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Mesothelioma.net Blog > 2009 > November |
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Archive for November, 2009
Friday, November 27th, 2009
Lawsuits regarding negligent exposure to asbestos and the harms that it causes are becoming more commonplace, even in cases where the opposition is a big and powerful company. The circumstances around the rise of asbestos litigation are peculiar, to say the least. The medical community has been passively aware of the dangers of asbestos for nearly eighty years, but dangerous use of the material continued until just before the turn of the century and concerns about asbestos exposure are still serious to this day. The recent increase of legal action against companies that negligently exposed their employees to asbestos reflects both the latency of asbestos related disease, that is, how long the disease takes to develop after exposure to asbestos, and a concerted attempt to downplay the negative ramifications of the asbestos industry throughout the twentieth century.
Mesothelioma and other asbestos related cancers can take anywhere from a few years to more than half a century to become easily diagnosable, which means that many mesothelioma patients today could have been exposed to asbestos fibers as early as the late 1950’s – right during the peak of the asbestos industry. Asbestos related industries were incredibly important to the United States during and directly after World War II for bolstering and maintaining our superior navy and stimulating our post war economy, which unfortunately led to a dangerous lack of focus on the material’s adverse effects.
These circumstances are presently causing somewhat of a culmination of asbestos related litigation. More and more asbestos related lawsuits are being filed, many of which incite some public interest because of the companies that are involved. One such lawsuit was filed Friday of last week against Chevron USA, a well known oil conglomerate.
The lawsuit was filed by Provost Umphrey attorney Keith Hyde on the behalf of Betty Lou, the widow of Billy Cunningham, a former employee of Chevron USA. Billy Cunningham died of mesothelioma, a cancer caused by asbestos, due to his exposure to the material during his employment with Chevron.
The lawsuit stated that “During Cunningham’s employment with Gulf Oil, he used and was exposed to toxic materials including asbestos dust and/or fibers. As a result of such exposure, he developed an asbestos-related disease, mesothelioma, for which he died a painful and terrible death on Feb. 11, 2009. The defendant acted with malice…and gross neglect for exposing Cunningham to asbestos.”
The fact that employers of yesteryear acted in gross neglect in spite of the fact that the dangers of asbestos were known is becoming a focal point in asbestos related litigation. The Chevron USA lawsuit goes on to say that “…the defendant failed to timely and adequately warn workers of the dangers of asbestos…and failed to take the necessary engineering, safety, industrial hygiene and other precautions and provide adequate warning and training to ensure that the deceased was not exposed to the asbestos-containing products.”
Asbestos has been known to be a dangerous substance for more than half a century, and while it’s a tragedy that so many people have suffered from exposure to the substance, it appears as if justice is finally being served, if slowly.
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Thursday, November 26th, 2009
Various combination treatments are consistently shown to be the most effective method of combating mesothelioma, an aggressive cancer most often caused by exposure to asbestos. Much like other cancers, the three most prevalent treatment options for mesothelioma are chemotherapy, radiation therapy, and surgery. Recently, several studies have shown specific advantages in combining one or more bodies of treatment.
An article published in the European Journal of Surgical Oncology recently reported that in a controlled study cytoreductive surgery, or surgery to remove malignant cancer cells, combined with certain forms of chemotherapy was a more effective treatment option than either surgery or chemotherapy alone. Similarly, a team of researchers in Victoria, Australia recently discovered that a new type of radiation therapy is far more effective at combating mesothelioma in combination with surgery or chemotherapy than it is by itself. Studies that discover which types of treatments best compliment each other are vital in the fight against mesothelioma.
Mesothelioma attacks the mesothelium, a membrane that forms a protective lining around several body cavities including the pleura or chest cavity, the peritoneum or abdominal cavity, and the pericardium or lining of the heart. Sadly, patients diagnosed with mesothelioma are only expected to live between six and eighteen months. More and more the cancer is becoming a serious concern in the United States and abroad due to its growing diagnoses and poor prognosis. Although it is caused by exposure to asbestos, a fibrous substance often used as insulation and fire retardant before the turn of the century, mesothelioma can take decades to develop after a patient is initially exposed to the dangerous fibres. The time that it takes the disease to develop combined with its generic, flu like symptoms make it a poor candidate for early detection and contribute to its shocking prognosis.
The medical community has long suspected the effectiveness of combination therapies for the treatment of mesothelioma, and new studies continue to corroborate that opinion. Lung Cancer, a medical journal, recently published a clinical trial which states that trimodal therapy (surgery, chemotherapy and radiation therapy in combination) improves survival rates in pleural mesothelioma patients, that is, patients with mesothelioma of the chest or lungs. The trial included 35 pleural mesothelioma patients, all of whom received radical pleurectomy surgery followed by four cycles of chemotherapy, followed by four to six weeks of radiation therapy.
Radical pleurectomy surgery is an alternative to extrapleural pneumonectomy, a surgery where an entire lung is removed from the patient. While radical pleurectomy aims to remove malignant cancer cells much like extrapleural pneumonectomy, it leaves the lungs in tact which tends to result in an improved recovery rate. This study specifically targeted radical pleurectomy patients because of their likelihood to recover from surgery more rapidly. Because of the nature of the trimodal therapy study, it was important that the patients were fit to continue other treatments after surgery.
“The aim of our prospective study was to analyze the feasibility and describe the long-term outcomes of patients treated with RP [radical pleurectomy] as surgical therapy modality in a standardized trimodality therapy concept,” the study states.
The study was a success, improving the patient’s average survival rates by a full year beyond normal expectations. The targeting of radical pleurectomy surgery was a key factor to the success of the treatment, researchers said, stating “[radical pleurectomy] as a surgical strategy allows patients to capitalize on all the aspects that a multimodality treatment approach has to offer without compromising the surgical oncological result and thus we believe RP [radical pleurectomy] is a cornerstone of the promising long-term results achieved in our pilot study. The observed and theoretical benefits of this trimodality treatment approach warrant confirmation in larger multi-center prospective controlled studies.” Researchers worldwide continue to study combination treatment strategies to improve the quantity and quality of life for mesothelioma patients.
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Friday, November 20th, 2009
In comparison with other developed nations, the United States takes a rather hostile stance towards alternative medicines and natural or holistic healing for the treatment of cancer. Many professionals in the medical community claim that the reason for their hesitation to adopt natural healing techniques lies in the lack of research or verified studies that riddle alternative healing success stories. Proponents of alternative medicine, on the other hand, often claim that the American health care industry is too focused on monetary gain and tends to promote methods of treatment that are profitable rather than effective. The astounding affordability of alternative medicine may contribute to this mindset. Many natural healing techniques are comprised simply of radical dietary changes, huge amounts of vitamin supplements, herbal remedies and mental fortitude exercises, all of which are vastly more affordable than chemotherapy, radiotherapy and surgery.
While alternative medicine doesn’t receive too much publicity in the United States, the fact is that in some cases it does seem to work. Even in the case of mesothelioma, a terminal cancer caused by asbestos exposure, natural healing remedies have proved incredibly successful in some cases. Mesothelioma is a very aggressive cancer whose prognosis is often shockingly poor. Persons diagnosed with mesothelioma are normally given six to eighteen months to live, and that’s with conventional treatments for retarding the progress of the disease.
In some cases, doctors recommend that mesothelioma patients forgo difficult medical procedures such as chemotherapy, radiotherapy and surgery in the belief that they will not prove successful and will simply reduce the patient’s quality of life during their final months. For many mesothelioma patients, this is when they turn to alternative or holistic healing.
That was exactly the case for Rhio O’Conner and Paul Kraus. Both men were diagnosed with mesothelioma and given a very poor prognosis. They were told that conventional medicine was unlikely to improve their situation, and subsequently turned to natural alternatives.
The treatments that Rhio and Paul embraced consisted mostly of switching to a diet rich in fruits and vegetables, taking huge amounts of vitamin supplements including intravenous vitamin C, taking some herbal remedies, and adopting a positive mindset that includes daily affirmations of health and recovery.
Rhio O’ Conner lived for more than seven years after his diagnosis, which is some four or five times longer than is expected in mesothelioma patients who are good candidates for conventional treatment options. Paul Kraus continues to fight mesothelioma today, more than eleven years after his diagnosis.
Clearly, alternative medicine does have some value. The medical communities in Mexico and in the European Union recognize the benefits of some alternative medicine practices and offer them far more readily than the United States. Treatments such as ozone therapy and laetrile (vitamin B-17) therapy that have gained little or no traction in the USA are considered reasonable options in other countries.
The lack of research makes it difficult to compare the effectiveness of conventional and alternative medicine, specifically in the case of mesothelioma. With success stories like those of Rhio O’Conner and Paul Kraus, however, it’s unreasonable to exclude natural medicine as a viable treatment option.
Sources: World without Cancer: The Story of Vitamin B-17 by Edward Griffin, http://www.abc.net.au/7.30/content/2001/s302183.htm, http://www.ozone-association.com
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Tuesday, November 17th, 2009
With the help of his team, Raphael Bueno, the Director of the Thoracic Surgery Residency Program at Brigham and Women’s Hospital in Boston, MA, has developed a new test that could prove useful for mesothelioma patients considering surgery. The new test would help to qualify patients for surgery more accurately, indicating them as either more or less likely to be good outcome patients, that is, patients with a longer survival time after surgery.
Typically, to better understand a patient’s prognosis, the doctor weighs a few different factors including the cancer’s stage, whether it can be removed, the appearance of the malignant cells under a microscope, and whether the cancer has spread to the lymph nodes. Unfortunately, these examinations themselves can involve invasive procedures, and all just to better understand how beneficial surgery might actually be.
Raphael Bueno says “Usually you need major surgery to determine the stage which can help predict outcome.”
Raphael and his team have been working to uncover less invasive ways to predict the results of major surgery. Some gene based methods for understanding the behaviors of certain cancers do exist, but their test results are difficult to duplicate due to their inherent complexity which involves the analysis of huge data sets.
Fortunately, Dr Bueno’s team has developed a simpler test, which, while it also uses gene comparison, compares the ratios of just four gene sets making it considerably less complex than other techniques. The four key genes were selected by comparing gene sets of mesothelioma patients who had good outcomes after surgery against patients who had poor outcomes.
The test appears to be very effective. In a study performed to better understand the accuracy of the test, tissue samples from 120 mesothelioma patients preparing to undergo surgery were analyzed, and the results used to place the patients in either a “good outcome” or “poor outcome” group. The patients themselves were then carefully observed after their surgery to determine the success of the procedure. The results showed that members of the “poor outcome” group survived an average of 9.5 months, while members of the “good outcome” group survived a substantially greater 16.8 months, corroborating the accuracy of the gene test.
According to the authors of a study concerning the test published in the May 6 Journal of the National Cancer Institute, the test could prove useful to mesothelioma patients who are weighing their treatment options. The study states:
“Patients whose gene ratio test results predict a good prognosis after surgery may more confidently select the treatment option that includes surgery. Patients assigned to the predicted poor outcome group…could be counseled to forgo surgery, which would not benefit them, and to seek best supportive care.”
By preventing surgeries that could shorten a patient’s survival expectancy and promoting those that would benefit patients, the test is expected to improve overall survival for mesothelioma patients.
Source: Gordon GJ, Dong L, Yeap BY, Richards WG, Glickman JN, Edenfield H, Mani M, Colquitt R, Maulik G, Van Oss B, Sugarbaker DJ, Bueno R. Four-gene expression ratio test for survival in patients undergoing surgery for mesothelioma. Journal of the National Cancer Institute. 2009;101:678-686.
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Monday, November 16th, 2009
The European Journal of Surgical Oncology recently published a study that claims intraperitoneal chemotherapy preceded by cytoreductive surgery is the most effective treatment method for peritoneal mesothelioma. Peritoneal mesothelioma accounts for about 10 to 20 percent of annual mesothelioma diagnoses, and is indicated by malignant tumors stemming from the abdominal cavity rather than the lungs. The study shows that the strategic combination of surgical and chemotherapy treatments tend to result in more encouraging recovery rates in patients than either treatment does alone. The study followed several British researcher’s analysis of the results of operative and chemical therapy treatments performed on seventeen different patients who underwent both surgery for peritoneal mesothelioma and intraperitoneal chemotherapy.
Mesothelioma is nearly exclusively caused by exposure to asbestos. The disease can take years or even decades to fully develop following asbestos exposure, which makes it very difficult to diagnose. Additionally, because of the long amount of time that the disease takes to develop, it is usually well advanced by the time it is discovered and treatments can begin. Peritoneal mesothelioma specifically effects the abdominal cavity; its symptoms include swelling or pain in the abdominal region, lumps under the skin in the abdominal region, a distinct change in bowel movements, nausea or fatigue.
After the study, the researchers stated that “Cytoreductive surgery combined with intraperitoneal chemotherapy appears to be the optimal treatment for selected patients with peritoneal mesothelioma… …Increased familiarity with this condition’s presentation and natural history, and knowledge of available treatment options, will hopefully facilitate treatment of these patients.”
Treatments for peritoneal mesothelioma currently include surgery, radiation and chemotherapy. Clearly, no single treatment can be considered the most likely to succeed in any given case. It’s important that each case of mesothelioma is diagnosed and treated individually as a unique challenge; it is, however, encouraging that combination therapies are proving more effective in certain cases and that the battle against mesothelioma appears to be gaining momentum on some fronts.
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