Category: Cancer
New Leaders Committed to Seeking Cure for Mesothelioma
A woman who lost her 33-year-old son to mesothelioma and a doctor whose work led to the only chemotherapy drug approved to date to treat asbestos-related cancer will lead the national organization that provides patient support and funds peer-reviewed research on mesothelioma.
Hanne Mintz and Dr. Axel Hanauske will serve as 2011 co-chairs of the Mesothelioma Applied Research Foundation, the non-profit national organization announced. Malignant pleural mesothelioma is a cancer of the lining of the lungs caused by inhaling asbestos particles. The symptoms of the disease typically appear decades after exposure to asbestos, a mineral fiber used in building materials and insulation. About 3,000 Americans die each year of mesothelioma.
Dr. Hanauske is global brand development leader for Eli Lilly & Co., and is a professor of medicine at the Technical Institute in Munich, Germany, where his team of researchers discovered the effectiveness of chemotherapy using Alimta/Cisplatin in treating mesothelioma. Alimta, which is given in combination with Cisplatin, another cancer drug, works by blocking enzymes that are believes to spur growth of mesothelioma tumors. Alimta is distributed by Eli Lilly & Co.
Dr. Hanauske said he has seen advances in mesothelioma treatment and feels a responsibility to keep developing new treatments option until a cure is found for mesothelioma.
Hanne Mintz, whose son Adam died of mesothelioma, is owner of Paragon Language Services, Inc., a professional translation and interpreting agency in Los Angeles, CA. Ms. Mintz began seeking a cure for meosthelioma when her son was first diagnosed and has pledged to support the Meso Foundation in its efforts to advance mesothelioma research and save lives.
“It instills hope that researchers around the world are choosing to concentrate their efforts on the underfunded, under-recognized and not-so-glamorous world of mesothelioma,” Ms. Mintz said in a statement. “Research holds the answers while funding is its lifeblood; this is why the Foundation relies heavily on its generous supporters to ensure that promising research is rewarded with adequate funding. I look forward to seeing the pieces of the puzzle fall into place during my tenure.”
Mesothelioma Patient Survives More than Seven Years After Diagnosis with Rare Tumor
Mesothelioma, a cancer associated with inhaling asbestos, typically appears as malignant tumors in the lining of the lung or the lining of the abdomen. The cancer also can appear in the lining of the heart, though it’s uncommon. This form is called pericardial mesothelioma and accounts for only 1 percent of mesothelioma cases.
In the medical journal Rare Tumors, doctors at the University of Virginia report on the case of a 59-year-old man who has survived more than seven years since being diagnosed with pericardial mesothelioma. The man appeared at the hospital in 2003 after experiencing symptoms of periodic chest pain and fatigue after exertion. An x-ray of his heart revealed a large mass in the lining of the heart attached to the right ventricle.
Doctors performed surgery and removed much of the mass, but couldn’t remove all of it because of its involvement with the heart muscle. Lab tests confirmed it to be malignant mesothelioma. Typically, malignant tumors in the lining of heart are the advance guard of a cancer spreading from the lung, breast or elsewhere. Mesothelioma tumors originating in the lining of the heart are rare.
The patient received chemotherapy for three years, but his disease continued to advance. The initial chemotherapy consisted of eight cycles of gemcitabine and cisplatin. The combination of gemcitabine and cisplatin is one of the most common chemotherapy treatments for mesothelioma patients. After doctors observed the malignant mass growing again in January 2005, the patient received an additional six cycles of chemotherapy consisting of gemcitabine and carboplatin. Doctors observed that the mesothelioma was spreading again in November 2005; an MRI revealed that the mass had increased in size.
The patient received high-dose radiation treatment and tolerated the treatments well. The mass shrank in size after radiation. The patient has survived 50 months since the completion of radiation with no evidence of the mesothelioma returning. It has been 86 months since the initial diagnosis.
While the doctors acknowledge the outcomes are often less striking than this case, the doctors recommend high dose radiation for patients with inoperable or recurring pericardial mesothelioma.
About 2,500 to 3,000 Americans are diagnosed with mesothelioma each year, many of them workers who were exposed to asbestos decades ago in the workplace. The most common form of mesothelioma, accounting for about 60-70 percent of cases, is pleural mesothelioma, a cancer of the lining of the lung. Most of the remaining cases involve the abdominal cavity and are known as peritoneal mesothelioma.
More Personalized Treatment for Mesothelioma Patients in the Future
Physicians who specialize in treating mesothelioma predict that in the next five to 10 years, researchers will identify more accurate ways to detect the disease and tailor treatment to individual patients. Mesothelioma is an incurable cancer of the lining of the lung or abdomen closely associated with exposure to asbestos. Asbestos was widely used in building materials, fireproofing and insulation through much of the 20th century.
In an article in the November issue of Clinical Lung Cancer, Drs. Linda Garland of the Arizona Cancer Center, Raja Flores of the Mount Sinai School of Medicine in New York and Anne Tsao of the M.D. Anderson Cancer Center predict that the global burden of mesothelioma will increase in the decade ahead, particularly outside the United States. In the U.S., about 2,500 to 3,000 die each year of mesothelioma. With cases of mesothelioma expected to spread, doctors need more effective treatments for the aggressive cancer and more personalized treatments for patients, they say.
Under current medical practice, doctors select mesothelioma patients to undergo radical surgery to remove cancerous tumors based on factors including the stage of the cancer, specific structure of the cancer cells, lung function and the patient’s overall health. But these factors are not very good predictors of long-term survival. Less than a third of the mesothelioma patients selected undergo radical surgery live four to five years, according to the article.
The researchers say there is an opportunity for development of tests for earlier detection of mesothelioma through telltale molecules in the bloodstream, known as biomarkers. Biomarkers are a relatively new but promising area of genetic research. One researcher has compared biomarkers to fingerprints of the disease. For example, the prevalence of a biomarker protein identified as microRNA-29c in mesothelioma tissue has been linked to longer patient survival and improved prognosis after surgery, according to an important recent study. These patients may be better candidates for tumor removal surgery, if the biomarker are validated by further research.
The article authors say that progress has been made in the last decade in the development of chemotherapy drugs for mesothelioma. Longer survival for mesothelioma patients may be possible with chemotherapy regimens tailored to the individual patients in the future. According to the studies, this may be possible if biomarkers can be pinpointed to help doctors identify which patients are receptive to individual chemotherapy drugs such as pemetrexed-based therapy.
Doctors are still awaiting the development of a break-through drug or therapy that may allow the targeting of mesothelioma tumors, according to the article. In the next five to 10 years, they say there will be promising developments toward a brighter future for mesothelioma patients.
Researchers Report Clearer Understanding of How Asbestos Causes Mesothelioma
The paradox of how asbestos kills cells and yet spurs growth of cancerous tumors has perplexed scientists for decades. A group of scientists led by researchers at the University of Hawaii claim to have new insights into the process. Their research may offer new tools to identify people at risk of developing mesothelioma and to prevent or slow tumor growth in people already diagnosed with asbestos-related disease.
Thousands of Americans have been exposed to asbestos and are at risk of developing malignant mesothelioma, a cancer of the lining of the lung or abdomen. Approximately 2,000 to 3,000 people die of mesothelioma each year in the United States and tens of thousands more worldwide. In addition, asbestos exposure raises the risks that smokers will develop lung cancer.
But the long latency period of 30 to 50 years from asbestos exposure to the appearance of tumors may offer a window of opportunity to block the trigger mechanism that causes asbestos-related cancer.
People often unknowingly inhale microscopic asbestos fibers at workplaces and the fibers can permanently lodge in the lung, causing inflammation. Most human cells exposed to asbestos die within 24 to 48 hours. Dead cells should not be able to multiply and form tumors. So how do cancerous tumors eventually form?
In an article in the Proceedings of the National Academy of Sciences, the researchers describe how asbestos kills cells through a process called programmed cell necrosis that leads to the release of a molecule called mobility group box 1 protein or HMGB1. The protein begins an inflammatory chain reaction in tissue that causes the release of mutagens that promote tumor growth. Cancer often occurs in the presence of chronic inflammation.
Asbestos exposure leads to elevated levels of HMGB1 in the blood, the researchers note. In the study, people with a history of asbestos exposure had HMGB1 levels that were more than four times higher than those of healthy people who had not been exposed.
The researchers say that mesothelial cell death and release of HMGB1 function as triggers in mechanism that leads to asbestos-related cancers. Based on that, they suggest it may be possible eventually to target HMGB1 to treat mesothelioma and identify groups of people who have been exposed to asbestos by simple blood tests to measure HMGB1 levels. By interfering with the inflammatory reaction prompted by asbestos, it may be possible to decrease the occurrence of mesothelioma and reduce the rate of tumor growth among people already diagnosed with mesothelioma.
In the future, therapeutic approaches aimed at blocking chronic inflammation and in particular the protein HMGB1 could reduce the risk of malignant mesothelioma among workers exposed to asbestos.
To test their theory, the lead researchers, Drs. Haining Yang and Michele Carbone of the University of Hawaii plan to conduct a clinical trial in Cappadocia, Turkey, where more than 50 percent of the population of two rural villages dies of mesothelioma from exposure to mineral fibers used in building materials. If the trial produces positive results, they plan to try a similar approach on groups of people exposed to asbestos in the U.S.
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