mesothelioma treatment Archives

New Surgical Procedures for Cancer Patients Limit the Danger of Complications

March 26, 2013 by Steven Kazan

Recently, I noticed an article published by Cure Magazine that talked about the different innovations that are allowing cancer surgery patients to recover more quickly with fewer complications.

What are the standard surgical procedures?
Before I get into highlights of the article, I think it’s important to delve into the types of surgery that doctors may use to treat non-small cell lung cancer. The National Cancer Institute lists the following four types:

1. Wedge resection removes the tumor, as well as some of the healthy tissue that surrounds it.
2. Lobectomy cuts out an entire section of the affected lung.
3. Pneumonectomy gets rid of an entire lung.
4. A sleeve resection removes part of the bronchus, which is the airway that connects the windpipe to the lung.

Surgery for small cell lung cancer may be more complicated because this form of the disease often affects both lungs at the same time. The lymph nodes may be abnormal, as well. In either case, patients may need to undergo additional treatments with radiation or chemotherapy.

Regardless of the type of surgery that doctors use, there are always risks for post-operative complications. These include pain, blood clots, nerve damage and infections. However, scientists are trying to improve surgical procedures to curb the danger.

New tools are helping doctors
Traditionally, doctors operate on cancer through open surgery, which means that they make incisions that are large enough to provide visual and physical access to the tumor. The risks associated with open surgery can be reduced if the incisions are smaller.

To that end, doctors can use a variety of tools to reach malignant tissues while causing minimal damage to the healthy areas. These may include laparascopes, which are tiny telescopic cameras that let doctors see inside patients, and surgical robots that doctors can control remotely. Also, a procedure known as natural orifice translumenal endoscopic surgery, or NOTES, allows clinicians to insert tools through a patient’s body via flexible endoscope, which is a tube that creates a passageway when it goes through the mouth.

“Minimally invasive procedures now represent about half of all cancer surgeries we do,” Eric Grogan, M.D., told Cure Magazine. “Ten years ago, 95 percent would have been traditional open surgeries. The minimally invasive approaches have changed the risks-benefits ratio a bit because it has slightly reduced the risk of the operation.”

Although these innovations reduce tissue damage, they still carry the risk of blood clots and infection. In order to tackle the former, more doctors are prescribing blood-thinners to be taken after surgery.

Infection control is a little bit more complicated and requires more work. This includes the prescription of antibiotics, blood glucose monitoring, controlled-warming of a patient’s body after surgery and careful administration of anesthesia during an operation, which is important for the prevention of pneumonia.

Asbestos exposure is a real public health threat. Every year, asbestos-induced lung cancer claims the lives of about 4,800 individuals in the U.S., as estimated by the Environmental Working Group. That number is expected to increase over the next 10 years or so.

Fortunately, it looks like surgical options are becoming safer for patients. However, let’s not let that diminish the importance of curbing asbestos use and production.

Vitamin-Drug Combo May Help Treat Mesothelioma

March 25, 2013 by Steven Kazan

Recently, I learned about a team of researchers in Italy who are working on a new combination treatment that brings together vitamin C, the chemotherapy agent gemcitabine and EGCG, which is an antioxidant found in green tea.

On the surface of it, this may sound like a strange approach to treating mesothelioma. However, the paper, which was published in the journal PLOS ONE, suggests researchers found promising results.

Looking at the individual components
Before we get into the details of what the scientists did in the laboratory, it may help first to understand what components they were working with.

First, there’s the use of antioxidants. These are nutrients that help stabilize the destructive forces of free radicals, which are molecules that degrade the cells in your body, drive the aging process and increase the risk of cancer. Free radicals come from all over the environment: air pollution, ultraviolet radiation, unhealthy food – even the simple act of food metabolism in the body creates free radicals. However, antioxidants help neutralize the effects of free radicals.

Vitamin C, which is also known as ascorbate or ascorbic acid, is a popular example of an antioxidant. You consume this nutrient every time you eat any of a large variety of fruits and vegetables.

Green tea also has antioxidants, including EGCG, which belongs to a class of plant molecules known as polyphenols.

Usually, in the context of cancer care, antioxidants are discussed as a preventive measure. However, previous studies convinced the scientists from Italy that vitamin C and EGCG may actually be able to act directly against tumor cells. For their study, the researchers combined these two antioxidants with the chemotherapy drug gemcitabine. This medication interferes with cancer cells’ ability to replicate the DNA that they need to reproduce and grow, thereby curbing the growth of malignancies. Currently, doctors prescribe gemcitabine for diseases such as breast cancer, ovarian cancer, pancreatic cancer and non-small cell lung cancer.

Researchers test-drive their drug-antioxidant combo
The researchers’ goal for this study was to find a possible new treatment for mesothelioma, a disease that currently has no cure. In the laboratory, they combined vitamin C, EGCG and gemcitabine. They referred to this mixture as Active Nutrients/Drug, or AND. In order to test the effects of AND, the scientists created both cell models and rodent models of mesothelioma.

In the cell model, they observed that the individual components of AND seemed to work in a synergistic manner, with each active ingredient enhancing the effects of the others, causing the diseased cells to die.

In the mouse model, the researchers found that AND reduced the size of the animals’ tumors, decreased the number and size of metastases, and prevented abdominal bleeding.

“Here we show that a triple combined treatment based on EGCG, ascorbate and gemcitabine (AND therapy) reduces mesothelioma growth and metastasization,” the researchers wrote in PLOS ONE. “Due to the lack of side effects, we propose that this combined therapy should be evaluated in other preclinical and clinical models.”

Because this experiment was conducted using cell and animal models, it may be years before scientists evaluate the performance of AND in human clinical trials. Still, this study is important because it provides the foundation for a potential new way to tackle mesothelioma.

We at Kazan Law look forward to the future direction of this work.

Filed Under: mesothelioma treatment Tagged With: mesothelioma research

Mesothelioma can Cause Heart Complications

March 18, 2013 by Steven Kazan

At Kazan Law, we know that the effects of mesothelioma on the body can be far-reaching. I recently came across a report in the Indian Journal of Pathology and Microbiology, which published a case report detailing a mesothelioma patient who developed atrial fibrillation, or AF. The Japanese doctors who treated him theorized that the heart complication was a result of physical crowding caused by tumors in his chest.

Growths in the chest can interfere with health
The authors of the study noted that advanced cases of pleural mesothelioma can lead to the growth of mediastinal masses or tumors. Doctors from MedStar Washington Hospital Center describe the mediastinum as the area of the chest that is between the lungs. Small masses may not cause any symptoms, but sometimes, mediastinal tumors can cause chest pain, persistent cough, difficulty swallowing, trouble breathing, fever, night sweats or unexplained weight loss.

Doctors can diagnose the presence of a mediastinal tumor by conducting a chest x-ray, CT scan or biopsy. They may also perform a mediastinoscopy, which inserts a super-thin camera into the chest cavity for a visual inspection.

Usually, a mediastinal growth can be controlled with the help of surgery.

What is AF?
A danger associated with any tumor is the possibility that the abnormal tissue growth can disrupt the function of any surrounding organs. In the case of a mediastinal tumor, the heart can be affected.

The authors of the case study found that, in one patient, a mediastinal tumor that grew out of mesothelioma may have caused AF.

Here’s what you need to know about AF: The American Heart Association describes it as a condition in which the normal rhythm of the heart is disrupted, and the top two chambers of the organ do not beat effectively. As a result, blood can pool in these chambers and form clots. These clots can cause a stroke if they block the circulation of blood to important areas of the body.

Furthermore, AF can lead to heart fatigue, chronic fatigue, poor circulation and other problems.

People who have AF sometimes describe feeling a fluttering sensation in their chest, but one of the dangers of this condition is that symptoms are not always obvious, and patients may not be properly diagnosed for some time.

Doctors find a possible new cause of AF
It turns out there was another interesting case that caught my attention – in Japan, doctors treated a 70-year-old man who was diagnosed with mesothelioma at the age of 66. When he was admitted to the hospital for the last time, he showed evidence of a mediastinal tumor, AF and other problems. He eventually died 29 days later.

The medical exam that followed his death revealed that several of his organs and major blood vessels were impacted by the mediastinal tumor and other growths. AF was a likely result of this interference.

“AF due to a mediastinal tumor can be cured by surgical excision of the tumor,” the doctors wrote. “Although the treatment of advanced mesothelioma is difficult, chemotherapy using pemetrexed and cisplatin, antibody-based therapies targeting epidermal growth factor receptor, and immunotherapy have been attempted recently. Advanced mesothelioma can cause AF, and the reduction in the tumor size using such therapies may prevent AF. It is important to diagnose mesothelioma at an early stage.”

This is just one more reason why global efforts to ban the use and production of asbestos are important, and why we at Kazan Law believe so much in what we do.

Filed Under: mesothelioma treatment Tagged With: mesothelioma heart

Cancer Center Recruiting Mesothelioma Patients for Clinical Trial Showing Encouraging Results

February 22, 2013 by Steven Kazan

When it comes to medication, sometimes the way that doctors administer it is an important factor that can affect its effectiveness. One active area of scientific research aimed at developing better treatments for malignant mesothelioma involves exploring different methods of delivering drugs.

For example, Genelux, a pharmaceutical manufacturer based in California, is working in collaboration with the Memorial Sloan Kettering Cancer Center to evaluate the performance of GL-ONC1. The researchers want to know how effectively the agent can treat diseases such as mesothelioma and non-small cell lung cancer after doctors deliver it directly into the intra-pleural cavity of patients who develop malignant pleural effusions.

Current treatments fall short
Experts from the National Cancer Institute say that the treatments most suited for mesothelioma may partly depend on the stage of one’s disease. For example, if you are in the earliest stages of the illness, doctors may recommend surgery to remove the abnormal pleural lining and portions of other tissues in order to minimize the amount of malignant tissue that is present. This may be combined with radiation therapy as well as chemotherapy, both of which help further eradicate the cancerous cells.

In the advanced stages of the disease, surgery may no longer be an option.

Although these treatments may help alleviate the symptoms of your disease while extending survival time, they cannot cure mesothelioma. This underscores the need for better approaches to this illness.

Pleural effusions may provide a window
In order to develop a better treatment for respiratory malignancies caused by exposure to asbestos, scientists at Genelux created GL-ONC1, which is a modified form of the vaccinia virus that produces green fluorescent protein (GFP) in the body after it is activated. The GFP allows medical providers to track the medication’s activity.

Researchers at Genelux designed GL-ONC1 as a regimen for patients who develop malignant pleural effusions, which affect about 30 percent of individuals who have respiratory cancers. The NCI described this medical complication as an abnormal accumulation of fluid in the pleural space that envelopes the lungs. If not treated properly, a pleural effusion may cause chest pain, cough and shortness of breath.

Previous studies to evaluate GL-ONC1 suggested that the agent is safe in humans who have other types of cancer. This new trial will deliver the drug candidate as a single dose to patients who develop pleural effusions because of diseases such as mesothelioma. The goal is to further verify safety while determining the best dose for intra-pleural delivery.

Clinical trial will benefit everyone
The current trial on GL-ONC1 will ultimately enroll a maximum of 54 patients, all of whom will have to undergo video-assisted thoracic surgery and pleural biopsies. Like all clinical trials, there is a risk of failure. However, regardless of whether the experiment produces the desired results, scientists will gain valuable knowledge into how to tackle respiratory cancers.

At Kazan Law, we appreciate the value of these experiments. If you are interested in participating in this or any other clinical trials, talk to your doctor. You can also consult the NCI or the American Cancer Society, both of which carry information on the latest ongoing studies.

Remember that not all individuals with a particular disease may be eligible for specific clinical trials. Furthermore, you may not see the positive results you want. However, your participation would promote the work to help future patients.

Filed Under: mesothelioma treatment Tagged With: Genelux, GL-ONC1, Memorial Sloan Kettering, mesothelioma clinical trials

3 Factors that Impact a Mesothelioma Prognosis

February 21, 2013 by Steven Kazan

Receiving the news that you have malignant pleural mesothelioma can be overwhelming, but knowing your diagnosis is a positive first step in fighting the battle. Next, your team of healthcare providers need to determine how extensive your disease is. This will help them decide which treatments are the most appropriate for you and which ones are not worth the expense and side effects.

At Kazan Law, we try to keep up with the latest medical developments. We know that when it comes to forming prognoses of cancer patients, doctors often rely on staging systems that describe the physical extent of the malignancy. However, when it comes to mesothelioma, arriving at an opinion may be more challenging. One team of scientists from Rome decided to comb through the various prognostic factors that researchers studied throughout the years and published their review in the journal Oncology.

Staging systems are inadequate
There are several treatment options for mesothelioma patients: chemotherapy, radiation therapy, surgery or a combination of any of these. Deciding which regimen to undergo depends partly on how advanced the disease is.

Experts from the National Cancer Institute say that surgical options – either extrapleural pneumonectomy or pleurectomy/decortication – are typically only recommended for patients who are in stage I of the disease. This means that the cancerous tissue is limited to certain areas of the chest lining. For stages II-IV, radiation or chemotherapy are often prescribed. However, some patients may still be eligible for pleurectomy/decortication.

The options for patients who have recurrent mesothelioma are mostly limited to participating in a clinical trial.

One problem with the staging system for mesothelioma is that, by the time patients are diagnosed, the disease is usually in its advanced stages. This underscores the need for better techniques to identify the disease and determine its extent.

Reviewers go from macro to micro
Although cancer prognoses often rely on staging systems, the amount of information that can describe mesothelioma is more vast than some medical professionals may know. The review recently published in Oncology grouped the various predictive factors of this disease into three main groups:

Clinical factors. These include sex, age, extent of asbestos exposure, symptom severity, performance status, radiological imaging, blood cell abnormalities, enzyme abnormalities and the presence of certain proteins in the blood serum. Additionally, both patients’ cancer staging and their responses to treatment may also impact their prognoses.
Genetic factors. Although asbestos exposure is the only known direct cause of mesothelioma, the carcinogen interacts with a unique set of genes in each patient. Prognoses may depend in part on the presence of mutations in individuals. Furthermore, the severity of a disease can be affected by mechanisms in the cells that control how certain genes are expressed.
Molecular pathway factors. The way in which the machinery in your cells behaves can influence how well the diseased tissue thrives. For example, most healthy cells are programmed to die after a certain time, or after an extensive amount of damage takes place. It is not uncommon for cancerous cells to be missing this mechanism for cell death.

The Environmental Working Group estimates that mesothelioma claims the lives of more than 2,500 individuals in the U.S. every year. Having more effective methods of forming prognoses can help doctors decide which patients are eligible for certain treatments, including those that are more targeted.

“Until the suggested novel gene and immunologic therapies have demonstrated their effectiveness, the best approach that can be offered to patients remains as extensive a surgical cytoreduction as possible, followed by adjuvant chemo- and radiotherapy,” the reviewers wrote. “Still, an adequate knowledge and evaluation of prognostic factors can help in defining the multidisciplinary approach to therapy in order to reduce the mortality from this lethal disease.”

Filed Under: mesothelioma treatment Tagged With: mesothelioma diagnosis, mesothelioma prognosis

Can a Modified Form of a Human Virus Kill Cancer?

February 20, 2013 by Steven Kazan

Most people are aware of the fact that viruses can cause a myriad of unfortunate effects, including a runny nose, coughing, fever and body aches.

In the right hands, however, viruses can actually be beneficial. One biopharmaceutical company is developing a virus-based therapy that may one day help treat lung cancer, including cases caused by asbestos exposure.

How can viruses be helpful?
The fact that viruses can wreak havoc on the body has inspired several scientists to conduct experiments to see if they can use them to kill diseased tissues. The National Cancer Institute describes these oncolytic viruses as targeting cancer cells, and not healthy ones. This may either kill the malignancy directly, or make tumors more vulnerable to radiotherapy and chemotherapy.

Oncolytic viruses may exist naturally, but biopharmaceutical companies such as Oncolytics Biotech are engineering their own viruses in the lab.

Phase 2 clinical trial shows promise
Oncolytics Biotech has been developing an oncolytic virus under the name Reolysin, which is a modified form of the human reovirus. So far, the company has explored the use of Reolysin for treating head and neck cancers.

In order to determine the effects of Reolysin on lung cancer, the researchers conducted a Phase 2 trial that included 20 patients who had squamous cell carcinoma of the lung. All study participants underwent six treatment cycles of the chemotherapy drugs carboplatin and paclitaxel, which were administered in combination with intravenous treatments of Reolysin.

Results showed that 19 patients experienced shrinkages in their tumors.

“It’s exciting to have 95 percent of patients in this study exhibit tumor shrinkage and these results further suggest that Reolysin may have potential use in neoadjuvant (pre-surgical) settings,” Brad Thompson, president and CEO of Oncolytics Biotech, said in a statement. “Based on these findings we intend to continue to look at Reolysin as a treatment for cancers of the lung and cancers that metastasize to the lung.”

The company is continuing to enroll patients for further studies of Reolysin.

Incidence of asbestos-induced lung cancer will increase
The NCI describes squamous cell carcinoma of the lung as a form of non-small cell lung cancer. It affects a group of cells that are thin, flat and resemble fish scales. Symptoms of this disease include chest pain, a cough that grows worse over time, wheezing, loss of appetite, unexplained weight loss, tiredness, problems swallowing, difficulty breathing or hoarseness.

Experts estimate that more than 228,000 new cases of lung cancer will be diagnosed in the U.S. in 2013. Eighty-four percent of these will be non-small cell lung cancer, and 25 percent of all lung cancer cases will be squamous cell carcinoma.

Although the developed world has done much to curb the use of asbestos, diseases related to this toxic material can take years to develop. For this reason, the incidence of conditions such as lung cancer and malignant mesothelioma will probably continue to increase for the next 10 years or so, as estimated by the Environmental Working Group. The organization asserts that, currently, asbestos-induced lung cancer is responsible for 4,800 deaths in the U.S. every year.

If the researchers from Oncolytics Biotech are successful in bringing Reolysin to market, countless lung cancer patients may benefit.

Filed Under: mesothelioma treatment Tagged With: cancer treatment, reolysin

New Device may Assist Diagnosis of Lung Cancer Caused by Asbestos Exposure

February 19, 2013 by Steven Kazan

Whenever people think of lung cancer, they are likely to associate the disease with tobacco use. However, exposure to asbestos is a potential risk factor as well. The link between these two diseases drives scientific research into several directions, from studies on how to treat the illness to the creation of better diagnostic tools. The latter is especially important because better detection can lead to a more effective treatment.

At Technion-Israel Institute of Technology, which is Israel’s oldest university, scientists joined forces with the device manufacturer Alpha Szenszor to develop a product that can diagnose lung cancer simply by analyzing samples of the air that individuals exhale.

Different tools are available – and invasive
The Centers for Disease Control and Prevention described the telltale signs of lung cancer as wheezing, difficulty breathing, unexplained weight loss and coughing, which may be bloody. If lung cancer is caused by asbestos exposure, symptoms can take 15 years after initial contact with the toxic material to develop.

The American Cancer Society lists several tools that doctors have at their disposal for diagnosing lung cancer. These include imaging scans of the chest, such as chest X-rays, MRI, CT and PET. However, these radiological tests often need to be confirmed with the help of other, more invasive diagnostic tools, such as thoracentesis, which analyzes the fluid that builds up around the lungs, or a biopsy, which collects cell samples from the tumors themselves.

Breathe in, breathe out
Scientists are always trying to find better ways to diagnose diseases. When it comes to lung cancer, this could mean creating a test that is less invasive and easier to use on patients. Collaborators at Technion and Alpha Szenszor believe that an answer may be found the breaths that patients exhale.

Within the air that individuals breath out are substances known as volatile organic compounds (VOCs). Researchers from the Netherlands note that diseases such as lung cancer cause the lungs to release distinctive VOCs because of inflammation. Developing technology that could diagnose lung cancer and other conditions, simply by analyzing the VOCs in patients breaths, could prove useful. Compared to biopsies, this approach would be less invasive and easier for patients to endure.

“At Alpha Szenszor, we are excited to be working with one of the world’s premier research institutes in a field where the transformational benefits to human life have been so clearly demonstrated,” CEO Steve Lerner said in a statement. “We look forward to this partnership with Technion as a critical step in the validation of early stage diagnostics through direct digital detection of gaseous biomarkers.”

Lung cancer numbers are on the rise
A new tool, such as the one that Technion and Alpha Szenszor plan to commercialize, will be especially valuable in light of the changing dynamics of diseases caused by asbestos exposure. Specifically, the Environmental Working Group estimates that asbestos-induced lung cancer claims the lives of about 4,800 individuals in the U.S. every year. This in addition to other asbestos-related diseases, such as malignant pleural mesothelioma, gastrointestinal cancers and asbestosis, which, when combined with lung cancer, cause nearly 10,000 deaths every year.

Adding to the urgent need for new diagnostic tools is the fact that the incidences of these diseases will only increase during the next 10 years or so. At Kazan Law, we are happy to support and promote scientific research that will help us curb these trends.

Filed Under: mesothelioma treatment Tagged With: lung cancer diagnosis, mesothelioma diagnosis

Shocking Discoveries on Researchers Downplaying Side Effects of Drugs for Mesothelioma and Other Cancers

February 11, 2013 by Steven Kazan

In the fight against malignant diseases caused by asbestos exposure, doctors may take several approaches. While surgery can physically remove the abnormal tissue, radiation and chemotherapy may be more common for patients whose conditions are advanced. These different treatments often work together.

At Kazan Law, we are very familiar with the side effects of chemotherapy. We are also excited about the fact that scientists are constantly developing new drugs while figuring out more effective ways to administer the existing ones. However, Reuters Health recently reported on a disturbing trend in which researchers seem to be downplaying the side effects of the drugs that they study.

Research finds surprising results
Ian Tannock, a scientist from Princess Margaret Hospital in Toronto, investigated how forthcoming researchers were in the presentation of 164 individual studies. He made some shocking discoveries:

Two-thirds of the papers did not list the serious side effects of chemotherapy, radiation or surgery in the introductory abstract of the publication.
One-fifth of the authors did not include the toxicities within their studies’ results tables.
One-third of the scientific articles did not discuss toxicities in either their papers’ abstracts or discussion sections.
One-third of the studies shifted the focus of their papers during the research if the authors found that they were not getting the results they hoped for. This can mean the difference between reporting lifespan without cancer and lifespan with relapsing disease.

These trends are important to note because doctors sometimes read only the paper’s abstract, increasing the chances that they can miss important information. Tannock also discovered that these behaviors were not limited to cancer studies.

“Investigators want to go overboard to make their studies look positive,” Tannock told Reuters Health.

Altering the way an experiment’s results are reported can increase the chances of publication, which in turn boosts the authors’ likelihood of receiving grants and tenure.

Tannock suggested that scientific journals can discourage these practices by requiring authors to talk about side effects and other problems within their abstracts. Furthermore, those who read journal articles need to learn how to be more critical.

Chemo side effects and asbestos-induced diseases
The National Cancer Institute lists the most common side effects of chemotherapy as nausea, vomiting, fatigue, hair loss, oral sores, pain and decreased blood cell counts. These complications occur because medications for cancer usually target cells that have a high rate of growth, including healthy ones.

Not all patients diagnosed with malignant mesothelioma, lung cancer or other diseases experience the same chemotherapy side effects. This tends to depend on the type of treatment a patient is undergoing, as well as his or her overall health before the course begins.

If you experience any side effects from your cancer treatment, it is important to discuss them with your medical team. Sometimes these side effects can curb your motivation to adhere to your regimen, which can only lead to more problems. Instead, ask you physician about how you can cope.

For example, the American Cancer Society has several tips on how you can deal with changes in your appetite caused by nausea or problems in the mouth. Eating a balanced diet is still important during cancer therapy because it will help you maintain your strength and stay healthy.

To help increase your desire to eat, try walking before meals or eating with loved ones. Additionally, you should try to add variety to different aspects of your mealtime, such as the setting or the types of food that you consume.

Sitting down to three average-sized meals a day may seem daunting if you have a low appetite. Instead, consider eating several smaller meals throughout the day. This may make it easier to keep food down.

Filed Under: mesothelioma treatment Tagged With: chemotherapy side effects

Clinical Trials Continue to Support Multimodal Therapy for Mesothelioma

February 1, 2013 by Steven Kazan

nurse with female patient The Environmental Working Group estimates that the incidence of malignant mesothelioma will continue to increase for another 10 years or so. This is cause for concern because there is no standard treatment strategy for this disease, which in turn underscores the need for more research.

At Kazan Law, we are happy to keep tabs on the latest developments. For years, scientists have known that mesothelioma patients are unlikely to be cured because of the use of any single treatment, whether it is chemotherapy, radiation therapy or even surgery. However, patients may have more success if their doctors administer multiple treatments.

One team of researchers from Italy recently published the results of a study that supports this approach.

Mesothelioma requires intense treatment
Scientific research to determine the best treatment for a disease usually requires that different strategies be compared against each other. Because mesothelioma is relatively rare compared to other diseases, this task has proved exceedingly difficult, according to experts from the American Cancer Society. Furthermore, the cancer is hard to approach because it can spread easily and does not grow as one single mass of tumorous tissue.

However, there is evidence showing that patients benefit the most from a regimen that combines several different treatments, a strategy known as multimodal therapy. This includes:

Chemotherapy to shrink the cancer. Cisplatin and pemetrexed are two of the most common drugs that doctors use. While cisplatin damages the DNA of cancer cells in order to keep them from dividing, pemetrexed prevents the cells from actually making this DNA, as stated by the National Cancer Institute.
Surgery to remove the diseased tissue. One procedure is the extrapleural pneumonectomy (EPP). Experts from the University of California in San Francisco describe this procedure as one that excises an entire lung, plus portions of the diaphragm, pleura and the lining of the heart.
Radiation therapy to kill any abnormal cells left behind.

New study supports multimodal therapy
There have been several studies that show multimodal therapy may be a good approach for mesothelioma patients. Based on the success of this research, the team of scientists from Italy conducted their own study to investigate the impact of this regimen. In this study, subjects who were diagnosed with mesothelioma underwent three cycles of chemotherapy that combined cisplatin with pemetrexed, an EPP three to eight weeks later, and radiation four to eight weeks after surgery.

The researchers initially enrolled 54 patients, all of whom had mesothelioma between Stages I and III. Ninety-six patients completed chemotherapy, 83 percent underwent EPP and 41 percent completed all three segments of the multimodal therapy.

Results showed that the median amount of time in which patients lived without any significant deteriorations was 6.9 months. The median overall survival time was 15.5 months. One-third of study participants still had event-free disease after one year. After two years, that figure was almost one-fourth.

“The combination of pemetrexed plus cisplatin followed by surgery and hemithoracic radiation is feasible and has a manageable toxicity profile in carefully selected patients. It may be worthy of further investigation,” the scientists wrote in the journal BMC Cancer.

However, the researchers also noted that two subjects died due to complications from radiation therapy. After this happened, the scientists adjusted their experiment by using lower doses of radiation for subsequent patients. This underscores the need for physicians to select the candidates for certain treatments, such as radiation therapy and surgery, very carefully.

Filed Under: mesothelioma treatment Tagged With: mesothelioma multimodal therapy

Understanding Metastasis and Mesothelioma

January 31, 2013 by Steven Kazan

woman holding xray There are several therapeutic approaches that doctors may take in order to treat malignant mesothelioma. Both chemotherapy and radiation are capable of killing diseased cells. Additionally, some patients may be eligible for surgery that can remove as much of the cancerous tissue as possible.

However, even with these treatments, patients who have mesothelioma are still at risk for medical complications if their disease metastasizes.

What is metastasis?
We understand cancer as a disease in which a group of cells within one piece of tissue in the body goes rogue and multiplies far beyond what is considered a normal, healthy rate. This leads to the growth of tumors, which can become deadly if they interfere with the function of the surrounding tissues.

Metastasis occurs when these malignant cells break off from the tumor, travel to another part of the body and produce another tumor. Experts from the American Cancer Society (ACS) describe this process as occurring through one of three pathways in the body: circulation through the lymph nodes, circulation through the blood vessels or along the surfaces that line the body’s cavities. Mesothelioma is one of the few cancers that can spread via the cavity linings.

The metastasis process takes place over four steps:

A group of tumor cells stops growing.
This group breaks away from the tumor.
The cells move out of the affected tissue and either enter one of the circulatory systems, or travels along the body cavity lining.
The cells settle in a new location and grow into a new tumor.

Metastasis is deadly in part because its symptoms can easily be mistaken for another health condition.

Metastasis can affect mesothelioma patients
When doctors need to determine how bad a case of mesothelioma is, one of factors that they measure is how far the cancerous cells have spread.

For example, the National Cancer Institute describes localized stage I mesothelioma as being confined to the lining of the chest wall, diaphragm or possibly the lung. However, in the advanced stages of the disease, cancer may spread beyond these tissues and affect the diaphragm and lungs themselves, as well as the lymph nodes, trachea, esophagus, fatty tissues, soft tissues, peritoneum, ribs, the sac that encapsulates the heart, or the heart itself. In some stage IV cases, the malignancy may travel even further and strike the spine, brain, prostate and thyroid.

Scientists are taking a closer look
In order to tackle metastasis more effectively, some scientists who study cancer have decided to make this specific phenomenon their niche.

“Fewer than 8 percent of researchers mention the word ‘metastasis’ in their grant applications, in the context of actually working on the problem…Figuring out how to prevent cancer – a key research focus today – would be the best approach…but that’s of little help to patients who already have cancer,” said Dan Welch, a member of the ACS Scientific Council, as quoted by the ACS. “To prevent something, you have to know its cause. We have no idea why cancer cells spread, let alone what prompts them to disseminate throughout the body.”

One possible key to understanding metastasis is the study of the tumor microenvironment in which breakaway cells settle. Scientists are also exploring the genes that are involved in metastasis, and why certain clusters of breakaway cells can remain dormant for decades before forming new tumors.

The Environmental Working Group projects the incidence of asbestos-related diseases to increase for another 10 years or so. At Kazan Law, we are optimistic that scientists are on the right track to helping such cancer patients and truly understanding the cause of metastasis.