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Thursday, April 2, 2009
Tuesday, March 24, 2009
Mesothelioma
ABOUT MESOTHELIOMA
Mesothelioma is an asbestos-caused cancer of the membranes that surround many of the body’s vital organs. This membrane, known as mesothelium, secretes a lubricating fluid that provides easy movement of the organs within the body. When the mesothelium becomes cancerous, it is called mesothelioma. Surrounding the lung, the mesothelium is called the pleura and the form of mesothelioma is called pleural mesothelioma; in the abdomen, it is the peritoneum and the cancer is called peritoneal mesothelioma; the lining around the heart is the pericardium and there mesothelioma is identified aspericardial mesothelioma. There is also mesothelial tissue in the reproductive organs: in males, this tissue is called the tunica vaginalis testis and in women the tunica serosa uteri. Mesothelioma of the reproductive tissues has only presented in men, so it is known asmesothelioma of the tunica vaginalis.
Mesothelioma is a diffuse malignancy and spreads itself throughout a tissue area. Some forms of cancer are characterized by a single, solid tumor mass, whereas malignant mesothelioma presents as an invasion of a large number of smaller masses throughout an entire area. The diffuse nature of mesothelioma has important implications for how mesothelioma is treated, as complete surgical extraction of the cancerous tissue is difficult.
Types of Mesothelioma
There are multiple forms of mesothelioma. The differences involve the location in which the tumor begins, known as its origin site, and the type of cells that the tumor invades, known as its histological subtype.
Location of Disease
The most common form of mesothelioma is pleural mesothelioma, where the cancer attacks the pleural tissue surrounding the lung. As many as eighty percent of all mesothelioma diagnoses are for pleural mesothelioma. The pleura’s proximity to the lung is the reason many people mistakenly think of mesothelioma as lung cancer, which it is not. Pleural mesothelioma can spread (“metastasize”) to the lung, but the origin site is the actual pleural tissue surrounding the lung—not the lung itself. There are manydifferences between mesothelioma and lung caner.
After pleural mesothelioma, the next most common type is peritoneal mesothelioma, which develops in the majority of other cases. There is some evidence to suggest that diagnoses of mesothelioma are on the rise. While pericardial mesothelioma and mesotheliomas of the tunica vaginalis are also possible forms of the disease, they are very rare tumors and occur less often.
Histological Subtype
Besides the location in which the tumors form, the other identifying factor in the diagnosis of mesothelioma is the histological subtype of the cancer. This refers to the type of cells that the tumors invade. There are three histological subtypes of mesothelioma: epithelioid mesothelioma, which attacks epithelial cells, sarcomatoid mesothelioma, which attacks sarcomatous cells, and bi-phasic mesothelioma, where the tumor attacks both epithelial and sarcomatous cells. The identification of the proper subtype is an important diagnostic factor because it greatly affects the disease’s prognosis. Epitheloid mesothelioma has the best response rate for treatment, while sarcomatoid mesothelioma has the worst.
Tuesday, December 23, 2008
Researchers with the largest Phase III trial to date for mesothelioma
Researchers with the largest Phase III trial to date for mesothelioma, an aggressive cancer affecting the lining of the lung, reported results showing that patients on a new chemotherapy drug regimen live longer and have less pain than those on an older drug. The findings were announced at the annual meeting of the American Society of Clinical Oncology meeting in Orlando, Fla., on May 20, 2002.Pemetrexed (brand name Alimta™) is a novel antifolate, a class of drugs that targets the folic acid metabolic pathway, which effects availability of certain B complex vitamins. The results of the trial show that tumors shrank in 41 percent of patients on pemetrexed in combination with a more commonly used chemotherapy agent called cisplatin. Only 17 percent of patients receiving cisplatin alone experienced tumor shrinkage.
Additionally, those on the pemetrexed combination lived nearly three months longer than those on cisplatin alone.According to lead author, Nicholas J. Vogelzang, M.D., University of Chicago Cancer Research Center, "This is the largest clinical trial ever conducted in this disease and the 25 to 30 percent improvement in survival for patients on the combination therapy is the first time anyone has documented a significant improvement in patients treated for mesothelioma."
Malignant pleural mesothelioma is associated with a history of asbestos exposure in about 70 to 80 percent of all cases and there is no approved or very effective chemotherapy for the disease. Researchers hypothesized that pemetrexed might prove effective in treating this disease because it targets key enzymes thought to play a role in allowing the rapid growth of this tumor. Early Phase I trial results in 11 patients tested with pemetrexed and cisplatin were promising and a definitive randomized Phase III trial was developed. Since there are no established therapies for this condition, a standard chemotherapy agent called cisplatin that has shown efficacy in treating other diseases, was used as the control arm.
The Phase III study initially planned to enroll 456 patients from April 1999 to March 2001. However, after enrolling 150 patients, a high rate of severe toxicity and death was associated with the pemetrexed and cisplatin arm of the trial. Elevated levels of homocysteine, a chemical byproduct that results when proteins are broken down in the blood, were found, which provided a basis for redesign of the trial to reduce the dangerous drug side effects. Two hundred and eighty patients were enrolled to the revised protocol. Using a strategy to reduce drug side effects that has been successful in the past, this new protocol added folic acid to the regimen because pemetrexed as an antifolate agent reduces levels of this important vitamin. Folic acid was given prior to and during the trial, and vitamin B12 was given only during the trial. Both vitamins should boost folic acid levels, reduce homocysteine formation, and hence reduce toxicity to pemetrexed. "We now have a significantly less toxic regimen than the one we started with," said Vogelzang.Because of the presumed importance of the vitamins to the study, the researchers examined not only the combination therapy versus the single drug therapy, but also looked at the results of patients on the vitamin supplements versus those early enrollees who had not initially received vitamins.
Standard treatment for malignant mesothelioma has been surgery. Surgical treatment rarely results in cure and long-term survival is unusual. Use of radiation therapy and/or chemotherapy following surgery has not improved survival for patients but radiation treatments may alleviate some pain associated with the disease. Resource: http://www.mesothelioma-asbestos-cancer-info.com/mesothelioma-updates.html
Additionally, those on the pemetrexed combination lived nearly three months longer than those on cisplatin alone.According to lead author, Nicholas J. Vogelzang, M.D., University of Chicago Cancer Research Center, "This is the largest clinical trial ever conducted in this disease and the 25 to 30 percent improvement in survival for patients on the combination therapy is the first time anyone has documented a significant improvement in patients treated for mesothelioma."
Malignant pleural mesothelioma is associated with a history of asbestos exposure in about 70 to 80 percent of all cases and there is no approved or very effective chemotherapy for the disease. Researchers hypothesized that pemetrexed might prove effective in treating this disease because it targets key enzymes thought to play a role in allowing the rapid growth of this tumor. Early Phase I trial results in 11 patients tested with pemetrexed and cisplatin were promising and a definitive randomized Phase III trial was developed. Since there are no established therapies for this condition, a standard chemotherapy agent called cisplatin that has shown efficacy in treating other diseases, was used as the control arm.
The Phase III study initially planned to enroll 456 patients from April 1999 to March 2001. However, after enrolling 150 patients, a high rate of severe toxicity and death was associated with the pemetrexed and cisplatin arm of the trial. Elevated levels of homocysteine, a chemical byproduct that results when proteins are broken down in the blood, were found, which provided a basis for redesign of the trial to reduce the dangerous drug side effects. Two hundred and eighty patients were enrolled to the revised protocol. Using a strategy to reduce drug side effects that has been successful in the past, this new protocol added folic acid to the regimen because pemetrexed as an antifolate agent reduces levels of this important vitamin. Folic acid was given prior to and during the trial, and vitamin B12 was given only during the trial. Both vitamins should boost folic acid levels, reduce homocysteine formation, and hence reduce toxicity to pemetrexed. "We now have a significantly less toxic regimen than the one we started with," said Vogelzang.Because of the presumed importance of the vitamins to the study, the researchers examined not only the combination therapy versus the single drug therapy, but also looked at the results of patients on the vitamin supplements versus those early enrollees who had not initially received vitamins.
Standard treatment for malignant mesothelioma has been surgery. Surgical treatment rarely results in cure and long-term survival is unusual. Use of radiation therapy and/or chemotherapy following surgery has not improved survival for patients but radiation treatments may alleviate some pain associated with the disease. Resource: http://www.mesothelioma-asbestos-cancer-info.com/mesothelioma-updates.html
Thursday, December 18, 2008
Mesothelioma (WikiPedia)
Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart,[1] the pericardium (a sac that surrounds the heart) or tunica vaginalis.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing mesothelioma.[2] Unlike lung cancer, there is no association between mesothelioma and smoking.[3] Compensation via asbestos funds or lawsuits is an important issue in mesothelioma (see asbestos and the law).
The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing mesothelioma.[2] Unlike lung cancer, there is no association between mesothelioma and smoking.[3] Compensation via asbestos funds or lawsuits is an important issue in mesothelioma (see asbestos and the law).
The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Saturday, November 1, 2008
How common is mesothelioma?
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.
What is Mesothelioma?
Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
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