Our good friend Debbie Brewer, in the UK, (pictured with sons Rich and Kieran) who has been in remission from her mesothelioma since December 2008, had a worrying report from her latest medical checkup. She visited her oncologist in the UK on Sept. 16, and they have detected some increase in size in her lymph node as the result of a CT scan of her chest, abdomen and pelvis.

“My oncologist is putting me in the Meso box again, and I am not going there,” she told me in an email this morning.

She’s posted the medical records on her blog, Mesothelioma & Me, so please visit her site to check out the full report. According to the findings section, the scan detected “a new 5mm nodule and several smaller new nodules withing the lower left lobe.” However, the scan does not show any growth or changes in the existing areas where they knew there was tumor previously.

It’s been a rough several weeks for Debbie, as she only recently was released from the hospital after suffering a bad case of swine flu and pneumonia! In her blog, she says she is hopeful the increased lymph node could be related to the infection and pneumonia from her illness rather than cancer cells.

Debbie experienced wonderful success in the treatment of her mesothelioma under the care of Dr. Thomas J. Vogl, who she began seeing in May 2008 for an experimental new treatment, chemoembolization. Under his care, her tumor (which she calls Theo) shrunk an amazing 83 percent. Debbie must travel to Germany to participate in the clinical trial at J.W. Goethe University Hospital at Frankfurt University.

Debbie said she has contacted Dr. Vogl about her latest test results, and will consult with him about treatment following a P.E.T. scan.

We know that Debbie is an ultimate fighter and wonderful advocate for mesothelioma awareness and for justice for victims of asbestos disease. Please send her some well wishes! You can contact her through her blog or email her at phu_phita@hotmail.com. I know she’d love to hear from you!

I will keep you posted!

I reported last week that Debbie Brewer, our friend in the UK, had another amazing report from Germany, where she has been undergoing chemoembolization to treat her mesothelioma. Her tumor has now shrunk a total of 83 percent! Debbie is sharing her experience with media in Britain, hoping to gain more widespread acceptance of chemoembolization as a treatment for meso, and to raise awareness that the therapy, currently in clinical trials, exists.

Debbie was diagnosed with mesothelioma in November 2006, at which time her doctor gave her only a few months to live. That was when Debbie began looking for new treatments. She began chemoembolization in May 2008.

Chemoembolization, which is being pioneered by Dr. Thomas J. Vogl at J.W. Goethe University Hospital at Frankfurt University, introduces chemotherapy directly into a tumor, where it is basically sealed off so that it is concentrated in the area of need. The clinical trial started three years ago, and will continue for about two more years. The treatment is only available at the clinic in Germany.

Recently, BBC News featured Debbie and her efforts to bring chemoembolization to the UK, and beyond.

Watch the video.

Our friend Debbie Brewer has reported that after her visit with Dr. Thomas J. Vogl in Germany this week, she can report that her tumor has shrunk an additional TWENTY PERCENT!! This is a total of 73 percent smaller than when she began the experimental chemoembolization process! Amazing!!

Even better, Debbie reports on her blog, Mesothelioma & Me, that a doctor in London is interested in bringing Professor Vogl to the UK to present his technique! Currently, this therapy is only available in Germany, where Dr. Vogl is pioneering the procedure for the treatment of cancer including mesothelioma at the University Clinic, Frankfurt.

Those who have been following Debbie’s story know she began chemoembolization under Dr. Vogl’s care in May 2008, and now she is essentially in remission! As a result of her success, Debbie is a vocal campaigner to bring the procedure to more widespread availability.

Debbie was just featured in The Plymouth Herald, speaking out about her success with chemoembolization and her efforts to bring the treatment to the UK. Doctors originally told Debbie she had only six to nine months to live at her original diagnosis.

I know a lot of people who follow this blog are excited about the wonderful results our friend Debbie Brewer has experienced as a result of her participation in a chemoembolization trial in Germany, with her tumor shrinking 53 percent, and now essentially “dead.” The trial is spearheaded by Dr. Thomas J. Vogl, who is head of the Department of Diagnostic and Interventional Radiology at J.W. Goethe University Hospital at Frankfurt University. He has developed the clinical trial to use chemoembolization to treat mesothelioma.

Because there is so much interest in this clinical trial, even though it is currently only available in Germany, I contacted Dr. Vogl to see if he could provide a little more information about the program.

Q: Explain the basic procedure of chemoembolization / locoregional therapy in the treatment of cancer. How does it work?

A: The basic principle of chemoembolization/locoregional therapy is to achieve a transarterial approach to the tumorous lesion. In the treatment of mesothelioma we have to find the direct supply to the cancer. Then the chemoembolization material can be selectively inserted directly to the lesion. A concentration of cytotoxic drugs of up to 20 times higher can be achieved compared to systemic chemotherapy with reduced adverse events. By cutting off the vascular supply, chemotherapy can be retained in the affected region for several weeks.

Q: How did you learn that this treatment is effective for mesothelioma?

A: During treatment of patients with primary and secondary lung cancer we learned that locoregional therapies are effective for the treatment of mesothelioma.

Q: When did this clinical trial begin? (or how long has it been going on?)

A: The clinical trial started three years ago and will be continued for the next two years.

Q: What are the goals of the clinical trial for this treatment?

A: The goals of the clinical trial are to improve local tumor control, to reduce clinical symptoms like breathing problems and pain, and to increase survival.

Q: How many people with mesothelioma are you currently treating in this clinical trial?

A: Currently we treat 300 to 400 patients with primary and secondary lung cancer per year, and we treat about 20 patients with mesotheliomas.

Q: What are the general / overall results you are seeing in the trials?

A: Clinical symptoms and clinical status of the patients have improved. Local tumor control has improved as well.

Q: What is involved in evaluating a person to see if they are a good candidate for this type of treatment? (What is a good candidate?)

A: Normally we need the following material from the patient before treatment: histology of the cancer, therapy protocols so far obtained, images showing the extension of the tumor. A patient with a localized pleuromesothelioma in one half of the chest is a good candidate.

Q: Explain the procedure for someone receiving this treatment – what happens during a typical treatment visit? How long does it take?

A: After local anesthesia, the femoral vein, which is located in the inguinal region, is punctured. Then a small femoral sheath is usually inserted in the vein through which different catheters can be inserted. After displaying the caval vein, a catheter is pushed forward into the tumor feeding vessels after trespassing the pulmonary arteries. For preventing pain analgetic drugs are administered. Then the chemoembolization as well as the embolizing material are applied. Towards the end of the procedure, the catheters and the sheath system are removed and a compression bandage is applied in order to prevent complications in the inguinal region such as hematoma. After surveillance of 6 to 24 hours, in which complications might be detected and treated, the patient will be discharged. Up to 24 hours after the procedure a CT scan is performed in order to evaluate response to treatment or complications.

Q: How often / frequently does a person receive treatment?

A: The patient normally receives the treatment three up to four times in a 1-month interval.

Q: What are typical side effects of treatment?

A: The typical side effects of the treatment are very low. Normally the patient suffers from fatigue. Nausea and an increasing shortness of breathing are also rarely observed.

Q: How would someone apply to participate in this clinical trial? (Is it still open to receive new patients?)

A: If you send me material (medical reports, MR images, CT scans) I can check it and provide a treatment plan thereafter.

If you are interested in learning more about chemoembolization, or being evaluated for possible inclusion in the clinical trial, you can contact Dr. Vogl here:

Prof. Dr. Th. J. Vogl
Department of Diagnostic and Interventional Radiology
University Hospital
Theodor-Stern-Kai 7
D-60596 Frankfurt

Email: T.Vogl@em.uni-frankfurt.de
Contact telephone number: 0049-69-6301-7277

A young woman suffering from breast cancer, which later spread to her liver and vertebrae, has been inspired by our friend Debbie Brewer’s success with the groundbreaking chemoembolization trial in the treatment of mesothelioma, and hopes to travel to Germany for similar treatments.

Our readers will remember that Debbie recently announced that her tumor has shrunk 53 percent following the chemoembolization treatments, which she received as a part of a clinical trial under the care of Dr. Thomas Vogl, who is pioneering the procedure at the University Clinic, Frankfurt. Debbie began the treatments in May 2008.

A report in the Plymouth Herald says Stephanie Chouette hopes to raise about £12,000 for a three-month course of chemotherapy with Dr. Vogl. Stephanie would undergo “local chemoperfusion,” which the report says is similar to chemoembolization. Her friends and loved ones are hosting a fund raiser Jan. 23 at the Derriford Hospital leisure centre’s function room.

Following her successful treatments, Debbie has begun spearheading a campaign to bring a chemoembolization trial to the UK. She is asking supporters to sign an online petition asking the Prime Minister to support the initiative, which would “ensure that all Mesothelioma patients get treatment in the UK,” so they do not have to travel abroad for healing.

You must be a British citizen or resident to sign the petition. Deadline to sign is July 6, 2009.

I was thrilled this morning to get an email from our good friend Debbie Brewer in the UK reporting her tumor (nicknamed Theo) is now 43 PERCENT smaller!

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!!

Our friend Debbie Brewer, who lives in the UK, reported another good result with her mesothelioma treatment after a visit to Professor Vogl’s team last week in Germany. After three procedures during which she is undergoing chemoembolization, Debbie has seen a 33 percent decrease in the size of her tumor!

The procedure, which is still in a trial stage, targets the tumor with localized chemotherapy. Debbie must travel to Frankfurt, Germany, for the procedure, under the direction of Dr. Thomas J. Vogl, Chairman, Department of Radiology, Department of Diagnostic and Interventional Radiology – University Hospital, Johann Wolfgang Goethe, University of Frankfurt am Main.

Debbie reports that her tumor (Theo, as she calls him) shrunk 18 percent with the first two procedures, and 15 percent after the third treatment. She also says Dr. Vogl is exploring the idea of bringing a mobile unit to the UK that would give people there access to the new therapy. Check out her blog for the latest updates!

In April I shared a web site, Mesothelioma and Me, by UK resident Debbie Brewer, who was recently diagnosed with mesothelioma. The site is Debbie’s personal journal about her experiences as she battles mesothelioma, as well as shares stories about her family and daily life.

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.