Debbie provided a link to a story published in November 2009 by ABC News that outlines the work of specialists at Austin Health Centre in Victoria. The treatment, spearheaded by Dr. Malcolm Feigen, a radiation oncologist at the Centre, uses high doses of radiotherapy, concentrated on specific areas of the lining of the lungs to target mesothelioma tumors.

According to the ABC report, 13 patients participated in a pilot program to test this new targeted radiotherapy treatment. Most had some surgery prior to the radiotherapy treatment, and some also had chemotherapy before or after the treatment, although Dr. Feigen believes the patients showed the most benefit primarily as a result of the radiotherapy regimen.

Participants in the U.S. clinical trial at the Mesothelioma Center receive a multi-modality therapy that incorporates surgery, chemotherapy and radiation therapy in combination.

Listen to the interview with Dr. Feigen about the Australian research, which was broadcast on ABC’s AM morning current affairs program.

SOURCE: myMeso › Australian doctor researching radiotherapy for treatment of pleural mesothelioma

Taylor was recently honored for his accomplishments at the Celebrate Princeton Invention reception, held Dec. 18. He developed Alimta in partnership with scientists at Eli Lilly and Co.  after spending more than 40 years on the Princeton faculty. However, he began research that would lead to the mesothelioma drug’s development while a graduate student at Cornell University.

According to a Princeton news release, Taylor became fascinated by reports of a compound obtained from spinach and liver that had a unique chemical structure with a nucleus previously only observed in the pigments of butterfly wings. The compound from liver, now known as folic acid, he found was essential for the synthesis of DNA and RNA, and for the growth of cells.  Taylor observed that changes to the structure of folic acid could transform it from a growth-promoting to a growth-inhibiting compound, and dedicated his career to determine how it could be used to kill cancer cells.

Since its approval by the FDA in 2004, the drug has received three additional FDA approvals, most recently in July when it became the first chemotherapy approved for use as a maintenance therapy for patients with locally advanced or metastatic nonsquamous non-small cell lung cancer. Alimta has been successful in improving the quality of life and extending the lifespan of millions of cancer patients in nearly 100 countries around the world.

Taylor has previously been honored with the ACS Heroes of Chemistry Award, the International Society of Heterocyclic Chemistry Senior Award in Heterocyclic Chemistry, and the Research and Development Council of New Jersey’s Thomas Alva Edison Patent Award for Invention.

SOURCE: myMeso › Alimta developer to be inducted into Chemistry Hall of Fame

According to the research summary, the objective of the study was to evaluate the perioperative and long-term outcomes associated with extrapleural pneumonectomy for patients with malignant pleural mesothelioma. Pleural mesothelioma affects the lining of the chest cavity and lungs. Other forms of mesothelioma include pericardial, which affects the lining of the heart and is extremely rare; and peritoneal, which affects the lining of the abdomen. Mesothelioma is atributed almost exclusively to asbestos exposure.

According to the Multimedia Manual of Cardiothoracic Surgery, extrapleural pneumonectomy was introduced in the 1940s for the treatment of extensive infections of the lung and pleural space. Over the past 20 years, the extrapleural pneumonectomy technique has been modified and applied to the treatment of locally advanced malignant pleural mesothelioma, achieving substantial reductions in mortality. The surgery involves the removal of the lung with visceral and parietal pleurae, pericardium and diaphragm.

Researchers selected 70 patients between October 1994 and April 2008 to undergo the procedure. Prognostic factors included age, gender, side of disease, asbestos exposure, histology, positron emission tomography, date of surgery, neoadjuvant chemotherapy, completeness of cytoreduction, lymph node involvement, peioperative morbidity, adjuvant radiotherapy and pemetrexed-based chemotherapy.

The mean age of patients was 55 years. The median survival was 20 months, with a 3-year survival of 30 percent. Analyses showed improved survival for patients with asbestos exposure, negative lymph node involvement, and receipt of adjuvant radiation or postoperative pemetrexed-based chemotherapy.

The study was conducted by physicians from the University of Sydney, Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital; The Baird Institute for Applied Heart and Lung Surgical; Department of Medical Oncology, Sydney Cancer Center, Royal Prince Alfred Hospital; and Department of Radiation Oncology, Sydney Cancer Center, Royal Prince Alfred Hospital; all in Sydney, Australia.

SOURCE: myMeso › Study supports extrapleural pneumonectomy to treat select mesothelioma patients

According to the journal summary, the findings are based on a small number of patients, so researchers are approaching these results with caution and anticipate more study to confirm the results. The team examined mesothelioma in 2,567 five-year survivors of Hodgkin lymphoma, who had been treated with radiation alone, chemotherapy alone, or a combination of the two.

The study indicated that mesothelioma risk was almost 30 times greater in Hodgkin lymphona patients treated with radiation than in the general population.

The journal article was summarized by HemOncToday, which reports clinical news in oncology and hematology. The publication says the median follow-up period for patients included in the radiation-mesothelioma study was 18.1 years, at which time researchers found 13 patients had malignant mesothelioma at least five years after being treated for Hodgkins lymphoma.

HemOncToday reports there were no cases of mesothelioma among patients treated with chemotherapy alone, but that patients treated with both radiation and chemotherapy were almost 44 times more likely to develop malignant mesothelioma.

Harry S. Jacob, MD, HemOncToday chief medical editor, provided this perspective:

“Seminal studies by Scripps Research Institute investigators demonstrated that asbestos with high-iron content (as opposed to low-Fe level asbestos) was more likely to cause mesotheliomas in miners. In vitro iron-asbestos promoted oxygen radical generation that altered DNA, providing rationale for the epidemiologic studies. The combination of radiation-mediated oxygen radicals plus lung iron asbestos (or tobacco-mediated iron deposition) may underlie these findings.”

SOURCE: myMeso › Link between radiation and mesothelioma?

Mistletoe is in fairly widespread use in Europe as a complementary therapy in cancer care. It is given in conjunction with traditional cancer treatments such as chemotherapy, to strengthen the body’s immune system and build its natural defenses. It is believed mistletoe therapy can help cancer patients cope with the side-effects of chemotherapy and radiation.

Mistletoe is considered an anthroposophical medicine, which takes into account a total view of the human body and the human being, including physical constitution, the life force, the consciousness and the ego or free will. Mistletoe is harvested from different trees, with different types of mistletoe having different uses. According to the American Cancer Society, the type of mistletoe used in this therapy grows on species of trees native to England, Europe and western Asia. It is NOT the type of mistletoe commonly seen in the U.S. Mistletoe therapy is only available in clinical trials in the United States.

The extract, which comes from the plant’s leaves and twigs but not its berries, is generally given as an injection and after an initial professional application patients can do the treatment themselves at home. Debbie began her mistletoe treatment at The Park Attwood Clinic, which still oversees the process, although she administers her own injections now.

Debbie says she learned about the treatments from a couple who visited her web site, Mesothelioma & Me. She began the mistletoe therapy at the same time as her chemoembolization treatment, which uses targeted chemotherapy applied directly to her tumor and contained with the tumor. For about two years, she also has been struggling with alopecia, which had caused her to lose large patches of her hair.

“Since I started the mistletoe and the chemoembolization, I have noticed within the last two months my hair has grown back and is its natural color,” she wrote to me in an email. “The mistletoe boosts the immune system and also is very good at quelling the side effects of the chemo, although the side effects with chemoembolization are not as bad as the normal chemo.” She said mistletoe is offered on the German health care system, but it is not recognized by the UK system.

Debbie gives herself the mistletoe injections twice a week.

“I would have to say that a lot of the benefits I have had over the last five treatments is down to the mistletoe,” she says. “It works very well alongside the chemo treatment.”

She left today to travel to Germany for the sixth round of her chemoembolization treatments, and will learn the results of the fifth round, which she received November 6. So far, she has experienced tumor shrinkage after each round of chemoembolization.

SOURCE: myMeso › Mistletoe treatment believed to provide relief for cancer patients

As most of you know, Debbie has been battling mesothelioma since November 2006. In May 2008, she began a process called chemoembolization, which specifically targets and attacks her tumor, and basically seals the chemotherapy in with the tumor.

Debbie travels to Germany every month or so for the treatment. She saw her doctor, Dr. Thomas J. Vogl, for her fifth treatment on Thursday, Nov. 6, where she found that the tumor had shrunk another 10 percent since the fourth treatment in September. This is a total reduction of 43 percent since she started the therapy!

You can follow Debbie’s story on her blog, Mesothelioma and Me.

Bless you Debbie! We are so excited for your great progress!!

SOURCE: myMeso › More happy news for Debbie as tumor shrinks!

According to the report, the study involved 20 patients treated between 2002 and 2004 who received Alimta and Gemzar every 21 days, along with folic acid, vitamin B12 and dexamethasone. Cancer Consultants reports overall response rate was 15 percent, disease control rate was 50 percent, median time to disease progression was 10.4 months and the median survival time was 26.8 months. Additionally, the report notes that toxicities were tolerable.

Cancer Consultants notes that peritoneal mesothelioma makes up less than 20 percent of all cases of mesothelioma, with pleural mesothelioma being more common. Peritoneal mesothelioma is a specific form of mesothelioma that affects the peritoneum, which is the serous membrane that forms the lining of the abdominal cavity.

Pleural mesothelioma is the most common form of the disease, making up about 75 percent of all cases. Pleural mesothelioma affects the outer lining of the lungs and chest cavity.

Because of its relative rarity, there have been few studies of chemotherapy as a treatment for peritoneal mesothelioma, and there are no controlled trials of various treatment options available for peritoneal mesothelioma.

Traditional therapy for peritoneal mesothelioma has involved surgical debulking followed by systemic and/or intraperitoneal chemotherapy.

Cancer Consultants, which delivers educational programs and resources to more than 18 million targeted seekers of cancer information, has been producing and distributing cancer information for patients and professionals since 1998.

The publication notes that this study is one of the first devoted to systemic chemotherapy treatment for peritoneal mesothelioma and as such provides an important baseline for research.

SOURCE: myMeso › Drug combo effective for peritoneal mesothelioma

She had her first round of chemoembolization therapy in May, and a second in June. Since the June treatment, her tumor is now 18 percent smaller! Debbie returns to Germany for another round of treatment this month, and is hopeful that the tumor has continued to shrink.

In July, the BBC featured Debbie in an interview, talking about chemoembolization. She hopes to spread the word about this treatment so that more people might explore it’s possibilities for mesothelioma. Click here to view the BBC video.

Debbie shares her mesothelioma story on her blog, www.mesothelioma-and-me.com. She was diagnosed with meso in November 2006. It is suspected that she contracted meso as a result of being exposed to asbestos dust on her father’s work clothes as a child. He was a lagger and would often scrape asbestos from pipes during his day’s job.

According to the web site www.radiologyinfo.org, chemoembolization is a combination of chemotherapy and a procedure called embolization, to treat cancer. Debbie is being treated by Dr. Thomas J. Vogl, Chairman, Department of Radiology, Department of Diagnostic and Interventional Radiology – University Hospital, Johann Wolfgang Goethe, University of Frankfurt am Main.

In this procedure, Dr. Vogl catheterizes the tumor and administers localized chemotherapy directly into the arteries feeding the tumor. Once the chemo has been administered, other agents can be administered to block off the blood supply to the tumor.

We look forward to another stellar report following Debbie’s visit to Germany this month!

SOURCE: myMeso › Debbie talks about meso treatment on BBC

Heather’s treatment included radical surgery to remove her left lung, the lining around her heart, half her diaphragm, her sixth rib, and a few lymph nodes, followed by a chemotherapy regimen every three weeks for 12 weeks.  She now calls herself the “poster child for hope after meso.”

According to the Star-Tribune article, Dr. Sugarbaker is more guarded, although optimistic. The paper quotes him as saying, “right now in this present moment she is disease-free.”

Dr. Sugarbaker is arguably the leading mesothelioma physician in the U.S., and is largely credited with developing the surgical technique for mesothelioma resection and for recognizing the importance of a multimodality approach to treatment that combines surgery with chemotherapy and radiation therapy.

The National Cancer Institute estimates about 2,000 cases of mesothelioma are diagnosed in the U.S. each year. The disease has a long latency period of between 20 and 50 years, and it is unusual to find it in someone so young. Mesothelioma is linked only to asbestos exposure, so its victims are traditionally people who work in asbestos mining or come into contact with asbestos through other occupational exposure.

In Heather’s case, her mesothelioma is most likely due to secondhand exposure, from asbestos on her father’s work clothes. The Star-Tribune reports that Heather’s dad, Rollie Rosedahl, was a construction laborer who often worked with asbestos-containing products. Heather says she often wore her father’s jacket and boots when he’d come in from work.

The National Cancer Institute says that asbestos related disease like mesothelioma and asbestosis can occur in people with only brief exposures, and that there is evidence that family members of workers exposed to asbestos face an increased risk of developing mesothelioma.

SOURCE: myMeso › Meso survivor ‘claims cured’

According to the report, the study evaluated a regimen of Navelbine (vinorelbine) and Platinol (cisplatin) for the treatment of 54 patients with newly diagnosed non-resectable mesothelioma. The median number of cycles of chemotherapy administered was four. There were two complete responses and 14 partial responses.

The median survival was 16.8 months, and the median time to tumor progression was 7.2 months. The one-year survival was 61 percent, the two-year survival was 31 percent, and the three-year survival was 4 percent.

The authors of the study say these results are as good as or better than currently used combinations for treatment of mesothelioma.

SOURCE: myMeso › Chemo combo highly effective for mesothelioma

It is hoped the new treatment will replace or delay the need for the standard treatment in these cases, a pleural pneumonectomy, which involves removal of the lung and which can be extremely debilitating to patients.

According to a press release from the medical center, Dr. Robert Taub, the study’s principal investigator, director of the Mesothelioma Center at NewYork-Presbyterian/Columbia and professor of clinical medicine at Columbia University College of Physicians and Surgeons, says, “Current surgical and chemotherapy treatments of patients with malignant pleural mesothelioma are unsatisfactory, and have not been shown to significantly prolong survival. In this study, we will investigate whether a combination of chemotherapy and radiation targeted directly at the lung’s lining can improve outcomes while avoiding surgery. In addition, this approach has shown to have minimal toxic side effects compared to systemic chemotherapy.”

The Mesothelioma Center is the only one nationwide that is offering this experimental therapy to treat pleural mesothelioma.

The study is being conducted at the Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital and Columbia University Medical Center. According to the release, participating patients will receive several rounds of targeted chemotherapy using the drugs cisplatin and doxorubicin via surgically implanted catheters. Some patients will be randomly selected to receive additional systemic (intravenous) chemotherapy using the drugs cisplatin and pemetrexed. All patients will receive targeted radiotherapy using the P-32 radioisotope.

Patients may elect to receive additional surgical treatment, including removal of the affected lung lining or lung. Subsequently, patients will be offered outpatient systemic chemotherapy with cisplatin and pemetrexed.

For more information, visit www.hiccc.columbia.edu.

SOURCE: myMeso › Clinical trial for mesothelioma at NY hospital

Some of you who are following Debbie on her journal have already heard the good news – on June 20, she learned that her tumor (which she wittily nicknamed Theo) has shrunk by 10 percent after the first of three scheduled chemoembolization treatments. She had her first treatment May 20, and the second June 20, when she learned Theo had gotten smaller.

According to www.radiologyinfo.org, chemoembolization is a combination of chemotherapy and a procedure called embolization to treat cancer, most often of the liver. According to the web site, catheter embolization is the deliberate introduction of foreign (”embolic”) material such as gelatin sponge or metal coils to stop bleeding or cut off blood flowing to a tumor or arteriovenous malformation.

Debbie traveled to Frankfurt, Germany, to have the procedure, which is still a trial, done by Dr. Thomas J. Vogl, Chairman, Department of Radiology, Department of Diagnostic and Interventional Radiology – University Hospital, Johann Wolfgang Goethe, University of Frankfurt am Main.

In this procedure, Dr. Vogl catheterizes the tumor and administers localized chemotherapy directly into the arteries feeding the tumor. Once the chemotherapy has been administered, other agents can be administered to block off the blood supply to the tumor.

Debbie’s description of the procedure is a little more colorful:

“A small incision will be made to expose the artery that feeds the tumour which is in the femour. A catheter is inserted and pushed up into the area affected. Embolization is a glue like substance which is put in to seal off the tumour and the chemo is then added and the whole area sealed off. The chemo is left to do its job. It is something like having a room with 2 doors, sealing off the back door and throwing in an explosive and sealing up the front door.”

One of the strangest things? The clinic where Debbie visits Dr. Vogl for these treatments is located on a street of the same name as her tumor’s nickname! Theodore Stern Kia 7. Visit Debbie’s blog to read all about her experiences with Dr. Vogl and this treatment. She even has photos of herself at the clinic.

Debbie points out that chemoembolization is not a cure for mesothelioma, but is thought to slow the growth of the tumor or reduce it, allowing the patient a longer life.

In conjunction with or following this treatment, Debbie will undergo a dendritic cell vaccine. According to the web site drugresearcher.com, dendritic cells – a part of the body’s immune system that detects foreign proteins in the body – can be used as vaccines by mixing them with genetic material from the patient’s tumour and infusing the treated cells back into the patient. The dendritic cells present the tumour antigens to the body’s white blood cells (T lymphocytes) for destruction.

SOURCE: myMeso › Debbie’s mesothelioma tumor shrinks!

The article, which studied the cost of care for elderly cancer patients in the United States, used Surveillance, Epidemiology, and End Results-Medicare files to identify 718,907 cancer patients and 1,623,651 noncancer control subjects. Researchers estimated net costs of care for elderly cancer patients for the 18 most prevalent cancers and for all other tumor sites combined.

The study reports that costs of care were estimated for each phase by use of Medicare claims data from January 1, 1999 through December 31, 2003. They found that costs to Medicare were highest for lung, colorectal and prostate cancers.

An article in HealthDay News examining this latest report says study co-author Robin Yabroff attributes rising costs to a growing population of seniors in the U.S., as well as the inclusion of more prescription drugs in Medicare coverage. Yabroff is an epidemiologist at the U.S. NCI.

The report states that the number of patients receiving chemotherapy for lung, colorectal and breast cancer rose from 1991 to 2002, and that those increasing costs do not even reflect many of the newest, most expensive drugs now in use.

The HealthDay report quotes Dr. Len Lichtenfeld, deupty chief medical officer at the American Cancer Society, as saying that “the impact to Medicare is going to be substantial.” He goes on to say that the increasing costs for new drugs may actually prevent some patients from getting the treatment they need. Even if the drug is covered by Medicare, he says, the cost of the patient’s co-pay may be too high for them to afford it.

SOURCE: myMeso › Cancer treatment costs rise, affect Medicare

According to the company’s news release, available in its entirety on the Mesothelioma Applied Research Foundation web site, the trial is moving forward after a favorable review of currently available safety and efficacy data from the Phase II portion of the study. This is an international study, expected to enroll 660 patients with testing centers in the United States, Belgium, Germany, the Netherlands, New Zealand, Spain, Sweden and the United Kingdom. It will be an ongoing randomized, double-blind, placebo-controlled trial.

Information provided by Merck says the trial will examine the safety, tolerability and anti-tumor activity of oral vorinostat with best supportive care as compared to best supportive care plus placebo in patients with advanced mesothelioma who have failed or are intolerant to prior chemotherapy, icnlucing pemetrexed in combination with either cisplatin or carboplatin.

Primary endpoints of the Phase III trial include overall survival as well as characterization of the overall safety and toxicity of vorinostat in patients with advanced malignant mesothelioma.

Patients interested in more information about the trial and how to enroll should call toll-free 1-866-890-6619 (in the U.S.) and 1-888-577-8839 (outside the U.S.) or visit the Merck Cancer Trials web site.

Zolinza is currently approved in the U.S. for treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma (CTCL) who have progressive, persistent or recrruent disease on or following two systemic therapies.

SOURCE: myMeso › Merck begins vorinostat Phase III meso trial

Of course, on Monday this week, it was announced and reported here that Onconase had failed the primary objective of its late-stage trial. This news was particularly disappointing since the drug already has orphan drug status in the U.S., Europe and Australia due to the very high hopes for its success. Despite failing in its primary objective, however, testing did show that the drug is effective in a secondary effect, helping to prolong the life of those treated after standard chemotherapy has failed.

The report of Onconase’s initial failure prompted WTN’s Clark to revisit Quintessence to find out if the Onconase failure would derail the development of their QBI-139. In his new report, Clarks says he found researchers undaunted and pressing forward. He says they hope to move the drug into clinical trials sometime this summer, and they believe the success of Onconase’s secondary role and hopeful FDA approval in that area will help pave the way for general acceptance of RNase cancer therapies.

In his earlier report, Clark pointed out that QBI-139 has several differences from Onconase in the way it is produced, which he believes will make it inherently more effective than Onconase.

He points out that mesothelioma is a particularly difficult cancer to treat, and wonders if the selection of mesothelioma as a research track by Alfacell was made to help fast-track the development of the drug. Perhaps, he wonders, the drug might be more effective on “more common and easier to treat cancers than mesothelioma.”

SOURCE: myMeso › Quintessence continues with mesothelioma drug

Today there was a great article in the Detroit Free Press about Atkinson. The article states that Atkinson considers his “Achilles heel” in the competition to be the fact that he’s never played the tough Torrey Pines U.S. Open course, not that he has lung cancer. The avid golfer was on the links shortly after his diagnosis (he shot a 78) and walked the course after completing four rounds of chemotherapy. His goal for the celebrity tournament is to break 100.

You can also keep an eye out for Atkinson on NBC Nightly News tomorrow, June 5. He is scheduled to appear, barring any unexpected national events that bump him from the slot.

Atkinson will be teamed with celebrities Justin Timberlake, NBC Today Show anchor Matt Lauer, and Dallas Cowboy star Tony Romo in the tournment, which will be aired on NBC Sports at 2 p.m. ET June 15.

How wonderful that Atkinson has this chance in the spotlight to talk about lung cancer, and to promote efforts to increase funding for research and to raise awareness. He also is an official spokesman for the Lung Cancer Alliance.

SOURCE: myMeso › Atkinson in the news again

Results of the company’s late-stage trial of the drug showed that Onconase did not achieve significantly higher survival rates among patients with unresectable malignant mesothelioma when given in combination with doxorubicin, another cancer chemotherapy drug.

According to a report on Pharmaceutical Online, the preliminary results are based on 320 evaluable events that occurred in the clinical trial out of a total of 428 patients randomized. The analysis of the data did not show a statistically significant improvement for evaluable patients receiving Onconase plus doxorubicin. The median survival time (MST) for evaluable patients who received Onconase plus doxorubicin was 11.1 months as compared to 10.7 months for patients who received doxorubicin as a single agent.

However, there is a silver lining to the study. Pharmaceutical Online reports those patients who failed a previous chemotherapy regimen who received Onconase plus doxorubicin experienced a MST of 10.5 months compared with 8.7 months for those patients who received doxorubicin, which is considered a statistically significant result.

Reuters reports as a result of this secondary finding, Alfacell will now submit a marketing application to the Food and Drug Administration for use of the drug on those patients, with hopes to have it approved by the end of the year.

SOURCE: myMeso › Onconase fails in primary late-stage trial

Complementary medicine is used along with standard medicine, while alternative medicine is used in place of standard treatments.

Complementary and alternative medicine may include dietary supplements, megadose vitamins, herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual healing, and meditation.

Not long ago, I shared Charlene Kaforey’s good news, when she discovered her mesothelioma mass had diminished by half after completing a first round of cancer vaccines, considered an alternative treatment.

Recent news has included reports of research ranging from the effects of nonsteroidal anti-inflammatory medicines in combination with chemotherapy, to the use of Chinese mushrooms in homeopathic treatment, to a study indicating traditional chemotherapy might enhance the effectiveness of cancer vaccines, which are currently in clinical trials.

The problem, according to complementary medicine (CM) professor Edzard Ernst, in an editorial published recently in BMJ Clinical Evidence, is that “one side of the debate argues that there is no scientific evidence that can support CM, while the other side believes scientific evidence cannot be applied to CM.”

The danger, he says, is that waiting for absolute evidence might prevent someone from trying a therapy that could be beneficial, but siding with the idea that CAM simply cannot be proven may lead a patient into treatment that could cause more harm than good.

The National Cancer Institute’s Office of Complementary and Alternative Medicine (OCCAM), which coordinates the Institute’s research program in CAM, has established a goal of evaluating data from CAM practitioners with the same rigorous scientific methods employed in evaluating treatment responses with conventional medicine.

Major categories of CAM therapies, as determined by OCCAM, include alternative medical systems (built upon complete systems of theory and practice, like traditional Chinese medicine or homeopathy), energy and electromagnetic based therapies, exercise therapies (like yoga), manipulative and body-based methods, mind-body interventions (like hypnotherapy), nutritional therapeutics, pharmacological and biologic treatments (like vaccines), and spiritual therapies (healing, prayer).

OCCAM is developing the NCI Best Case Series (BCS) program based on its evaluations of CAM therapies, in which it provides an independent review of medical records and medical imaging from patients treated with unconventional cancer therapies.

But whether or not alternative and complementary medicine can be proven effective, people will still seek it out, says Professor Ernst. The “almost insatiable hunger of patients” for CM has driven its importance, he says, despite criticisms, praise or skepticism from the medical community, scientists or politicians, and in spite of the fact that more often than not health insurance does not cover the treatments.

Obviously, this topic – and its accompanying debate – needs much more examination. I will be exploring it more in the future. Do you have an experience with complementary or alternative medicine? Share it with us!

SOURCE: myMeso › Complementary, alternative medicine debate

The results are based on a study of 409 patients, mostly from the United Kingdom, which set out to assess the potential benefits of combining active symptom control, which usually involves steroid drugs and radiotherapy, with chemotherapy. Results showed no real benefit from adding the chemotherapy drugs compared with just treating the symptoms of the disease.

The BBC quotes one of the authors of the study, Dr Richard Stephens from the Medical Research Council Clinical Trials Unit, as saying, “While thousands are and will be affected by this deadly disease, our trial, which is one of the few large trials ever conducted in this disease, emphasizes how difficult mesothelioma is to treat. This is mainly because mesothelioma forms in the lining of the lung. This makes it hard to target.”

One chemotherapy drug, vinorelbine, was shown by the study to have some promise, but researchers do not think blanket chemotherapy treatment is a promising direction for treatment of mesothelioma, according to the Lancet report.

Researchers do not necessarily consider these findings to be bad news, as a study that defines what does not help can be beneficial to patient health because it helps reduce the chance that patients will undergo stressful treatments that are ineffective.

Results of a completely different chemotherapy study conducted by researchers at Duke Comprehensive Cancer Center were released May 18, revealing that chemotherapy given in conjunction with cancer vaccines may actually boost the immune system’s response to the vaccines, according to a report by ScienceDaily.

The Duke study focused on a drug used to treat lymphoma, but could have implications for clinical trials with vaccines being used to treat many cancers including lung cancer, brain tumors and colorectal cancer.

According to the FDA, it is the goal of cancer vaccine clinical trials not to prevent cancer, but to treat existing tumors. The idea is to train the person’s immune system to recognize the living cancer cells and attack them.

In July 2007, the American Association for Cancer Research examined the issue of cancer vaccines and, according to a report by Medical News Today, they found that “ongoing therapeutic cancer vaccine trials have yet to show evidence of vaccines spurring a patient’s immune system to shrink tumors – yet patients who receive these vaccines in trials tend to live longer and respond better to subsequent treatment.”

The full study, titled Cancer Vaccines: Moving Beyond Current Paradigms is available to read online at Clinical Cancer Research.

Full results of the Duke study will be presented May 31 at the American Society of Clinical Oncology meeting in Chicago, Ill.

SOURCE: myMeso › Mesothelioma and chemotherapy research

With a stage III diagnosis, she underwent chemotherapy treatments from October to December of that year, and then, faced with the prospect of a pleurectomy or pneumonectomy, which would remove part or all of the affected lung, decided to try alternative medicine.

Charlene went to the ITL Alternative Cancer Treatment Clinic in Freeport, Grand Bahamas, in January 2008, where she underwent an 8-week treatment called Immuno-Augmentation Therapy (IAT). Upon returning home, she administers her own vaccines several times a day, and has been continuing a twice-daily intravenous vitamin C program with the help of a nurse friend.

She celebrated her birthday Sunday, then on Monday went for her first CT scan since beginning her alternative treatment. Charlene reports, “There was overall improvement in my scan results!! The tumor was half of what it was previously, the pleural thickening was reduced, fluid is reduced and the pleural effusion is gone. I am thrilled, and stunned. Of course, I’m still guardedly optimistic, since I do still have cancer and the results could change at any time. But this, for now, this is the best birthday present I could have gotten!”

Alternative therapies like IAT are not authorized by the American Medical Association, and there is still a lot of skepticism and caution surrounding them. Generally, medical insurance does not cover alternative medical treatments like IAT.

Treatments that are not considered conventional medicine, but that are undertaken along with traditional medical therapies, like chemotherapy, radiation and surgery, are called complementary. Treatments used in place of conventional medicine, like the IAT Charlene is undergoing, are called alternative medicine.

IAT, along with other complementary and alternative medicine (CAM) programs, are being studied by the U.S. Department of Health and Human Services, the Food and Drug Administration (FDA) and the National Center for Complementary and Alternative Medicine (NCCAM), which operates under the Department of Health and Human Services.

Patients considering complementary or alternative treatments are encouraged to thoroughly research possible risks, benefits, and scientific evidence, and to discuss alternatives with their physician.

For more information, visit the NCCAM online, in the “health” section under “be an informed consumer.” They have information on topics including what to do when considering using CAM, how to select a CAM practitioner, and paying for CAM treatment.

I will be exploring CAMs in the coming weeks, and hope to talk to physicians and alternative and complementary treatment doctors and specialists about these programs, as well as patients like Charlene who are using them. If you’ve had an experience with a CAM, leave a comment or email me and share your experience.

I am thrilled for Charlene! Happy Birthday!!

SOURCE: myMeso › Living with Meso – Charlene’s story UPDATE

While undergoing chemotherapy to treat her mesothelioma, Charlene Kaforey had time to explore her options. As a Stage III patient, she was worried about her chances for quality of life or even long-term survival if she underwent surgery.

During this time, she found information about the ITL Alternative Cancer Treatment Clinic, located in Freeport, Grand Bahama Island. After talking to patients who reported success, she decided to try this unusual route for her own treatment.

She made her first visit to the clinic January 7, 2008. Mesothelioma patients like Charlene initially complete an 8-week course of treatment, which includes daily blood tests, several injections daily of a serum designed to boost the body’s immune system so that it can fight the cancer, and intravenous vitamin C plus two shots of cancer vaccines, twice per week, she says.

The blood work is to monitor the body for responsiveness to the treatment in order to fine tune it to the patient and set up an ongoing course that is administered by the patients themselves after leaving the clinic, Charlene says. Treatment at ITL is a process that lasts for the rest of your life, she explains.

Now back home in New York, she administers her own shots eight to 12 times per day. She also is continuing the intravenous vitamin C at home, although she says that is optional. She also needed to complete 5 of the 12 weeks of the cancer vaccines at home. Patients return to the clinic every four months for two weeks at a time for re-evaluation and adjustments to their serum regimen. Charlene is scheduled to return in June.

“What they tell you at ITL is that it will not necessarily make the cancer you have go away, but will hopefully prevent it from spreading any further,” Charlene said. “So if they can do that, and give me six years, that would be wonderful. That would be six quality years instead of two miserable years.”

Patients considering ITL need to know that because the facility is considered alternative medicine, it is not accredited by the American Medical Association or other governing boards of that type, and some insurance companies will not cover the cost of treatments.

ITL requires payment at time of services, which, according to the clinic’s web site, for Immuno Augmentive Therapy (IAT) of the kind Charlene receives, run around $7,500 for the first four weeks and about $700 per week thereafter. That cost does not include the vitamin C IV’s or the vaccines. Patients also must cover the costs to travel to the facility, and for accommodations during their eight weeks of treatment.

“Everyone has had different experiences [with insurance],” Charlene said. “I submitted my bills to my insurance company and I’ll just see what they do. Some people get partial payment, some insurance pays nothing,” she says. “But what’s your life worth to you?”

In addition to the financial challenge, there also is the issue of travel and time away from family. Charlene was lucky; she had different family members with her throughout her 8-week stay. They became as much a part of daily clinic life as she did.

“Seeking treatment at the clinic definitely involves family decisions. The cost is a major consideration and so is the time away from home. While the cost is much less than the approximately $200,000 price tag involved with the surgery/chemo/radiation regime, insurance will pay for those debilitating treatments. Plus, knowing you may have limited time remaining, do you want to leave family and friends for 2 months,” Charlene said. “It is a really individual decision. You have to look realistically at what your own choices are and what you need to do for yourself and your family. We viewed this as an investment of time and financial resources for the long term. Two months away is worth it if I get 4-6 more years with my family.”

A big part of Charlene’s experience at ITL was meeting other mesothelioma patients, as well as people with other types of cancer, and sharing stories. Her last week at the clinic, she said there were seven mesothelioma patients there, all around the same age – mostly women in their 40s and 50s, with whom she felt a real connection.

“You talk to real-life people who are there, who are surviving and living quality lives after their doctors had told them there was no hope. The stories are so different and so amazing, and yet you share so much because you’re all going through this. It gives you hope to meet patients who have survived 28, 20 ,12 or even 4 years after being given a death sentence,” Charlene said.

That connection with other patients has led Charlene to explore forming an outreach and support group where she lives, in Rochester, New York, where she plans to work for fund raising for a cure and to raise awareness of mesothelioma.

Alternative medicine is controversial. Its results often do not have a long history of documentation. People who choose this route understand that they are stepping out into largely uncharted waters.

Charlene is happy to share her story with others who are facing mesothelioma in their own lives, either as a patient or as a family member of someone with meso.

If you would like to talk with Charlene, please email wendi@mymeso.org and I will be happy to forward your information to her.

SOURCE: myMeso › Living with Meso – Charlene’s story, Part 4

After being diagnosed with mesothelioma at age 48, and exploring traditional options and undergoing four rounds of chemotherapy, Charlene Kaforey was looking for alternatives. Her physicians had earlier recommended a pleurectomy or pneumonectomy, which would remove part or all of the affected lung. That option was still on the table following chemo.

But after doing extensive research, Charlene was concerned about quality of life after such a procedure. Diagnosed as Stage III, she knew that only 25 percent of patients at her status survive 20 months, with less than 10 percent surviving 5 years. Both surgeries involve significant mortality rates and require 6-9 months recovery time.

“Currently, I don’t have a lot of symptoms,” she says. “I thought, why, if I feel good, do I want to end that by having the surgery and possibly never feeling good again?

“When I was at the hospital, I looked around the waiting room and saw everyone in wheelchairs, or hooked up to oxygen. I actually started crying. People don’t look good. They don’t look healthy, and they’re struggling. I thought, is this what’s going to happen to me? I didn’t feel a lot of hope.”

During her chemotherapy, from October-December 2007, Charlene researched mesothelioma and its treatments relentlessly. That was when she discovered the ITL Alternative Cancer Treatment Clinic, located in Freeport, Grand Bahama Island.

According to its web site, ITL Cancer Clinic was founded in 2003 and is directed by Dr. John Clement. ITL Cancer Clinic is the operating company for the Immunology Research Centre Ltd., a not-for-profit corporation of the Commonweal of the Bahamas, licensed to treat patients diagnosed with cancer. The Immunology Research Centre was founded in 1977 by Dr. Lawrence Burton, the developer of Immuno-Augmentive Therapy (IAT). The clinic treats all kinds of cancer, including mesothelioma.

Charlene’s daughter, working on a college project about promoting mesothelioma awareness inspired by her mother’s illness, discovered a web site with a link to the clinic. Charlene contacted the organization on whose site she found the link, to find out if they knew anyone who had been treated there. Initially, the answer was no. But two weeks later, they called her back and put her in touch with an ITL patient.

“I talked to her and she’s 6 years out,” Charlene said, which means the patient has survived six years after diagnosis. “She has it in both lungs and here she is, traveling and living life.”

Encourged, Charlene contacted the ITL Clinic directly for more information. Staff reviewed her medical history to see if she would be a candidate for treatment at ITL, and put her in touch with other mesothelioma patients being treated there.

“I’m skeptical by nature,” Charlene says. “It’s so out of the ordinary, but when I was talking to people out 6 years and feeling good compared to others who did more traditional treatments, some of whom didn’t make it very long, or life was hard, and it seemed like a good option for me.”

Friends and family initially resisted the idea, feeling that she should take the more traditional path, including surgery.

“People thought I was crazy at first. They had read all the literature [from traditional treatment facilities] and felt that I needed to do the surgery,” Charlene says. “Do I know for certain this will work? No. But I just don’t think the statistics support my having a good quality of life or a good chance of survival with surgery and traditional methods. So I’m going to do it.”

Next: The ITL Experience

SOURCE: myMeso › Living with Meso – Charlene’s story, Part 3

Following is a story that appeared in the Detroit Free Press about the remembrance service, and the mission of asbestos awareness. I will post some stories and images from the conference this week, but I wanted to share this excellent report.

By Amber Hunt, Free Press Staff Writer

For Andrew Manuel, it began with back pain.

But the seemingly benign symptom turned out to be something far more sinister, and within two years, the married father of three shed 65 pounds, underwent surgery to have a lung removed and endured chemotherapy and radiation to no avail.

At 42, he was dead. The killer: mesothelioma, a cancer linked to asbestos.

“When I heard the diagnosis, I said, ‘Meso-what?’ ” said Manuel’s wife, Latanyta Manuel, 45, on Sunday. “All I heard was ‘lung cancer,’ and I said, ‘No, that’s not possible.’ My husband never smoked or drank, but they said this cancer is about asbestos.”

On Sunday, a group of people affected by the deadly disease, which they refer to as “meso” for simplicity’s sake, gathered at the Marriott in downtown Detroit’s Renaissance Center for a remembrance brunch.

The event was sponsored by California-based Asbestos Disease Awareness Organization and the Karmanos Cancer Institute in Michigan.

Some, such as Manuel, had lost loved ones. Others have been diagnosed with the deadly disease themselves.

They gather annually, they said, to support each other and to spread the word about asbestos-related diseases, including lung cancer and asbestosis.

Asbestos is a fiber that for decades was routinely used for fireproofing and insulation.

While the U.S. government has limited its use, asbestos still can be found in many products, including some stuccos, vinyl flooring and even theater curtains, according to the Asbestos Resource Center.

“Asbestos is still being imported. It’s still being put in products,” said Michelle Zigielbaum, whose husband, Paul, has been diagnosed with peritoneal mesothelioma.

By the time he was diagnosed, his stomach was so full of fluid and tumors that “I looked like a pregnant woman,” Paul Zigielbaum said.

The Asbestos Disease Awareness Organization recently conducted a study that tested 250 products off store shelves for asbestos content. A first lab found that 18 of the products contained asbestos.

A second lab confirmed that eight of the products had asbestos, while a third confirmed that five products — including a child’s toy — contained asbestos.

Those gathered Sunday said they and their loved ones got sick in different ways.

Andrew Manuel’s father worked in a pipeline, bringing asbestos back into the home. Paul Zigielbaum said he believes he was exposed secondhand, too, but said he also believes that contact with everyday products contributed.

All blamed aggressive asbestos lobbyists as the reason the United States hasn’t banned the substance altogether.

“It’s disturbing to see how companies and politicians try to cover it up,” said Dwayne Manuel, Andrew Manuel’s 26-year-old son. “This is a preventable disease.”

Latanyta Manuel said she just wants to honor her husband’s wishes and spread awareness about the disease.

“Once it erupts, it just kind of takes over,” she said. “People need to know.”

Contact AMBER HUNT at 586-826-7267 or alhunt@freepress.com.

SOURCE: myMeso › Conference educates about asbestos

When Charlene Kaforey, 48, was diagnosed with pleural mesothelioma in July 2007, she immediately began seeking out information and treatment options.

The prognosis for mesothelioma is still bleak. There is no cure, and most studies estimate survival time between 4-12 months, depending on the stage of presentation. Charlene’s mesothelioma was diagnosed relatively early, so she was hopeful.

She visited mesothelioma specialist Dr. David J. Sugarbaker at Brigham & Women’s Hospital in Boston, Mass., Dr. Valerie W. Rusch at Memorial Sloan Kettering Cancer Center in New York, and Dr. Harvey Pass at the NYU Cancer Institute.

Immediately, doctors talked about extrapleural pneumonectomy, a surgery to remove the entire lung, entire diaphragm, and the lining of the chest cavity and the heart. Surgery would be followed by 6 weeks of radiation, and possibly chemotherapy. One doctor even talked about performing a heated chemotherapy wash of the chest cavity while on the operating table. At that time, they believed Charlene was a stage I, and such surgeries could give her a 40 percent chance of a 5 year survival. One doctor mentioned getting her as much as 10 years.

One of the doctors talked about limiting the surgery to a pleurectomy/decortication, a technique to remove the parietal pleura from the lung. The median survival after pleurectomy for malignant mesothelioma ranges from 6-21 months, and 9-40 percent of patients survive up to 2 years. However in later stages, the survival rates are almost identical between the two surgeries.

Research is still unclear as to whether extra-pleural pneumonectomy provides significantly greater benefits than pleurectomy, and if either is significantly more effective than non-surgical options.

Charlene didn’t have a lot of tumor bulk, so she was sent for a mediastinoscopy, a biopsy surgery that allows doctors to view the middle of the chest cavity and to remove lymph nodes from between the lungs to test them for cancer or infection. They found that Charlene did have lymph node involvement.

“I went from a Stage I to Stage III overnight,” she says. “It was shocking.”

Because of the lymph node involvement, doctors recommended she postpone considering pleurectomy or pneumonectomy and undergo chemotherapy. Survival rates from either surgery for a Stage III patient is much less, and only 25 percent survive 20 months, with less than 10 percent surviving 5 years. Both surgeries involve significant mortality rates and require 6-9 months recovery time.

“Looking at it now, I feel in some ways that having the lymph node involvement was a godsend for me,” Charlene says. “I mean, my condition was more serious, but because I was doing the chemotherapy, it gave me time to look for more information and to really think more about my options. Otherwise, I would have rushed into a very serious surgery with a long, difficult recovery and I’d probably be without a lung and diaphragm right now.”

Charlene offers one word of caution to meso patients.

“While you may feel time is of the essence, don’t rush into a procedure until you really understand what is involved, and what benefits you can expect to receive, what the risks and complications are, how long and difficult the recovery will be,”she said.

She talked to other meso patients and read everything she could get her hands on. Quality of remaining life is a big issue to consider.

“I realized that I might have only 18 to 30 months maximum to live, and that I would spend at least 9 months in a brutal recovery. I was feeling good with little to no symptoms. I couldn’t justify giving up my good health to surgery, knowing I may never feel good again, and might have only another 9 months of poor quality life after recovering from the surgery,” Charlene says.

Next: Charlene explores alternative medicine

SOURCE: myMeso › Living with Meso – Charlene’s story, Part 2

Chairman Coady’s story

Leading the charge for the organization is Rear Admiral Phil Coady, U.S. Navy (Ret.), who serves as chairman of the board of directors. A career Navy officer, Coady was diagnosed with non-small cell lung cancer in early 2005. He underwent surgery to remove the affected lobe and went through chemotherapy. In late 2005, the cancer recurred with metasteses to his bones. Chemotherapy has been successful in slowing the advance of the cancer for the past two years, and Coady is fighting for other lung cancer survivors.

Although Coady doesn’t suffer from mesothelioma, he is very much aware of the risks posed by asbestos. His work during his time in the Navy very often put him in contact with the substance, he said, and seven of his friends died from mesothelioma since his retirement.

In addition, for 10 years following his retirement, Coady worked as president of the Navy Mutual Aid Association, a non-profit veterans benefit group and life insurance service, where he saw what he thought was a disproportionate amount of lung cancer deaths.

He notes that shipboard service in the Navy, particularly during the years he served, routinely involved exposure to asbestos, second hand smoke and other possible carcinogens. Veterans also were at risk from exposure to chemicals such as Agent Orange, sulfur mustard gas, and other battlefield combustion products.

“I had heavy exposure to asbestos in the Navy,” he says. “I spent a lot of my time as an engineer on ships. In the 1960s there were no precautions about asbestos that I recall at all. We tore out asbestos with hand tools. A dust mask might have been our most aggressive protection.”

With a family history of pulmonary fibrosis, a chronic scarring of the lungs, Coady always had his asbestos exposure in the back of his mind in relation to his health, and had regular CT scans to check for the disease, which he did eventually develop as a result of his exposure. Then, in 2005, the scans also showed lung cancer.

“Ironically, it was really my concern about asbestos that probably saved my life,” Coady said, crediting his regular screenings with catching his cancer early.

Next: The stigma of lung cancer

SOURCE: myMeso › LCA lobbies for lung cancer funding, awareness

Veglin is undergoing clinical trials at the University of Southern California’s Keck School of Medicine, and, in August 2007, MESORFA teamed up with doctors at the Yale Cancer Medical Center in an endeavor to meet the needs of the mesothelioma patients on the East Coast.

Veglin inhibits VEGF proteins, halting the formation of blood vessels and limiting the ability of tumors to grow and spread. Veglin is an antisense oligonucleotide, meaning that it can bond to messenger RNA (nucleic acid that directs protein production) and block the production of VEGF proteins.

Trials are targeting patients that have already undergone chemotherapy, and also newly diagnosed patients.

To determine if you qualify for Veglin, please contact Jennifer Paul, Executive Director, by calling 1-800-909-MESO (6376).

SOURCE: myMeso › MESORFA supports Veglin trials

Randy is a 47-year-old Professor of Computer Science, Human-Computer Interaction, and Design at Carnegie Mellon University (CMU) in Pittsburgh, Pennsylvania. In September 2006, he was diagnosed with metastatic pancreatic cancer. He pursued a very aggressive cancer treatment that included major surgery and experimental chemotherapy; however in August of 2007 he was told that the cancer had metastasized to his liver and spleen. He then started palliative chemotherapy intended to extend his life as long as possible, which was then estimated to be three to six months. He remains vigorous and active six months later (February 2008.)

Although Randy’s cancer is not mesothelioma or asbestos-related, I thought his message could be inspiring and provide hope, as people diagnosed with mesothelioma are usually not expected to live for long, and most die within two years of their diagnosis.

SOURCE: myMeso › The Last Lecture

Treating Mesothelioma

Because this is such a rare cancer, it has been hard for doctors to compare the value of different treatments. Since many doctors have little or no experience treating this disease, you may be referred to a specialist at a large medical center.Treatment options include surgery, chemotherapy and radiation therapy.One problem with treating mesothelioma is that it does not grow as a single mass. Instead it tends to spread along surfaces, nerves, and blood vessels. This makes it hard for one or more types of treatment to get rid of all of the disease.While surgery is not likely to cure the cancer, it might extend the patient’s life.Depending on the type and stage of the cancer, chemotherapy may be given as the main treatment or along with surgery. Chemotherapy for this disease is given to relieve symptoms, not to cure the cancer.As a rule, radiation treatment doesn’t help much for mesothelioma, and the need to treat a large part of the lung leads to problems with lung damage. But radiation can be used along with surgery to kill small areas of cancer that cannot be seen and removed during surgery. It can also be used as a way to ease symptoms such as shortness of breath, pain, bleeding, or trouble with swallowing. If fluid builds up in the chest, radioactive drugs can be put into the space after the fluid is drawn out. This might help keep the fluid from coming back.

New in Mesothelioma Research

There is always research going on in the area of mesothelioma. Much of this research has focused on learning exactly how asbestos changes normal cells and their DNA to cause cancer. Understanding how these fibers produce cancer might help us find ways to prevent those changes.Now that we know about the dangers of asbestos, we can limit or stop its use in homes, public buildings, and the workplace. But rules to protect people from asbestos are much less strict (or they do not exist at all) in some other countries.Research is also going on to learn about the role (if any) of a virus (SV40) that has been linked to mesothelioma in some studies.Because chemotherapy drugs have not worked very well against advanced mesothelioma, several new ideas are now being studied. These include drugs which kill cancers by stopping their blood supply and drugs which interfere with the ability of some cancer cells to grow quickly.Doctors are always learning more about the best way to treat people with mesothelioma. Treatments that combine surgery, radiation therapy, and chemotherapy are now being studied and may provide the most promising option for some patients.New drugs, along with other types of treatments, are now being tested in clinical trials.Another new approach is a type of gene therapy. This treatment uses special viruses that have been changed in the lab. The virus is injected into the space around the lungs where it infects the cancer cells. When this happens, the virus in turn injects a gene into the cancer that may help immune system cells to attack the cancer.

Research at UAB

The University of Alabama Birmingham (UAB) Comprehensive Cancer Center is a research and teaching hospital, and is currently conducting a number of studies on the treatment of mesothelioma.In 2005, UABs Spring/Summer magazine published information about ongoing studies being conducted by Katri Selander, M.D., Ph.D., a Cancer Center Associate Scientist, and Pierre Triozzi, M.D., about the effects of bisphosphonates on cancer cells.Bisphosphonates are drugs that are commonly used to treat and prevent osteoporosis. They also are used to treat metastatic breast and prostate cancers.The UAB article reported that Drs. Selander and Triozzi “have examined the effects of bisphosphonates on cancer cell cultures and in animal models, and have found that the drugs kill mesothelioma cells in both.” Further results of these studies were reported in the May 1, 2006 issue of Clinical Cancer Research, Vol. 12, 2862-2868; and in the European Journal of Pharmacology, Volume 559, Issue 1, dated March 15, 2007. Key points of the article in Clinical Cancer Research said that “the diagnositc use of radioactive bisphosphonates has revealed the accumlation of bisphosphonates in mesothelioma” and said that results of the studies “support further study of bisphosphonates in the management of mesothelioma.” The European Journal of Pharmacology report states that “Pre-clinical studies indicate that bisphosphonates also ihibit the growth of various cancer cells in vitro” and “in … mouse AB-12 mesothelioma cells.” For more information, visit UAB’s Comprehensive Cancer Center.

SOURCE: myMeso › Mesothelioma Treatment Options

What is Mesothelioma?

Mesothelioma cancer, or malignant mesothelioma, is an extremely rare disease generally affecting the lining of the lungs, and, more rarely, the abdominal cavity and/or the heart. Mesothelioma cancer is most strongly associated with exposure to asbestos, and can remain latent in those exposed for 30 to 40 years.

There are three types of mesothelioma cancer: pleural, in which the cancer affects the lining of the lungs/chest;  peritoneal, which affects the lining of the abdominal cavity; and pericardial, which affects the lining of the heart.

Pleural mesothelioma is the most common form of malignant mesothelioma, accounting for approximately three out of every four cases. The pleura is defined as the outer lining of the lungs and chest cavity. Pleural mesothelioma typcially has a latency period of 30-40 years or longer.

Peritoneal mesothelioma generally accounts for about 25 percent of maglignant mesothelioma cases diagnosed each year. It can have a shorter latency period than pleural mesothelioma, developing in 20-30 years or shorter. It affects the peritoneum, which is the lining of the abdominal cavity. Peritoneal mesothelioma generally occurs more often in males than females.

Pericardial mesothelioma, which affects the pericardium, the lining of the heart, is extremely rare. This form of malignant mesothelioma is usually fatal, due to its difficulty in diagnosis and treatment. It is generally diagnosed in a very late stage, and surgical or other treatment options are dangerous and difficult.

Mesothelioma in general is fairly rare in the United States. There are an estimated 2,000 to 3,000 new cases of mesothelioma each year in the United States. However, in European countries, especially the UK, as well as in Australia, the rate of mesothelioma is increasing.

For years, mesothelioma was thought to be  rare in people under age 55. Traditionally seen primarily in older men, usually with a background of working in a factory, shipyard, mine or other environment with heavy asbestos exposure, today more and more cases of secondary exposure are being diagnosed, and it is affecting greater number of women.

The average age for someone with mesothelioma used to be around 72, but each year it seems mesothelioma affects younger people, and a greater number of women. Last year, a 3-year-old girl was diagnosed with mesothelioma, stunning the physicians who were treating her.

Mesothelioma is a serious disease. By the time the symptoms appear and cancer is diagnosed, the disease is often advanced. The average survival time is about 1 year. The 5-year relative survival rate is around 10%, but this rate has been slowly improving.

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Many of these patients live much longer than 5 years after diagnosis, and 5-year rates are used to produce a standard way of discussing prognosis.

Five-year relative survival rates do not include patients dying of other diseases and are considered to be a more accurate way to describe the prognosis for patients with a particular type and stage of cancer. That means that relative survival only talks about deaths from mesothelioma. Of course, 5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago. They may no longer be accurate. Improvements in treatment result in a more favorable outlook for recently diagnosed patients.

Symptoms of Mesothelioma

Early symptoms of mesothelioma can be very general. Thus, they are often ignored.

Symptoms of pleural mesothelioma (lining of the chest) can include:

* pain in the lower back or at the side of the chest

* shortness of breath

* trouble swallowing

* hoarseness

* cough

* fever

* sweating

* tiredness

* weight loss

* swelling of the face and arms

* muscle weakness

Symptoms of peritoneal mesothelioma (lining of the abdominal cavity) include:

* belly pain

* weight loss

* nausea

* vomiting

* fluid or a lump in the abdomen

Symptoms of pericardial mesothelioma (lining of the heart) include:

* constrictive pericarditis

* pericardial effusion

* cardiac tamponade

* heart failure caused by myocardial infarction

Of course, these same symptoms can also be caused by other minor ailments. But if you have worked with asbestos and you have any of these symptoms, you should see your doctor right away.

Diagnosing Mesothelioma

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions.

Diagnosis begins with a review of the patient’s medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. As a rule, a chest x-ray is not useful in finding mesothelioma early.

One test being studied is a blood test. This test measures the levels in the blood of a certain protein that is higher in people who have lung damage due to asbestos. It is even higher if the person has mesothelioma.

A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located.

If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.

If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity.

If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

New developments in Diagnosis of Mesothelioma

A recently published report in the Journal of the American Medical Association holds out hope for earlier detection of mesothelioma, a deadly cancer linked to asbestos exposure.

Researchers compared three types of endoscopic collection for accuracy in detecting cancerous cells in the lymph nodes to determine their accuracy.

Typically, doctors use several different techniques to diagnose lung cancers, including mesothelioma. Those techniques include physical exams, chest X-rays, CT scans and surgical biopsies to examine the cells in the lungs and the lymph nodes.

Lung cancer is one of the most common cancers worldwide, and the outcomes are typically unpromising. The low survival rates for lung cancer are often attributed to the difficulty of diagnosing the disease early enough for effective treatment.

This is especially true of mesothelioma, a disease that affects the tissues of the lining between the chest wall and the lungs. Often, by the time mesothelioma is detected, the cancer has reached untreatable stages.

Because of this, researchers are increasingly turning to new methods of detection that may identify deadly cancers at earlier stages when chemotherapy, surgery and other treatments may be effective.

The most accurate methods of diagnosis to date involve collecting cell samples from the lungs or lymph nodes for examination under a microscope. The most common method for collecting these cells is a mediastinoscopy, which is an invasive surgery that involves anesthesia and incision. The surgeon makes an incision at the top of the breast bone and inserts a thin, lighted tube into the chest cavity to withdraw cell and fluid samples.

Mediatinoscopy is typically used to determine whether fluids in the chest cavity contain cancerous cells or asbestos fibers.

In the past few years, doctors have developed less invasive procedures to collect tissue samples from the chest. These procedures use an endoscope, a small medical device that consists of a camera mounted on a flexible tube. Ultrasound probes, needles and other instruments can be inserted through the tube to remove samples for biopsy. These endoscopic procedures are far less invasive than more traditional methods, reducing the risks to patients who undergo them.

In the study reported in JAMA, researchers compared three different procedures using an endoscope, each of them considered minimally invasive:

• Transbronchial needle aspiration (TBNA)

• Endobronchial ultra-sound guided fine needle aspiration (EBUS-FNA)

• Transesophegeal endoscopic ultrasound-guided fine needle biopsy (EUS-FNA)

In each procedure, an endoscope was used to remove tissues or fluids with a fine needle. The researchers then compared the findings among the three methods to determine which was the most sensitive for detecting the presence of cancerous cells in the lymph nodes of the chest.

The study consisted of tests taken on 138 patients in the U.S. who were believed to have lung cancer. Each patient underwent all three procedures in sequence.

The results of the study showed:

- 30% (42) of the patients had malignant lymph nodes

- EBUS-FNA detected 29 of the cancers. TBNA only detected 15

- EUS-FNA and EBUS-FNA used in combination detected 93% of the cancers.

The combination was also able to detect malignancies in patients who would not have been identified by CT scans of the chest. The results of the study suggest that the minimally invasive procedures may be a viable alternative to more invasive standard procedures for evaluation patients believed to have lung cancer.

The lower risks associated with the procedure will make the diagnostic process more comfortable for patients and provide for a shorter recovery time.

Reference: Wallace, M, Pascual, J, Raimondo, M, et al. Minimally invasive endoscopic staging of suspected lung cancer. Journal of American Medical Association. 2008. 299(5) 540-546. Source: www.asbestos.com

New System May Give Lung Cancer Patients Hope

The Associated Press Aug. 31, 2007 http://www.msnbc.msn.com/id/20533486

Thousands more lung cancer patients each year could be offered surgery or other aggressive therapy under a new system that classifies many tumors as more treatable than in the past.

It is the first big overhaul of a decades-old method used to predict survival and help determine whether a lung cancer patient will have surgery, chemotherapy or be treated at all.

The new guidance is to be presented at a conference of lung cancer specialists in Seoul, South Korea, that starts Saturday. It is expected to be adopted by policy-making groups in the next year. Lung cancer is the world’s top cancer killer, claiming 1.3 million lives each year.

In the United States, 213,380 new cases and 160,390 deaths from the disease are expected this year. Nearly 60 percent of people die within one year of diagnosis, and nearly 75 percent die within two years, American Cancer Society statistics show.

In treating it, doctors use a formula called tumor staging. It is based on a tumor’s size, how far it has spread and other factors to predict a patient’s survival odds and to guide treatment.

More precise sorting

The current system was developed from about 5,000 tumor samples from University of Texas M.D. Anderson Cancer Center in Houston decades ago — before improved scanning technology was available to evaluate a cancer’s spread.

The new plan is based on 100,000 tumor samples from around the world including Asia, where lung cancer rates are projected to climb because of trends in smoking, unhealthy lifestyles and aging populations. It keeps four broad groupings but sorts people more precisely based on refined understanding of tumor characteristics.

The result: “There will clearly be shifting of patients from categories not operable to operable” — as many as 10,000 a year in the United States, said Dr. David Johnson, a lung cancer specialist at Vanderbilt University in Nashville, Tenn. He reviewed the plan, which was partly published in a medical journal recently.

The stage of the tumor at diagnosis is the best predictor of survival. Only 20 percent of cases are diagnosed in Stages 1 or 2, when tumors are small and confined to a lung, Johnson said. About 30 percent to 40 percent are found in Stage 4, after they have widely spread. The rest are in the middle.

Five-year survival rates are 47 percent for Stage 1 and 26 percent for Stage 2, but only 8 percent for Stage 3, and 2 percent for Stage 4, according to the American College of Surgeons.

Most lung cancers are the type called ”non-small cell,“ which is covered by the new staging system. The system was developed by the International Association for the Study of Lung Cancer, a group of lung cancer specialists from around the world.

Changing groupings

Dr. Peter Goldstraw, a surgeon at the Royal Brompton Hospital in London, led the project, and Canadian scientists independently validated the recommended changes by comparing survival across geographic regions.

Among the changes: creating more sub-stages for tumor size, reassigning some large tumors to a more advanced stage, reclassifying tumors that have spread into the fluid surrounding the lung, and recognizing that spread to certain lymph nodes is more dangerous than its spread to others.

“By changing some of these groupings, some patients will get moved to an earlier stage of disease for which we tend to be more aggressive” in treatment, said Dr. Joan Schiller, a lung cancer specialist at the University of Texas Southwestern Medical Center in Dallas .

“Before, a patient may have only been offered chemotherapy. They may now be offered chemotherapy and radiation,” or more intense radiation, she said. Conversely, some people thought to have earlier-stage tumors now will be grouped with those whose tumors have widely spread, and discouraged from undergoing therapies that have little chance of helping them.

“In some cases, patients were getting inappropriately aggressive treatment,” Schiller said.

Some people with very small tumors may get away with less therapy — taking out just a segment of lung instead of an entire lobe, said Dr. Stephen Swisher, a chest surgeon at M.D. Anderson.

The impact of the changes in Europe and Japan is unclear because doctors in those countries tend to remove whole lungs rather than lobes to treat lung cancer, Johnson noted. Doctors hope that ultimately survival will improve, but that won’t happen “unless we get patients into the right hands” and they get correct treatment, Johnson said.

Revising the staging system also will do little good if doctors don’t do the right tests to properly stage a tumor, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. Staging for lung and other types of cancer should become even more precise in the near future as biomarkers and gene tests are developed to better sort patients, he added.

© 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Risk Factors for Mesothelioma

The main risk factor for developing mesothelioma is exposure to asbestos.

Asbestos refers to a family of fibrous minerals made of silicate. Asbestos was once used in many products such as insulation, floor tiles, door gaskets, soundproofing, roofing, patching compounds, fireproof gloves and ironing board covers, and even brake pads.

As the link between asbestos and mesothelioma has become well known, the use of this material has almost stopped. Most use stopped after 1989, but it is still used in some products. Experts have linked this drop in asbestos use to the fact that the rate of development of mesothelioma is no longer increasing [in the U.S.].

Still, up to 8 million Americans may already have been exposed to asbestos. Exposure to asbestos particles suspended in air and building materials is much less hazardous except when they are being removed.

Since asbestos is a naturally occurring mineral, it can also be found in dust and rocks in certain parts of the United States as well as the world.

According to the U.S. Environmental Protection Agency, as many as 733,000 schools and public buildings in the country today contain asbestos insulation. As many as 10% to 15% of schools in the United States may contain asbestos insulation.

People who may be at risk for occupational asbestos exposure include some miners, factory workers, insulation manufacturers, railroad workers, ship builders, gas mask manufacturers, and construction workers, particularly those involved with installing insulation.

Several studies have shown that family members of people exposed to asbestos at work have an increased risk of developing mesothelioma, because asbestos fibers are carried home on the clothes of the workers.

The incidence rate for mesothelioma in men is dropping, probably because they are no longer being exposed directly to asbestos in their work. But the incidence rate for mesothelioma in women is steady, which suggests that they are being exposed in a way that is not directly tied to work, but more to their environment either at home or work. One example would be asbestos in buildings where they work or live.

A study from California also links mesothelioma to naturally occurring asbestos deposits in mountains.

Another important point about asbestos and mesothelioma is that the risk of mesothelioma does not drop with time after exposure to asbestos. The risk appears to be lifelong and undiminished.

There are 2 main forms of asbestos — serpentine and amphiboles. Serpentine fibers are curly and pliable. Chrysotile is the only type of serpentine fiber and it is the most widely used form of asbestos. Amphiboles are thin, rod-like fibers. There are 5 main types — crocidolite, amosite, anthrophylite, tremolite, and actinolyte. Amphiboles (particularly crocidolite) are considered to be the most carcinogenic (cancer-causing).

However, even the more commonly used chrysotile fibers are associated with malignant (cancerous) mesotheliomas and should be considered dangerous as well.

When asbestos fibers are inhaled, most are cleared in the nose, throat, trachea (windpipe), or bronchi (large breathing tubes of the lungs). Fibers are cleared by sticking to mucus inside the air passages and being coughed up or swallowed. The long, thin, fibers are less readily cleared, and they may reach the ends of the small airways and penetrate into the pleural lining of the lung and chest wall. These fibers may then directly injure mesothelial cells of the pleura, and eventually cause mesothelioma.

Asbestos fibers can also damage cells of the lung and result in asbestosis (formation of scar tissue in the lung), and/or lung cancer.

The risk of lung cancer among people exposed to asbestos is increased by 7 times, compared with the general population. Indeed, asbestosis, mesothelioma, and lung cancer are the 3 most frequent causes of death and disease among people with heavy asbestos exposure.

Peritoneal mesothelioma, which forms in the abdomen, may result from coughing up and swallowing inhaled asbestos fibers. Cancers of the larynx, pancreas, esophagus, colon, and kidney may also come from asbestos exposure, but the increased risk is small.

The risk of developing a mesothelioma is related to how much asbestos a person was exposed to and how long this exposure lasted. People exposed at an early age, for a long period of time, and at higher levels are most likely to develop this cancer.

Mesotheliomas take a long time to develop. The time between first exposure to asbestos and diagnosis of mesothelioma is usually between 20 and 50 years.

Other Asbestos-Related Cancer

Asbestos Related Lung CancerLung cancer, or bronchial carcinoma, occurs in several forms. The most common causes of lung cancer are smoking and asbestos.

This web site has focused on the most lethal of the lung cancers – mesothelioma. Not every asbestos-related lung cancer, however, is a mesothelioma. Other thoracic carcinomas, such as adenocarcinoma, are also caused by exposure to asbestos.

The connection between asbestos exposure and lung cancer was noted as early as 1925, and confirmed over the next 70 years by many epidemiologic studies of asbestos-exposed workers.

The four main types of commercially used asbestos, chrysotile, amosite, anthophyllite, and mixtures containing crocidolite, have all been associated with an increased risk of lung cancer. About one in seven people who suffer from asbestosis, a lung disease resulting from high exposure to asbestos, eventually develop lung cancer.

Asbestos is estimated to account for 3,400 to 8,500 new lung cancer cases in the United States each year. Like mesothelioma, the latency period between asbestos exposure and the development of asbestos related lung cancer may be two, three, four, or even more decades.

Very often, asbestos-related cancer victims also suffer from asbestosis, a scarring of the lung tissue caused by asbestos exposure. About one in seven people with asbestosis will eventually develop lung cancer.

Although commonly associated with lung cancer, adenocarcinoma is a type of cancer that develops in cells lining glandular types of internal organs, such as the lungs, breasts, colon, prostate, stomach, pancreas, and cervix.

Another type of adenocarcinoma, mucinous adenocarcinoma, accounts for only 10-15% of all adenocarcinomas and is particular to aggressive carcinomas that are comprised of at least sixty percent mucus. Non-small cell lung cancers make up over three quarters of all new lung cancer cases in the United States.

While there is only one type of small cell lung cancer, there are three types of non-small cell lung cancer. The three types of non-small cell lung cancer are squamous carcinoma, large cell carcinoma, and adenocarcinoma. When adenocarcinoma develops in the lung’s air sacs, it is called bronchioalveolar adenocarcinoma. About forty percent of all lung cancer cases diagnosed today are adenocarcinoma.

The progression of adenocarcinoma is quite unpredictable. In most cases, adenocarcinoma spreads slowly and causes very few lung cancer symptoms. But it can also be extremely invasive, aggressively spreading through the body and causing death before it can be treated. Given the disease’s variability, the five-year prognosis for patients with adenocarcinoma is dim: most are given only a 10 percent chance of survival.

Sometimes, tumors spread to the liver, adrenal glands, and bones, making adenocarcinoma much more difficult to treat. Symptoms of adenocarcinoma lung cancer may include shortness of breath, the coughing up of blood, fatigue, chest pains, and unexplained weight loss. Adenocarcinoma is usually treated with surgery, radiation therapy, and chemotherapy.

SOURCE: myMeso › What is Mesothelioma?

This is a cancer that has a really long incubation period, with the time between first exposure to asbestos and the development of mesothelioma ranging from 20 and 50 years. Even scarier, the American Cancer Society (ACS ) says that the risk of mesothelioma DOES NOT DROP with time after exposure to asbestos. The risk appears to be lifelong and undiminished.

As a result, most patients diagnosed with mesothelioma are older. The ACS says about three-fourths of people diagnosed are over 65 years old. They may already be weak from symptoms of the disease, or unable to tolerate aggressive therapies.

Of course, it’s now known that exposure to asbestos is the main reason for the development of mesothelioma, and also asbestosis (formation of scar tissue in the lungs) and adenocarcinoma, another form of the asbestos-related cancer. The highest risk group seems to be people who were exposed to asbestos through their work. The ACS estimates that up to 8 million Americans may already have been exposed to asbestos.

As awareness of mesothelioma grows, it is hoped that more people who know they were exposed to asbestos will seek diagnosis early. It has been shown that a chest x-ray often isn’t very effective in diagnosing mesothelioma, so there has been interest in a blood test that measures the levels of certain proteins that is higher in people who have lung damage due to asbestos.

But even with early diagnosis, traditional cancer treatments, like chemotherapy, radiation and surgery, are not very effective against mesothelioma. One problem is that it does not grow as a single mass. Instead it tends to spread along surfaces, nerves, and blood vessels. This makes it hard for one or more types of treatment to get rid of all of the disease. Cancer treatments may ease symptoms, like shortness of breath, pain, bleeding or trouble swallowing, but they are unlikely to provide a longterm cure.

So how do people continue to hope? What keeps them fighting? I’d really like to know. Please share your story with me.

Also, a GREAT site to check out is the Lung Cancer Support Community. Their link is in the blogroll, or type in www.lchelp.org. They have message boards, chats, information and even a place to start your own blog.

SOURCE: myMeso › How to keep hoping?