Cancer Resources

Background:

“Malignant Peritoneal Mesothelioma is a rare form of cancer in which (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body’s internal organs.” The disease then proceeds to affect the abdomen wall or in this case, the peritoneum. It then goes on to infect a serious of membranes in the region as well as the membranes that enclose several other major organs. Mesothelioma is most oftenly found in people who have in some way inhaled asbestos particles or other airborn particles at their job or place of residence. Although, there is no connection between mesothelioma and smoking, which is a major factor in lung cancer. While smoking has not been proven to cause mesothelioma, it has been found to increase the risk of other asbestos-induce cancer. Of the 2.6 million annually diagnosed cases of mesolthelioma, 15% to 20% are peritoneal mesothelioma. Continue reading ‘Malignant Peritoneal Mesothelioma’ »

First, let’s be clear about what mesothelioma is before identifying which geographic locations are most likely to be affected by this debilitating, dangerous, and life-threatening condition. This disease (a cancer that affects areas lining the lungs and abdomen) is almost exclusively caused by asbestos exposure. Other conditions that can be caused by asbestos exposure include scarring of the lungs (asbestosis), lung cancer, and general malaise.

Areas Of The United States Recording The Highest Rates Of Cases

Below, we address the environmental issues that are leading factors of asbestos exposure that results in higher rates of this disease and asbestosis. Of course, that is a direct determinant to where there are the highest rates of asbestos-related diseases. Continue reading ‘Incidence Rate of Mesothelioma Based on Geographic Location’ »

Asbestos has been in our lives for the past 3,000 years. Even in these times did people notice the harmful effects. 2,000 years ago, ancient Greeks like Strabo and Romans such as Pliny the Elder wrote about strange lung illnesses that befell slaves who mined and worked with asbestos. However, it was not until 1989 that the United States banned the mineral due to its negative health implications.

Asbestos was generally considered an extremely useful material in a number of different industries. As a silicate mineral, asbestos is a highly insulating material. It resists the effects of heat, flame, chemicals, electricity, and degradation. Additionally, it is very flexible and has high tensile strength. Thus, it is no surprise that it was added to drywall, roofing tiles, texturing, gaskets, brake pads, stage curtains, and even firefighter’s gear. Continue reading ‘Cancers Relating to Asbestos Exposure’ »

The litigation surrounding asbestos and Mesothelioma has been legendary. It represented the little guy against huge corporate entities. The entities prevailed for a very long time, but ultimately the fact asbestos exposure was causing Mesothelioma and lung cancer could not be avoided. Eventually, the government moved to ban asbestos in products and then the controversy started.

The great asbestos wars of the 1960s, 70s and 80s were iconic. The issue of whether asbestos in products caused health problems was highly disputed. The manufacturers claimed that it didn’t. Workers claimed that not only did it, but the manufacturers had known it did and still released it in products. This created a war of lawyers unlike any seen in a long time.

Eventually, it became clear that the manufacturers of asbestos were in the wrong. As is often the case, the government took its sweet time doing anything but finally did. The response finally occurred on July 12, 1989 when the EPA issued a final ruling effectively banning asbestos in the vast majority of products whether they be building materials, brake pads, insulation or whatever. The story, however, was not at an end. Continue reading ‘Mesothelioma – The Asbestos Ban That Wasn't’ »

The US Environmental Protection Agency (EPA) has wanted to ban all uses of asbestos since 1979, and this year it’s closer to succeeding than ever before. In a recent policy speech, EPA administrator Lisa Jackson said that reforming the regulation of dangerous materials and chemicals was one of her department’s top priorities. The focus of their reform is the 1976 Toxic Substances Control Act. The EPA is working with New Jersey senator Frank Lautenberg on legislation that he will introduce to update and toughen that law.

The original law assumed that all chemicals were benign until proven otherwise, and placed the burden of proof on the EPA. The new legislation will reverse this arrangement: manufacturers will be required to prove that their products are safe. All chemicals and materials will now be evaluated against current standards for human health and environmental safety. The revised legislation also requires that the standards be based on valid scientific research.

In 1973 the then-fledgling agency ruled that spray-on asbestos insulation constituted a serious air-pollution hazard, and banned its use in the US. Sixteen years later, the EPA widened its ruling to ban all use of asbestos. The industry immediately attacked the ruling in federal court, and two years later, it was struck down. Since then, despite the large and increasing body of knowledge about the fatal potential of asbestos exposure, this dangerous substance is used in hundreds of applications in homes, automobiles and industry. The new legislation, with the prospect of stronger safety standards, provides the best chance for implementing a total ban against asbestos. Continue reading ‘EPA Takes Aim at Asbestos’ »

Another interesting study is called, “Gefitinib in Patients with Malignant Mesothelioma: A Phase II Study by the Cancer and Leukemia Group B” – Clinical Cancer Research March 2005 11; 2300 by Ramaswamy Govindan, Robert A. Kratzke, James E. Herndon II, Gloria A. Niehans, Robin Vollmer, Dorothy Watson, Mark R. Green, Hedy L. Kindler and on behalf of the Cancer and Leukemia Group B. Here is an excerpt: “Abstract – Purpose: The Cancer and Leukemia Group B conducted a phase II study of gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, in patients with previously untreated malignant mesothelioma. Experimental Design: Eligible patients had unresectable pleural or peritoneal mesothelioma, measurable disease, no prior therapy, and performance status 0-1 by Cancer and Leukemia Group B criteria. Gefitinib (500 mg p.o.) was administered once a day for 21 days. Patients underwent restaging after every two cycles. Therapy was continued until disease progression or unacceptable toxicity. Results: The most common grade 3 toxicities were diarrhea (16%) and nausea (12%). Of 43 patients enrolled, 1 patient (2%) had a complete response, 1 patient (2%) had a partial response, 21 (49%) had stable disease lasting two to eight cycles, 15 (35%) had progressive disease, and 5 (12%) had early deaths. One-year survival was 32% [95% confidence interval (CI), 21-50%]. Median survival and failure-free survival were 6.8% (95% CI, 3.5-10.3) and 2.6 months (95% CI, 1.5-4.0), respectively. The 3-month failure-free survival was 40% (95% CI, 25-56%). EGFR expression score by immunohistochemistry done in 28 patients was categorized as low (EGFR 1+ or 2+) or high (EGFR 3+) expression: 97% had EGFR over[removed]2+ or 3+). The median and 3-month failure-free survival were 3.6 months and 40% for those patients with low EGFR expression compared with 8.1 and 40% for those with high EGFR expression.” Continue reading ‘Unresectable Pleural and Peritoneal Mesothelioma Research’ »

An interesting study is called, “Aggressive multimodality therapy for malignant pleural Mesothelioma” – The Annals of Thoracic Surgery – Volume 58, Issue 1, July 1994, Pages 24-29 by Thomas W. Rice MD, David J. Adelstein MD, Thomas J. Kirby MD, Matthew G. Saltarelli MD, Siva R. Murthy MD, Marjorie A. Van Kirk RN, Herbert P. Wiedemann MD and James K. Weick MD – Here is an excerpt: “Abstract – Nineteen patients with clinical stage I malignant pleural mesothelioma were treated with aggressive multimodality therapy. Nine patients underwent pleurectomy and decortication followed by immediate intrapleural chemotherapy with cisplatin and mitomycin C. Ten patients required pleuropneumonectomy followed within 1 week to 2 weeks by intrapleural administration of cisplatin (100 mg). Four to 8 weeks after operation, 15 patients underwent postoperative adjuvant cisplatin-based systemic chemotherapy. There were three postoperative complications (16%) requiring reoperation and one postoperative death (5%). Intrapleural chemotherapy was well tolerated with no complications. Systemic chemotherapy was poorly tolerated, and there was one chemotherapy-related death. Sixteen patients (84%) experienced good to excellent palliation. Three patients are currently alive with no evidence of recurrent disease at 10, 35, and 43 months. The median overall survival was 13 months and the median disease-free survival, 11 months. Overall and disease-free 3 year survivals were 17% and 22%, respectively. Patients with epithelial malignant pleural mesothelioma had significantly better overall survival (p = 0.037) and disease-free survival (p = 0.02) than patients with sarcomatous or biphasic malignant pleural mesothelioma. We conclude that despite major toxicity, in select patients with clinical stage I malignant pleural mesothelioma, aggressive multimodality therapy offers effective palliation and occasional long-term disease-free survival.” Continue reading ‘Pleurectomy and Decortication Followed by Immediate Intrapleural Chemotherapy’ »

Another interesting study is called, “Value of calretinin immunostaining in differentiating epithelial mesothelioma from lung adenocarcinoma.” By Ordóñez NG. The University of Texas M.D. Anderson Cancer Center, Houston 77030 – Mod Pathol. 1998 Oct;11(10):929-33.  Here is an excerpt: “Abstract – Only recently have immunohistochemical markers been recognized that are commonly expressed in epithelial mesotheliomas but not in adenocarcinomas. Among these, calretinin generated a great deal of interest, but the number of studies evaluating the practical use of calretinin immunostaining in the diagnosis of mesothelioma is limited, and the study results are controversial. To evaluate whether calretinin immunostaining can assist in distinguishing between epithelial pleural mesothelioma and lung adenocarcinoma and other carcinomas metastatic to the pleura, 38 pulmonary adenocarcinomas, 117 nonpulmonary adenocarcinomas, 28 squamous cell carcinomas of the lung, 8 large-cell undifferentiated carcinomas of the lung, and 9 transitional cell carcinomas metastatic to the lung were studied. Reactivity was observed in all of the 38 mesotheliomas, whereas only 3 of the 38 pulmonary adenocarcinomas and 11 of the 117 nonpulmonary adenocarcinomas (5/38 ovarian, 2/15 endometrial, 2/23 breast, 2/16 colonic, 0/8 kidney, 0/8 prostatic, 0/6 thyroid, and 0/3 pancreatic) exhibited weak or focal staining. Eleven of the 28 squamous carcinomas of the lung were also positive. No reactivity was observed in any of the large cell undifferentiated carcinomas of the lung or in the transitional cell carcinomas. It is concluded that calretinin immunostaining is not only helpful in discriminating epithelial pleural mesotheliomas from pulmonary adenocarcinomas but that it can also assist in distinguishing epithelial mesotheliomas from nonpulmonary adenocarcinomas metastatic to the pleura.” Continue reading ‘Mesothelioma and the Potential Accessibility of Tumors’ »

Another interesting study is called, “Neoadjuvant Chemotherapy Followed by Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma” by Walter Weder, Peter Kestenholz, Christian Taverna, Stefan Bodis, Didier Lardinois, Monika Jerman, Rolf A. Stahel – Journal of Clinical Oncology, Vol 22, No 17 (September 1), 2004: pp. 3451-3457.  Here is an excerpt: “PATIENTS AND METHODS: Eligible patients had MPM with clinical stage T1-3, N0-2, M0 disease considered to be completely resectable and a WHO performance status of 0 to 2. Neoadjuvant chemotherapy consisted of three cycles of cisplatin 80 mg/m2 on day 1 and gemcitabine 1,000 mg/m2 on days 1, 8, and 15, given every 28 days. Surgery had to consist of a complete extrapleural pneumonectomy, including resection of pericardium and diaphragm. Postoperative radiotherapy was to be considered for all patients.

RESULTS: Nineteen patients with MPM were included in this pilot study. According to the European Organization for Research and Treatment of Cancer prognostic score, two patients were in the good prognosis group, and 17 patients were in the poor prognosis group. The response rate to neoadjuvant chemotherapy was 32%. The major toxicity was thrombocytopenia. Extrapleural pneumonectomy was performed in 16 patients with no perioperative mortality. Major surgical complications occurred in six patients, and all were treated successfully. Thirteen patients received postoperative radiotherapy. The median survival time was 23 months. Two patients remain alive and free of disease 41 and 38 months after initiation of therapy. Continue reading ‘Mesothelioma and Neoadjuvant Chemotherapy’ »

Exposure to hazardous asbestos has been a problem for over a century.  The common form of exposure typically came from the workplace.  However, that has changed as asbestos has been found in the water supplies of various municipalities.  One interesting study is called, “Cancer mortality in relation to asbestos in municipal water supplies.” By Wigle DT – Arch Environ Health. 1977 Jul-Aug;32(4):185-190.  Here is an excerpt: “Abstract – The mortality experience of twenty-two municipalities in Quebec grouped by evidence of exposure to asbestos fibers in water supplies (known high, possible high, and probable low exposures) was evaluated. Excess mortality due to cancer of the stomach (males), pancreas (females), and lung (males) was observed in the two municipalities with known high exposures. The excesses among males have been due to occupational exposure to asbestos. The absence of excess mortality due to pancreatic cancer among males suggested that the excess among females was not due to waterborne asbestos. The study therefore did not reveal evidence of excess cancer mortality that could be attributed to exposure to asbestos in drinking water.” Continue reading ‘Asbestos Exposure in the Water Supply and Excess Cancer Mortality’ »