As with most cancers, early detection is the key to fighting mesothelioma.
That’s sometimes easier said than done.
Malignant pleural mesothelioma is one of the toughest cancers for doctors to diagnose. It’s a relatively rare cancer and the disease’s symptoms are similar to lung cancer. The treatments, however, are different. With a quick, accurate diagnosis, mesothelioma can be a manageable disease.
According to new research, a group of Danish doctors may have cracked the code on early diagnoses of pleural mesothelioma, which occurs in the lining of the lung. The doctors relied on biomarkers, or the structure of the blood and lung fluid, to identify mesothelioma in its early stages.
The team found absent or decreased levels of the enzyme methylthioadenosine phosphorylase in the majority of mesothelioma patients tested. When combined with other forms of testing, this could provide earlier diagnosis and increase the chances of surviving longer. Symptoms of the illness include shortness of breath, fatigue and painful coughing fits.
The Danish doctors measured MTAP levels in more than 100 patients. They found that 65 percent of the patients had decreased levels of MTAP. In a second study, the doctors found that they could diagnose mesothelioma accurately the majority of the time.
Pleural mesothelioma occurs in the lining of the lung. Mesothelioma can also strike in the abdomen or the heart.
An estimated 3,000 patients are diagnosed in the United States with mesothelioma each year. The disease is caused by exposure to asbestos.
Patients who are diagnosed with the disease live for about two years. But when detected and treated in its early stages, patients have lived for more than decade. But not every doctor is familiar with the disease and sometimes it’s misdiagnosed as lung cancer.
The Danish report is encouraging for those suffering from the incurable disease.
Anybody who has worked around asbestos is at risk of contracting mesothelioma. Trades commonly associated with the disease are pipefitters, railroad workers and roofers. But it’s not uncommon for schoolteachers whose classrooms were coated with asbestos material to become victims.
Diagnosis is also complicated by the fact that the latency period is 10 years or more after initial asbestos exposure. Some cases have seen latency periods up to 40 years or more.
Patients who exhibit the first onset of symptoms are encouraged to visit a mesothelioma specialist to receive an accurate diagnosis.
More mesothelioma patients are seeking second opinions from doctors, which can lead to significant differences in how the cancer is treated.
Although mesothelioma can be detected with the right tests, some doctors can easily mistakenly diagnose the disease as lung cancer, or as something else completely. The mistake is simple to make, especially with a rare cancer such as mesothelioma.
Both cancers have some of the same symptoms. Patients can experience dry cough, chest pain, shortness of breath and difficulty breathing. Doctors have been known to misread slides and test results. Sometimes they may not be able to see all the possibilities and overlook key evidence. That’s why it’s important to share your medical and occupational history with the doctor, especially if you think that you were around asbestos.
Mesothelioma is caused by asbestos exposure. Some mesothelioma patients can pinpoint the cause of their cancer to when they worked with asbestos, or asbestos-containing products.
Asbestos products were once commonly used in thousands of products from hairdryers to home insulation. Hundreds of thousands of people who worked around these products were exposed to asbestos on a daily basis. Asbestos is still used in the U.S. today. Throughout the years it’s likely that a number of those exposed have been misdiagnosed.
There are about 3,000 people diagnosed with mesothelioma every year. About 10,000 people die from asbestos diseases annually.
Mesothelioma develops most often in the membrane that lines the lungs called the pleura. Mesothelioma can also develop around the abdomen and the heart.
Doctors can diagnose the type of cancer using several tests including CT scans, scopes and biopsies. Doctors may differ on treatment options depending on the type and stage of mesothelioma.
It’s important to know that seeking a second opinion is not an indictment of the doctor. Doctors are usually glad to recommend other physicians who can help patients get a second opinion. It’s not uncommon for some patients to seek out three or more "second" opinions. Sometimes it’s comforting for patients to hear the opinions from several physicians just to make sure they’re getting the proper treatment and diagnoses.
Of course receiving a second opinion can be expensive. There could be more tests, more travel and more medical costs. But in most cases patients won’t have to undergo the same diagnostic tests twice. Patients are entitled to view and send their medical records to other doctors who will be giving the second opinion.
It’s also important to check with healthcare providers to see if a secondary visit is covered by insurance. Some providers actually require a second opinion before approving major surgery or treatment.
Not to be overlooked during the process is the trust factor. Patients should choose doctors they are most comfortable with. Trust in the medical staff and receiving proper care can drastically improve the quality of life for a mesothelioma patient.
A combination therapy might hold promise for extending the lives and preserving more lung function of patients with malignant pleural mesothelioma, a cancer of the lining inside the chest.
Patients in mesothelioma treatment often undergo an extensive surgery known as a modified extrapleural pneumonectomy, which involves removal of the lung and surrounding tissue and is usually accompanied by radiation of the whole chest area. But the new combination approach for mesothelioma patients adds a treatment called photodynamic therapy to a more conservative, lung-sparing surgery called a pleurectomy.
Photodynamic therapy is a light-based treatment that is designed to eliminate any microscopic bits of residual cancer that surgeons are unable to remove. The therapy, which penetrates just a few millimeters into tissue, has three components that are administered: a nontoxic compound that sensitizes cancer cells to light; then oxygen; then specially tailored light. While the therapy is federally approved for treatment of several cancers, it remains experimental for malignant pleural mesothelioma.
Researchers at the University of Pennsylvania in Philadelphia set out to determine whether the lung-sparing surgery could be used instead of an extrapleural pneumonectomy, and whether the use of photodynamic therapy would extend patients’ survival time, compared with typical survival times in mesothelioma patients.
Nine women and 19 men with malignant pleural mesothelioma, ranging in age from 27 to 81, participated in the Phase II study from 2004 to 2008. Half received the more extensive surgery along with photodynamic therapy, while the other half had the lung-sparing surgery along with the light-based therapy.
Twelve patients in each group had stage III/IV mesothelioma—and researchers noted that many of the research subjects, due to the advanced stage of their mesothelioma or to their advanced age, would not be candidates for surgical treatment. In all, 22 patients also had chemotherapy. The two groups were comprised of mesothelioma patients with similar demographic traits such as age, sex and disease characteristics.
Among the patients who had the more extensive surgery and photodynamic therapy, the median overall survival—the point in time after treatment was completed at which half the patients were still alive—was 8.4 months. For the patients receiving the lung-sparing surgery plus the light therapy, that median point had not been reached yet, after more than two years of follow-up.
The surgeon who performed the procedures in the study, Dr. Joseph Friedberg of the Penn Mesothelioma and Pleural Program, said researchers had hoped that preservation of patients’ lungs would improve their quality of life, and that the extended survival time of those patients was a complete surprise. The scientists are continuing to investigate exactly how the photodynamic therapy might be helping to fight mesothelioma—possibly by creating a “vaccine” effect with residual disease that sparks the immune system to fight any remaining cancer. Or, the photodynamic therapy might have made any residual cancer more vulnerable to other follow-up treatments.
Mesothelioma sufferers could get a boost if lawmakers approve a plan to allow the FDA to rapidly approve innovative drugs and treatment.
Florida Rep. Cliff Stearns introduced the Faster Access to Specialized Treatments act that will fast-track medical options for patients who don’t have the time to wait. The goal is to get much needed treatment to those who have fallen ill with rare diseases, such as mesothelioma, a cancer caused by exposure to asbestos.
For example, if scientists discover that a new medication can shrink a tumor, that treatment could be approved quickly, even if the study isn’t yet complete. According to a report in the Journal of Clinical Oncology, the current state of drug approval is slow. In the fast-track process that currently exists, it took about seven years to get new drugs to market.
Many mesothelioma patients don’t have that long to wait.
The disease strikes about 3,000 people in the United States each year. Mesothelioma can occur in the lining of the lung, the abdomen or the heart. Doctors have yet to find a cure. However, scientists have found several treatments that can prolong life and make the disease less aggressive.
People suffering from other rare diseases will also benefit from this bill. A rare disease is one that affects no more than 200,000 Americans. Mesothelioma is one of the 7,000 rare diseases that fit into this category. The FDA reports that 30 million Americans are diagnosed with these rare diseases.
While rare, mesothelioma usually occurs in people who have worked in trades where they were exposed to asbestos.
The new legislation will update the 20-year-old accelerated approval process that experts say are now outdated. Under that law, Congress gave the United States Food and Drug Administration permission to approve drugs quickly for those suffering from HIV, AIDS and other rare cancers.
Several biomedical firms and advocacy groups representing those with rare diseases have praised Congress for considering the bill. Mesothelioma patients will join in giving Congress the praise it deserves.
Diseases like mesothelioma have been forgotten for years because it’s so rare. In fact, many doctors fail to accurately diagnose the disease. Mesothelioma shares many of the same symptoms as lung cancer and has similar warning signs. Common symptoms are chest pain, persistent cough, breathing difficulty and fatigue. Symptoms don’t normally occur until 10 or more years after initial exposure to asbestos.
Mesothelioma patients may one day live longer thanks to an unlikely ally: the common cold.
Researchers at the Perelman School of Medicine at the University of Pennsylvania say that a clinical trial using a modified cold virus can help attack mesothelioma tumors. The study was featured in the American Journal of Respiratory and Critical Care Medicine. Researchers studied the effects of nine mesothelioma patients who were injected with the adenovirus, a modified version of the common cold.
Mesothelioma is one of the most aggressive and deadliest forms of cancer. It is always found in people who have at some time in their lives came in contact with asbestos. Approximately 3,000 new patients are diagnosed with mesothelioma every year according to the International Mesothelioma Program at Brigham and Women’s Hospital / Harvard Medical School.
In the study, scientists altered the cold virus to contain high levels of interferon-alpha, an immune system stimulant. Interferon-alpha is a protein made by immune cells that boosts the body’s ability to fight off viral infections and some cancers, according to the study.
The nine patients, all with varying degrees of mesothelioma, were injected with the virus into the chest cavity containing the tumor. When the virus began killing the cancer cells, some patients showed signs that their immune systems continued to fight the tumor.
Of the nine who were treated, evidence of stability or tumor regression was seen in five patients. Doctors observed no signs of regression in four patients with advanced stages of mesothelioma.
The study’s author, Dr. Steven M. Albelda, said that the treatment could eventually help patients with early stage malignant mesothelioma. Doctors are continuing to study the technique along with chemotherapy in early stage patients in Pennsylvania. The trial is sponsored by the National Cancer Institute and the Schulze Family Foundation.
For years, asbestos was used as a common building material because of its resistance to fire, heat and water. Those who have worked around asbestos including factory workers, pipefitters, shipbuilders, construction workers and military veterans are more likely to contract the disease. Family members of those who worked with asbestos are also at risk because the fibers could have been carried home on workers’ bodies and clothing.
Some treatments for mesothelioma have been shown to prolong patients’ lives, but there is no known cure. About 10 percent of people with malignant mesothelioma live at least 5 years after diagnosis, according to the American Cancer Society.