mesothelioma

Cancer Update from John Hopkins

2008-08-18T00:29:00.000-07:00

This information is being circulated at Walter Reed Army Medical Center as well.
Please circulate to all you know; Cancer update
John Hopkins - Cancer News from John Hopkins

No plastic containers in micro
No water bottles in freezer.
No plastic wrap in microwave.
A dioxin chemical causes cancer, especially breast cancer.
Dioxins are highly poisonous to the cells of our bodies. Don't freeze your plastic bottles with water in them as this releases dioxins from the plastic.
Recently, Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us.
He said that we should not be heating our food in the microwave using plastic containers...
This especially applies to foods that contain fat. He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body. Instead, he recommends using glass, such as Corning Ware, Pyrex or ceramic containers for heating food... You get the same results, only without the dioxin. So such things as TV dinners, instant ramen and soups, etc., should be removed from the container and heated in something else.
Paper isn't bad but you don't know what is in the paper. It's just safer to use tempered glass, Corning Ware, etc.

He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons. Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nuked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food. Cover food with a paper towel instead.

41 Secrets Your Doctor Would Never Share

2008-06-18T03:46:00.000-07:00

If You Only Knew ...
Reader's Digest offered two dozen doctors a chance to tell it like it really is, and general practitioners, surgeons, shrinks, pediatricians, and other specialists took the challenge. Some wanted to be anonymous; some didn't care. But all of them revealed funny, frightening, and downright shocking things that can help you be a better, smarter patient.

We're Impatient

• I am utterly tired of being your mother. Every time I see you, I have to say the obligatory "You need to lose some weight." But you swear you "don't eat anything" or "the weight just doesn't come off," and the subject is dropped. Then you come in here complaining about your knees hurting, your back is killing you, your feet ache, and you can't breathe when you walk up half a flight of stairs. So I'm supposed to hold your hand and talk you into backing away from that box of Twinkies. Boy, do I get tired of repeating the stuff most patients just don't listen to.

--Cardiologist, Brooklyn, New York

• I was told in school to put a patient in a gown when he isn't listening or cooperating. It casts him in a position of subservience.
--Chiropractor, Atlanta

• Thank you for bringing in a sample of your (stool, urine, etc.) from home. I'll put it in my personal collection of things that really gross me out.
--Douglas Farrago, MD, editor, Placebo Journal

• One of the things that bug me is people who leave their cell phones on. I'm running on a very tight schedule, and I want to spend as much time with patients as I possibly can. Use that time to get the information and the process you need. Please don't answer the cell.
--James Dillard, MD, pain specialist, New York City

• I wish patients would take more responsibility for their own health and stop relying on me to bail them out of their own problems.
--ER physician, Colorado Springs, Colorado

• So let me get this straight: You want a referral to three specialists, an MRI, the medication you saw on TV, and an extra hour for this visit. Gotcha. Do you want fries with that?
--Douglas Farrago, MD

• I used to have my secretary page me after I had spent five minutes in the room with a difficult or overly chatty patient. Then I'd run out, saying, "Oh, I have an emergency."
--Oncologist, Santa Cruz, California

• Many patients assume that female physicians are nurses or therapists. I can't tell you how often I've introduced myself as Dr. M. and then been called a nurse, therapist, or aide and asked to fetch coffee or perform other similar tasks. I have great respect for our nurses and other ancillary personnel and the work they do, but this doesn't seem to happen to my male colleagues.
--Physical medicine and rehabilitation doctor, Royal Oak, Michigan

• The most unsettling thing for a physician is when the patient doesn't trust you or believe you.
--Obstetrician-gynecologist, New York City

• It really bugs me when people come to the ER for fairly trivial things that could be dealt with at home.
--ER physician, Colorado Springs, Colorado

• Your doctor generally knows more than a website. I have patients with whom I spend enormous amounts of time, explaining things and coming up with a treatment strategy. Then I get e-mails a few days later, saying they were looking at this website that says something completely different and wacky, and they want to do that. To which I want to say (but I don't), "So why don't you get the website to take over your care?"
--James Dillard, MD

• I know that Reader's Digest recommends bringing in a complete list of all your symptoms, but every time you do, it only reinforces my desire to quit this profession.
--Douglas Farrago, MD

Pills, Pills, Pills
• Sometimes it's easier for a doctor to write a prescription for a medicine than to explain why the patient doesn't need it.
--Cardiologist, Bangor, Maine

• Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest.
--Internist, Philadelphia

• Taking psychiatric drugs affects your insurability. If you take Prozac, it may be harder and more expensive for you to get life insurance, health insurance, or long-term-care insurance.
--Daniel Amen, MD, psychiatrist, Newport Beach, California

• Ninety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making.
--Internist, Rochester, Minnesota

Bills, Bills, Bills

• Doctors respond to market forces. If the reimbursement system is fee-for-service, that results in more services. If you build a new CT scan, someone will use it, even though having a procedure you don't need is never a good thing.
--Family physician, Washington, D.C.

• I really do know why you're bringing your husband and three kids, all of whom are also sick, with you today. No, they are not getting free care.
--Douglas Farrago, MD

• Doctors get paid each time they visit their patients in the hospital, so if you're there for seven days rather than five, they can bill for seven visits. The hospital often gets paid only for the diagnosis code, whether you're in there for two days or ten.
--Evan S. Levine, MD

• Twenty years ago, when I started my practice, my ear, nose, and throat procedures financially supported my facial plastic surgery practice. Today, my cosmetic practice is the only thing that allows me to continue to do ear, nose, and throat procedures, which barely cover my overhead.
--Ear, nose, throat, and facial plastic surgeon, Dallas/Fort Worth

Free Advice

• Avoid Friday afternoon surgery. The day after surgery is when most problems happen. If the next day is Saturday, you're flying by yourself without a safety net, because the units are understaffed and ERs are overwhelmed because doctors' offices are closed.
--Heart surgeon, New York City

• In many hospitals, the length of the white coat is related to the length of training. Medical students wear the shortest coats.
--Pediatrician, Baltimore

• Often the biggest names, the department chairmen, are not the best clinicians, because they spend most of their time being administrators. They no longer primarily focus on taking care of patients.
--Heart surgeon, New York City

The Darker Side

• It saddens me that my lifelong enjoyment and enthusiasm for medicine has all but died. I have watched reimbursement shrink, while overhead has more than doubled. I've been forced to take on more patients. I work 12- to 14-hour days and come in on weekends. It's still the most amazing job in the world, but I am exhausted all the time.
--Vance Harris, MD, family physician, Redding, California

• In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don't know anybody who can live that way.
--James Dillard, MD

• Not a day goes by when I don't think about the potential for being sued. It makes me give patients a lot of unnecessary tests that are potentially harmful, just so I don't miss an injury or problem that comes back to haunt me in the form of a lawsuit.
--ER physician, Colorado Springs, Colorado

• Doctors often make patients wait while they listen to sales pitches from drug reps.
--Cardiologist, Bangor, Maine

• It's pretty common for doctors to talk about their patients and make judgments, particularly about their appearance.
--Family physician, Washington, D.C.

• Everyone thinks all doctors know one another. But when we refer you to specialists, we often have no idea who those people are. Generally, we only know that they accept your insurance plan.
--Pediatrician, Hartsdale, New York

• In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time.
--Family physician, Washington, D.C.

• Plan for a time when the bulk of your medical care will come from less committed doctors willing to work for much lower wages. Plan for a very impersonal and rushed visit during which the true nature of your problems will probably never be addressed and issues just under the surface will never be uncovered.
--Vance Harris, MD

• At least a third of what doctors decide is fairly arbitrary.
--Heart surgeon, New York City

• Doctors are only interested in whether they are inconvenienced -- most don't care if you have to wait for them.
--Family physician, Washington, D.C.

The Sensitive Side

• When a parent asks me what the cause of her child's fever could be, I just say it's probably a virus. If I told the truth and ran through the long list of all the other possible causes, including cancer, you'd never stop crying. It's just too overwhelming.
--Pediatrician, Hartsdale, New York

• Most of us haven't been to see our own physicians in five years.
--Physical medicine specialist, Royal Oak, Michigan

• When a doctor tells you to lose 15 to 20 pounds, what he really means is you need to lose 50.
--Tamara Merritt, DO, family physician, Brewster, Washington

• If a sick patient comes to me with a really sad story and asks for a discount, I take care of him or her for no charge.
--Surgeon, Dallas/Fort Worth

• Though we don't cry in front of you, we sometimes do cry about your situation at home.
--Pediatrician, Chicago

Shocking Stats
60% of doctors don't follow hand-washing guidelines.
Source: CDC Morbidity and Mortality Weekly Report

96% of doctors agree they should report impaired or incompetent colleagues or those who make serious mistakes, but ...

46% of them admit to having turned a blind eye at least once.
Source: Annals of Internal Medicine

94% of doctors have accepted some kind of freebie from a drug company.
Source: New England Journal of Medicine

44% of doctors admit they're overweight.
Source: Nutrition & Food Science; Minnesota Medicine

58% would give adolescents contraceptives without parental consent.
Source: New England Journal of Medicine

Anatomy of a Doctor's Bill

Just how much of the $100 your doctor charges for taking 30 minutes to investigate your stomach pain goes into his pocket? After paying the bills, he gets less than half. The breakdown, according to Robert Lowes, senior editor at Medical Economics:

$3.50 for malpractice insurance

$3.50 for equipment, repairs, and maintenance

$6 for supplies, including gowns, tongue depressors, and copy paper

$7 for rent and utilities

$11 for office expenses, such as telephones, accounting fees, advertising, medical journals, licenses, and taxes

$28 for secretary, office manager, and medical assistant salaries and benefits

$41 Amount that goes into the doctor's paycheck

Over the course of a year, that adds up to $155,000, the annual salary of the average family physician. That number rose just 3.3% between 2002 and 2006, while expenses increased nearly 25% over the same period.

Mesothelioma complementary and alternative medicine

2008-06-10T00:41:00.000-07:00

In the ongoing quest for a cure for mesothelioma and other life-threatening illnesses, the debate over the validity and effectiveness of complementary and alternative medicine (CAM) continues to stir up strong emotions.

Complementary medicine is used along with standard medicine, while alternative medicine is used in place of standard treatments.

Complementary and alternative medicine may include dietary supplements, megadose vitamins, herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual healing, and meditation.

Not long ago, I shared Charlene Kaforey’s good news, when she discovered her mesothelioma mass had diminished by half after completing a first round of cancer vaccines, considered an alternative treatment.

Recent news has included reports of research ranging from the effects of nonsteroidal anti-inflammatory medicines in combination with chemotherapy, to the use of Chinese mushrooms in homeopathic treatment, to a study indicating traditional chemotherapy might enhance the effectiveness of cancer vaccines, which are currently in clinical trials.

The problem, according to complementary medicine (CM) professor Edzard Ernst, in an editorial published recently in BMJ Clinical Evidence, is that “one side of the debate argues that there is no scientific evidence that can support CM, while the other side believes scientific evidence cannot be applied to CM.”

The danger, he says, is that waiting for absolute evidence might prevent someone from trying a therapy that could be beneficial, but siding with the idea that CAM simply cannot be proven may lead a patient into treatment that could cause more harm than good.

The National Cancer Institute’s Office of Complementary and Alternative Medicine (OCCAM), which coordinates the Institute’s research program in CAM, has established a goal of evaluating data from CAM practitioners with the same rigorous scientific methods employed in evaluating treatment responses with conventional medicine.

Major categories of CAM therapies, as determined by OCCAM, include alternative medical systems (built upon complete systems of theory and practice, like traditional Chinese medicine or homeopathy), energy and electromagnetic based therapies, exercise therapies (like yoga), manipulative and body-based methods, mind-body interventions (like hypnotherapy), nutritional therapeutics, pharmacological and biologic treatments (like vaccines), and spiritual therapies (healing, prayer).

OCCAM is developing the NCI Best Case Series (BCS) program based on its evaluations of CAM therapies, in which it provides an independent review of medical records and medical imaging from patients treated with unconventional cancer therapies.

But whether or not alternative and complementary medicine can be proven effective, people will still seek it out, says Professor Ernst. The “almost insatiable hunger of patients” for CM has driven its importance, he says, despite criticisms, praise or skepticism from the medical community, scientists or politicians, and in spite of the fact that more often than not health insurance does not cover the treatments.

Obviously, this topic - and its accompanying debate - needs much more examination. I will be exploring it more in the future. Do you have an experience with complementary or alternative medicine? Share it with us!

Pericardial Mesothelioma

2008-04-23T11:17:00.000-07:00

There are three types of the asbestos related cancer known as mesothelioma: pleural mesothelioma, which affects the lungs, peritoneal mesothelioma, which affects the abdominal region, and pericardial mesothelioma, which affects the heart. While the majority of those diagnosed with mesothelioma are diagnosed with pleural mesothelioma, there are a small percentage of sufferers who are diagnosed with the rarest form of this cancer, which is pericardial mesothelioma.

Like the other forms of this asbestos related cancer, pericardial mesothelioma can take several decades to develop from the time of exposure, with the average latency period being between twenty and forty years. This means that those people who may have contracted this form of cancer while working with asbestos in the 1970s, may not even be aware that they have the cancer, as symptoms may not yet have developed.

Pericardial mesothelioma is where the lining that surrounds the heart and provides protection and lubrication is attacked by cancer cells. There are a number of symptoms associated with pericardial mesothelioma, including persistent coughing, shortness of breath, chest pain, and palpitations. These are symptoms that you should look out for if you have worked with asbestos in the past, and should you experience any of these symptoms, it is important to seek medical assistance as early as possible.

As with the other forms of mesothelioma, the symptoms associated with pericardial mesothelioma can be very non-specific, and this means that they could easily be put down to one of a range of more common illnesses, which increases the risk of a misdiagnoses. If you have worked with asbestos, you should therefore make your doctor aware of this fact, as this can help to speed up diagnosis should these symptoms manifest.

Mesothelioma FAQ

2008-04-23T11:14:00.001-07:00

What exactly is mesothelioma?
Mesothelioma is a form of cancer that can affect the lung, abdominal, or heart regions of the body. Mesothelioma is cancer of the mesothelium, which protects the major organs of the body. This form of cancer is the result of exposure to asbestos dust and fibers and can take twenty to forty years to develop. There is no cure for mesothelioma, although treatments are being discovered that can extend the lifespan of the sufferer slightly. Once developed, the average lifespan of the victim is around six to twelve months.

Are there different variations of this cancer?
Yes, there are three forms of mesothelioma: pleural mesothelioma, peritoneal mesothelioma, and pericardial mesothelioma. Each of these affects a different part of the body. All types have the same long latency period, and all can kill within months of manifestation of symptoms.

What are the three variations of mesothelioma?
The most common form of mesothelioma is pleural mesothelioma, and this is the form of cancer that affects the lining of the lungs. This is where fluid forms between the chest cavity and the lungs. Some of the symptoms relating to this form of mesothelioma include breathing and swallowing difficulties, shortness of breath, fever, coughing, weight loss and coughing up blood.

The second most common form of this cancer is peritoneal mesothelioma, and this form of the cancer affects the mesothelium around the stomach and abdominal area. The pressure of the tumors against the abdominal wall creates a range of symptoms, including nausea, vomiting, stomach pains, abdominal swelling, loss of appetite, weight loss, chest pain, breathing problems, bowel obstruction, anemia, fever, and blood clotting abnormalities.

The rarest form of the cancer is pericardial mesothelioma, and this form of the cancer affects the protective lining around the heart. Symptoms of this form of mesothelioma include chest pain, persistent coughing, fever and palpitations.

Is mesothelioma difficult to diagnose?
Mesothelioma is a cancer that is notoriously difficult to diagnose for a number of reasons. Firstly, the disease has such as long latency period that there are no symptoms to diagnose for many years, which means that by the time a diagnosis is made, it is often too late for any form of effective treatment to be administered. Also, many of the symptoms linked to mesothelioma are very non-specific, which means that they could apply to a variety of other more common diseases, so misdiagnoses can easily be made.

What can I do if I develop mesothelioma?
Although there is no cure for this cancer, there are treatments available that can help to alleviate symptoms and even extend your lifespan. You need to ensure that you are monitored by your doctor every step of the way. You can also ask about support groups, where you will be able to get together with others in the same situation in order to come to terms with your illness. And finally, you should look into claiming compensation for your illness, which can be done through a specialized asbestos and mesothelioma lawyer.

Five worst Cancer causing foods

2008-04-19T02:41:00.000-07:00

There are some foods that people who are at high risk for developing cancer should definitely avoid. Generally, says natural health researcher Mike Adams, they should avoid foods that contain ingredients known to cause cancer, such as refined sugars and grains , hydrogenated oils, and nitrates. But which foods are the absolute worst?

The top five cancer-causing foods are:

1. Hot dogs
Because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.
2. Processed meats and bacon
Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.

3. Doughnuts
Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.
4. French fries
Like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acrylamides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .
5. Chips, crackers, and cookies
All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.

Malignant mesothelioma. Medical oncology: standards, new trends, trials--the French experience.

2008-02-15T02:20:00.001-08:00

Clinical trials investigating new trends in the treatment of stage I and II malignant mesothelioma have shown both intra-pleural immunotherapy and systemic chemo-immunotherapy to be efficacious. Intra-pleural gamma-interferon (gamma-IFN) therapy was associated with tolerable toxicity and an overall response (ORR) rate of 19%, while treatment with intra-pleural recombinant interleukin-2 (IL-2) was more toxic, but yielded an ORR of 47% in phase I trial and 55% in a phase II study. The association of intravenous cisplatin and subcutaneous alpha-interferon (alpha-IFN) was also associated with an encouraging ORR of 40% and a median survival of 12 months. Treatment with cisplatin, alpha-IFN and mitomycin C was associated with moderate toxicity and an ORR of 21% and a median survival of 12 months. The association of cisplatin, alpha-IFN and IL-2 was, however, extremely toxic and resulted in an ORR of 15%. The majority of patients responding to intra-pleural immunotherapy and systemic chemo-immunotherapy had epithelial type mesothelioma. The most encouraging results obtained from trials investigating systemic chemotherapy were following treatment with cisplatin, 5-fluorouracil, mitomycin C and etoposide, where an ORR of 38% and an overall median survival rate of 16 months were achieved. Toxicity was mainly haematological and tolerable.

Mesothelioma: The Basics

2008-02-15T02:14:00.000-08:00

What is mesothelial tissue?
The mesothelium is a protective sac that covers and protects most internal organs in the body. It is composed of two layers, one layer covers the organ and the second layer forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the lungs) to move easily. The area between the two layers is often called the pleural space. Mesothelial tissue is found lining the abdominal cavity organs, the lungs and the heart. What is mesothelioma?

Mesothelioma occurs when the mesothelial cells grow out of control. These cells also lose the ability to stop producing the lubricating fluid when there is enough. This results in organs being encased with a thick rind of tumor tissue and excess fluid build up, causing symptoms. These cells can grow and invade other organs, or spread to other areas of the body. When the cells spread to other areas of the body, it is called metastasis.

The majority of mesotheliomas are found in the lining of the lung. About ten percent of cases are found in the abdominal cavity lining, and even more rarely, mesothelioma is found in the lining of the heart.

Am I at risk for mesothelioma?
Mesothelioma is a rare cancer, with only 2,300 cases diagnosed in 2000, in the United States. It is eight times more common in men, which is due in most part to work-related exposure to asbestos. Risk also increases with age. The biggest risk factor for developing the disease is exposure to asbestos, accounting for 70 to 80 percent of all cases. Asbestos has been used in many products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. Particles can be released from these products, particularly during the manufacturing process, and inhaled. Prior to knowing the dangers, asbestos miners and other workers exposed to asbestos worked without wearing any protection. Since the 1970's, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure and requires protective equipment in the workplace. Family members of people who worked with asbestos were also exposed to the toxin when it was carried home on clothing and hair, putting them at increased risk for mesothelioma. It takes 20 to 40 years from the time of asbestos exposure until mesothelioma is detected. This exposure was usually over a period of time, but has been reported to be as little as one or two months of exposure. Smoking does not seem to increase the risk of developing the disease.

The incidence of mesothelioma in Western Europe is much higher, with 5,000 new cases in 2000. This is because maximal exposure to asbestos in Europe occurred around 1970, whereas the maximum exposure in the U.S. was from the 1930s to 60s. It is expected that rates in the U.S. should begin to decline, whereas rates in Europe are expected to plateau in 2018 before declining.

How can I prevent mesothelioma?
By decreasing exposure to asbestos, the risk of mesothelioma is decreased. Workers who are exposed to asbestos on the job should wear protective clothing and masks. These workers should change their clothing before leaving the work site to avoid carrying any particles home. OSHA has set standards regulating these procedures. What screening tests are available?

There is no good screening test for mesothelioma. Radiologic studies (x-ray, CT scan) are not sensitive enough to detect tumors before symptoms occur.

What are the signs of mesothelioma?
The symptoms of mesothelioma are caused by a build-up of tumor tissue surrounding the lung and fluid in the pleural space that prevents the lung from expanding fully. This causes pressure on the lung, leading to pain and shortness of breath. As the disease progresses, patients may lose weight and have a dry, hacking cough. In the abdomen, this fluid and tumor tissue causes abdominal swelling, pain and weight loss.

How is mesothelioma diagnosed and staged?
Patients who present with symptoms worrisome for mesothelioma may have a chest x-ray done, indicating a build-up of fluid in the lining of the lung. These patients would then undergo CT scan to further evaluate the cancer. In the case of abdominal mesothelioma, a CT scan obtained to visualize the anatomy in the abdomen.

Patients would then undergo a biopsy to have the diagnosis confirmed. In the lung, a thoracoscope is used to go through the chest wall, between the ribs to obtain a sample of the tissue. A peritoneoscope is used to enter the abdomen to obtain a tissue sample in abdominal mesothelioma.

Staging refers to determining the extent of the disease and this dictates the treatment. Physicians use the TNM system (also called tumor - node - metastasis system). This describes the size of the tumor (T), if the lymph nodes are involved (N), and if it has spread to other areas of the body (M). This is then interpreted to a stage between one and four. Patients with earlier stage tumors tend to live longer and respond better to available treatments.

What are the treatments for mesothelioma?
Treatment is dependent on the stage of the disease, the location of the tumor, the patient's age and state of health at the time. Younger, healthy patients, with early stage disease may be candidates for surgery that removes the mesothelial tissue around the tumor. This surgery is extensive and it is not well understood how much benefit it provides the patient.

Traditional radiation therapy has not shown a benefit, and can cause damage to the healthy lung tissue in the process of treating the cancer. Research is investigating ways of giving radiation directly to the tumor, using implants or UV light therapy. Chemotherapy has often been used to treat patients with mesothelioma, but until recently trials did not find any one medication to be superior to others. These medications have had responses in 10 to 20 percent of patients, but combining more than one medication has not increased these rates. Recently, a new medication called pemetrexed (Alimta) was given in combination with cisplatin with positive results. Patients received either cisplatin alone or cisplatin in combination with pemetrexed. Patients who received the combination of drugs had increased response rates, survived longer, and had fewer side effects. This regimen is now considered standard of care for mesothelioma not treatable with surgery. Researchers are conducting studies that administer the chemotherapy directly into the pleural space. So far, the results of these studies have been disappointing.

Because the current therapies have limited effectiveness, researchers are studying new ways to treat mesothelioma. Some of the treatments being investigated include interleukin 2 (a biologic therapy), lovastatin (a cholesterol-lowering drug), immunotherapy, gene therapy (a method that attempts to correct the abnormal gene that causes the cancer to grow out of control), and Photodynamic Therapy (PDT-a treatment that uses a laser to activate a photosensitizing drug during the surgical removal of the cancer). Patients should talk with their physicians about current clinical trials for mesothelioma.

One problem that patients may encounter is the recurring build-up of fluid in the pleural space. This fluid can be removed with a chest tube (a tube that is put into the chest wall and left in for a period of time to allow drainage) or a procedure called thoracentesis (a small needle is put through the chest wall, into the pleural space, the fluid is drained, and the needle removed). In the abdomen, the procedure to remove fluid is called paracentesis. In this procedure, a needle is inserted through the abdomen into the fluid filled space, and the fluid is drained.

If this is a chronic problem, patients may have a catheter placed in the chest semi-permanently, allowing them to drain the fluid themselves at home as they need to. Removal of the fluid alleviates the difficulty breathing and chest pain caused by the build-up.

Follow-up testing?
The physician will follow the patient with physical examinations, chest x-rays, and CT scans.

References
DeVita, V., Hellman, S., & Rosenberg, S. Cancer: Principles and Practice of Oncology, Seventh Edition (2004). Lippincott, Williams & Wilkins, Philadelphia, Pennsylvania.

Light, R. Pleural Diseases, Fourth Edition (2001). Lippincott, Williams & Wilkins, Philadelphia, Pennsylvania.

Vogelzang, N et al., Phase III Study of Pemetrexed in Combination With Cisplatin Versus Cisplatin Alone in Patients With Malignant Pleural Mesothelioma, Journal of Clinical Oncology, 21: 2636-2644 (2003)

National Cancer Institute. Mesothelioma: Questions & Answers

The Mesothelioma Applied Research Foundation : This nonprofit organization’s website is a great resource for patients, families & healthcare professionals.

Treatment - Surgery

2007-12-19T23:58:00.000-08:00

In some cases, surgery may be indicated to alleviate symptoms or slow the progression of mesothelioma. Surgery may be performed in tandem with other treatments such as chemotherapy and radiation, also known as “multi-modal therapy.”

Whether a surgery is recommended in your case will depend on factors unique to your situation, including the type and location of the cancer, the “stage” of the cancer, and your overall health. Of course, whether your doctor recommends surgery in your case will depend on factors individual to your case.

Pleural Mesothelioma Surgeries

Thoracentesis

This procedure involves the draining of fluid that may build up (called a “pleural effusion”) in the chest between the lung and the pleura. A tube is placed in the chest in order to drain out the fluid. Thoracentesis is a “palliative” treatment, meaning that its purpose is to help relieve discomfort.

Pleurodesis

Pleurodesis is a surgical procedure to help control pleural effusion, which is the buildup of fluid between the lungs and the lung lining. Pleurodesis closes the space between the lung and the lung lining, reducing the chance for fluid to accumulate.
There are two approaches to performing a pleurodesis. In the first, a tube that is inserted into the chest drains the excess fluid. After this fluid is drained, a schlerosing agent (a substance that causes tissue to scar or harden), such as sterile talc powder, is injected through the chest tube and into the pleural space. The schlerosing agent is allowed to distribute itself through the pleural space, with the patient being asked to move about in order to facilitate the distribution. Once the agent is distributed, suction is applied to the tube in the chest. Similar to collapsing a plastic bag, the suction brings the two pleural surfaces together, allowing them to “scar” together.

The second method of pleurodesis uses thoracoscopy, whereby a small incision, or a series of small incisions, are made in the skin. A thoracoscope is passed through the incision in order to get a better look at the pleura. The schlerosing agent is then applied to the area.

Pleurectomy/Decortication

Pleurectomy/decortication involves removing the pleura, where most of the tumor is located. This procedure may help control pleural effusions (fluid build-up) and help to decrease the pain caused by the tumor. It is a palliative treatment, meaning that its goal is to help to lessen the discomfort caused by mesothelioma.

Pneumonectomy

A pneumonectomy is the removal of all or part of the lung. Your surgeon will make an incision in the side of the chest. When the lung is revealed, the surgeon visually assesses the tumor and decides how much tissue should be removed.

Extrapleural pneumonectomy

This extensive surgery usually involves the removal of the pleura, pericardium, diaphragm, and the whole lung on the side of the cancerous tumor. Your surgeon may decide to remove some of the surrounding tissues, as well.

Peritoneal Mesothelioma Surgeries

Paracentesis

Peritoneal mesothelioma can cause fluid to build up in the abdomen in a process called peritoneal effusion. This excess fluid is drained through a needle and tube inserted into the abdomen. Paracentesis (sometimes called an “ascitic tap”) can help take the pressure off the internal organs, and also helps reduce the risk of infection that may be caused by the fluid buildup. This is a “palliative” procedure, meaning that the goal of paracentesis is to help to relieve the discomfort associated with peritoneal mesothelioma.

Peritonectomy

A “peritonectomy” involves removing the peritoneum, the lining of the abdomen where the mesothelioma first develops. This form of surgery is most often used when the cancer is detected in the very early stages of the disease. Your surgeon might recommend that a peritonectomy be performed in tandem with “intraperitoneal hypothermic perfusion,” a form of heated chemotherapy where the chemotherapy drugs are administered directly into the abdomen during and/or after surgery.

Cytoreductive (or “debulking”) surgery

During cytoreductive or debulking surgery, the surgeon opens the abdominal cavity (a procedure known as a “laparotomy”) to look for all signs of cancer and attempt to remove as much of the tumor as possible. This surgery can be quite long in duration because of the amount of detail the surgeon must use to search for and remove signs of cancer in the abdominal area. Your surgeon might recommend that this surgery be performed in tandem with “intraperitoneal hypothermic perfusion,” a form of heated chemotherapy administered into the abdominal cavity.

Pericardial Mesothelioma Surgeries

Pericardiocentesis

This is the process for drawing fluid out of the affected area to help to relieve the discomfort associated with pericardial mesothelioma. For this procedure, a needle is inserted into the pericardium (the sac around the heart) to drain the fluid and relieve circulatory problems. The draining of this fluid can be associated with complications, however.

Extrapleural pneumonectomy

An aggressive surgery also used in appropriate situations to treat pleural mesothelioma, an extrapleural pneumonectomy involves removal of the pleura, diaphragm, pericardium, and the entire lung on the side of the tumor.

Coping With Cancer

2007-12-19T23:50:00.000-08:00

When you hear that you have been diagnosed with cancer, your first inclination will probably be that your “normal” life is about to change, and in some respects, this may be true. You will have to come to terms with your diagnosis in your own mind, and then tell family and friends. There will be appointments to keep, treatment decisions to make and medical bills to pay. Familiar routines may become disrupted or absent altogether. How you successfully contend with these difficulties, or how you “cope”, can be one of the most important steps you will take in maintaining a positive outlook on life.

The first step in making your life “normal” again is to realize that you will most likely cope with your mesothelioma in the same manner you have handled other aspects of your life. The person you have always been, whether laid back or in control, is the person you will continue to be. You will learn to substitute new roles for lost ones, and will continue to adapt to the changes life will bring your way.

In this section, three areas in which you will use your coping skills will be discussed. These include:

Emotional Coping

When you are facing a serious illness, your emotions can play an important role in how you feel about life, and these emotions can extend to your family and friends as well. You can minimize the impact by understanding that your feelings are normal, and then by moving ahead and becoming proactive in your treatment and care.

Physical Coping

Many people think of coping as only an emotional process, but dealing with treatment regimens and their potential side effects, as well as quality of life concerns must also be addressed. While you can’t control the fact that you have been diagnosed with mesothelioma, you can learn to minimize its effects on your health and wellness.

Financial Coping

Serious illnesses like mesothelioma can deplete your life savings quickly. Most cancer treatments such as surgery, chemotherapy and radiation can be costly, and because of the rarity of mesothelioma, you may feel you want to travel to a specialist for a second opinion or for treatments not available in your local area. By being aware of the financial resources available, including compensation from the asbestos industry, you can help ease the stress on yourself and your family and, therefore, maintain control over your life.

Mesothelioma Legal Advice

2007-12-19T23:48:00.000-08:00

Mesothelioma was recognized as a legitimate cause of death by the US government in 1989 and consequently commercial use of asbestos was banned. It was done after numerous researches unquestionably proved that mesothelioma is a deadly cancer caused by asbestos exposure. For people who are suffering from mesothelioma, the good news is that now they can get compensated for all their medical expenses and treatment. But, it is not as easy as it sounds. You cannot fight the legal battle on your own for you will require a professional, experienced and a reputable mesothelioma lawyer to help you fight your case and get you fair compensation from the responsible source of asbestos exposure.

In case you decide to not go for a full fledged legal battle your lawyer can also assist you in getting an out of court settlement from the liable asbestos source. To file a case against the offender, you need to have a number of evidences with you which will make your lawsuit strong. This evidence may be your employment record with a company, your medical reports proving mesothelioma as well as witnesses who can testify for you.

Mesothelioma patients or their family members can file a claim against the negligent employers who did not ensure protective workplace safety measures against an asbestos filled environment. The compensation thus obtained can help the patient with the treatment and medical bills and it can help make up for some of the anguish and distress which the patients and their families suffer. Check out the articles in our mesothelioma legal advice for sound lawful advice before you file your mesothelioma compensation case.

Is Mesothelioma a sleeping dragon?

2007-12-11T07:13:00.000-08:00

Mesothelioma is caused by exposure to asbestos. Asbestos is a substance found naturally. It is made of strong flexible fibres. It was used extensively in industry because the fibres are not affected by heat or chemicals and a poor conductor of electricity. It is estimated that over 5,000 products have or had asbestos in them.

Of the six types of asbestos, only four are used commercially. These are chrysotile, crocidolite, amosite and anthrophyllite. Of these, crysotile or white asbestos accounts for 99% used in USA. In it natural state or well contained and maintained in products, asbestos do not pose a real hazard. It is when asbestos is broken down and fibres are released that there is concern.

Asbestos fibres are very thin and sharp. The fibre is 2,000 times thinner than a human hair. It measures under 0.3 microns or one millionth of a millimetre in diameter and five microns in length. It is not visible with the naked eye or through a microscope.

When released, the fibres remain in the atmosphere for a long time and can be carried great distances. When the fibres are inhaled, they stick to the lung tissue and are not expelled by breathing out or coughing. Some remain in the lungs, others gravitate into the pleural lining.

Asbestos exposure can lead to disease and develops over a long period of time. Asbestos related diseases are asbestosis, pleural plaques and lung cancers. The lung cancer can be either cancer of the lung itself or mesothelioma, a cancer of the lung lining. These cancers can take between 20 and 50 years to develop.

A recent article in a UK Newspaper highlighted the case of a Hospital Consultant who developed mesothelioma. He cannot recall any exposure to asbestos. It may well be that he was inadvertently exposed to asbestos without his knowledge i.e. such as living in the vicinity of a factory that leaked asbestos into the atmosphere.

Professor Peto has shown that new cases of mesothelioma will continue to increase in the early part of the twenty first century. He also said, "Every single person in the UK has asbestos in their lungs. It is the level of exposure that is important."

We also know that people who has a history of asbestos exposure has a greater risk of lung cancer if they smoked. In a survey in 1992, 2602 individuals with lung cancer were interviewed. One in eight was exposed to asbestos and of these a third still smoked. A US study suggested that non-smokers exposed to asbestos have a five times greater risk of lung cancer. If they smoked, then the risk increased by a factor of 11. Smoking and asbestos exposure increases the risk of developing lung cancer to 52 times that of the general population.

At present no one knows how many lung cancers are due to asbestos exposure because of the long latency period and that cigarette smoking remains the major cause. Mesothelioma, however, is caused by asbestos exposure and this has been the basis of numerous high value legal claims.

As for the future, in the USA and Europe, asbestos related diseases will gradually increase to a peak. Of concern, however, are areas of conflict. In the Middle East, when a building was bombed, or when numerous buildings were bombed during the invasion of Iraq, do we have any idea how much asbestos was released into the atmosphere?

We are, however, certain that during the 9/11 disaster, asbestos fibres were released. When the Twin Tower collapsed, there were 400 tons of asbestos in the structure. The toxic cloud that hung over Manhattan, contained high level of asbestos. It is estimated that over 100,000 people suffered asbestos exposure. The greatest exposure was amongst first responders. Deborah Reeve was the first to die from asbestos related disease after 9/11. She was a first responder and paramedic. She died in March 2005 from mesothelioma. This concerned experts because mesothelioma takes a very long time to develop. They concluded that her exposure must have been excessive.

A study result showed that 70% of recovery and rescue workers who were active during and after the World Trade Centre collapse had some form of respiratory problem. A six year follow up study showed that sufferers with respiratory problems continue to have the same ailments.

"In the six years since the attacks," Nadler said, "We have accumulated a mountain of evidence that thousands of those exposed are suffering from chronic respiratory disease and, increasingly, a variety of rare cancers."

Hopefully, as experts predict, within the next few years asbestos related diseases will peak and the annual new cases will drop. If not, could it be a sleeping dragon about to wake up?

Article Source: ArticlesMaker.com

About the Author: Dr. Phil Hariram is a retired General Practitioner. He has treated various medical conditions. His website on asbestos and mesothelioma is intended to help anyone who is looking for comprehensive information on the asbestos related diseases. Visit his website: http://www.themesothelioma-info.com and learn about this very serious condition.

Symptoms of Mesothelioma

2007-12-11T07:09:00.000-08:00

Mesothelioma has a poor prognosis, especially since by the time the doctor has determined a patient has mesothelioma, the cancer has progressed greatly. The symptoms of mesothelioma are common with other types of health conditions. Unless the doctor is aware that someone was exposed to asbestos, he or she will not necessarily be looking for mesothelioma. Being exposed to asbestos is the only known manner of contracting this cancer.

Symptoms of mesothelioma will vary based on the type of mesothelioma, the progression of the cancer, the location of the tumor, the health status of the patient, and so on. A person can experience symptoms such as back aches and muscles aches. Their breathing can be interrupted or the patient can experience shortness of breath in general. Other symptoms could be a bad cough that persists for a prolonged period, chest pain, weight loss, or general fatigue. Again, unless the doctor is aware there has been exposure to asbestos, these symptoms can be a result of numerous health conditions, which may not lead to a clear diagnosis.

What's the treatment for mesothelioma?

2007-12-11T07:04:00.000-08:00

Like most cancers, the outlook for recovery (prognosis) for people with mesothelioma depends on when the disease is diagnosed and how aggressively it is treated. The treatment plan depends on the stage and location of the cancer, as well as the age and desires of the patient. Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Surgery is a common treatment for mesothelioma. Before any surgery is considered for the treatment of malignant mesothelioma, the patient's overall health has to be evaluated. Tests are done to make sure the cancer has not spread to distant sites, and to evaluate how well the patient's lungs and heart are functioning. Lung tests look for any signs of lung damage from tobacco or from other diseases, including asthma and chronic obstructive pulmonary disease (COPD). These tests determine how risky surgery would be, especially if a lung needs to be removed. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed. Surgery is a common treatment of malignant mesothelioma.

Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy uses drugs to kill cancer cells. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy). Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesothelioma, chemotherapy may be put directly into the chest (intrapleural chemotherapy).

To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.

Intraoperative photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.

Because mesothelioma is very hard to control, the U.S. National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) that are designed to find new treatments and better ways to use current treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with mesothelioma.

New treatments for malignant mesothelioma and possible preventive measures, such as a vaccine, are being evaluated in clinical trials, and the future holds some promise. Clinical trials are research studies that evaluate new treatments for safety and effectiveness. There are no guarantees that a new treatment will work, and there are some risks. However, a clinical trial is not undertaken unless the researchers believe the treatment may have some value.

Some treatments for malignant mesothelioma that are being evaluated. Different combinations of chemotherapy drugs have been tried with mixed results. Putting chemotherapy drugs directly into the pleural or peritoneal space is being researched because of its advantage over traditional chemotherapy. Because the drug is placed directly into the cavity, much greater doses can be given to patients without causing severe side effects. Some studies have shown this therapy to control effusions and reduce tumor size. In brachytherapy (intracavitary radiation therapy), a radioactive substance is placed directly into the pleural or peritoneal space. Multimodality therapy is any combination of surgery, radiation therapy and chemotherapy. In gene therapy a virus that has been genetically altered is introduced into the tumor. The virus infects the cancerous cells and makes them vulnerable to anticancer drugs. Treatments that stimulate the body's immune system to fight cancer cells are called immunotherapy.

Because mesothelioma now represents less than one percent of cancers and and are infrequently seen in the practice of most community oncologists, finding the correct treatment can be very difficult. Proper management of mesothelioma often requires evaluation at larger tertiary hospitals or Comprehensive Cancer Centers by specialists in medical, surgical and radiation oncology with experience in all aspects of the clinical care of mesothelioma patients, including the newest experimental treatments. Because treatment has resulted in modest benefit, patients may question the treatment options suggested. It is often a good idea to seek a second opinion. A second opinion can provide more information and help you feel more confident about the treatment plan that you choose. Also, some insurance companies require a second opinion before they will agree to pay for certain treatments.

Cancer Update from Johns Hopkins University

2007-12-05T07:41:00.000-08:00

This information is being circulated at Walter Reed Army Medical Center as well.
Please circulate to all you know; Cancer update
Johns Hopkins - Cancer News from Johns Hopkins

No plastic containers in micro

No water bottles in freezer.

No plastic wrap in microwave...

A dioxin chemical causes cancer, especially breast cancer.

Dioxins are highly poisonous to the cells of our bodies. Don't freeze your plastic bottles with water in them as this releases dioxins from the plastic.

Recently, Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us.
He said that we should not be heating our food in the microwave using plastic containers.. .

This especially applies to foods that contain fat.

He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body...
Instead, he recommends using glass, such as Corning Ware, Pyrex or ceramic containers for heating food... You get the same results, only without the dioxin. So such things as TV dinners, instant ramen and soups, etc., should be removed from the container and heated in something else.
Paper isn't bad but you don't know what is in the paper. It's just safer to use tempered glass, Corning Ware, etc.
He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons...

Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nuked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food.
Cover food with a paper towel instead.

This is an article that should be sent
To anyone important in
Your life!

2007-12-04T01:44:00.000-08:00

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