Mesothelioma Research

Mesothelioma Research

Unfortunately, a diagnosis of mesothelioma has never carried much hope for the victim. Mesothelioma is an aggressive form of cancer that's rarely diagnosed until it's reached an advanced stage. Treatment options have been limited and the prognosis is usually grim.

Nonetheless, because there's been a rise in the disease and more doctors and research scientists are stepping up and taking notice of this dreaded illness, more research pioneers have jumped on the bandwagon in the search for better treatment and ultimately a cure for the disease.
Finding New Treatments

As more and more money begins to be spent on this disease which affects individuals from many countries throughout the world, new treatments are emerging all the time. Research allows doctors and scientists to better understand the design of the disease and researchers are eager to develop both new forms of common treatments as well as totally new treatment procedures. Good research and proper funding allows the opportunity to do both.

As these drugs or procedures are developed, they are tested in clinical trials by people who already have the disease. The success or non-success of the clinical trial will dictate whether or not the drug or procedure will be approved in the U.S. by the Food and Drug Administration (FDA). Once the FDA issues an approval, the new treatment will be available to the general public, not just a hand-selected group of trial patients.
What's New in Research?

Chemotherapy - Chemo has always been the treatment of choice for mesothelioma patients, usually as a palliative measure to relieve symptoms and make the patient more comfortable. Strides in the field of chemotherapy vs. mesothelioma are promising. The most notable new drug is Alimta©. This drug, when combined with another long-used chemo drug called Cisplatin, is the only Food and Drug Administration approved agent designated for specific use in combating malignant pleural mesothelioma.

Another drug currently on the FDA's Fast Track system and awaiting imminent approval is Onconase©. Onconase is a first-in-class drug that has been shown to target cancer cells while sparing normal cells.

Anti-Angiogenesis drugs - As the name indicates, these drugs are designed to prevent angiogenesis, the process by which new blood vessels are formed from pre-existing vessels. Angiogenesis plays a key role in the spreading of tumors, so researchers are searching for ways to halt the process in cancer patients. One anti-angiogenesis drug for the treatment of mesothelioma is currently being offered. It's called Avastin and it lowers the levels of a protein that prompts angiogenesis, therefore inhibiting cell growth.

Intensity Modulated Radiation Therapy - Unlike standard radiation therapy, this new form of radiation is done in the interest of limiting the amount of radiation hitting the healthy tissue surrounded the area where the tumor is located.

Gene Therapy - Many researchers are taking a close look at gene therapy in regards to its success in treating a number of diseases, including mesothelioma. According to the American Cancer Society, this approach to treating mesothelioma uses special viruses that have been modified in the laboratory. The modified virus is injected into the pleural space and infects the mesothelioma cells. When this infection occurs, the virus injects a gene into the mesothelioma for interferon-beta, an immune system hormone (cytokine) that may help activate immune system cells to attack the cancer.
Becoming Part of a Clinical Trial

Most oncologists (cancer doctors), especially those that specialize in the treatment of mesothelioma, will most likely be aware of the clinical trials that are currently seeking patients who are fighting mesothelioma.

If you are a candidate, you should know that there are basically 4 types of clinical trials.
Treatment trials - these trials test new approaches to cancer treatment, be it a drug, radiation therapy, a multi-modal therapy, or a totally new treatment procedure.
Prevention trials - these trials test approaches to lowering the risk of developing a certain kind of cancer.
Screening trials - such trials test new ways to detect cancer, particularly in its early stages. These are important trials in the field of mesothelioma, which is usually diagnosed in its late stages.
Supportive care trials - these trials test ways to improve comfort and quality of life for cancer patients, often referred to as palliative treatments.

Patients can be involved in various phases of a trial.
Phase I helps determine how a new drug should be given and attempts to measure safe dosage. This phase generally involves only a handful of volunteers.
Phase II trials usually focus on one particular type of cancer and are used to test the safety of the drug and how well it works in combating a particular cancer.
Phase III trials test new drugs or treatments in comparison with the current standard. In a process called randomization, the participant will be assigned to the standard group or the new group. Phase III trials are the largest and may often involve doctors and hospitals throughout the country.

Your doctor can best determine if you are a candidate for any ongoing trials and will take the responsibility of submitting the proper paperwork for consideration. Don't be afraid to ask about new clinical trials or inquire about one of which you may be aware.

The Hidden Risks

The Hidden Risks

While most cases of mesothelioma involve men and women who were directly exposed to asbestos, more and more cases of second-hand exposure are coming to light. Family members of workers who brought asbestos home on their clothing have contracted the disease and are now wondering who's responsible.

In addition, communities where asbestos was mined or asbestos-products were produced are gradually discovering cases of mesothelioma among those who never had direct contact with the mineral or any products containing it. In the case of Libby, Montana, for instance, hundreds have already died of mesothelioma due to the fact that asbestos was mined there for many years.

What's Being Done to Stop Exposure?

What's Being Done to Stop Exposure?

After the U.S. government issued warnings in the mid 1970s as to the dangers of asbestos, employers began to provide their workers with protective gear essential to maintaining good health while working with the mineral. Many countries chose to ban asbestos altogether.

In 1989, the US Environmental Protection Agency (EPA) issued a final rule banning most asbestos-containing products. In 1991, this regulation was overturned by the Fifth Circuit Court of Appeals. That means some products still contain asbestos, but laws say they must be clearly labeled. Some countries still mine and use asbestos on a regular basis and export the mineral to other countries that have not yet issued a ban.

Hopefully, new cases of exposure should be lessening, but that won't be evident until the current rash of mesothelioma cases has peaked and is passed. Because of mesothelioma's long latency period, most of today's diagnosed cases involve individuals who were exposed prior to the 1970s.

Who Is at Risk?

Who Is at Risk?

Individuals who have worked many years at particular jobs where asbestos was in plentiful use are most at risk for developing mesothelioma or any other sort of asbestos-related disease.

One of the highest incidences of mesothelioma is among shipyard workers who were employed during the peak years of World War II, not only in America but also in other countries. Because shipyards often performed overhauls on war ships, workers were exposed to large amounts of friable asbestos and inhaled the mineral on a regular basis for long hours at a time. Shipyard workers that were consistently at risk include:
Shipfitters
Pipefitters
Boilermakers
Insulators
Plumbers
Electricians
Welders

Other professions that have also reported high numbers of cases of mesothelioma are:
Auto mechanics
Bricklayers
Auto inspectors
Carpenters
Drywallers
Glazers
Grinders
Iron Workers
Longshoremen
Power Plant Workers
Railroad Workers
Millwrights

Causes of Mesothelioma

For many, cancer may seem like a mystery illness. Often, no one knows why certain people develop it and others don't. Everyone understands, of course, that smokers have a higher chance of developing lung cancer and other cancers caused by their smoking habit. High-fat diets and other nutritional issues may also have a bearing on whether or not an individual develops cancer during their lifetime.

For mesothelioma patients, the cause has become quite clear. Up to 85% of all diagnosed cases of mesothelioma can be definitively linked to exposure to asbestos. For decades, concerned doctors and research scientists speculated about the dangers of asbestos and warned industries to discontinue its use, but a conclusive link wasn't actually made until 1999, when it was too late for the millions around the world who had already suffered prolonged exposure to the dangerous mineral.
How Does Asbestos Make You Sick?

Asbestos is a naturally-occurring mineral that possesses excellent insulating and heat-shielding properties. Because of this, it has been used for decades - even centuries - in a variety of products, including building materials like insulation, gaskets, floor and ceiling tiles, and drywall tape, as well as in automotive products such as brake pads and shoes and clutch plates.

Asbestos is not dangerous when left undisturbed. As a matter of fact, scientists estimate that asbestos occurs naturally in our air and drinking water and that everyone breathes in the mineral at some time or another. However, when asbestos is damaged and becomes "friable" - soft and weak - it is more easily airborne, and hence, inhalation can occur more easily.

Individuals who worked with asbestos that was cut, crushed, sanded, torn, or otherwise manipulated were prone to inhaling these dangerous fibers. Prior to the asbestos warnings of the 1970s, individuals who worked with asbestos were given little or no protective gear, even though it has been proven that experts have known about the dangers of asbestos for more than a century and warned industries of the risks.

Usually, those exposed to asbestos on a regular basis do not get sick immediately. As a matter of fact, asbestos diseases often do not appear for 20-50 years after exposure. However, a handful of workers who were first responders at the World Trade Center disaster in 2001 have already died of mesothelioma due to extreme exposure to the material.

Asbestos fibers that are breathed into the lungs cannot be expelled, so they remain there, embedding themselves in the lining of the lung (the mesothelium) and causing inflammation. Cancerous tumors may develop decades later.

Symptoms of mesothelioma

Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.

Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions.

Mesothelioma that affects the pleura can cause these signs and symptoms:

chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up

In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.

Risk factors

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.

Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.

Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.

Prevention & Expectations

What can be done to prevent the disease? Since the 1970s, the Environmental Protection Agency and the Occupational Safety and Health Administration have regulated the asbestos industry in the U.S. In the past, asbestos was used as a fire retardant and an insulator. Other products are now used in its place. The controversy involving exposure to different forms of asbestos continues. There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.

Removal is taking place in schools and other public buildings throughout the U.S. The hope is that these measures will greatly reduce the occurrence of this cancer.

What are the long-term effects of the disease?
A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted exception.

What are the risks to others?
Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.

Notable people with mesothelioma

Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works also died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.

Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the US Marines as a young adult—asbestos was then commonly used to insulate ships' piping—or because of its use as an insulating material in car racing suits. (It is also reported that he worked in a shipyard during World War II, where he might have been exposed to asbestos.

History

The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos. The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa.

Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker. The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.

In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.

Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.

By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.