Mesothelioma Pages

Recent studies, including an article published by Department of Thoracic Surgery at Catholic University in Rome, Italy, show a combination of PET and CT scans are showing higher accuracy in mesothelioma diagnoses. While a PT scan provides a close look at potential abnormalities and details of the body on a molecular level, a CT scan provides a thorough map of the body’s interior. Together these two scans create a cross section of valuable information, which aid health care providers before, during and after mesothelioma treatment.

Mesothelioma is a cancer caused by asbestos fibers that have been inhaled or ingested. Once asbestos fibers become lodged in lung lining, or lining of other abdominal cavities, a process of tumor growth ensues, spreading irregularly through surrounding areas. Mesothelioma begins with an extensive latency stage, often between twenty and fifty years. During this time it can be difficult to diagnose. Following this latency stage, when symptoms do begin to demonstrate, patient life expectancy becomes quite short, averaging just eighteen months.

Combination use of PET-CT scans give treatment providers a thorough look at the patients mesothelioma-affected areas, helping dictate whether patients are good candidates for surgery or other treatments. Mesothelioma treatments are often difficult and hard on the patient, many of which are older and already suffering negative affects from the cancer. With a PET-CT combination, physicians can more accurately identify the extent of the tumor growth, their spread and size, and better decide between available treatment options.

If surgery is scheduled following PET-CT scans, surgeons will be better prepared with an extensive view of tumor size and spread. Rather than subjecting the patient to a long and extensive procedure while searching for all affected areas, surgeons will have detailed knowledge of where to look and for what to look. This could mean shorter surgery time, less incisions and a faster recovery.

Recovery could also benefit from PET-CT combination scans. Following surgery, chemotherapy, radiation therapy or other mesothelioma treatment, providers will be able to follow the internal changes affected by treatment. Potential spread of tumors, metastasis or infection could be painlessly tracked, affording patients more time to rest and heal from their procedures, rather than suffering through invasive follow-up care.

Mesothelioma affects an estimated twenty thousand people worldwide each year. The World Health Organization considers mesothelioma’s cause, asbestos, a type 1 carcinogen, and expects mesothelioma and other asbestos related illness are on the rise. This is greatly due to an increase in asbestos use throughout the developing world, representing a demographic limited in adequate health care facilities able to diagnose and treat mesothelioma.

A new treatment technology has come under scrutiny by the US Department of Health and Human Services (HHS). Stereotactic Body Radiation Therapy (SBRT) is being used for high precision radiation treatment of non-small cell lung cancers (NSCLC), including mesothelioma.

Mesothelioma is caused by exposure to toxic chemical asbestos. Asbestos has been used for decades in building and construction components. Although relatively safe when contained in another material, asbestos fibers become a threat when airborne. If inhaled, asbestos fibers can begin a mutation process in organ lining that develops into mesothelioma cancer. Mesothelioma is characterized by a long latency period and a short life expectancy following diagnosis.

Mesothelioma develops web like systems of malignant tumors through the lining of lungs (called pleural mesothelioma) or other abdominal cavities such as the heart or diaphragm (called peritoneal mesothelioma). Mesothelioma treatments regularly include surgery, chemotherapy and radiation therapy—typically in combination. Due to the irregular tumor formation associated with mesothelioma, SBRT seems a fitting treatment for the disease. However, HHS is questioning SBRTs effectiveness.

Suggesting there is not enough evidence to support SBRT’s alleged value and safety, HHS requested a more thorough explanation of the technology and associated treatment. Directed by Kelley N. Tipton, M.P.H., a brief was prepared by ECRI Institute Evidence-based Practice Center, for the Agency for Healthcare Research and Quality of HHS. The brief discussed SBRT’s advantages and specific treatment highlights. Although SBRT is currently being used in cases of mesothelioma, the brief concluded, “a full systematic review of the current literature cannot answer questions on the effectiveness and safety of SBRT compared to other radiotherapy interventions.”

Over five thousand five hundred pieces of literature were reviewed for the brief; one hundred twenty-four specific to the issue at hand were selected for further study. These hundred and twenty-four detailed cases of malignant tumors treated with SBRT without other forms of radiation therapy.

The brief explained SBRT was a preparation-intensive treatment that “requires rigorous quality control and quality assurance measures for treatment planning and treatment delivery.” Without such careful measures, effectiveness and safety could be lost during therapy administration.

Following study and review of available data, the brief’s research team concluded: “Comparative studies are needed to provide evidence that the theoretical advantages of SBRT over other radiation therapies actually occur in the clinical setting.”

Safety and effectiveness of SBRT on NSCLS treatments will be studied further during clinical trials scheduled for 2013.

Researchers in Orlando Florida have been studying new early detection tests for pleural mesothelioma. Led by Dr. Harvey Pass, the team used Somalogic Inc.’s “Multiplex SOMAmer Assay” test to compare asbestos-exposed blood samples to samples of patients diagnosed malignant pleural mesothelioma.

Mesothelioma has long been difficult to diagnose as it is characterized by a latency period of several decades. Typically taking twenty to fifty years to demonstrate symptoms, this rare cancer grows through the lining of lungs and other abdominal cavities undetected. Irregularly patterned tumors spread through the mesothelium, or lining tissues, creating a web of cancerous infestation.

Mesothelioma is a commonly studied cancer as there is no known cure. Mesothelioma treatments can only offer extended life expectancy and enhanced quality of life. Due to its long development period, researchers and scientists continue to search for early detection tools as well as a final cure.

Mesothelioma is caused by exposure to toxic chemical asbestos. Most often contained in another material, such as floor tiles, insulation, or plumbing gaskets, asbestos fibers can be released due to wear and tear on the containing material, or immediate destruction such as in a fire or disaster. Once asbestos fibers are airborne they become a threat to health and safety of anyone in range. If inhaled, the fibers lodge themselves in the mesothelium and the body responds by growing pod-like tumors around the foreign matter.

Researchers in this study used SOMAmers, single-strand DNA molecules that have been chemically enhanced, to track proteins of pleural mesothelioma. Study team members were able to look for serum biomarkers using an aptamer-based proteomic platform. When the cancerous tumor cells died, they released proteins containing biological information, which aided researchers to locate 19 biomarkers.

Overall, the accuracy of “Multiplex SOMAmer Assay” in this round of testing was 93%. A staggering 15 out of 19 cases were positively detected with mesothelioma. Not only were 100% of affected samples recognized, but also 80% were accurately tested as asbestos exposed samples, in comparison to the samples of malignant pleural mesothelioma.

This is great news for a growing number of mesothelioma patients around the world. Thousands have had to wait for years just on symptom signs, and then wait again for proper diagnosis, as the disease is often misdiagnosed as bronchitis or pneumonia. Life expectancy following diagnosis averages eighteen months as the severity of mesothelioma has greatly increased by the time diagnosis is made. These study results are a huge step in the direction of early detection, and earlier treatment, for this aggressive cancer.

Thoracic surgeon Dr. David J. Sugarbaker and researchers from Brigham and Women’s Hospital in Boston have completed a study on extended mesothelioma patient survival times as related to aggressive treatment. The study was published in European Journal of Cardiothoracic Surgery and included data from over six hundred patient cases.

Mesothelioma is a rare cancer caused by asbestos fibers. If asbestos fibers or dust is inhaled or ingested, it can begin a cancerous growth in the lung lining or lining of other abdominal cavities. This development takes decades to grow and symptoms are typically not seen until twenty to fifty years after asbestos exposure.

Mesothelioma affects about three thousand Americans each year and an estimated fifteen to twenty thousand worldwide. Following diagnosis, patient life expectancy ranges from six months to several years, averaging eighteen months. Standard mesothelioma treatments, where available, include surgery, chemotherapy and radiation therapy. Many patients choose palliative treatment to manage breathing and pain so they can gain quality of life without undergoing cancer-direct treatments.

There is no cure for mesothelioma and the case numbers are rising worldwide as asbestos continues to be used. In many developing countries the toxic chemical is used without proper safety precautions. In such countries health care facilities and treatments are minimal. The World Health Organization estimates an increase in global mesothelioma cases to ninety thousand annually if asbestos use is not curbed.

Using records available through International Mesothelioma Patient Registry, Dr. Sugarbaker and his research team found that combination mesothelioma treatments including an extrapleural pneumonectomy were more likely to result in longer patient survival times. An extrapleural pneumonectomy is a procedure specific to mesothelioma treatment and involves removal of cancerous tissue in abdominal cavity linings. Patients receiving such major surgeries underwent removal of a lung, part of the diaphragm and some chest lining tissue.

Patient cases studied included those from 1988 to 2007. Results showed that 18%, or 117 patients, lived at least three years following surgery. This percentage averaged a 59 month survival time, much greater that the average associated with less aggressive treatments.

Of the 117 patients who experienced longer survival times, one third were women and over half had mesothelioma present in the left side of the chest. Overall, extended lifetimes were associated with younger patients.