Tuesday, January 18, 2011

Mesothelioma Research And Present Prognosis

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Mesothelioma is a man made cancer, caused by asbestos which is a naturally found silicate mineral. Asbestos is put to use widely in industries for cement manufacture, construction activities, ship building etc. It is found in mines and its requirement has increased greatly due to its qualities like resistance to heat, insulation capacity etc. But it has not been revealed for many years that the minute particles can cause the deadly form of cancer. Now it is proved beyond doubt, but many have fallen victims to the malicious disease. Hence a mesothelioma prognosis becomes totally shattering and useless in the present scenario.
The cures of mesothelioma, mesothelioma prognosis and researches are topics to be dealt with in detail. The tiny asbestos particles which are inhaled, damage the mesothelium which is the protective covering of our internal organs. The infection gradually spreads and disrupts the normal functioning of the organs. Since there is no complete cure available for the disease, the prognosis of the disease is not advantageous. But there is a ray of hope prevailing that the researches going on at the different laboratories will help to find a proper cure for the disease in the near future.
There are many treatment methods adopted by the doctors which include conventional therapies like radiation and chemotherapy. However these methods have not given hundred percent results since the disease shows up very late. Immediately after the diagnosis, the condition of the patient deteriorates. In case the disease is detected and treated early, there are better chances for survival. But the very characteristics of the disease make it impossible.
Now more emphasis is given to prevention of the cancer due to the cited reasons. The immunity of the workers have to be improved and other practical measures are to be followed to avoid the deadly cancer. Masks and protective clothing are widely used in the workshops and asbestos mines. New therapies like photodynamic therapy, gene therapy, immunotherapy etc are developed by researchers to defeat the cancerous particles.




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Nanomaterials of Carbon Origin

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Another interesting study is called, “Induction of mesothelioma in p53 mouse by intraperitoneal application of multi-wall carbon nanotube” by Atsuya Takagi, Akihiko Hirose, Tetsuji Nishimura, Nobutaka Fukumori, Akio Ogata, Norio Ohashi, Satoshi Kitajima and Jun Kanno – The Journal of Toxicological Sciences Vol. 33 (2008) , No. 1 February 105-116.  Here is an excerpt: “ABSTRACT-  Nanomaterials of carbon origin tend to form various shapes of particles in micrometer dimensions. Among them, multi-wall carbon nanotubes (MWCNT) form fibrous or rod-shaped particles of length around 10 to 20 micrometers with an aspect ratio of more than three. Fibrous particles of this dimension including asbestos and some man-made fibers are reported to be carcinogenic, typically inducing mesothelioma. Here we report that MWCNT induces mesothelioma along with a positive control, crocidolite (blue asbestos), when administered intraperitoneally to p53 heterozygous mice that have been reported to be sensitive to asbestos. Our results point out the possibility that carbon-made fibrous or rod-shaped micrometer particles may share the carcinogenic mechanisms postulated for asbestos. To maintain sound activity of industrialization of nanomaterials, it would be prudent to implement strategies to keep good control of exposure to fibrous or rod-shaped carbon materials both in the workplace and in the future market until the biological/ carcinogenic properties, especially of their long-term biodurability, are fully assessed.”
One interesting study is called, “Inactivation of p16INK4a expression in malignant mesothelioma by methylation.” By Wong L, Zhou J, Anderson D, Kratzke RA. –
Research Service, Minneapolis VA Medical Center, Minneapolis, MN, USA –
Lung Cancer. 2002 Nov;38(2):131-6.  Here is an excerpt: “Abstract – The molecular mechanisms of oncogenesis in mesothelioma involve the loss of negative regulators of cell growth including p16(INK4a). Absence of expression of the p16(INK4a) gene product is exhibited in virtually all mesothelioma tumors and cell lines examined to date. Loss of p16(INK4a) expression has also been frequently observed in more common neoplasms such as lung cancer as well. In a wide variety of these malignancies, including lung cancer, p16(INK4a) expression is known to be inactivated by hypermethylation of the first exon. In a survey of ten mesothelioma cell lines, one cell line (NCI-H2596) was identified as possessing loss of p16(INK4a) gene product following gene methylation. This methylation in these mesothelioma cells could be reversed, resulting in re-expression of p16(INK4a) protein, following the treatment of the cells with cytidine analogs, which are known inhibitors of DNA methylation. In previous clinical trials in mesothelioma, the cytidine analog dihydro-5-azacytidine (DHAC) has been found to induce clinical responses in approximately 17% of patients with mesothelioma treated with this drug, including prolonged complete responses. In addition, we identified evidence for methylation of p16(INK4a) in three of 11 resected mesothelioma tumor samples. When both cell lines and tumors are combined, inactivation of p16(INK4a) gene product expression following DNA hypermethylation was found in four of 21 samples (19%). We are further exploring the clinical significance of inhibition of methylation in mesothelioma by cytidine analogs. This may provide a potential treatment target in some mesothelioma tumors by inhibition of methylation.”
One interesting study is called, “Immunohistochemistry in the distinction between malignant mesothelioma and pulmonary adenocarcinoma: a critical evaluation of new antibodies” by A S Abutaily, B J Addis, W R Roche – J Clin Pathol 2002;55:662-668
Here is an excerpt: “Abstract – Aim: The value of immunohistochemical staining in differentiating between malignant mesothelioma and pulmonary adenocarcinoma was re-examined using newly available commercial antibodies, with the aim of increasing the sensitivity and specificity of diagnosis, and simplifying the antibody panel required.
Methods: Forty one malignant mesotheliomas and 35 lung adenocarcinomas were studied. Commercial antibodies to calretinin, E-cadherin, N-cadherin, surfactant apoprotein A (SP-A), thyroid transcription factor 1 (TTF-1), thrombomodulin, and cytokeratin 5/6 were applied using the streptavidin–biotin–peroxidase complex procedure on formalin fixed, paraffin wax embedded tissue.   Results: E-cadherin was expressed in all adenocarcinomas and in 22% of the mesotheliomas. TTF-1 expression was detected in 69% of the adenocarcinomas and none of the mesotheliomas. Positive staining with polyclonal anticalretinin was detected in 80% of the mesotheliomas and 6% of the adenocarcinomas. N-cadherin was expressed in 78% of mesotheliomas and 26% of adenocarcinomas. Thrombomodulin was expressed in 6% of the adenocarcinomas and in 53% of the mesotheliomas. Cytokeratin 5/6 expression was detected in 6% of the adenocarcinomas and 63% of the mesotheliomas. The results were compared with the standard laboratory panel for mesothelioma diagnosis: anticarcinoembryonic antigen (anti-CEA), LeuM1, BerEP4, and HBME-1.
Conclusion: Of the antibodies used in this study, E-cadherin was 100% sensitive for pulmonary adenocarcinoma and TTF-1 was 100% specific for pulmonary adenocarcinoma. The application of these two antibodies alone was adequate for the diagnosis of 69% of adenocarcinomas and 78% of mesotheliomas. Where TTF-1 is negative and E-cadherin is positive, a secondary panel of antibodies, including BerEP4 and LeuM1 (CD15) and antibodies directed against CEA, calretinin, cytokeratin 5/6, thrombomodulin, and N-cadherin, is required for differentiation between malignant mesothelioma and pulmonary adenocarcinoma.”




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Mesothelioma Research And Bridging The Gap

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Continued research regarding mesothelioma and the link to asbestos exposure is necessary if we ever hope to find a cure.  Imagine someone you love returning home from the second world war.  They find a job as an auto mechanic, raise a family, and play by the rules.  Decades later, they tragically die from mesothelioma cancer because someone failed to warn them of the dangers of asbestos fibers.   Does any reasonable person believe this is fair or just?   Of course not.  Unfortunately, we cannot go back in time and prevent the asbestos exposure.  But what we can do is try to promote public awareness about this deadly disease and highlight some of the great research being done.
One interesting study is called, “Malignant mesothelioma: attributable risk of asbestos exposure.” By R Spirtas, E F Heineman, L Bernstein, G W Beebe, R J Keehn, A Stark, B L Harlow, and J Benichou – Occup Environ Med 1994;51:804-811 doi:10.1136/oem.51.12.804.  Here is an excerpt:
“OBJECTIVES–To evaluate a case-control study of malignant mesothelioma through patterns of exposure to asbestos based upon information from telephone interviews with next of kin. METHODS–Potential cases, identified from medical files and death certificates, included all people diagnosed with malignant mesothelioma and registered during 1975-1980 by the Los Angeles County Cancer Surveillance Program, the New York State Cancer Registry (excluding New York City), and 39 large Veterans Administration hospitals. Cases whose diagnosis was confirmed in a special pathology review as definite or probable mesothelioma (n = 208) were included in the analysis. Controls (n = 533) had died of other causes, excluding cancer, respiratory disease, suicide, or violence. Direct exposure to asbestos was determined from responses to three types of questions: specific queries as to any exposure to asbestos; occupational or non-vocational participation in any of nine specific activities thought to entail exposure to asbestos; and analysis of life-time work histories. Indirect exposures were assessed through residential histories and reported contact with family members exposed to asbestos. RESULTS–Among men with pleural mesothelioma the attributable risk (AR) for exposure to asbestos was 88% (95% confidence interval (95% CI) 76-95%). For men, the AR of peritoneal cancer was 58% (95% CI 20-89%). For women (both sites combined), the AR was 23% (95% CI 3-72%). The large differences in AR by sex are compatible with the explanations: a lower background incidence rate in women, lower exposure to asbestos, and greater misclassification among women. CONCLUSIONS–Most of the pleural and peritoneal mesotheliomas in the men studied were attributable to exposure to asbestos. The situation in women was less definitive.”
Another good study is called, “Chrysotile asbestos is the main cause of pleural mesothelioma” by Allan H. Smith, MD, PhD, Catherine C. Wright, MPH
School of Public Health, University of California, Berkeley, CA.  Here is an excerpt:
“Abstract – In contrast to amphibole forms of asbestos, chrysotile asbestos is often claimed to be only a minor cause of malignant pleural mesothelioma, a highly fatal cancer of the lining of the thoracic cavity. In this article we examine the evidence from animal and human studies that relates to this issue. Reported data do not support widely quoted views regarding the relative inertness of chrysotile fibers in mesothelioma causation. In fact, examination of all pertinent studies makes it clear that chrysotile asbestos is similar in potency to amphibole asbestos. Since asbestos is the major cause of mesothelioma, and chrysotile constitutes 95% of all asbestos use world wide, it can be concluded that chrysotile asbestos is the main cause of pleural mesothelioma in humans.”




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What Are My Survival Chances?

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The survival rate for mesothelioma patients about twenty years ago was less than one year from the time of diagnosis, but with early detection and aggressive treatment mesothelioma patients are living longer that predicted. With new developments and ongoing research mesothelioma sufferers are gaining more hope about their treatment and longer life expectance.
Nature of Mesothelioma
Mesothelioma is a disease caused by exposure to asbestos. In most cases symptoms ofmesothelioma may not appear for decades after initial exposure to asbestos. Because it is not detected until it has reached its later stages makes it very difficult to treat. The symptoms of mesothelioma are often mistaken for other common diseases such as influenza or phenomena because the symptoms are so similar and those suffering from this disease may not even realize that they have developed mesothelioma.
Longer Survival Chances for Mesothelioma Patients
There are new tests which was developed over the years that aid in early detection of mesothelioma. Most of these tests have helped mesothelioma patients lead a more comfortable and longer life. There have been reports of a number of mesothelioma patients who have even survived past their predicted survival date. In some cases a number of patients have been cured of this disease due to early diagnosis and aggressivemesothelioma treatment. Researchers believe treatments that improve the immune system can stabilize and even cure mesothelioma.
Over the past years more and more mesothelioma survivors are beginning to speak out about this disease and sharing their stories about how they overcame it. Below are two exciting stories about mesothelioma survivors and what they are doing to fight this disease. These survivors are providing hope for mesothelioma patients and their loved ones.
Paul Kraus, an Australian mesothelioma survivor was diagnosed with peritoneal mesothelioma in 1997. According to Mr. Kraus he developed mesothelioma about 35 years earlier where he was exposed to asbestos working in a factory. He has been very outspoken about his disease and decided to do whatever it takes to fight this cancer. He became a vegetarian and started taking vitamins and nutritional supplements to his daily diet. He also tried a treatment known as ozone therapy which was a very effective treatment. Kraust believe that a combination of all the therapy, drugs and change in diet helped to stabilize his mesothelioma. According to Kraust’s doctor he is disease free and could continue living for a long time.
Rhio O’Connor is another mesothelioma survivor who recently published a book about his ordeal with mesothelioma. He recommends alternative treatments instead of thetraditional medicine, surgery, radiation therapy and chemotherapy. Mr. O’Connor stated that he has lived with mesothelioma for seven years. He decided not to undergo the traditional treatment of surgery, chemotherapy and radiation therapy. Instead he decided to develop his own regimen with the help of several expert physicians. His regimen included to drastically change his diet. He also adds to his daily diet 100 nutritional supplements and daily mediation among others.




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Researchers Making Inroads

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A diagnosis of mesothelioma can be a devastating, but new therapies and treatments are showing promise for those suffering from this incurable form of cancer. 
Some experimentaltreatments for mesothelioma, the cancer caused by asbestos exposure, are showing encouraging results, but standard treatments including chemotherapy, radiation therapy, and surgery are still the norm.
This type of cancer attacks the mesothelium—the internal sack that lines the abdomen. Often called “asbestos lung cancer” this illness does not affect the lungs directly but rather the lining around the lungs. There are two types of mesothelioma–pleural mesothelioma involving the membrane around the lungs, and peritoneal mesothelioma which concerns the abdominal cavity. Treatment for both types is similar.
Prognosis for this cancer depends greatly upon how early the cancer is detected and on the individual. Experimental treatments for this type of cancer include photodynamic therapy, gene therapy, and immunotherapy, and others are also being developed and tested. Most people diagnosed with this type of cancer respond best to chemotherapy—but often life expectancy for those diagnosed is a year or less.
Despite the grim prognosis, some patients who have been diagnosed with mesothelioma have lived more than ten years. However, studies indicate that survival is not as dependent on treatment as it is on some unknown factor within the diagnosed patient. Even with such long-term survival, this type of cancer is not considered curable.
With conventional methods failing to give patients hope for long-term survival, researchers are looking at any new treatments and therapies. One therapy that appears promising is the use of  anti-angiogenesis, a therapy that stops tumors from making new blood vessels, which limits the tumor’s growth. Currently, several clinical trials are being conducted using anti-angiogenesis drugs. One drug, Veglin, is having some success in patients suffering from other cancers and will soon be tested on mesothelioma patients. 
Other treatments being used, while not curative, have lengthened the survival rates of some patients. One commonly-used therapy is called palliative, which involves taking a needle and draining excess fluid from affected areas. Drugs are used to prevent the build-up of fluids, which increases quality of life for the patient.
Some clinics are also using the body’s own defenses to fight the growth of cancerous tumors, including those that develop with mesothelioma. Researchers are looking at how the body’s immune system can be tapped to help fight all forms of cancer, with some promising results.  Our bodies contain substances within our cells that have been known to block tumor growth or increase the immune system’s power. Interferon, monoclonal antibodies,  interleukins, and colony-stimulating factors are examples of this type of biological treatment.
As research continues on these new treatments, hope grows for those suffering from this incurable cancer.




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Mesothelioma Support Groups Reach Out to Patients Across the Country

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Each year approximately 2,000 to 3,000 people are diagnosed with mesothelioma across the country. This terminal disease, primarily linked to exposure to asbestos, creates hardships for both the patient and the people closest to them. While dealing with the diagnosis of mesothelioma and the treatment process, patients and their caregivers can reach out for support from a number of helpful resources throughout the country.
Due to the ongoing search for a cure to this aggressive cancer, mesothelioma treatmentitself can be aggressive in an effort to extend the life expectancy and quality of life for the patient. One resounding feeling that results from the pain and the variety of treatments that are necessary to combat mesothelioma is stress. Fortunately, numerous options are available to patients to reduce stress. Patients commonly seek out therapeutic ways to address their stress, such as breathing techniques, massage and meditation.
The grief that accompanies cancer diagnosis can seem overwhelming. Thankfully, there is hope. The American Cancer Society sponsors myriad support groups at their local chapters around the country, their most prominent being I Can Cope, an online support group available through their website.
In addition to those found online, in-person support groups can be found locally around the country. Many support groups can be found through local hospitals and clinics in the patient’s area. At many of these in-person support groups patients can find emotional support from others who are undergoing the same hardships, as well as information on specialized doctors and new treatments that are being developed.
Mesothelioma caregivers are not exempt from the pain and grief that their loved ones endure. Many caregivers can find themselves overwhelmed with numerous daily tasks associated with medical treatment and care. Healthy nutrition and exercise can be an important tool to relieve stress and deal with the challenges that caregivers face.
Caregivers are not alone in their hardship. There are many professionals who are trained to help people deal with the stress and grief of a terminal diagnosis that can provide additional support to caregivers. Remember that asking for help, whether on behalf of the caregiver or patient, is never a sign of weakness.




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YSU received $200,000 in federal stimulus money for asbestos removal

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Youngstown State University of Youngstown, Ohio is one of the latest recipients of federal stimulus money to remediate asbestos issues. The university’s Garfield Building is in good company, with Toledo’s Madison Building and Midtown Cleveland Inc.’s Agora theater all receiving $ 200,000 each in Brownfield Revolving Loan Fund grant for asbestos removal.
Asbestos is a highly hazardous mineral that was commonly used in construction prior to the late 1980′s when it was finally banned. Asbestos his been linked to all sorts of respiratory diseases, but some of the most commonly associated and most fatal include asbestosis, lung cancer and mesothelioma, a rare cancer of the protective lining of the heart, lungs, chest and abdomen.
“The removal of this asbestos in this particular facility is in anticipation of future redevelopment of the building for research labs and those sort of facilities and potential classrooms for the STEM [Science, Technology, Engineering and Mathematics] College,” explained YSU spokesman Ron Cole.
The Garfield Building has been vacant for years because it requires significant renovations that the university has not been able to afford until now. While asbestos is being removed – the first step in any renovation – the university will be looking for future funding sources to complete the remodeling. Renovations are expected to being within the next three months.
With the asbestos removed, no longer will the Garfield Building building pose a health or environmental health threat to the YSU campus. Although asbestos is relatively safe if left undisturbed, in the event of a fire or a cave in, the building could release millions of carcinogenic asbestos fibers, generating a campus wide exposure that could lead to the development of asbestos cancer.




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