolite form of asbestos, but eventually hope to study how all six forms of asbestos interact with certain proteins on cell surfaces. Some forms of asbestos can dissolve in the lungs if they are inhaled, but others are believed to essentially “stick” to cells, especially at high concentrations, and eventually cause lung diseases.
“For the first time, this will give us data on biological activity that should help policymakers determine which forms of asbestos are the most dangerous,” said Steven Lower, associate professor of earth sciences at Ohio State and a coauthor on the study.
“The hypothesis we’re testing is that binding of cell surface receptors to asbestos fibers triggers a signal event, which initiates the cancer,” said Lower, also a faculty member in the School of Environment and Natural Resources. “There seems to be something intrinsic about certain types of asbestos, blue asbestos in particular, that elicits a unique signal, and it triggers inflammation, the formation of pre-malignant cells and, ultimately, cancer.”
The first protein to be studied is epidermal growth factor receptor, which is present on the surface of every human cell. Understanding the intricacies of the binding process between the mineral and one or more proteins will provide an index of the biological activity of a particular type of asbestos, and might lead the researchers to figure out how to prevent or undo that interaction, Lower said.
Taylor said the driving motivation behind the research is the potential to find a way to intervene and prevent illness even after someone is exposed to asbestos. Mesothelioma symptoms don’t typically appear until 30 to 50 years after exposure. After diagnosis, however, the cancer is difficult to control, and there is no cure.
This work is supported by the National Science Foundation.
Taylor and Lower conducted the research with Ann Wylie of the University of Maryland and Brooke Mossman of the University of Vermont.
Friday, July 17, 2009
Alternative Treatments
Choosing how to battle Mesothelioma can be a daunting task. Most likely, conventional treatments, such as surgery, chemotherapy, and radiation, will be the first options offered to newly diagnosed patients. Choices should be made carefully and with much thought, considering side effects, recuperation time, and overall quality of life.
Many cancer sufferers also choose to investigate alternative cancer therapies and non-invasive treatments for pain management. No healthcare provider will suggest the total abandonment of conventional treatment but, especially when chronic pain is involved, they may advocate a few less conventional ways of dealing with the struggles of cancer. Ultimately, the choice is up to the individual, but many have found the alternative therapies below to be helpful.
Acupuncture
This ancient Chinese practice has only recently been touted as an excellent pain reducer for cancer sufferers but has, for decades, been recognized as a great way to relieve chronic muscle pain. Even cancer specialists at such renowned hospitals as Memorial-Sloan Kettering are recommending this technique and realizing exceptional results. A recent French study showed a 36% drop in pain level for cancer patients who received regular acupuncture treatments. Those who bleed easily or are at high-risk for infection, however, should avoid this alternative therapy.
Massage
Because it increases circulation and relieves stress, massage can be a wonderful way to reduce pain, even for a short amount of time. Massage is also known to aid in reducing fatigue and depression and decreasing nausea. Furthermore, the touch of another human being offers comfort that no other therapy can match.
Meditation
Because meditation of any kind - spiritual or secular - calms the mind and relaxes the body, it holds many advantages for cancer patients who are not only in pain, but usually suffering from high levels of stress as well. Meditation has also been shown to possibly improve immune function. Another advantage of meditation is that anyone can do it as it can be performed in the home with little or no physical exertion and at little or no cost to the patient once meditation techniques are learned.
Transcutaneous Electrical Nerve Stimulation (TENS) Therapy
TENS therapy has been used to successfully treat pain in cancer patients for the last two decades. This therapy involves placing electrodes on the skin in key areas along the nerve pathway. A tiny battery-powered generator then emits a small amount of electricity through lead wires to the electrodes. It is widely believed that this stimulation overrides the brain’s pain messages and prompts the body to produce a morphine-like substance that reduces pain. TENS therapy is safe for everyone though some patients may feel anxiety related to receiving “electric shocks.” However, there are few side effects associated with this alternative treatment, making it especially favorable for those who are intolerant of pain medications.
Hypnosis
Though not as popular as previously mentioned alternative therapies, hypnosis has begun to be accepted as yet another way to achieve pain management for cancer patients and those afflicted with other types of chronic pain. Individuals who explore this avenue should be sure that their hypnotherapist is licensed and experienced.
Controlling pain is essential to improving a Mesothelioma patient’s quality of life. When you’re stricken with cancer, it’s important to live each day to its fullest. To learn more about treatment options, both conventional and alternative, as well as other important facts about this disease, sign up for our free Mesothelioma Resource Kit, available at this site.
Many cancer sufferers also choose to investigate alternative cancer therapies and non-invasive treatments for pain management. No healthcare provider will suggest the total abandonment of conventional treatment but, especially when chronic pain is involved, they may advocate a few less conventional ways of dealing with the struggles of cancer. Ultimately, the choice is up to the individual, but many have found the alternative therapies below to be helpful.
Acupuncture
This ancient Chinese practice has only recently been touted as an excellent pain reducer for cancer sufferers but has, for decades, been recognized as a great way to relieve chronic muscle pain. Even cancer specialists at such renowned hospitals as Memorial-Sloan Kettering are recommending this technique and realizing exceptional results. A recent French study showed a 36% drop in pain level for cancer patients who received regular acupuncture treatments. Those who bleed easily or are at high-risk for infection, however, should avoid this alternative therapy.
Massage
Because it increases circulation and relieves stress, massage can be a wonderful way to reduce pain, even for a short amount of time. Massage is also known to aid in reducing fatigue and depression and decreasing nausea. Furthermore, the touch of another human being offers comfort that no other therapy can match.
Meditation
Because meditation of any kind - spiritual or secular - calms the mind and relaxes the body, it holds many advantages for cancer patients who are not only in pain, but usually suffering from high levels of stress as well. Meditation has also been shown to possibly improve immune function. Another advantage of meditation is that anyone can do it as it can be performed in the home with little or no physical exertion and at little or no cost to the patient once meditation techniques are learned.
Transcutaneous Electrical Nerve Stimulation (TENS) Therapy
TENS therapy has been used to successfully treat pain in cancer patients for the last two decades. This therapy involves placing electrodes on the skin in key areas along the nerve pathway. A tiny battery-powered generator then emits a small amount of electricity through lead wires to the electrodes. It is widely believed that this stimulation overrides the brain’s pain messages and prompts the body to produce a morphine-like substance that reduces pain. TENS therapy is safe for everyone though some patients may feel anxiety related to receiving “electric shocks.” However, there are few side effects associated with this alternative treatment, making it especially favorable for those who are intolerant of pain medications.
Hypnosis
Though not as popular as previously mentioned alternative therapies, hypnosis has begun to be accepted as yet another way to achieve pain management for cancer patients and those afflicted with other types of chronic pain. Individuals who explore this avenue should be sure that their hypnotherapist is licensed and experienced.
Controlling pain is essential to improving a Mesothelioma patient’s quality of life. When you’re stricken with cancer, it’s important to live each day to its fullest. To learn more about treatment options, both conventional and alternative, as well as other important facts about this disease, sign up for our free Mesothelioma Resource Kit, available at this site.
Mesothelioma Specialists
David J. Sugarbaker, MDChief, Division of Thoracic SurgeryBrigham and Women's HospitalThe Division of Thoracic Surgery Brigham and Women's Hospital, Harvard University75 Francis StreetBoston, MA 2115 Chief, Department of Surgical ServicesDana-Farber Cancer InstitutePhone: (617) 732-6824
W. Roy Smythe, MDProfessor and Chairman, Department of SurgeryTexas A&M University System Health Sciences CenterScott & White Hospital 2401 South 31st StreetTemple, TX 76508 Phone: 254-724-2595
David C. Rice, MDAssistant Surgeon and Assistant Professor of Surgery; Director, Mesothelioma Program; Director, Minimally Invasive Surgery Program, Thoracic SurgeryM. D. Anderson Cancer Center, The University of Texas1515 Holcombe BlvdHouston, TX 77030 Phone: (713) 794-1477
Valerie W. Rusch, FACSChief Thoracic Service; William G. Cahan ChairMemorial-Sloan Kettering Cancer Center 1275 York AvenueNew York, NY 10021 Phone: (212) 639-5873
Raja M. Flores, MDAttending Thoracic SurgeonMemorial-Sloan Kettering Cancer Center, New York, NYPhone: (212) 639-2806
Paul H. Sugarbaker, MD, FACS, FRCSDirector, Surgical OncologyCenter for Gastrointestinal Malignancies; Washington Cancer Institute 106 Irving St.Washington, DC 20010 Phone: (202) 877-3908
Brian W. Loggie, MDProfessor of SurgeryCreighton University School of Medicine601 North 30th StreetOmaha, NE 68131 Chief, Division of Surgical Oncology; Director of Cancer CenterCreighton University Medical CenterPhone: (402) 280-4100
Claire F. Verschraegen, MDDirector, Clinical Trial Office and Investigational Drug ProgramCancer Research and Treatment Center, University of New MexicoPhone: (505) 272-4551
David P. Mason, MDStaff Surgeon, Department of Thoracic and Cardiovascular SurgeryCleveland Clinic Foundation Phone: (216) 444-4053
David M. Jablons, MDAssistant Professor of Surgery UCSF Cardiothoracic Surgery University of California San FranciscoChief, General Thoracic SurgeryMt. Zion Medical Center 350 Parnassus Avenue, Suite 150San Francisco, CA 94143-0118 Phone: (415) 885-3882
Lary A. Robinson, MDDirector, Division of Cardiovascular and Thoracic Surgery Principal Thoracic Surgical OncologistH. Lee Moffitt Cancer Center and Research Institute, University of South Florida12902 Magnolia DriveTampa, FL 33612Phone: (813) 972-8412
Craig W. Stevens, MD, PhDDivision Chief, Radiation OncologyH. Lee Moffitt Cancer Center & Research Institute Tampa, FLPhone: (813) 972-8424
Robert N. Taub, MDProfessor of Clinical MedicineColumbia University College of Physicians and SurgeonsNew York Presbyterian Hospital 161 Fort Washington AvenueNew York, NY 10032 Phone: (212) 305-4076
Daniel Sterman, MDAssistant Professor, Department of MedicineUniversity of Pennsylvania Medical Center, University of Pennsylvania3400 Spruce StreetPhiladelphia, PA 19104-4283 Phone: (215) 614-0984
Eric Vallieres, MDAssociate Professor of SurgerySection of General Thoracic SurgeryUniversity of Washington Medical Center1221 Madison StreetSeattle, WA 98104 Phone: (206) 598-4477 Thoracic SurgerySwedish Cancer Institute Phone: (206) 215-6800
Stephen C. Yang, MDChief, Division of Thoracic SurgeryAssociate Professor of Surgery and OncologySurgical Director, Lung Transplantation ProgramDirector, Thoracic Oncology ProgramSidney Kimmel Comprehensive Cancer Center at Johns HopkinsJohns Hopkins Medical Institutions, Baltimore, MD 401 North BroadwayBaltimore, MD 21231 Phone: (410) 614-3891
Mark J. Krasna, MDChief, Division of Thoracic SurgeryUniversity of Maryland School of MedicineDirector, Thoracic Oncology ProgramUniversity of Maryland Greenebaum Cancer Center, Baltimore, MDPhone: (410) 328-6366
David H. Harpole, Jr., MDAssociate Professor of SurgeryDirector of General Thoracic Surgery (DUMC)Chief of Cardiothoracic Surgery (Durham VAMC)Cardiovascular and Thoracic SurgeryDuke University Medical Center, Duke UniversityDUMC 3627 104 Research DriveDurham, NC 27710 Phone: (919) 668-8413
Harvey Pass, MDProfessor and Chief, Division of Thoracic Surgery and Thoracic OncologyDepartment of Cardiothoracic SurgeryNYU Medical Center, NYU160 East 34th StreetNew York, NY 10016 Phone: (212) 731-5414
Gregory P. Kalemkerian, MDClinical Associate Professor, Department of Internal Medicine; Co-Director of Thoracic Oncology; Cancer Center MemberUniversity of Michigan Comprehensive Cancer Center, University of Michigan1500 East Medical Center DriveAnn Arbor, MI 48109-0848 Phone: (734) 936-5281
Joseph S. Friedberg, MDChief, Division of Thoracic SurgeryPenn Presbyterian Medical Center, University of Pennsylvania39th and Market StreetsPhiladelphia, PA 19104 Phone: 1-800-789-PENN (7366)
Robert Cameron, MDDirector, Thoracic OncologyDepartment of SurgeryUCLA Medical Center, University of California10833 Le Conte Ave Los Angeles, CA 90095 Phone: (310) 794-7333
Arkadiusz Dudek, M.D., Ph.D.Assistant Professor of Medicine, member of the University's Cancer CenterUniversity of Minnesota Cancer Center, University of Minnesota420 Delaware St. SEMinneapolis, MN 55455 Phone: 612-624-0123
Mary-Louise Keohan, MDMemorial Sloan-Kettering Cancer Hospital 1275 York AvenueNew York, NY 10021 Phone: (212) 639-2809
Hedy Lee Kindler, M.D.Director of the Mesothelioma ProgramAssistant Professor of Medicine, Section of Hematology/OncologyUniversity of Chicago Cancer Research Center, University of Chicago5841 South Maryland AvenueChicago, IL 60637 Phone: 773-834-7424 (Intake specialist Karen Wendling)
Roman Perez-Soler, MDProfessor, Associate Director of Clinical Oncology and a member of the Executive Advisory Committee of the GCRC, Department of MedicineNYU Medical Center, NYU530 First AvenueNew York, NY 10016 Phone: (212) 263-8043
Francisco Robert-Vizcarrondo, MDProfessor, Hematology & OncologyThe Kirklin Clinic, UAB Health System, University of Alabama at Birmingham2000 6th Avenue SouthBirmingham, AL 35233 Phone: (205) 934-9999
Dong M. Shin, MDAssociate Director of Academic Development, Hematology, Oncology, and OtolaryngologyEmory Winship Cancer Institute, Emory University1365 Clifton RoadAtlanta, GA 30322 Phone: 404-778-1900
W. Roy Smythe, MDProfessor and Chairman, Department of SurgeryTexas A&M University System Health Sciences CenterScott & White Hospital 2401 South 31st StreetTemple, TX 76508 Phone: 254-724-2595
David C. Rice, MDAssistant Surgeon and Assistant Professor of Surgery; Director, Mesothelioma Program; Director, Minimally Invasive Surgery Program, Thoracic SurgeryM. D. Anderson Cancer Center, The University of Texas1515 Holcombe BlvdHouston, TX 77030 Phone: (713) 794-1477
Valerie W. Rusch, FACSChief Thoracic Service; William G. Cahan ChairMemorial-Sloan Kettering Cancer Center 1275 York AvenueNew York, NY 10021 Phone: (212) 639-5873
Raja M. Flores, MDAttending Thoracic SurgeonMemorial-Sloan Kettering Cancer Center, New York, NYPhone: (212) 639-2806
Paul H. Sugarbaker, MD, FACS, FRCSDirector, Surgical OncologyCenter for Gastrointestinal Malignancies; Washington Cancer Institute 106 Irving St.Washington, DC 20010 Phone: (202) 877-3908
Brian W. Loggie, MDProfessor of SurgeryCreighton University School of Medicine601 North 30th StreetOmaha, NE 68131 Chief, Division of Surgical Oncology; Director of Cancer CenterCreighton University Medical CenterPhone: (402) 280-4100
Claire F. Verschraegen, MDDirector, Clinical Trial Office and Investigational Drug ProgramCancer Research and Treatment Center, University of New MexicoPhone: (505) 272-4551
David P. Mason, MDStaff Surgeon, Department of Thoracic and Cardiovascular SurgeryCleveland Clinic Foundation Phone: (216) 444-4053
David M. Jablons, MDAssistant Professor of Surgery UCSF Cardiothoracic Surgery University of California San FranciscoChief, General Thoracic SurgeryMt. Zion Medical Center 350 Parnassus Avenue, Suite 150San Francisco, CA 94143-0118 Phone: (415) 885-3882
Lary A. Robinson, MDDirector, Division of Cardiovascular and Thoracic Surgery Principal Thoracic Surgical OncologistH. Lee Moffitt Cancer Center and Research Institute, University of South Florida12902 Magnolia DriveTampa, FL 33612Phone: (813) 972-8412
Craig W. Stevens, MD, PhDDivision Chief, Radiation OncologyH. Lee Moffitt Cancer Center & Research Institute Tampa, FLPhone: (813) 972-8424
Robert N. Taub, MDProfessor of Clinical MedicineColumbia University College of Physicians and SurgeonsNew York Presbyterian Hospital 161 Fort Washington AvenueNew York, NY 10032 Phone: (212) 305-4076
Daniel Sterman, MDAssistant Professor, Department of MedicineUniversity of Pennsylvania Medical Center, University of Pennsylvania3400 Spruce StreetPhiladelphia, PA 19104-4283 Phone: (215) 614-0984
Eric Vallieres, MDAssociate Professor of SurgerySection of General Thoracic SurgeryUniversity of Washington Medical Center1221 Madison StreetSeattle, WA 98104 Phone: (206) 598-4477 Thoracic SurgerySwedish Cancer Institute Phone: (206) 215-6800
Stephen C. Yang, MDChief, Division of Thoracic SurgeryAssociate Professor of Surgery and OncologySurgical Director, Lung Transplantation ProgramDirector, Thoracic Oncology ProgramSidney Kimmel Comprehensive Cancer Center at Johns HopkinsJohns Hopkins Medical Institutions, Baltimore, MD 401 North BroadwayBaltimore, MD 21231 Phone: (410) 614-3891
Mark J. Krasna, MDChief, Division of Thoracic SurgeryUniversity of Maryland School of MedicineDirector, Thoracic Oncology ProgramUniversity of Maryland Greenebaum Cancer Center, Baltimore, MDPhone: (410) 328-6366
David H. Harpole, Jr., MDAssociate Professor of SurgeryDirector of General Thoracic Surgery (DUMC)Chief of Cardiothoracic Surgery (Durham VAMC)Cardiovascular and Thoracic SurgeryDuke University Medical Center, Duke UniversityDUMC 3627 104 Research DriveDurham, NC 27710 Phone: (919) 668-8413
Harvey Pass, MDProfessor and Chief, Division of Thoracic Surgery and Thoracic OncologyDepartment of Cardiothoracic SurgeryNYU Medical Center, NYU160 East 34th StreetNew York, NY 10016 Phone: (212) 731-5414
Gregory P. Kalemkerian, MDClinical Associate Professor, Department of Internal Medicine; Co-Director of Thoracic Oncology; Cancer Center MemberUniversity of Michigan Comprehensive Cancer Center, University of Michigan1500 East Medical Center DriveAnn Arbor, MI 48109-0848 Phone: (734) 936-5281
Joseph S. Friedberg, MDChief, Division of Thoracic SurgeryPenn Presbyterian Medical Center, University of Pennsylvania39th and Market StreetsPhiladelphia, PA 19104 Phone: 1-800-789-PENN (7366)
Robert Cameron, MDDirector, Thoracic OncologyDepartment of SurgeryUCLA Medical Center, University of California10833 Le Conte Ave Los Angeles, CA 90095 Phone: (310) 794-7333
Arkadiusz Dudek, M.D., Ph.D.Assistant Professor of Medicine, member of the University's Cancer CenterUniversity of Minnesota Cancer Center, University of Minnesota420 Delaware St. SEMinneapolis, MN 55455 Phone: 612-624-0123
Mary-Louise Keohan, MDMemorial Sloan-Kettering Cancer Hospital 1275 York AvenueNew York, NY 10021 Phone: (212) 639-2809
Hedy Lee Kindler, M.D.Director of the Mesothelioma ProgramAssistant Professor of Medicine, Section of Hematology/OncologyUniversity of Chicago Cancer Research Center, University of Chicago5841 South Maryland AvenueChicago, IL 60637 Phone: 773-834-7424 (Intake specialist Karen Wendling)
Roman Perez-Soler, MDProfessor, Associate Director of Clinical Oncology and a member of the Executive Advisory Committee of the GCRC, Department of MedicineNYU Medical Center, NYU530 First AvenueNew York, NY 10016 Phone: (212) 263-8043
Francisco Robert-Vizcarrondo, MDProfessor, Hematology & OncologyThe Kirklin Clinic, UAB Health System, University of Alabama at Birmingham2000 6th Avenue SouthBirmingham, AL 35233 Phone: (205) 934-9999
Dong M. Shin, MDAssociate Director of Academic Development, Hematology, Oncology, and OtolaryngologyEmory Winship Cancer Institute, Emory University1365 Clifton RoadAtlanta, GA 30322 Phone: 404-778-1900
Clinical Trials
Promising new drugs must be extensively tested to make sure they are safe and effective before the Federal Drug Administration (FDA) can approve them for use in patients. To learn all the potential side effects, the most effective dosages and how effective a new drug is against a specific disease requires testing in humans. For safety, the FDA has developed a system of clinical trials to provide data on medications that promise new & better treatments of illness.
Before a new drug can even be considered for experimental use in humans, it must undergo exhaustive testing in animals to make sure there are no serious dangers involved. Patients can benefit from participating in clinical trials by getting newer and more powerful treatments.
There are various types of clinical trials. A basic understanding of the clinical trials system can help patients learn the risks and benefits of participating in various clinical trials. In cases where established treatments have been exhausted, an investigational treatment may offer new hope for serious illness like cancer.
Phase I trials: the first step in testing a new drug or treatment for approval. Since the effects in humans are not fully known, researchers keep the study group as small as possible. The study size may range from 20 to 80 participants. The goals of this stage are to evaluate the safety of the drug and learn what side effects may occur. A dosage range that is safe and effective is also determined.
Phase II trials: is the next step in gaining approval of a new drug. Once the safety has been established in Phase I trials, the experimental drug or treatment can be used in a larger test group to see how effective it is against a singles illness or a group of diseases. Phase II trials employ a larger test group of up to 300 participants. The goals are to learn if the drug is effective for a specific application and to further evaluate the drug’s safety.
Phase III trials: is the final step before a drug can be approved. Larger study groups of 1,000 to 3,000 participants enable researchers to collect a bigger database of information about a new drug. The goals of this step are to confirm a drug’s effectiveness and monitor side effects. To learn how effective the drug is, these studies usually compare it to an established drug or treatment known to be effective for a specific disease. This information helps doctors to use the drug in the safest and most effective way.
Phase IV trials: are post-marketing studies that gather information about how an approved drug works against other diseases, and how best to use the drug. Clinical studies explore more than just new drugs. Any intervention that could possibly improve health or fight disease needs to be systematically studied in a controlled way. So medications, surgery, lifestyle changes, medical testing techniques and even alternative therapies are put though rigorous testing to ensure patient safety.
Treatment
Prevention
Diagnostic techniques
Screening methods
Quality of Life
To learn more about how participating in clinical trials can impact your treatment, fill out our free info packet request. If you are considering enrolling in a study, discuss the potential benefits and possible risks with your medical team. If you decide to participate, you’ll not only be helping yourself, but many other people fighting serious illness as well.
Before a new drug can even be considered for experimental use in humans, it must undergo exhaustive testing in animals to make sure there are no serious dangers involved. Patients can benefit from participating in clinical trials by getting newer and more powerful treatments.
There are various types of clinical trials. A basic understanding of the clinical trials system can help patients learn the risks and benefits of participating in various clinical trials. In cases where established treatments have been exhausted, an investigational treatment may offer new hope for serious illness like cancer.
Phase I trials: the first step in testing a new drug or treatment for approval. Since the effects in humans are not fully known, researchers keep the study group as small as possible. The study size may range from 20 to 80 participants. The goals of this stage are to evaluate the safety of the drug and learn what side effects may occur. A dosage range that is safe and effective is also determined.
Phase II trials: is the next step in gaining approval of a new drug. Once the safety has been established in Phase I trials, the experimental drug or treatment can be used in a larger test group to see how effective it is against a singles illness or a group of diseases. Phase II trials employ a larger test group of up to 300 participants. The goals are to learn if the drug is effective for a specific application and to further evaluate the drug’s safety.
Phase III trials: is the final step before a drug can be approved. Larger study groups of 1,000 to 3,000 participants enable researchers to collect a bigger database of information about a new drug. The goals of this step are to confirm a drug’s effectiveness and monitor side effects. To learn how effective the drug is, these studies usually compare it to an established drug or treatment known to be effective for a specific disease. This information helps doctors to use the drug in the safest and most effective way.
Phase IV trials: are post-marketing studies that gather information about how an approved drug works against other diseases, and how best to use the drug. Clinical studies explore more than just new drugs. Any intervention that could possibly improve health or fight disease needs to be systematically studied in a controlled way. So medications, surgery, lifestyle changes, medical testing techniques and even alternative therapies are put though rigorous testing to ensure patient safety.
Treatment
Prevention
Diagnostic techniques
Screening methods
Quality of Life
To learn more about how participating in clinical trials can impact your treatment, fill out our free info packet request. If you are considering enrolling in a study, discuss the potential benefits and possible risks with your medical team. If you decide to participate, you’ll not only be helping yourself, but many other people fighting serious illness as well.
Types of Doctors
After you’ve been diagnosed with mesothelioma, your world will seem as if it’s full of doctors. You’ll have an appointment with one type of doctor on one day, perhaps another the next day, and maybe even another a few days later…all in the course of perhaps a week.
While all the doctors will undoubtedly have your best interests in mind, understanding exactly what each one does can be confusing to the new cancer patient. Here’s a list of specialists you’ll probably encounter before and after your diagnosis.
General Practitioner
This is your everyday doctor…the one you see when you have a cold or flu or when you’ve sprained your ankle. He or she will most likely be the first person you turn to for answers about any symptoms you might be experiencing. Your general practitioner will ask questions about your medical history, gauge your workplace exposure to asbestos, examine your symptoms, and do an overall preliminary check-up. If he/she suspects cancer, you will be referred to the next doctor.
Oncologist
An oncologist is a cancer specialist. This doctor will go a few steps further to determine an accurate diagnosis. He may suggest CT scans, MRIs, or conventional x-rays, will probably test pulmonary function, or may order a biopsy. When tests are completed, if cancer is confirmed, it is the oncologist who will determine the next step. If he believes the cancer is operable, you will be referred to a surgeon. If not, the oncologist will suggest chemotherapy, radiation, or some alternative form of treatment. The oncologist provides ongoing follow-up care throughout the treatment process, suggesting new courses of action when appropriate.
Radiologist
Radiologists are in charge of administering x-rays, MRIs, and CT scans. If your oncologist prescribes radiation therapy as part of your course of treatment, a radiologist will administer this treatment as well.
Pulmonary Therapist
A pulmonary therapist is a lung specialist who monitors the effects of mesothelioma on the patient’s respiratory system. Because breathing can become quite difficult as mesothelioma progresses, the pulmonary therapist will provide treatments and devices to ease your breathing and make you more comfortable. You will probably see the pulmonary therapist quite often.
Psychologist
Dealing with mesothelioma is equally as taxing on your mental health as it is on your physical health. Depression, anxiety, denial, guilt, and a host of other emotions will no doubt become a part of your daily routine. A psychologist can help you sort out your feelings and cope with your diagnosis. Many psychologists are specifically trained to work with cancer patients.
While all the doctors will undoubtedly have your best interests in mind, understanding exactly what each one does can be confusing to the new cancer patient. Here’s a list of specialists you’ll probably encounter before and after your diagnosis.
General Practitioner
This is your everyday doctor…the one you see when you have a cold or flu or when you’ve sprained your ankle. He or she will most likely be the first person you turn to for answers about any symptoms you might be experiencing. Your general practitioner will ask questions about your medical history, gauge your workplace exposure to asbestos, examine your symptoms, and do an overall preliminary check-up. If he/she suspects cancer, you will be referred to the next doctor.
Oncologist
An oncologist is a cancer specialist. This doctor will go a few steps further to determine an accurate diagnosis. He may suggest CT scans, MRIs, or conventional x-rays, will probably test pulmonary function, or may order a biopsy. When tests are completed, if cancer is confirmed, it is the oncologist who will determine the next step. If he believes the cancer is operable, you will be referred to a surgeon. If not, the oncologist will suggest chemotherapy, radiation, or some alternative form of treatment. The oncologist provides ongoing follow-up care throughout the treatment process, suggesting new courses of action when appropriate.
Radiologist
Radiologists are in charge of administering x-rays, MRIs, and CT scans. If your oncologist prescribes radiation therapy as part of your course of treatment, a radiologist will administer this treatment as well.
Pulmonary Therapist
A pulmonary therapist is a lung specialist who monitors the effects of mesothelioma on the patient’s respiratory system. Because breathing can become quite difficult as mesothelioma progresses, the pulmonary therapist will provide treatments and devices to ease your breathing and make you more comfortable. You will probably see the pulmonary therapist quite often.
Psychologist
Dealing with mesothelioma is equally as taxing on your mental health as it is on your physical health. Depression, anxiety, denial, guilt, and a host of other emotions will no doubt become a part of your daily routine. A psychologist can help you sort out your feelings and cope with your diagnosis. Many psychologists are specifically trained to work with cancer patients.
Treatment by Stage
A cancer diagnosis is always shocking and scary, no matter the age of the person involved. When someone finds out that they have Mesothelioma, depression may set it, anger might be present, and the life of the cancer victim will most certainly change.
Receiving proper treatment, however, is the most important issue after diagnosis.Mesothelioma is treated in a variety of ways, largely dependent on which stage of the disease is present in the afflicted individual. The patient’s age, general health, and the location of the cancer are also taken into consideration when determining the best course of action to be used to fight the disease.
In Stage I, sometimes referred to as “localized malignant Mesothelioma”, treatment might include the following:
Surgery to remove sections of the pleura, the lung, part of the diaphragm, and part of the lining around the heart.
Surgery to remove the pleura and the tissue near it, done in order to relieve symptoms. This is not considered a curative surgery.
Radiation to relieve symptoms when surgery is not indicated due to poor health.
The use of a clinical trial; i.e. medications being tested by patient volunteers in order to find better cures for Mesothelioma.
For those suffering from Stage II or III Mesothelioma, treatment may include the procedures listed below. Cure is often not possible for those who’ve reached Stage II or III Mesothelioma.
Thoracentesis or paracentesis – the draining of the fluid around the heart or abdomen, done in order to reduce symptoms and relieve pain.
Radiation or chemotherapy used to reduce symptoms.
Injection of chemotherapy or radioactive drugs directly into the pleural space. This will serve to kill some of the cancer cells and slow down fluid collection in this area.
Clinical trials
The treatment of Stage IV advanced malignant Mesothelioma will most likely involve keeping the patient as comfortable as possible. By this time, the disease has spread greatly and a cure is not possible, according to the American Cancer Society.
Chemotherapy or radiation, though the goals should be clearly explained to the patient and family. Such aggressive therapy, laden with side affects, may not be desirable given the impossibility of a cure at this time.
Supportive care - often performed in a hospice-type program. Advanced Mesothelioma patients usually require more care than a spouse or loved one can reasonably handle.
Pain medication
Clinical trials
In treating Mesothelioma, locating a specialist who is willing to discuss and explain all treatment options is essential. Take time to measure the pros and cons of various treatments and be sure that the patient is comfortable with the choices made. The Mesothelioma sufferer, like any cancer patient, should have a say in his/her individual treatment program.
Facing treatment for Mesothelioma can be overwhelming. For more information about the disease, its stages, and options for treatment, take a moment to sign up for the free Mesothelioma Resource Kit available on this website.
Receiving proper treatment, however, is the most important issue after diagnosis.Mesothelioma is treated in a variety of ways, largely dependent on which stage of the disease is present in the afflicted individual. The patient’s age, general health, and the location of the cancer are also taken into consideration when determining the best course of action to be used to fight the disease.
In Stage I, sometimes referred to as “localized malignant Mesothelioma”, treatment might include the following:
Surgery to remove sections of the pleura, the lung, part of the diaphragm, and part of the lining around the heart.
Surgery to remove the pleura and the tissue near it, done in order to relieve symptoms. This is not considered a curative surgery.
Radiation to relieve symptoms when surgery is not indicated due to poor health.
The use of a clinical trial; i.e. medications being tested by patient volunteers in order to find better cures for Mesothelioma.
For those suffering from Stage II or III Mesothelioma, treatment may include the procedures listed below. Cure is often not possible for those who’ve reached Stage II or III Mesothelioma.
Thoracentesis or paracentesis – the draining of the fluid around the heart or abdomen, done in order to reduce symptoms and relieve pain.
Radiation or chemotherapy used to reduce symptoms.
Injection of chemotherapy or radioactive drugs directly into the pleural space. This will serve to kill some of the cancer cells and slow down fluid collection in this area.
Clinical trials
The treatment of Stage IV advanced malignant Mesothelioma will most likely involve keeping the patient as comfortable as possible. By this time, the disease has spread greatly and a cure is not possible, according to the American Cancer Society.
Chemotherapy or radiation, though the goals should be clearly explained to the patient and family. Such aggressive therapy, laden with side affects, may not be desirable given the impossibility of a cure at this time.
Supportive care - often performed in a hospice-type program. Advanced Mesothelioma patients usually require more care than a spouse or loved one can reasonably handle.
Pain medication
Clinical trials
In treating Mesothelioma, locating a specialist who is willing to discuss and explain all treatment options is essential. Take time to measure the pros and cons of various treatments and be sure that the patient is comfortable with the choices made. The Mesothelioma sufferer, like any cancer patient, should have a say in his/her individual treatment program.
Facing treatment for Mesothelioma can be overwhelming. For more information about the disease, its stages, and options for treatment, take a moment to sign up for the free Mesothelioma Resource Kit available on this website.
Investigational treatments
Newer treatments are being researched which provide a great deal of hope for patients who do not respond to some of the established therapies in use today. Clinical trials provide information about improved treatments and give hope for better outcomes. Clinical trials are currently going on across the United States and worldwide. Photodynamic therapy employs a light sensitive drug that is administered into your pleural fluid. Exposure to a specific type of light activates the drug and causes a chemical reaction, which produces oxygen free radicals. The free radicals are very toxic to the tumor cells and cause necrosis, or tumor cell death. Another promising treatment is immunotherapy. Preliminary studies in early stage mesothelioma have shown encouraging results. Patients administered a form of interferon experienced complete response to therapy.Complementary and Alternative Therapies can help patients feel better and participate in their treatment longer.
Your medical teamIt’s important to have supportive medical team as well an experienced one. One resource for finding an expert in mesothelioma is your primary care doctor, who may be able to recommend. For more information about mesothelioma, including cancer centers that specialize in mesothelioma, complete the contact information.
Your medical teamIt’s important to have supportive medical team as well an experienced one. One resource for finding an expert in mesothelioma is your primary care doctor, who may be able to recommend. For more information about mesothelioma, including cancer centers that specialize in mesothelioma, complete the contact information.
Treatment Options
Even though mesothelioma is incurable, treatment is available. Treatment can prolong your life and make you more comfortable. The traditional therapies used in cancer treatment are the mainstay of mesothelioma treatment. These treatments are used alone and in combination to reduce the damage mesothelioma causes to your body.
Chemotherapy
Radiation treatment
Surgery
The type of treatment that is right for you depends on several factors. The best options for treatment can only be determined after a thorough evaluation by your medical team. An oncologist is a cancer specialist and will most likely lead the process. You may also see a radiologist, pulmonary therapists and an oncology-nursing specialist. To help you cope with discomfort and the emotions stirred up by a serious illness, a social worker can also be a part of your care team. Learn more about the finding a medical team that is experienced in caring for people with mesothelioma. The size and location of your tumor and the stage of your cancer must first be determined. To determine the stage of your cancer, MRI and CT scans are used. These tests are excellent at helping your doctor visualize the size, location and extend of any lung tumors. Other specialized testing using radionuclides can help tell if the disease has spread, or metastasized outside of the chest and abdominal cavities. Mesothelioma therapy is very individualized. They type of therapy that is best for you depends on:
Location of the cancer
Size of the cancer
Degree of invasion into nearby structures
Cancer staging
How widespread the cancer is
Patient’s age
Other medical conditions
Your health status and age will also play a big part in figuring out the very best way to treat your cancer. People with other health problems may not be candidates for very strong forms of treatment.
Treatment IncludesCancer treatment focuses on destroying the malignant cells while preserving the healthy ones. This can be achieved by chemical or physical means that wipe out the tumor cells. These treatment modalities can be used alone, or in combination to have the strongest effect on the disease. When an additional therapy is added to the main treatment for cancer it is called adjuvant therapy. Chemotherapy uses very toxic drugs to kill the tumor cells, but healthy cells can be affected too. Newer chemotherapy drugs have fewer side effects, and combinations of powerful drugs can also help reduce toxic effects. Response to some of the most effective chemotherapy regimens has been less than hoped for. The FDA recently approved a combination of cisplatin and pemetrexed for patients with mesothelioma because it showed a significantly stronger effect on the disease than a single drug. Radiation therapy employs strong doses of radiation to destroy the cancer cells. Radiation therapy is frequently used to shrink tumors before surgery, or to help patients feel less discomfort. While advances in technology allow the radiation to be very tightly focused, cells surrounding the treatment area do suffer significant damage. Tumors can also be removed surgically. In early stage disease, surgery can provide significant improvement and slow the progression of the disease. If the cancer has spread beyond the chest cavity, surgery is much less effective in slowing down the disease, although it can be used in advanced cases to help patients breathe more easily and feel more comfortable. During treatment, the progress of the disease will be monitored periodically. Using blood tests, x-rays and in some cases, MRI or CT scans, the size and extent of tumor can be followed. Depending on the response to treatment, the regimen can be stopped or adjusted. Side effects can also have an impact on the treatment regimen. Fortunately there are many medications that can help patients withstand the toxic effects of these treatments. Because mesothelioma is a very aggressive cancer that is difficult to detect and tends to spread, traditional treatments are less effective than they are in other forms of cancer. Some patients are not candidates for surgery or radiotherapy, especially in widespread or advanced disease. For these patients, chemotherapy may be the only treatment option.
Chemotherapy
Radiation treatment
Surgery
The type of treatment that is right for you depends on several factors. The best options for treatment can only be determined after a thorough evaluation by your medical team. An oncologist is a cancer specialist and will most likely lead the process. You may also see a radiologist, pulmonary therapists and an oncology-nursing specialist. To help you cope with discomfort and the emotions stirred up by a serious illness, a social worker can also be a part of your care team. Learn more about the finding a medical team that is experienced in caring for people with mesothelioma. The size and location of your tumor and the stage of your cancer must first be determined. To determine the stage of your cancer, MRI and CT scans are used. These tests are excellent at helping your doctor visualize the size, location and extend of any lung tumors. Other specialized testing using radionuclides can help tell if the disease has spread, or metastasized outside of the chest and abdominal cavities. Mesothelioma therapy is very individualized. They type of therapy that is best for you depends on:
Location of the cancer
Size of the cancer
Degree of invasion into nearby structures
Cancer staging
How widespread the cancer is
Patient’s age
Other medical conditions
Your health status and age will also play a big part in figuring out the very best way to treat your cancer. People with other health problems may not be candidates for very strong forms of treatment.
Treatment IncludesCancer treatment focuses on destroying the malignant cells while preserving the healthy ones. This can be achieved by chemical or physical means that wipe out the tumor cells. These treatment modalities can be used alone, or in combination to have the strongest effect on the disease. When an additional therapy is added to the main treatment for cancer it is called adjuvant therapy. Chemotherapy uses very toxic drugs to kill the tumor cells, but healthy cells can be affected too. Newer chemotherapy drugs have fewer side effects, and combinations of powerful drugs can also help reduce toxic effects. Response to some of the most effective chemotherapy regimens has been less than hoped for. The FDA recently approved a combination of cisplatin and pemetrexed for patients with mesothelioma because it showed a significantly stronger effect on the disease than a single drug. Radiation therapy employs strong doses of radiation to destroy the cancer cells. Radiation therapy is frequently used to shrink tumors before surgery, or to help patients feel less discomfort. While advances in technology allow the radiation to be very tightly focused, cells surrounding the treatment area do suffer significant damage. Tumors can also be removed surgically. In early stage disease, surgery can provide significant improvement and slow the progression of the disease. If the cancer has spread beyond the chest cavity, surgery is much less effective in slowing down the disease, although it can be used in advanced cases to help patients breathe more easily and feel more comfortable. During treatment, the progress of the disease will be monitored periodically. Using blood tests, x-rays and in some cases, MRI or CT scans, the size and extent of tumor can be followed. Depending on the response to treatment, the regimen can be stopped or adjusted. Side effects can also have an impact on the treatment regimen. Fortunately there are many medications that can help patients withstand the toxic effects of these treatments. Because mesothelioma is a very aggressive cancer that is difficult to detect and tends to spread, traditional treatments are less effective than they are in other forms of cancer. Some patients are not candidates for surgery or radiotherapy, especially in widespread or advanced disease. For these patients, chemotherapy may be the only treatment option.
Asbestosis
Simply put, asbestosis is a breathing disorder caused by inhaling high levels of asbestos. The accumulation of these fibers in the lungs causes scarring of lung tissue and makes it difficult to breathe.
It often takes years of exposure for asbestosis to surface but it can quickly worsen, especially if exposure continues.
Who Gets Asbestosis?
Asbestosis is almost always job-related and many of the victims are older individuals who were exposed to asbestos at work before the United States began to regulate its use in the mid-1970s. This naturally-mined material was used extensively in the construction and manufacturing businesses, especially as pipe insulation, in fire-retardant materials, as floor and ceiling tiles, and in brake and clutch linings.
Those at the highest risk for developing the disorder probably worked with asbestos or asbestos-containing products on a daily basis for at least 8 to 10 years. Miners may develop the disorder in less time.
Symptoms
When damage and scarring caused by inhaled asbestos fibers lead to stiffness in your lung tissue so that your lungs can't contract and expand normally, you will start experience symptoms of the disorder, which may include:
Shortness of breath
Decreased tolerance for physical activity
Coughing
Chest pain
Finger clubbing, in some cases
DiagnosisWhen considering a diagnosis of asbestosis, your doctor will probably inquire as to your exposure to asbestos. He/she may also ask whether any fellow employees have been affected by the disease. Your doctor may then order tests to confirm the diagnosis, including pulmonary function tests, CT scans, and chest x-rays.
TreatmentThe affects of asbestosis cannot be reversed but progression can be halted and symptoms treated. Above all us, further exposure to the toxic material should be eliminated. If you smoke, it’s necessary to stop immediately. Doctors may also treat you with medications that expand or relax blood vessels, and/or blood-thinners that prevent blood clots from forming and obstructing narrowed vessels.
It often takes years of exposure for asbestosis to surface but it can quickly worsen, especially if exposure continues.
Who Gets Asbestosis?
Asbestosis is almost always job-related and many of the victims are older individuals who were exposed to asbestos at work before the United States began to regulate its use in the mid-1970s. This naturally-mined material was used extensively in the construction and manufacturing businesses, especially as pipe insulation, in fire-retardant materials, as floor and ceiling tiles, and in brake and clutch linings.
Those at the highest risk for developing the disorder probably worked with asbestos or asbestos-containing products on a daily basis for at least 8 to 10 years. Miners may develop the disorder in less time.
Symptoms
When damage and scarring caused by inhaled asbestos fibers lead to stiffness in your lung tissue so that your lungs can't contract and expand normally, you will start experience symptoms of the disorder, which may include:
Shortness of breath
Decreased tolerance for physical activity
Coughing
Chest pain
Finger clubbing, in some cases
DiagnosisWhen considering a diagnosis of asbestosis, your doctor will probably inquire as to your exposure to asbestos. He/she may also ask whether any fellow employees have been affected by the disease. Your doctor may then order tests to confirm the diagnosis, including pulmonary function tests, CT scans, and chest x-rays.
TreatmentThe affects of asbestosis cannot be reversed but progression can be halted and symptoms treated. Above all us, further exposure to the toxic material should be eliminated. If you smoke, it’s necessary to stop immediately. Doctors may also treat you with medications that expand or relax blood vessels, and/or blood-thinners that prevent blood clots from forming and obstructing narrowed vessels.
Symptoms of Mesothelioma may include Peritoneal & Pleural
Specific symptoms of Peritoneal mesothelioma:
Weight loss
Abdominal pain
Buildup of fluid in the abdomen
Bowel obstruction
Abnormal blood clotting
Abdominal mass
Fever
Specific symptoms of Pleural Mesothelioma:
Pain in the lower back
Pain in the side of chest
A persistent cough
Shortness of breath
Husky voice
Difficulty swallowing
Fever
Regardless of the location, malignant mesotheliomas occur in three forms. The epithelioid type is the most common, accounting for 50-70% of all mesotheliomas. Between 20-35% of mesotheliomas are sarcomatoid. The remaining 7-20% of tumors are classified as mixed/biphasic. Epithelioid mesothelioma has the best outlook for survival.If your symptoms suggest you may have mesothelioma, you doctor will order a number of tests. Imaging studies like X-rays, CT scans and MRI show any abnormalities within the lungs. A complete blood count and levels of specific proteins can help make the diagnosis. However, the diagnosis of mesothelioma cannot be made by blood work and imaging studies in every case. Other more common diseases such as benign asbestos-related pleural disease and metastatic adenocarcinoma can have very similar appearances on imaging studies. Biopsy, and the use of special staining are often necessary for the accurate diagnosis of mesothelioma.
Promising studies on the early detection of mesothelioma may soon provided more accurate methods for diagnosis. If you have these warning signs you should consultant a qualified medical professional immediately. Only a doctor can make a diagnosis.
Weight loss
Abdominal pain
Buildup of fluid in the abdomen
Bowel obstruction
Abnormal blood clotting
Abdominal mass
Fever
Specific symptoms of Pleural Mesothelioma:
Pain in the lower back
Pain in the side of chest
A persistent cough
Shortness of breath
Husky voice
Difficulty swallowing
Fever
Regardless of the location, malignant mesotheliomas occur in three forms. The epithelioid type is the most common, accounting for 50-70% of all mesotheliomas. Between 20-35% of mesotheliomas are sarcomatoid. The remaining 7-20% of tumors are classified as mixed/biphasic. Epithelioid mesothelioma has the best outlook for survival.If your symptoms suggest you may have mesothelioma, you doctor will order a number of tests. Imaging studies like X-rays, CT scans and MRI show any abnormalities within the lungs. A complete blood count and levels of specific proteins can help make the diagnosis. However, the diagnosis of mesothelioma cannot be made by blood work and imaging studies in every case. Other more common diseases such as benign asbestos-related pleural disease and metastatic adenocarcinoma can have very similar appearances on imaging studies. Biopsy, and the use of special staining are often necessary for the accurate diagnosis of mesothelioma.
Promising studies on the early detection of mesothelioma may soon provided more accurate methods for diagnosis. If you have these warning signs you should consultant a qualified medical professional immediately. Only a doctor can make a diagnosis.
Symptoms of Mesothelioma may include:
Coughing
Shortness of breath or difficulty breathing
Difficulty Sleeping
Weight Loss
Pain in chest and abdomen
Fluid in the chest
Usually, difficulty breathing and a lingering cough bring patients into the doctor for evaluation. This occurs because tumors of the mesothelium make if hard for the lungs to expand smoothly. Large tumors, or tumors that spread to the chest wall can cause chest pain. When fluid builds up in the pleura, breathing can be even more difficult while lying down, making it hard to sleep. The spread of cancerous cells takes a toll on your body, causing weakness, extreme fatigue. Changes in your body’s ability to absorb nutrients as a result of invasion into the abdomen can cause weight loss. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.Depending on the type of mesothelioma, slightly different symptoms can occur. Peritoneal disease has an effect on the intestines, liver and other structures in the abdominal cavity. As fluid builds up, the abdomen can become very expanded. Because the liver plays a big part in manufacturing the substances needed to control bleeding, there is often a change in your ability to make blood clots. Weight loss occurs for several reasons, and is more dramatic in this form of the disease. The pleural form of mesothelioma can also cause damage to the upper airway. Swallowing can become difficult, and voice changes can occur if the larynx is affected.
Shortness of breath or difficulty breathing
Difficulty Sleeping
Weight Loss
Pain in chest and abdomen
Fluid in the chest
Usually, difficulty breathing and a lingering cough bring patients into the doctor for evaluation. This occurs because tumors of the mesothelium make if hard for the lungs to expand smoothly. Large tumors, or tumors that spread to the chest wall can cause chest pain. When fluid builds up in the pleura, breathing can be even more difficult while lying down, making it hard to sleep. The spread of cancerous cells takes a toll on your body, causing weakness, extreme fatigue. Changes in your body’s ability to absorb nutrients as a result of invasion into the abdomen can cause weight loss. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.Depending on the type of mesothelioma, slightly different symptoms can occur. Peritoneal disease has an effect on the intestines, liver and other structures in the abdominal cavity. As fluid builds up, the abdomen can become very expanded. Because the liver plays a big part in manufacturing the substances needed to control bleeding, there is often a change in your ability to make blood clots. Weight loss occurs for several reasons, and is more dramatic in this form of the disease. The pleural form of mesothelioma can also cause damage to the upper airway. Swallowing can become difficult, and voice changes can occur if the larynx is affected.
Mesothelioma Symptoms
Mesothelioma develops many years after exposure to asbestos. Sometimes, it may be 30 to 40 years before symptoms occur. Unfortunately, in the early stages of the disease, symptoms may be vague or not noticeable. Thus, if you have been exposed to asbestos in the past, even for a very brief time, it’s important to have regular check-ups to detect any lung abnormalities, even if you don’t have symptoms. Benign lung disease, such as asbestosis is common in people who have been exposed to asbestos. The symptoms can be very similar, and only a complete medical exam can provide an accurate diagnosis.
Early detection of mesothelioma allows doctor to use more effective and more powerful treatments. For this reason, you should watch carefully for any of the symptoms of mesothelioma.
Early detection of mesothelioma allows doctor to use more effective and more powerful treatments. For this reason, you should watch carefully for any of the symptoms of mesothelioma.
Mesothelioma Risk Factors
In as many as 75-85% of mesothelioma cases, there is a history of exposure to asbestos. The material was used extensively in numerous industries from the early 1900’s through the 1960’s. Through the World War II era, over 8 million workers were exposed to asbestos. Evidence that serious health problems were related to asbestos began to mount, and in 1999, a conclusive link between asbestos exposure and mesothelioma was made. Because it can take as long as 50 years for mesothelioma to develop, anyone who has been exposed should be evaluated by a physician experienced in this form of cancer. Even if you are not ill, you should learn about your legal rights in case mesothelioma is found in the future. Asbestos is a broad term which refers to a collection of minerals know as asbestiform. It is a small mineral comprised of tiny fibers. Asbestos fibers exist in two forms; they can be either amphibole or serpentine (chrysotile). Several studies suggest that the amphibole form of asbestos is more dangerous than the chrysotile form, especially in mesothelioma.These small particles float in the air, in an exposed environment and they may be inhaled or swallowed. Asbestos fibers breathed into the lungs cannot be expelled; they become embedded in the thin lining of the lungs, the mesothelium. Over the period of many years, cells in the mesothelium can become cancerous. In most cases of mesothelioma, it takes decades for the disease to cause symptoms. Although a serious hazard to your health, asbestos is an excellent insulating material. It is used in many products that need to withstand high heat such as home insulation and construction, brake pads, electrical equipment, hot water piping, boilers, ship engines, and welding supplies. People who have worked in these industries should be screened regularly for the development of lung disease. When the asbestos is contained within finished products such as walls and tiles, it does not appear to pose a health as long as it is not damaged or disturbed. However, damage or inadvertent destruction can release dangerous fibers into the air. When asbestos fibers are set free and inhaled, however, exposed individuals are at risk of developing an asbestos-related disease.While smoking has not been found to cause mesothelioma, smoking has been linked to an increased incidence in mesothelioma in asbestos exposed workers. Therefore, if you have had occupational e exposure to asbestos, smoking could raise the risk of developing mesothelioma.
Pericardial Mesothelioma
The rarest form of asbestos-related cancer, pericardial Mesothelioma attacks the lining that surrounds the heart, known as the pericardium. Though this type of Mesothelioma accounts for the lowest number of asbestos-related cancers diagnosed each year – about 5% to 15% - it is often associated with long-term exposure to asbestos. Those who worked in asbestos-laden buildings or with asbestos-containing products throughout the majority of their working years are often the victims of this dreaded disease.
Much like the other varieties of Mesothelioma, this type often does not manifest itself for decades. Unfortunately, this means that by the time it is diagnosed, many treatment options are not viable and a patient’s lifespan at point of diagnosis usually ranges from about 6 weeks to 12 months. Figures like these indicate the importance of regular pulmonary check-ups for those that have suffered long-term asbestos exposure.
Pericardial Mesothelioma can be one of the most painful forms of the disease. Symptoms most often include:
Chest pain
Heart palpitations
Shortness of breath
Persistent coughing
As with other forms of the disease, the symptoms of pericardial Mesothelioma can be mistaken for other illnesses or disorders. Patients who know or suspect they’ve been exposed to asbestos and are experiencing such symptoms should be sure to inform their doctor as to their prolonged exposure.
Testing used to positively diagnose this form of asbestos-related cancer usually begins with x-rays, MRIs, and CT scans, used to detect the presence of any unusual growths in the tissue surrounding the heart. If something is spotted, a biopsy will most likely be performed.
Because pericardial Mesothelioma is almost always detected at a late stage, treatment options are palliative rather than curative. Any procedures or treatments suggested by doctors are usually to help reduce pain or relieve the symptoms of the disease. For many, improving the patient’s quality of life for his/her remaining weeks or months is of the utmost importance at this stage. The age and general health of the patient as well as the patient’s individual wishes should, of course, be taken into consideration.
Palliative treatment options may include:
Radiation therapy – used to reduce fluid collection
Chemotherapy - used to attempt to reduce cancer cells. This aggressive form of therapy should be carefully considered as it will most likely detract from the patient’s quality of life but offer no cure.
Surgery – used on rare occasions in Stage IV patients to reduce fluid collection. If the disease were to be detected early enough and before it has metastasized, surgery may be performed to remove the affected portion of the pericardium.
Clinical trials
For most, unfortunately, pericardial Mesothelioma is a death sentence. If you or someone you’re close to has been diagnosed with this form of asbestos-related cancer, options will be limited. Be sure that your questions and concerns are answered by sending for our free Mesothelioma Resource Kit, which will help explain in more detail the course of the disease, its diagnosis and treatments, and any legal rights belonging to a patient diagnosed with pericardial Mesothelioma.
Much like the other varieties of Mesothelioma, this type often does not manifest itself for decades. Unfortunately, this means that by the time it is diagnosed, many treatment options are not viable and a patient’s lifespan at point of diagnosis usually ranges from about 6 weeks to 12 months. Figures like these indicate the importance of regular pulmonary check-ups for those that have suffered long-term asbestos exposure.
Pericardial Mesothelioma can be one of the most painful forms of the disease. Symptoms most often include:
Chest pain
Heart palpitations
Shortness of breath
Persistent coughing
As with other forms of the disease, the symptoms of pericardial Mesothelioma can be mistaken for other illnesses or disorders. Patients who know or suspect they’ve been exposed to asbestos and are experiencing such symptoms should be sure to inform their doctor as to their prolonged exposure.
Testing used to positively diagnose this form of asbestos-related cancer usually begins with x-rays, MRIs, and CT scans, used to detect the presence of any unusual growths in the tissue surrounding the heart. If something is spotted, a biopsy will most likely be performed.
Because pericardial Mesothelioma is almost always detected at a late stage, treatment options are palliative rather than curative. Any procedures or treatments suggested by doctors are usually to help reduce pain or relieve the symptoms of the disease. For many, improving the patient’s quality of life for his/her remaining weeks or months is of the utmost importance at this stage. The age and general health of the patient as well as the patient’s individual wishes should, of course, be taken into consideration.
Palliative treatment options may include:
Radiation therapy – used to reduce fluid collection
Chemotherapy - used to attempt to reduce cancer cells. This aggressive form of therapy should be carefully considered as it will most likely detract from the patient’s quality of life but offer no cure.
Surgery – used on rare occasions in Stage IV patients to reduce fluid collection. If the disease were to be detected early enough and before it has metastasized, surgery may be performed to remove the affected portion of the pericardium.
Clinical trials
For most, unfortunately, pericardial Mesothelioma is a death sentence. If you or someone you’re close to has been diagnosed with this form of asbestos-related cancer, options will be limited. Be sure that your questions and concerns are answered by sending for our free Mesothelioma Resource Kit, which will help explain in more detail the course of the disease, its diagnosis and treatments, and any legal rights belonging to a patient diagnosed with pericardial Mesothelioma.
Peritoneal Mesothelioma
Peritoneal Mesothelioma is the second-most prevalent form of asbestos-related cancer, rarer than the pleural variety, and accounting for about 10% - 15% of all diagnosed Mesothelioma cases. This form of cancer affects the lining of the abdomen, known as the peritoneum.
Doctors and researchers offer two theories as to how asbestos fibers are able to enter the peritoneum. Some believe that the fibers are caught and held by the mucus in the trachea or bronchi and ultimately swallowed. The second explanation notes that fibers lodged in the lungs may move into the lymphatic system and be transferred to the peritoneum.
Regardless of which explanation is correct, peritoneal Mesothelioma can be quite difficult to detect, as the cancer may lay dormant for many years. Like all types of asbestos-related cancers, documented incidences show that this type has, at times, been dormant for up to four decades. That, of course, makes it all the more difficult to treat this disease because, by the time it’s detected, it has reached its advanced stages.
The symptoms of peritoneal Mesothelioma are non-specific and can often be mistaken as indicators of a much less serious disease. Therefore, it’s important to let medical professionals know that the patient has been exposed to asbestos in the past. Symptoms of this type of Mesothelioma might include:
Abdominal pain
Abdominal swelling due to fluid accumulation
Weight loss
Loss of appetite
Weakness
Nausea
Bowel obstruction
Breathing difficulties
Location of the tumor will determine which symptoms are present and/or most severe and symptoms may be different according to the patient’s general health and age.
Often, the diagnosis of peritoneal Mesothelioma is accidental, perhaps discovered during an x-ray for another ailment. Additional x-rays, CT scans, or MRIs may be ordered but, ultimately, a tissue biopsy will be the most conclusive test.
Once this type of Mesothelioma is diagnosed, treatment options will be discussed. While there is currently no cure for this disease, the patient can be treated in a variety of ways to help ease symptoms, reduce pain, and prolong life. Options include:
Surgery – the surgery performed for peritoneal Mesothelioma may involve cutting out part of the lining and tissue from the abdominal area in order to remove the tumor. If the tumor is particularly large, a lung or a section of the diaphragm may need to be removed as well. Because this type of cancer is so often diagnosed in its late stages, surgery may not be an option as the cancer has already spread too much by this point.
Chemotherapy – the use of intra-peritoneal chemotherapy is often recommended to patients with peritoneal Mesothelioma. This involves the infusion of chemotherapy drugs directly into the abdominal cavity. It can be used after surgery or on its own.
Radiation therapy – radiation may be targeted directly at cancer cells or can be used for palliative reasons such as to reduce pain or shortness of breath or to control the spread of the tumor.
Clinical trials – some patients choose to participate in clinical trials or employ the use of therapies that have not yet been deemed successful in treating the disease, such as gene therapy or immunotherapy.
Although peritoneal Mesothelioma is not the most prevalent form of asbestos-related cancer, it is indeed a serious problem and many people die each year from the disease. If you, a friend, or a loved one has been diagnosed with this or any other type of asbestos-related cancer, learn about your options and rights by ordering our free Mesothelioma Resource Kit, full of information on the disease, its treatments, and the legal options of an asbestos-related cancer victim.
Doctors and researchers offer two theories as to how asbestos fibers are able to enter the peritoneum. Some believe that the fibers are caught and held by the mucus in the trachea or bronchi and ultimately swallowed. The second explanation notes that fibers lodged in the lungs may move into the lymphatic system and be transferred to the peritoneum.
Regardless of which explanation is correct, peritoneal Mesothelioma can be quite difficult to detect, as the cancer may lay dormant for many years. Like all types of asbestos-related cancers, documented incidences show that this type has, at times, been dormant for up to four decades. That, of course, makes it all the more difficult to treat this disease because, by the time it’s detected, it has reached its advanced stages.
The symptoms of peritoneal Mesothelioma are non-specific and can often be mistaken as indicators of a much less serious disease. Therefore, it’s important to let medical professionals know that the patient has been exposed to asbestos in the past. Symptoms of this type of Mesothelioma might include:
Abdominal pain
Abdominal swelling due to fluid accumulation
Weight loss
Loss of appetite
Weakness
Nausea
Bowel obstruction
Breathing difficulties
Location of the tumor will determine which symptoms are present and/or most severe and symptoms may be different according to the patient’s general health and age.
Often, the diagnosis of peritoneal Mesothelioma is accidental, perhaps discovered during an x-ray for another ailment. Additional x-rays, CT scans, or MRIs may be ordered but, ultimately, a tissue biopsy will be the most conclusive test.
Once this type of Mesothelioma is diagnosed, treatment options will be discussed. While there is currently no cure for this disease, the patient can be treated in a variety of ways to help ease symptoms, reduce pain, and prolong life. Options include:
Surgery – the surgery performed for peritoneal Mesothelioma may involve cutting out part of the lining and tissue from the abdominal area in order to remove the tumor. If the tumor is particularly large, a lung or a section of the diaphragm may need to be removed as well. Because this type of cancer is so often diagnosed in its late stages, surgery may not be an option as the cancer has already spread too much by this point.
Chemotherapy – the use of intra-peritoneal chemotherapy is often recommended to patients with peritoneal Mesothelioma. This involves the infusion of chemotherapy drugs directly into the abdominal cavity. It can be used after surgery or on its own.
Radiation therapy – radiation may be targeted directly at cancer cells or can be used for palliative reasons such as to reduce pain or shortness of breath or to control the spread of the tumor.
Clinical trials – some patients choose to participate in clinical trials or employ the use of therapies that have not yet been deemed successful in treating the disease, such as gene therapy or immunotherapy.
Although peritoneal Mesothelioma is not the most prevalent form of asbestos-related cancer, it is indeed a serious problem and many people die each year from the disease. If you, a friend, or a loved one has been diagnosed with this or any other type of asbestos-related cancer, learn about your options and rights by ordering our free Mesothelioma Resource Kit, full of information on the disease, its treatments, and the legal options of an asbestos-related cancer victim.
Pleural Mesothelioma
There are two types of Pleural Mesothelioma: Cancerous and non-cancerous.
Benign mesothelioma many times can be surgically removed and is generally not life threatening or a result of asbestos exposure. Malignant mesothelioma is very serious, though. The infliction is quite rare and less than three thousand people in the US get it each year.
The following section is about malignant pleural mesothelioma:
Pleural mesothelioma is a cancer of the cells that affects the skin or inner lining (known medically as the pleura) outside of the lungs and inside of the ribs. This is caused ONLY by exposure to asbestos fibers found in products made mostly by US corporations. The exposure could have occurred many, many years ago because it takes many years for the disease to show up. Pleural mesothelioma is the most common type of mesothelioma and chances are that if you have mesothelioma, this is the type you have.
Often Mesothelioma is diagnosed when no symptoms are present. This could be because a tumor is present or is randomly discovered through something like a routine exam. When these symptoms do occur, they can include shortness of breath, weight loss, chest pains, pains about the lower back, chronic cough, difficulty swallowing, and severe weakness. In the initial examination a medical examination will often show a pleural effusion, which is a bunch of fluid in the area between the lungs and the wall of the chest.
A chest x-ray or CT scan is the necessary first step in identifying mesothelioma, which is followed up with what is called a bronchoscopy. A bronchoscopy requires a viewing scope to look inside the lungs. The diagnosis itself requires a biopsy which allows the medical professionals to take a little piece of tissue from the area in question. This can be done using a tiny needle, an open cut, or even these days through a tube with a camera on the end of it. This is a procedure that must happen at the hospital, but it is not a painful procedure typically.
Any fluid build-up from the pleural effusion can generally be viewed via the x-ray and can be heard through the dr.’s stethoscope during examination. The only firm diagnosis of mesothelioma can be made through the biopsy described earlier. Because other things like tumors and benign effusions can look like mesothelioma, a biopsy is the only safe way to tell as a diagnosis of mesothelioma can be one of the most difficult in the book.
As the tumor spreads over the lining between the lungs and the chest, flexibility can be increasingly painful and restricted. Because of this, breathing becomes much more difficult. It begins with shortness of breath potentially while exercising but as function continues to drop short breath can become more and more of a persistent problem.
Although there is no cure for pleural mesothelioma, the treatment options have improved for managing symptoms. As with any cancer, the prognosis is better for those diagnosed early, and treatment can be more aggressive. Most pleural mesothelioma patients are treated with a multimodal therapy, or combination of treatment options. It is possible for patients with pleural mesothelioma to live for 5 to 10 years after diagnosis, although the average survival time is about a year.
Specific types of treatment include:
Chemotherapy and other drug-based therapies
Radiation therapy
Surgery
Intra-operative photodynamic therapy.
Experimental treatments such as gene therapy, angiogenesis inhibitors, immunotherapy, and many clinical trials are also in the development stages.
Although mesothelioma remains uncurable, many other treatments have had success in pain reduction and improving lung function. Surgeries to remove tumors and reduce pressure have shown promise in pain reduction, and pain control medications are constantly improving. In some cases, X-ray therapy has been shown to control tumor pain as well.
Benign mesothelioma many times can be surgically removed and is generally not life threatening or a result of asbestos exposure. Malignant mesothelioma is very serious, though. The infliction is quite rare and less than three thousand people in the US get it each year.
The following section is about malignant pleural mesothelioma:
Pleural mesothelioma is a cancer of the cells that affects the skin or inner lining (known medically as the pleura) outside of the lungs and inside of the ribs. This is caused ONLY by exposure to asbestos fibers found in products made mostly by US corporations. The exposure could have occurred many, many years ago because it takes many years for the disease to show up. Pleural mesothelioma is the most common type of mesothelioma and chances are that if you have mesothelioma, this is the type you have.
Often Mesothelioma is diagnosed when no symptoms are present. This could be because a tumor is present or is randomly discovered through something like a routine exam. When these symptoms do occur, they can include shortness of breath, weight loss, chest pains, pains about the lower back, chronic cough, difficulty swallowing, and severe weakness. In the initial examination a medical examination will often show a pleural effusion, which is a bunch of fluid in the area between the lungs and the wall of the chest.
A chest x-ray or CT scan is the necessary first step in identifying mesothelioma, which is followed up with what is called a bronchoscopy. A bronchoscopy requires a viewing scope to look inside the lungs. The diagnosis itself requires a biopsy which allows the medical professionals to take a little piece of tissue from the area in question. This can be done using a tiny needle, an open cut, or even these days through a tube with a camera on the end of it. This is a procedure that must happen at the hospital, but it is not a painful procedure typically.
Any fluid build-up from the pleural effusion can generally be viewed via the x-ray and can be heard through the dr.’s stethoscope during examination. The only firm diagnosis of mesothelioma can be made through the biopsy described earlier. Because other things like tumors and benign effusions can look like mesothelioma, a biopsy is the only safe way to tell as a diagnosis of mesothelioma can be one of the most difficult in the book.
As the tumor spreads over the lining between the lungs and the chest, flexibility can be increasingly painful and restricted. Because of this, breathing becomes much more difficult. It begins with shortness of breath potentially while exercising but as function continues to drop short breath can become more and more of a persistent problem.
Although there is no cure for pleural mesothelioma, the treatment options have improved for managing symptoms. As with any cancer, the prognosis is better for those diagnosed early, and treatment can be more aggressive. Most pleural mesothelioma patients are treated with a multimodal therapy, or combination of treatment options. It is possible for patients with pleural mesothelioma to live for 5 to 10 years after diagnosis, although the average survival time is about a year.
Specific types of treatment include:
Chemotherapy and other drug-based therapies
Radiation therapy
Surgery
Intra-operative photodynamic therapy.
Experimental treatments such as gene therapy, angiogenesis inhibitors, immunotherapy, and many clinical trials are also in the development stages.
Although mesothelioma remains uncurable, many other treatments have had success in pain reduction and improving lung function. Surgeries to remove tumors and reduce pressure have shown promise in pain reduction, and pain control medications are constantly improving. In some cases, X-ray therapy has been shown to control tumor pain as well.
What is Mesothelioma
Mesothelioma is a serious and rare form of lung cancer. It is most frequently seen in men between the ages of 50 to 70. Women are affected far less frequently. In the US, between 2000 and 3000 cases are diagnosed each year. Estimates suggest that the incidence of mesothelioma for every 100,000 in the US is about 1.8 and 0.9 internationally. This form of cancer affects people of every race equally. The number of people who have been diagnosed with mesothelioma has increased significantly in the past 30 years. Although many advances in treatment have been made, there is no cure for this type of cancer.
In mesothelioma, the cells of the mesothelium become cancerous and grow out of control. The mesothelium is a protective, two-layered membrane that covers the internal organs of the body including the lungs, heart and abdominal organs. Between these layers, the cells produce fluid, which allows easy movement of the heart and lungs within the chest cavity. The layer that covers the lungs is called the pleura, and the layer that covers the heart is called the pericardium. The peritoneum lines the abdominal cavity. Mesothelium also lines the male and female reproductive organs. Mesothelioma can affect any of these cells, but is usually seen in the pleural or peritoneal mesothelium. The most common form of mesothelioma is pleural.
The primary risk factor for developing mesothelioma is exposure to asbestos. Between 70-80% of people diagnosed with mesothelioma have been exposed to asbestos, usually in the workplace. Although it is possible to develop mesothelioma without any exposure to asbestos, it is very rare. While one person for every million people in the US will be diagnosed with mesothelioma, about 7-13 men who have been exposed to asbestos will be diagnosed with the disease. Symptoms frequently take 20 years to develop, but can take as long as 50 years to occur.
When cancerous cells invade the mesothelium, it becomes increasingly difficult to breathe. In the pleural form of mesothelioma, tumors growing in the mesothelium cause pleural effusions, which prevent the smooth movement of the lungs and other organs in the chest. Peritoneal mesothelioma invades the abdominal cavity and can cause loss of appetite weight loss, nausea and vomiting. Most patients seek medical care after having symptoms only 4-6 months.
Mesothelioma is a very aggressive form of cancer. Because it takes so long for symptoms to appear it can spread to the other organs in the chest, the chest wall and into the lymph nodes. The cancerous cells spread, or metastasize from the mesothelium into other parts of the body and damage internal tissues and organs. Treatment is more effective when the disease is detected early.
Treatment is aimed at reducing the size of tumors, and relieving symptoms. Chemotherapy, radiation treatment and surgery are some of the traditional treatment strategies used to help patients live longer, with fewer symptoms. New advances in photodynamic therapy and immunotherapy give hope for prolonging the lives of patients with mesothelioma. On average, however, the life expectancy after being diagnosed with mesothelioma is less than one year.
In mesothelioma, the cells of the mesothelium become cancerous and grow out of control. The mesothelium is a protective, two-layered membrane that covers the internal organs of the body including the lungs, heart and abdominal organs. Between these layers, the cells produce fluid, which allows easy movement of the heart and lungs within the chest cavity. The layer that covers the lungs is called the pleura, and the layer that covers the heart is called the pericardium. The peritoneum lines the abdominal cavity. Mesothelium also lines the male and female reproductive organs. Mesothelioma can affect any of these cells, but is usually seen in the pleural or peritoneal mesothelium. The most common form of mesothelioma is pleural.
The primary risk factor for developing mesothelioma is exposure to asbestos. Between 70-80% of people diagnosed with mesothelioma have been exposed to asbestos, usually in the workplace. Although it is possible to develop mesothelioma without any exposure to asbestos, it is very rare. While one person for every million people in the US will be diagnosed with mesothelioma, about 7-13 men who have been exposed to asbestos will be diagnosed with the disease. Symptoms frequently take 20 years to develop, but can take as long as 50 years to occur.
When cancerous cells invade the mesothelium, it becomes increasingly difficult to breathe. In the pleural form of mesothelioma, tumors growing in the mesothelium cause pleural effusions, which prevent the smooth movement of the lungs and other organs in the chest. Peritoneal mesothelioma invades the abdominal cavity and can cause loss of appetite weight loss, nausea and vomiting. Most patients seek medical care after having symptoms only 4-6 months.
Mesothelioma is a very aggressive form of cancer. Because it takes so long for symptoms to appear it can spread to the other organs in the chest, the chest wall and into the lymph nodes. The cancerous cells spread, or metastasize from the mesothelium into other parts of the body and damage internal tissues and organs. Treatment is more effective when the disease is detected early.
Treatment is aimed at reducing the size of tumors, and relieving symptoms. Chemotherapy, radiation treatment and surgery are some of the traditional treatment strategies used to help patients live longer, with fewer symptoms. New advances in photodynamic therapy and immunotherapy give hope for prolonging the lives of patients with mesothelioma. On average, however, the life expectancy after being diagnosed with mesothelioma is less than one year.
Mesothelioma Stages
Doctors employ the use of “stages” in both cancer diagnoses and monitoring to determine the progress of an individuals’ disease. Staging takes a close look at cancers, like Mesothelioma, and determines to what extent it has developed and/or spread. Most importantly, staging helps determine the course of treatment.
Currently, though there are three types of Mesothelioma – pleural, peritoneal, and pericardial – staging has thus far been established for the most frequently occurring form of this cancer - pleural - and not for the others. The three systems that stage this disease are the Butchart, TNM, and Brigham systems.
Butchart is the oldest system and is still the most commonly used. Its four stages are based on the extent of primary tumor mass.
Stage I: Mesothelioma is present in the right or left pleura (the thin, transparent membrane which covers the lungs and lines the inside of the chest walls) and may also involve the diaphragm (the muscle separating the chest from the abdomen) on the same side.
Stage II: Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may now be affected as well.
Stage IV: There is evidence of metastasis (the spreading of the Mesothelioma) through the bloodstream to other organs.
The TNM System looks at three components: the tumor (T), the lymph nodes (N), and the spreading of the disease, otherwise known as metastasis (M). It is also divided into four stages.
Stage I: Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium (the fluid filled sac that surrounds the heart), or diaphragm on the same side. Lymph nodes are not involved.
Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
Stage III: Mesothelioma has now invaded the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side. It may or may not have spread to lymph nodes on the same side as the primary tumor.
Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal cavity or neck. Any distant metastasis is included in this stage.
The most recent system to be devised is the Brigham System. It stages the disease according to the ability to surgically remove the tumor (resectability) and the involvement of the lymph nodes. It, too, is divided into four stages.
Stage I: Mesothelioma is resectable and no lymph node involvement.
Stage II: Mesothelioma is resectable but with lymph node involvement.
Stage III: Presence of unresectable Mesothelioma extending into the chest wall, heart, or through the diaphragm or peritoneum; with or without extra-thoracic lymph node involvement.
Stage IV: Distant metastatic disease (widespread cancer throughout the body).
Diagnosis is achieved in a number of ways, especially because other diseases may possess similar symptoms to those presented by Mesothelioma. A wide variety of imaging techniques may be used in diagnosis, such as CT scans, MRI, and conventional x-rays. Some doctors also choose to test the pleural fluid for malignant cells.
Biopsy, however, is by far the most accurate way to diagnose Mesothelioma. Needle biopsies, done under local anesthetic, may be used but provide only small tissue samples. That means the accuracy rate might be less than desirable. The preferred course of action in suspected Mesothelioma is an “open” biopsy, which provides a larger tissue sample. This type of biopsy is performed in a hospital setting under general anesthesia.
Do you suspect that you or someone close to you may be suffering from Mesothelioma or do you worry about a spouse or loved ones’ previous exposure to asbestos? Learn the facts about asbestos and the diseases it causes by ordering our free Mesothelioma Resource Kit
Currently, though there are three types of Mesothelioma – pleural, peritoneal, and pericardial – staging has thus far been established for the most frequently occurring form of this cancer - pleural - and not for the others. The three systems that stage this disease are the Butchart, TNM, and Brigham systems.
Butchart is the oldest system and is still the most commonly used. Its four stages are based on the extent of primary tumor mass.
Stage I: Mesothelioma is present in the right or left pleura (the thin, transparent membrane which covers the lungs and lines the inside of the chest walls) and may also involve the diaphragm (the muscle separating the chest from the abdomen) on the same side.
Stage II: Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may now be affected as well.
Stage IV: There is evidence of metastasis (the spreading of the Mesothelioma) through the bloodstream to other organs.
The TNM System looks at three components: the tumor (T), the lymph nodes (N), and the spreading of the disease, otherwise known as metastasis (M). It is also divided into four stages.
Stage I: Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium (the fluid filled sac that surrounds the heart), or diaphragm on the same side. Lymph nodes are not involved.
Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
Stage III: Mesothelioma has now invaded the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side. It may or may not have spread to lymph nodes on the same side as the primary tumor.
Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal cavity or neck. Any distant metastasis is included in this stage.
The most recent system to be devised is the Brigham System. It stages the disease according to the ability to surgically remove the tumor (resectability) and the involvement of the lymph nodes. It, too, is divided into four stages.
Stage I: Mesothelioma is resectable and no lymph node involvement.
Stage II: Mesothelioma is resectable but with lymph node involvement.
Stage III: Presence of unresectable Mesothelioma extending into the chest wall, heart, or through the diaphragm or peritoneum; with or without extra-thoracic lymph node involvement.
Stage IV: Distant metastatic disease (widespread cancer throughout the body).
Diagnosis is achieved in a number of ways, especially because other diseases may possess similar symptoms to those presented by Mesothelioma. A wide variety of imaging techniques may be used in diagnosis, such as CT scans, MRI, and conventional x-rays. Some doctors also choose to test the pleural fluid for malignant cells.
Biopsy, however, is by far the most accurate way to diagnose Mesothelioma. Needle biopsies, done under local anesthetic, may be used but provide only small tissue samples. That means the accuracy rate might be less than desirable. The preferred course of action in suspected Mesothelioma is an “open” biopsy, which provides a larger tissue sample. This type of biopsy is performed in a hospital setting under general anesthesia.
Do you suspect that you or someone close to you may be suffering from Mesothelioma or do you worry about a spouse or loved ones’ previous exposure to asbestos? Learn the facts about asbestos and the diseases it causes by ordering our free Mesothelioma Resource Kit
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