NIH “All of Us” Program May Guide Research for New Treatments For Mesothelioma

The National Institutes of Health has announced its “All of Us” research program is now open for enrollment. The program is looking for one million people to share their health information over decades to be used to speed up health research breakthroughs and to advance precision medicine.

Part of the Precision Medicine Initiative introduced by President Obama in January 2015, the “All of Us” program was created to support research to develop more effective ways to prolong health and treat disease. With the data bringing so many different “genes, microbiomes, environments, and lifestyles,” the information will make possible “more effective, targeted treatments for diseases like cancer and diabetes.”

“Imagine the power of a project that asks 1 million people from across the United States to volunteer to help find answers about virtually all health conditions we face,” said Alex M. Azar II, the secretary of Health and Human Services, and Francis S. Collins, the director of the National Institutes of Health, in an opinion piece they wrote in USA Today on May 7.

https://www.usatoday.com/story/opinion/2018/05/07/all-us-research-medical-issues-national-institutes-health-column/584949002/

Data Opens Door to Precision Medicine

The ultimate goal of the project is to create a database containing genetic information, biological samples, and dietary and lifestyle information of one million Americans who volunteer to share this information and, potentially, their electronic health records. This information will be used to “lay scientific foundation for precision medicine for many diseases,” according to the NIH.

https://syndication.nih.gov/multimedia/pmi/infographics/pmi-infographic.pdf

Precision, or personalized, medicine targets health care to the unique makeup of people and their diseases optimizing the potential for success of the treatment. This approach is especially beneficial for mesothelioma and other rare disease research.

Hoping for enrollees from “communities that have inadequately benefited from previous findings and breakthroughs,” Collins and Azar see the data as a way to “help science answer important questions about today’s growing epidemics and mysteries.” Mesothelioma continues to confound researchers and oncologists, so the unprecedented amount of data can only help improve outcomes.

“All of Us” Is Important to Mesothelioma Treatment

“By signing up for All of Us, you will join a mission to accelerate an emerging field called precision medicine,” said Azar.

Nearly 3,000 Americans are diagnosed with mesothelioma each year. There is no cure for the cancer, but treatments intended to go after the unique characteristics of the disease have shown promise. Oncologists and mesothelioma patients are hopeful that this approach to research will bring personalized care to the forefront of treatment strategies.

The NIH reports 27,000 people have already enrolled in the study.

“We have the opportunity to better understand and anticipate how the complex interactions of behavioral, biological, environmental and socioeconomic factors may affect the health of each us — as individuals,” said Azar and Collins.

“Understanding these interactions may be key to developing treatments that deliver more value and better health for every American.”

For more information and to enroll, visit JoinAllofUs.org.

Patient Engagement As Best Mesothelioma Care | Mesothelioma Help

Building a Relationship With Your Doctor Can Make a Difference in Your Mesothelioma Care

Relationships are what make life worth living. Throughout life we have many relationships – parents, siblings, friends, teachers, significant others, neighbors, co-workers. People come and go into our lives, depending on what we are doing, where we are living and working. Some relationships are long and fruitful, and others can be short and forgettable.

Not too many decades ago our relationship with our doctor was usually with one doctor, our family practitioner. Then it progressed to specialization, an OB/GYN, pediatrician, a primary care doctor, surgeon, and any other specialists that you might require. Now in the age of specialization and travel, you might have seen your primary care doctor only once, and he or she doesn’t really know you.

An article was just published about how having a relationship with your doctor can actually save your life. Continuity of care is something that is known to improve patient satisfaction and patient outcomes. It makes sense that if you trust your doctor, and he or she has known you over the years, they will be in a better position to know about your illnesses, and more importantly, know what is important to you.

The research was based in the United Kingdom and it involved examining 22 studies from nine countries. The countries involved in the studies were from two studies from Taiwan, and one from South Korea, Canada, U.S., United Kingdom, Croatia, Israel and the Netherlands. The countries had different cultures and different health care systems The studies showed that patients who went back to the same physician had a lower chance of dying, compared to patients who visited different doctors. This was shown in 82% of the studies.

Some of the rationales for this is that when you see the same physician you would talk more freely and give the doctor more information. Continuity of care is an important factor in patients who are satisfied with their care.

Relationships are important in all aspects of life including your medical care, whether it be for a serious illness such as malignant mesothelioma, or a regular check up. Make sure you are comfortable with your relationships – they could affect your health!

Is Mesothelioma Treatment Without Side Effects Possible?

Chemotherapy is vital in the treatment of mesothelioma. However, it often results in side effects, such as low blood cell counts, thinned or brittle hair, loss of appetite or weight, diarrhea, nausea and vomiting, that can be difficult for patients to manage and can sometimes outweigh the benefits of the treatment. Now, researchers report they have developed a technique for delivering medications that are “free of side effects.”

Researchers from the University of Virginia School of Medicine report that drugs are designed to target an offending molecule, that which makes a person sick, by completely blocking its access to a cell. By doing so, however, any good that the molecule may offer is also stifled. The team, led by J. Julius Zhu, professor of pharmacology at UVA, determined that molecules have different functions throughout a cell, and they were able to develop a targeted delivery method for drugs that can home in on a specific location of a cell while avoiding those locations that could lead to side effects, according to a July 5 press release from the University.

“The problem with side effects is caused because you just could not distinguish the molecules doing different things in the same cell,” Zhu said. “If you blocked a molecule, you blocked it regardless of what it was doing. And that usually has unwanted side effects.”

Treatment for mesothelioma, a rare, aggressive form of cancer caused by exposure to airborne asbestos fibers is complex and, depending on the stage of the disease, typically involves a multi-modal approach including surgery, radiation and chemotherapy. While these treatment options are among the keys to improve the chances of the battling the disease, they can come with pain and sometimes debilitating side effects leading to a poor quality of life. Patients often need to discontinue their mesothelioma treatments that are killing off the cancer cells because the side effects are nearly worse than the disease.

According to Zhu, the concept behind this targeted approach was “simple,” but the execution of it took many years. The new drugs, he says, will be especially useful for cancers, and “adds a new level of precision to the concept of precision medicine – medicine tailored exactly to a patient’s needs.” Precision medicine has the best chance of helping a mesothelioma patient achieve extended survival.

The technique will also speed up the development of new treatments by letting researchers more quickly understand what molecules are doing and which should be targeted, according to the press release.

Finding a way to safely deliver toxic chemotherapy and other anti-cancer drugs to mesothelioma patients is critically important to allow patients to continue to receive treatments without having other aspects of their health compromised from dangerous side effects.

Nearly 3,000 Americans are diagnosed with mesothelioma each year.

Read the full study in the May 16 issue of the journal Neuron.

https://www.cell.com/neuron/fulltext/S0896-6273(18)30283-6

Be There Through All the Seasons for Those Grieving A Loss to Mesothelioma

“Summertime and the living is easy,” as we change from Spring to Summer things start to slow down for most of us. The hurried pace we usually live at slows, and many of us take the time to enjoy the weather, our families and vacations. This is the time of year that most look forward to.

One of the most welcome things about summer is that it allows us time to reflect on things and make memories that will stay with us. For mesothelioma patients and their families, this time of the year can allow some time to reflect on life before the diagnosis, and now, living with mesothelioma.

Recently, we had lunch with the wife of a patient who recently died from malignant pleural mesothelioma. His journey had been around 10 months from diagnosis to death. This time was spent in an intense battle. He had chemo, surgery, multiple admissions, and couple of separate rehab stints. Through the dark days of winter he would often say that he wanted to go home. His journey was an emotional and physical strain on his wife and family. They did all they could for him, including taking him home. He died at home surrounded by his family.

In talking with his wife, it was clear that the long days of summer were not something that she was looking forward to. After months of talking with doctors, nurses and therapists, of constantly being on the go, time is weighing on her mind. She is reliving their journey and trying to adjust to long days and longer nights.

How do you help someone who is grieving? Like mesothelioma, everyone’s grief is their own. It is personal and belongs to the person experiencing it. When trying to help, remember you cannot fix or repair their situation. Listen and be there for the person. It is important to be present, listen, and lend the support that is needed, not what you think is needed.

Remember you never know what a person is going through in their own life. Grief happens all seasons. Reach out a hand to help. In today’s fast paced world, there is no substitution for human interaction and support during a difficult time.

Could Dying Mesothelioma Cells Make The Surviving Cells Fight Harder to Stay Alive?

The goal of treatments, such as chemotherapy and radiation, is to kill off mesothelioma cells to increase the survival for the patients. But researchers report they discovered dying cancer cells communicate to their surviving cells that can then alter their genetic makeup to fight back the drugs. Finding a way to block this cell-to-cell communication is now the target for development of a novel cancer treatment.

Researchers from The University of Alabama at Birmingham, Russia and South Korea looked closer at the status of cells in glioblastoma tumors to determine the relationship dying cells have with their neighboring active cancer cells. They found that cells undergoing apoptosis, or are dying, send signals to adjacent tumor cells that encourages them to become more aggressive and resist treatment, according to a June 21 press release from UAB announcing the findings.

Dying Cells Send Signals to Counterparts

The team used mouse models injected with a combination of apoptotic and “healthy” glioblastoma cells. When viewed in brain scans, the combination showed “much more aggressive tumor growth” and were “more therapy-resistant” than either the “healthy” cancer cells or the dying cells alone.

The researchers determined the dying cells secrete apoptotic extracellular vesicles (apoEVs) that can alter the RNA of the recipient cells which promotes drug resistance and “aggressive migration” of the cancer cells.

“This mechanism thus becomes a possible target for new therapies to treat glioblastoma, a primary brain cancer, and the mechanism may apply to other cancer types as well,” the researchers determined.

Mesothelioma is a rare, aggressive cancer that leaves oncologists and patients with few treatment options. Typically the patients are treated with chemotherapy, that works temporarily, but the insidious cancer often develops a resistance to the therapy rendering it ineffective.

“Clinically, our data may provide the rationale to the molecular targeting of RNA splicing events or specific splicing factors for novel cancer therapies,” said Ichiro Nakano, M.D., Ph.D., academic neurosurgeon at the University of Alabama at Birmingham and leader of the international study. “This may lead to decreased acquisition of therapy resistance, as well as reduction in the migration of cancer cells.”

Although the researchers did not look at mesothelioma cell apoptosis, research into other aggressive, difficult-to-treat cancers can lead to insight into the asbestos-caused cancer. Nearly 3,000 Americans are diagnosed with some form of mesothelioma each year. Survival is often less than one year.

Read the full study in the June 21 issue of Cancer Cell.

Sources:

June 21 issue of Cancer Cell
https://www.cell.com/cancer-cell/fulltext/S1535-6108(18)30226-5
The University of Alabama at Birmingham
http://www.uab.edu/news/research/item/9543-dying-cancer-cells-make-remaining-glioblastoma-cells-more-aggressive-and-therapy-resistant

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