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Are The Results Of Pneumectomy ‘Acceptable?’

One of the treatment options for patients with Mesothelioma is an aggressive surgery to remove the infected lung. This procedure is called a pneumonectomy. However, many people considering a pneumonectomy are truly concerned about their quality of life following the surgery. According to a study done in Italy that tracked pneumonectomy patients between January of 2003 and March of 2010 concluded that an “acceptable” quality of life is possible after this surgery.

The study tracked 71 patients who had undergone pneumonectomy due to Mesothelioma or lung cancer. There were 71 patients total who participated in this research. Of the total, 31 had the left lung removed and 26 the right. The other 11 patients had lung removal along with more in depth surgery that removed other parts like areas of the trachea, lung lining, and the diaphragm. Although the recovery process following this surgery is long and extremely intense, most patients involved in the study had an ‘acceptable’ quality of life one-year after the surgery.

In fact, one-year after having the pneumonectomy, 93% of these patients were still alive. However, all of them began to develop heart issues including tricuspid valve insufficiency, which refers to the valve not closing properly. This condition allows some of the blood to pass from the right ventricle into the right atrium as the heart beats. This ends up decreasing the pumping efficiency of the heart. The study participants also suffered from thickening of the heart’s ventricular walls. Three patients ended up dying from surgery-related complications.

Five years following the surgery, 20% of the study participants were still alive. However, a questionnaire regarding quality of life that was filled out at the one-year and five-year marks indicated that quality of life had decreased. According to researchers, the scores were still considered ‘acceptable.’ In a results summary published in an Italian medical journal, the research team concluded that the mortality following surgery and 5 years post surgery were satisfactory. The team did not consider the heart problems severe enough to affect quality of life in a dramatic way. The team concluded that ‘acceptable’ quality of life is possible following lung removal surgery to treat Mesothelioma and lung cancer.

The debate continues between Mesothelioma experts as to the risks verses benefits of subjecting patients to pneumonectomy. On average, this intensive and extreme surgical procedure does not increase life expectancy very much, and many consider quality of life extremely diminished following the surgery. Thus, the benefits of pneumonectomy remain questionable, and opting for this procedure is definitely a personal decision that needs to be made by the patient. Many doctors recommend the pleurectomy procedure versus the pneumectomy, as it is much less radical and the risks are much lower.

New Diagnostic Test For Mesothelioma To Be Released Soon

A new genetic markers diagnostics test, being released under the band name DecisionDx-Mesothelioma, may be available to physicians as early as the 3rd quarter of this year. This test was created and tested at Brigham and Women’s Hospital, located in Boston, Massachusetts. The DecisionDx-Mesothelioma test has been designed to detect a specific set of genes in patients who are suspected of having Mesothelioma. The gene profile will help provide doctors with a better picture of whether or not the respiratory symptoms the patient is suffering from are related to Mesothelioma.

The symptoms of Mesothelioma easily mimic the symptoms of other respiratory conditions. Thus, symptomology alone makes it difficult to diagnose this aggressive cancer. The symptoms can include chest pain, coughing, and shortness of breath. Often times, the physical symptoms do not even present themselves in patients with Mesothelioma until the later stages of the disease.

Castle Biosciences has acquired the technology and intellectual property rights of this genetics marker test developed by Brigham and Women’s Hospital. Castle Biosciences is a Texas based company that specializes in these types of molecular genetic diagnostic tests, which are used to diagnose rare cancers. Castle Biosciences currently has three diagnostic tests of this type. These are used by physicians to assist in diagnosing thyoma, uveal melanoma (eye cancer), and glioblastoma and gliomas (brain cancer).

Mesothelioma is typically difficult to diagnose because of its location and symptomology. It usually takes a combination of medical history, asbestos history, physical examination, imaging, and biopsies to diagnose Mesothelioma. The DecisionDx-Mesothelioma test could help diagnosticians locate genetic biomarkers linked to this aggressive cancer. This test may also be able to be used to predict the survival rates of patients who will be undergoing resection surgery.

According to Dr. Raphael Bueno, the Chief of Thoracic Surgery with Brigham and Women’s Hospital, this molecular test can be used with other clinical parameters to assist with identifying patients who are likely to benefit from aggressive Mesothelioma surgery. This new diagnostic test will also help physicians develop an adequate treatment plan, which is essential to increase the likelihood of success and a good prognosis.

Castle Biosciences is in the process of validating the new test based on federal regulatory standards, as well as the standards put forth by the College of American Pathologists and CLIA (Clinical Laboratory Improvement Amendments). Upon completion of the testing process, Castle Biosciences hopes to release this new diagnostics tool for Mesothelioma during the third quarter of 2012.

Mesothelioma More Prevelant In People With Specific Type of Mole

Mesothelioma is an aggressive type of cancer that begins in the mesothelium, which is the lining that protects the organs. This lining forms a sack around the organs and holds a fluid that provides a protective buffer. Mesothelioma is caused by exposure to Asbestos, which damages this lining by causing chronic irritation to the tissue around it. Asbestos is a needle-like mineral that imbeds itself into the organ tissues at the time of exposure. However, not everybody exposed to Asbestos ends up contracting Mesothelioma.

In a recent study done at the University of Hawaii, which is one of the top Mesothelioma research locations, it was found that a certain genetic mutation to the BAP1 gene may predispose people to cancers including Mesothelioma. This specific genetic mutation is known to cause something that looks like a mole on the skin, which could be used by physicians and pathologists to help determine whether or not somebody is predisposed to certain types of cancers. This mole-like tumor could help doctors determine whether or not certain people exposed to Asbestos are more likely to contract Mesothelioma. This could be a huge breakthrough, because as with most cancers, early detection of Mesothelioma leads to earlier treatment and a better overall prognosis.

The study conducted at the University of Hawaii looked at 118 different people from 7 unrelated families, 55 people without the BAP1 mutation and 63 with the mutation, in an attempt to find external markers to the BAP1 gene abnormality. In the BAP1 mutated group of people, most of them had an external marker that looked like abnormal moles. Although it does require a biopsy and diagnosis by a pathologist to confirm the BAP1 mutation, this discovery is important because it gives physicians something to make note of when looking at skin changes over time.

Since it is known that people with the BAP1 gene mutation are at higher risk for developing cancers including Melanoma and Mesothelioma, this gives physicians a visual marker to look out for. These mole-like spots are actually called Melanocytic BAP1-mutated atypical intradermal tumors (MBAITs). If patients notice skin changes that happen quickly or seem abnormal for them, it is important to see a physician to have the potential abnormality evaluated. The discovery of MBAITs could allow physicians to detect cancers earlier, which could give the patient a better long term outcome. This is just one more weapon in the arsenal scientists and researchers are developing to fight Mesothelioma and other deadly forms of cancer.

Carrying The Burden Of Mesothelioma

Many people think that the burden of Mesothelioma lies on the person who has been diagnosed with the disease. This is true in that the person diagnosed has the burden of suffering from the disease, going through the rigorous and complicated treatments, and dealing with the prognosis of the disease. However, many people who do not actually receive the diagnosis also carry the burden of Mesothelioma when a loved one is diagnosed. The fact is that thousands of new cases of Mesothelioma are diagnosed each year, and the prognosis is not good. The average lifespan of somebody newly diagnosed with the disease is 12 to 18 months from initial diagnosis. In an attempt to increase this by even months, the treatment may begin immediately, and let’s face it, the options are brutal.

First line treatment for Mesothelioma is usually aggressive chemotherapy. This may be followed by additional chemo treatments, along with radiation, and perhaps major surgery to remove the infected part of the body, which is usually a lung. During this treatment, family and loved ones are there to care for the person with Mesothelioma. Many families suffer terribly while watching a loved one go through this process, and knowing there isn’t much that they can do to change the outcome. Spouses step forward to care for the person suffering from the disease while taking on the extra financial and household burdens, as well. Every member of the family goes through the stages of the disease, and everybody carries the burden of Mesothelioma.

Unfortunately, at this time there is no cure for this aggressive and debilitating cancer. Researchers and scientists are working diligently to develop better treatment options and to attempt to cure this disease. It is known that Asbestos exposure causes Mesothelioma. Thus, advocacy groups are working hard to make this mineral unavailable and to have it listed as hazardous. However, many countries still mine the product and it is still used in building materials in many developing countries. The burden of Mesothelioma continues to grow each and every year, as more and more people are diagnosed with this horrible and aggressive cancer.

When seeking treatment for Mesothelioma, it is important to remember that the psyche is also affected and damaged, and it is necessary to treat the psychological aspects of the disease as well as the physical. Many families need help in getting through this type of trauma. It is important for families to get the help they need to carry the burden of Mesothelioma together.

Three Chemo Drugs Tested For Mesothelioma Treatment

Three different studies that recently appeared in the Journal of Thoracic Oncology give mixed messages about the effectiveness of pemetrexed-based chemotherapy treatments for Mesothelioma. The first study was specifically designed to assist physicians with determining which patients would best respond to this type of chemotherapy. Since pemetrexed therapy works by preventing cancer cells from producing the enzyme TS (thymidylate synthase), scientists were able to determine by measuring TS levels, which patients were not responding well to this type of chemotherapy. This discovery will allow oncologists to monitor the effectiveness of pemetrexed-based chemotherapy for Mesothelioma patients, and make changes in treatment for those not responding well, based on TS levels.

This same study also helped researchers confirm that when pemetrexed is converted into FPGS (folylpoly-y-glutamate synthetase) it seems to be more effective for many Mesothelioma patients. The research study results showed that patients with Mesothelioma who had higher levels of FPGS responded better to the treatment. Researchers concluded that these results warranted more research on the using these levels as indicators of the effectiveness of this type of treatment for Mesothelioma patients.

Australian researchers published information on a phase II study that suggests that sunitinib, an oral chemo drug, may be a viable option for some Mesothelioma patients. It was noted that currently there is no standard second-line treatment for Mesothelioma, but this oral chemotherapy drug may be a good choice for some groups of patients. In this study, 51 patients took two separate cycles of the oral drug sunitinib between July of 2006 and December of 2009. Six of the patients (12%) showed some response to the oral medication, and 34 of the patients(65%) stabilized. The research team concluded that the results were note worthy, and additional studies should be done in regards to using sunitinib as a second-line treatment option in patients with Pleural Mesothelioma.

The 3rd study published in this journal looked at the drug bortezomib for the treatment of Mesothelioma. Only about 23 patients responded to the drug in both first-line and second-line treatment trials. It was reported that one patient stabilized. However, most all of the participants saw disease progression during the first two cycles of receiving the drug bortezomib. The preclinical tests for the drug bortezomib looked somewhat promising. However, considering the results of the Phase II trials, the research team concluded that these results were not sufficient enough to warrant any further investigation and bortezomib did not seem to be a good treatment option for Mesothelioma patients.

Advocacy Group Requests Worldwide Ban On Asbestos

We have all heard the implications and horrible diseases related to Asbestos exposure. The biggest of these diseases is cancer, more specifically, Mesothelioma. This is cancer of the mesothelium, which is the tissue that surrounds and protects most of the organs in the body. Often times, it is the lining of the lungs that gets harmed the most by Asbestos, and this is called Pleural Mesothelioma.

It has been proven that Asbestos exposure is the primary cause of Mesothelioma. In a majority of the cases, this occurs when Asbestos fibers are inhaled into the lungs. The tiny, needle-like fibers sit in the lungs and cause irritation and festering. Eventually, this leads to tumors in the lining of the lungs. It is believed that as little as one small exposure to Asbestos can lead to this condition up to 40 years after the fact. Considering that it takes such limited exposure to cause this horrific disease, advocacy groups are requesting that the Asbestos mineral be banned globally.

Asbestos is a mineral that is mined in various parts of the world. In developed countries, it is not used much anymore because of the potential hazards involved. However, many developing countries still import Asbestos regularly, because it is a cheap building material. In many places throughout the world, it is still used in roof shingles, insulation, and building compounds, as well as in break pads and even some household items.

The advocacy group National Asbestos Helpline (NAH), which originated in Britain, is requesting a worldwide ban on the product. In part, this is due to the fact that Great Britain has the highest number of Mesothelioma cases, per capita, in the world. In Great Britain, the huge housing boom happened in the 40’s, 50’s, and 60’s, which is when Asbestos was hugely popular as a product used to build housing structures. This has caused a huge amount of Asbestos exposure to people young and old. Thus, Mesothelioma has become a huge problem in this country.

Joining the fight to stop the use of Asbestos globally are the Asbestos Disease Awareness Organization in America (ADAO) and the British Lung Foundation (BLF). The goal of these organizations is to get a minimum of one-thousand pictures and signatures of people who have been harmed by Asbestos exposure. These pictures and signatures, along with some stories, will be used to make a book that will give these horrible Asbestos related diseases a face. The hope is that this will have enough of an impact to shut down the production and use of Asbestos throughout the world. The fact is that thousands of people die each year from diseases related to Asbestos exposure, and the numbers continue to grow!

Canada Stops Fighting Against Asbestos Limitations

Throughout the time Asbestos has been mined, Canada has been one of the biggest mining countries of this mineral, and 90% of the product produced in Canada has been globally exported. In more recent times, a majority of the exports have gone to developing countries. In these countries, Asbestos is still used in a vast number of products including building supplies, roof shingles, break pads, cement pipes, and insulation. Although it is not as common anymore, when Asbestos was first discovered and mined about three-quarters of a century ago, the needle-sized fibers were used in all sorts of household items including clothing, coffee pots, toys, and even play-doh. It wasn’t until the 60’s and 70’s that scientists started linking certain cancers and diseases to this super mineral.

Over the past several decades, as science has proven how toxic and dangerous Asbestos is, many mines have shut down and many countries have stopped using the product. However, due to the fact that Asbestos is a huge industry for Canada, it has been difficult for the country to shut down the industry. In fact, just recently, a $58 million loan was granted to help re-open an Asbestos mine that has been closed for a few years. During this time, other countries have been putting pressure on Canada to make some changes regarding the mining and export of Asbestos, including allowing the Rotterdam Convention to list the mineral as a hazardous substance. Canada has continued to veto placing Asbestos on this list. However, just recently, Canada announced that it would no longer veto placing Asbestos on the hazardous substance list. An announcement was also made stating that the towns that would be affected by the decrease in Asbestos export would be supported, and $50 million would be spent to help these towns diversify.

Both the Canadian Cancer Society and the Quebec Medical Association denounce the reopening of the mine, and agree with the decision to put Asbestos on the hazardous materials list. The World Health Organization confirms that over 100,000 people die of Asbestos related diseases each year. Mesothelioma, a cancer caused solely by Asbestos exposure, is known to take thousands of lives worldwide each year. Thousands of new cases of Mesothelioma are diagnosed each year, and the average lifespan following diagnosis is 12 to 18 months. Thus, Canada’s agreement to let the Rotterdam Convention place Asbestos on the hazardous materials list is a huge step in the right direction for advocates of removing Asbestos from use globally.

Mesothelioma Drugs May Soon Be Administered Via Inhalation

Currently, researchers in Scotland are testing the effectiveness of administering Mesothelioma chemotherapy drugs via inhalation using a nebulizer. Up to this point in time, these types of drugs have primarily been administered by I.V., although a couple of the chemo drugs can be taken by mouth.

According to the research team and scientists at the University of Strathclyde in Glasgow, Scotland, delivery by nebulizer has many potential benefits due to the fact that the chemotherapy drug can be targeted and concentrated to only the affected area of the body. This would potentially decrease side effects, make the drug a better treatment option for people in a more fragile state, and allow the drug to work more quickly. It is believed that this will be a good option for patients who do not qualify for surgery.

In most cases, Mesothelioma occurs after Asbestos fibers have been inhaled into the lungs. These fibers find their way deep into the tissue of the lungs and fester there. After a period of time, the constant irritation causes cancerous tumors to form in the lining around the lungs. This condition is called Pleural Mesothelioma. It is an extremely aggressive form of cancer that spreads and metastasizes quickly. The average life expectancy following this particular diagnosis is 12 to 18 months.

The first line treatment for Pleural Mesothelioma diagnosed in the early stages is chemotherapy using the platinum based drug, Cisplatin. Currently, it is delivered by infusion. However, this method of delivery not only destroys the cancerous cells, it also destroys healthy cells in the body and severely dampens the immune system. Researchers believe that using an inhaled delivery system will decrease the damage to healthy cells and potentially increase the speed in which the cancer cells are destroyed. The recovery time following these chemotherapy treatments would potentially decrease, and this could help people with Mesothelioma live longer and healthier lives.

In a recent press release, it was noted that this delivery system would be ready for human trials in the near future. Researchers are hopeful that human trails will show that using a nebulizer delivery system of the drug Cisplatin in Mesothelioma patients will allow for more comfortable treatment for the patients, less side effects, and faster results due to the drug being concentrated in the area where it is needed. It is hoped that this treatment method will allow for patients to enter remission at higher rates and more quickly than with traditional chemotherapy delivery methods.

Chest Wall Implants May Help Surgical Mesothelioma Patients

Many patients who suffer from Mesothelioma go through a radical surgery to have the tumor and the areas surrounding the tumor removed. This surgery, called Pleurectomy, can be effective, but it can also leave the chest wall compressed, which can cause difficulty with breathing and functioning normally again.

In most cases, patients who undergo Pleurectomy surgery spend 2 weeks to 1-month in the hospital for recovery. Recently, a new reconstructive chest wall surgery that uses biological implants has been successful in helping patients recover more quickly and return to normal daily activities faster. The benefit of the surgery, besides cosmetic, is that it can take some of the pressure off of the lungs to make it easier for patients to breath after surgery.

Typically, following this type of tumor removal surgery, synthetic materials have been used to assist in rebuilding the chest wall. In other types of surgeries (heart valve for instance), there has been much success with using biological animal-based implants in patients in need. Thus, a study was done by a group of thoracic surgeons in the UK , and they performed chest wall reconstructive surgery on Mesothelioma and lung cancer patients using biological prostheses and graft patches. They used the biologic materials consecutively on 44 thoracic surgery patients between August of 2009 and August of 2011. Although three patients did die following the surgeries, the reasons for the deaths were not related to the chest wall reconstruction surgery using biologic materials.

The results of the study, which were published in the Annals of Thoracic Surgery, noted that there were no infections or complications related to the materials used in these surgeries and the biologic grafts used were satisfactory. It was noted that overall, the results and the outcomes were acceptable.

For many patients who have to undergo the Pleurectomy surgery, or some other type of lung surgery to remove cancerous tumors, these results are promising. Biologic materials tend to offer less complications than synthetic materials in the long run. Generally speaking, repeat surgeries are much less common in patients who have biologic animal-based implants versus synthetic implants.

Of the almost 2,500 new cases of Mesothelioma diagnosed in the United States every year, a majority of them are Pleural Mesothelioma. This type of cancer attacks the lining of the lungs, and is known to progress quickly. On average, patients diagnosed with this condition live 12 to 18 months following initial diagnosis. Pleurectomy surgery is one way physicians attempt to increase lifespan and quality of life for patients diagnosed with this condition. However, the road to recovery following surgery is extremely long. This new discovery might be one way to help patients with this condition recover more quickly from surgery.

Some States Are Changing Laws Regarding Mesothelioma Cases

Asbestos is a mineral that has been linked to the aggressive cancer known as Mesothelioma. Up to this point, most states have allowed lawsuits based on the “any breath/any fiber” theory. This theory follows that even one minor exposure to Asbestos, as simple as one breath of Asbestos dust or one fiber of Asbestos insulation, can cause Mesothelioma up to 40 years later. Thus, when a plaintiff files a claim against a company for Asbestos exposure, if there is any potential chance at all, regardless of how minimal, the company is generally help at least partially at fault.

The problem with this is that many companies have been forced into bankruptcy because of Asbestos related lawsuits. In fact, some companies have had to set up bankruptcy trusts to ensure that money would be available in the future for people who have been exposed to Asbestos and end up with a Mesothelioma diagnosis. To date, there are no other potential causes for the disease Mesothelioma. Asbestos is the only known link.

Some states, such as Pennsylvania and Texas, have made rulings against the “any breath/any fiber” theory. Even though there is no scientific proof to state that it a specific amount of exposure is necessary to contract Mesothelioma, these states ruled that Mesothelioma lawsuits needed to prove some relationship between the amount of exposure to Asbestos and the development of Mesothelioma. Louisiana is also debating whether or not they want to join Pennsylvania and Texas and put the burden of proof more on the shoulders of the plaintiffs.

As more people get diagnosed with Mesothelioma each year, chances are that states will be re-evaluating the laws regarding Mesothelioma cases. It is possible that other states may have to determine whether or not there needs to be more of a burden of proof put on the plaintiffs in these cases. Scientific research will also continue, and as links are put together and more proof is gathered to confirm the amount of Asbestos exposure necessary to cause Mesothelioma, the states will be able to develop more specific guidelines.

In the mean time, scientists do continue to support that as little as one strand of Asbestos fiber or one breath of Asbestos dust can and does cause Mesothelioma. However, science has also proven that cases are much more prevalent in people who have had increased exposure to the mineral. People who worked with Asbestos or lived in places where they were exposed to Asbestos that was not sealed seem to show a higher rate of contracting Mesothelioma. As time goes on, more states will determine what type of exposure rates are needed in order to file a lawsuit due to Asbestos exposure.