The alternative to P/D for pleural mesothelioma patients is the extrapleural pneumonectomy (EPP), a more radical procedure that involves removal of a lung, the diseased lining of the chest cavity and heart, and a portion of the diaphragm.  There has been an ongoing debate among mesothelioma physicians of the best surgical approach for improving the survival of mesothelioma patients.  

Mesothelioma is a rare form of cancer typically affecting the lining of the lungs. Primarily caused by exposure to airborne asbestos fibers, it is highly aggressive and is resistant to many of the current cancer treatments. Mesothelioma often has a complex growth pattern making complete surgical removal a very difficult task leaving oncologists and surgeons to determine which of the surgical procedures will offer the patient the best survival option.

Dr. Robert Cameron, Director of the UCLA Mesothelioma Comprehensive Research Program and Chief of Thoracic Surgery at the West Los Angeles VA Medical Center, and leader of the symposium, has long been a proponent of P/D and has been critical of physicians that offer EPP.  Cameron has said, “Taking out a lung does harm and there is absolutely no benefit to the patient.” 

Cameron was joined at the Symposium by some of the leading experts in the field, including: Dr. Anne Tsao of M.D. Anderson Cancer Center and Dr. Raja Flores of the Mount Sinai School of Medicine in New York. The two previously collaborated on an article regarding personalized treatment for mesothelioma patients. 

“With the treatment of mesothelioma, everything is changing,” said Tsao. “There was a lot of nihilism before. We see it turning from it being fatal to a chronic illness and, hopefully, to a cure.” 

Mesothelioma survivors were also present at the symposium and lauded the attending physicians for standing by the less-invasive surgery.  Several of the patients found P/D to be a viable alternative after being told there was nothing that could be done to help them in battling their disease. 

Organizers are already planning next year’s event to be held May 12-13, 2013. 

3,000 Americans are diagnosed with mesothelioma each year.  The patients and their physicians look forward to Symposiums such as this so that breakthroughs and perspectives on mesothelioma treatments can be shared with other physicians and the general public.

Pleural mesothelioma is a form of lung cancer that is almost always caused by asbestos exposure and is found in the outer lining of the lungs called the mesothelium.  While pleural mesothelioma affects the outer lining of the lungs, lung cancer is a malignancy in the lung itself.  The two pulmonary cancers are often difficult to distinguish; however, the treatments for lung cancer and pleural mesothelioma are often very similar.

This year’s grant recipients will receive $100,000 total distributed over two years.  Since the beginning of the Lung Partnership’s research grants program in 2005, over $3 million has been awarded to support lung cancer research.  

This year’s grant recipients include:

• Trever Bivona, MD, PhD, Assistant Professor, University of California, San Francisco.  Dr. Bovina will be focused on determining whether the chemotherapy drug erlotinib can be more effective through activation of a gene called AXL in cancer patients with the mutation of the epidermal growth factor receptor (EGFR) gene.  Mesothelioma patients are sometimes treated with erlotinib and other chemotherapy agents known to inhibit EGFR growth.
• Shadia Jalal, MD, Assistant Professor, Indiana University School of Medicine. Dr. Jalal will seek to understand the role of RAD51, a protein important to DNA repair, in metastasis of cancer to find ways to target the protein, with the ultimate goal of improving outcomes for people with metastatic lung cancer.
• Don Nguyen, PhD, Assistant Professor, Yale School of Medicine and Yale Cancer Center. Metastasis and chemo-resistance to lung cancer and mesothelioma may be due to cancer stem cells. Dr. Nguyen seeks to identify the molecules marking these cancer stem cells so that they can be easily identified and ultimately use the information to develop a method to assess the effectiveness of a therapy for an individual patient over time.

The awards are available to clinical and basic science fellows and junior faculty to “ensure effective translation of basic and behavioral research discoveries into patient therapies to reduce lung cancer incidence, morbidity and mortality.”

Many of the previous grant winners’ findings may contribute to improved survival rate and early detection for lung cancer and mesothelioma patients.

Vomiting (medically known as emesis) and nausea from chemotherapy treatments can significantly impact a patient’s quality of life and may even lead them to halt their chemo treatments.  While currently, doctors can prescribe a variety of anti-emetic medications, metoclopramide is one of the most common, to minimize the sickness, many patients are still affected with some amount of vomiting.

Now, researchers at Harper Cancer Institute at Indiana University have found that an off-label use of the anti-psychotic drug olanzapine has been shown to significantly eliminate chemotherapy-induced vomiting and nausea.  In fact, the results of olanzapine during the clinical trial were said to “trounce” the benefits of the often-prescribed metoclopramide.

30 of 42 patients in the double-blind phase III study who received olanzapine had no vomiting, and 28 of the patients did not experience any feelings of nausea.  On the other hand, just 12 of 38 patients who were treated with metoclopramide did not vomit, and only 9 did not feel nauseous. 

Lead researcher Dr. Rudolph M. Navari director of the Harper Cancer Institute at Indiana University said that olanzapine is known to cause weight gain over an extended period of use.  However, he said that cancer patients would only take the medicine 3-4 days a month and no weight gain was observed. 

Dr. Rudolph M. Navari presented the study findings during a press briefing in advance of the annual meeting of American Society of Clinical Oncology (ASCO), June 1-5, in Chicago. 

“This is a huge advance,” said ASCO president-elect Dr. Sandra M. Swain, a breast cancer expert, who co-moderated the teleconference. “We’ve come a long way to really treat and cure these patients … these side effects can be intolerable to patients. Sometimes patients will opt out of curative treatment, and we certainly don’t want that, when we know we’ve made advances.” 

Swain added, “[these findings are] a great step forward for quality of life for our patients.” 

If you have become sick after your chemotherapy treatments, ChemoCare.com suggests once you begin to feel better to drink small amounts of clear liquids including broth, juice, sports drinks and water. Progress to light foods such as jello, bananas and toast.  

Mesothelioma patients who are not getting relief from vomiting or nausea after chemotherapy treatments should discuss treatment options with their physician. 

The difficulty in successfully eradicating mesothelioma, an asbestos-caused cancer, is that the cancer is highly aggressive and is resistant to many treatments. Even though chemotherapy is considered the primary treatment for mesothelioma, many of the cancer cells continue to thrive or regenerate even after many cycles of the treatment. 

However, researchers at the Institute of Bioengineering and Nanotechnology (IBN) in Singapore believe they have found the reason for chemoresistance – cancer stem cells.  Even though cancer stem cells (CSC) make up just 1% of cancer cells, according to the study, it is these cells that survive the effects of anti-cancer drugs and continue to grow and divide causing the cancer to metastasize.

In order to assess the effectiveness of drugs on CSCs, the IBN team “developed a miniaturized biological assay called the Droplet Array to perform cheaper, faster and more convenient drug screening using limited samples.”  Previous assays required up to 5,000 cells, however, with the scarcity of CSCs, the team created an assay where just 500 cancer cells could be evaluated. 

The researchers found that doxorubicin, a chemotherapy drug that usually induces cell death in liver cancer, was not effective against the CSCs in liver cancer.  The same was true for CSCs in breast and colon cancer tumors.  The tests were confirmed by implanting CSCs and non-CSCs from liver tumors into mice.  Six weeks later the mice implanted with the CSCs had tumors form, whereas the non-CSCs did not develop any tumors.  The tests confirmed “self-renewal” properties of CSCs. 

“We hope that this finding will facilitate the development of more effective cancer drugs. We also hope to leverage on the Droplet Array’s capabilities to complement/replace animal models for drug toxicity testing, and develop new cancer diagnostics,” said Jackie Y. Ying, study lead. 

While symptoms of mesothelioma can be relieved through the use of surgical procedures, chemotherapy and radiation, once the symptoms appear the disease has typically progressed to an advanced stage, and survival is usually less than 18 months. Physicians, oncologists and mesothelioma patients are anxious to find a new treatment for the incurable disease.   Stopping tumor growth and preventing metastasis is critical for increasing survival in patients.

by Nancy Meredith

Americans have long envied the longevity of Europeans along the Mediterranean Sea.  Their good health has been attributed to their healthy lifestyle and their diet, known as the Mediterranean diet, of fresh fruits and vegetables, olive oil, nuts and an occasional indulgence in a glass of red wine.  While mesothelioma patients have long been encouraged to follow a healthy diet and to get light exercise while battling the disease, doctors have shied away from suggesting a glass of wine with their dinner. 

Now, new research suggests that one aspect of the Mediterranean diet – red wine – may benefit patients diagnosed with mesothelioma.  Researchers in Korea found that resveratrol, an ingredient found in the skin of red grapes, induces apoptosis in some malignant mesothelioma cells causing them to die. 

Mesothelioma is notoriously difficult to treat and is resistant to many cancer treatments.  One reason that pleural mesothelioma, a pulmonary cancer caused by the inhalation of asbestos dust, is difficult to treat is that regardless of the therapy used the cancer almost always recurs locally. The resistance of mesothelioma to treatment is due to its apoptotic defect, which prevents the medicines from killing the cancer cells allowing them to continue to grow and divide.    

Resveratrol Kills Mesothelioma Cancer Cells
However, Korean medical scientists at Soonchunhyang University found that resveratrol suppressed the levels of a protein called Sp1 and caused the death of cancer cells in laboratory mice that had malignant pleural mesothelioma.

Sp1, which is also known as specificity protein 1, appears to play a key role in tumor development in some cancers. The scientists said injecting the mice with resveratrol effectively suppressed the growth of mesothelioma tumors by inhibiting the protein.

The findings led the researchers to conclude, “that therapeutic and chemopreventative effects of resveratrol, by targeting Sp1, lead to the prevention of malignant pleural mesothelioma.”

Plants Beneficial for Cancer Prevention
The researchers noted that for years, scientists and physicians have been searching for cancer prevention benefits of fruits and vegetables and for their uses as a weapon in the fight against cancer. According to the Mayo Clinic, following a Mediterranean diet has been associated with “a reduced risk of overall and cardiovascular mortality, a reduced incidence of cancer and cancer mortality, and a reduced incidence of Parkinson’s and Alzheimer’s diseases.” 

Mesothelioma patients can follow the basic concept of the Mediterranean diet, as defined by the Mayo Clinic, for preparing healthy, satisfying meals:

• Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
• Replacing butter with healthy fats such as olive oil and canola oil
• Using herbs and spices instead of salt to flavor foods
• Limiting red meat to no more than a few times a month
• Eating fish and poultry at least twice a week
• Drinking red wine in moderation (optional) - please discuss any alcohol consumption with your physician

Mesothelioma has an extended incubation period and it typically takes 20 years to 40 years before sufferers notice symptoms.  Close to 3,000 Americans are diagnosed with the disease each year.  According to the Ministry of Environment, mesothelioma cases continue to increase in Korea with the peak year for malignant mesothelioma expected to be in 2045.

The study, recently published in the Journal of Occupational and Environmental Medicine, found that workers who were exposed to asbestos between 1971 and 2005 had a significantly higher risk of developing cardiovascular disease and suffering strokes than those who were not.    

“Asbestos is already linked to mesothelioma, an incurable cancer, and several other serious lung disorders,” said Belluck, whose New York personal injury firm, Belluck & Fox, LLP, dedicates its practice to representing clients with asbestos-related diseases.

“The fact that medical researchers are correlating it with other deadly conditions only highlights its dangers and points to the need for further study of the consequences of asbestos exposure,” he said.

Asbestos is a material that was widely used in shipyards, building, construction, the automobile industry and ceiling and floor tiles. Health organizations, both in the U.S. and internationally, have recognized it as a dangerous carcinogen. Some countries have banned it.

Asbestos is the only substance known to cause mesothelioma. This aggressive cancer affects the lining of the lungs and abdomen. An estimated 2,500 to 3,000 Americans lose their lives to mesothelioma each year.

In the British study, researchers found that workers exposed to asbestos showed a higher rate of death from ischemic heart disease, which is a reduced blood supply in the heart muscle. In addition, 63 percent were more likely to die of a stroke.

Belluck said anyone exposed to asbestos that has become ill should contact an experienced mesothelioma lawyer to learn about their legal options.

“Although it is true that workers are most frequently diagnosed with mesothelioma, they are certainly not the only people who are at risk,” Belluck said. “Asbestos was used in the construction of residences, office buildings and other places where the general public may be found. Even though asbestos is not used now, there are still older structures where asbestos has not been removed, making the threat more widespread.”

Many sufferers of asbestos-related diseases will need extensive medical treatment, he said.

“A successful mesothelioma or asbestos claim can make dealing with the disease, at lease from a financial standpoint, more manageable,” Belluck said. “That leaves victims free to focus on treatment and spending time with their loved ones, which is always most important.”

About Belluck & Fox, LLP

Belluck & Fox, LLP, is a nationally recognized law firm that represents individuals with asbestos and mesothelioma claims, as well as victims of crime, motorcycle crashes, lead paint and other serious injuries. The firm provides personalized and professional representation and has won over $400 million in compensation for clients and their families.

Partner Joseph W. Belluck is AV-rated by Martindale-Hubbell and is listed in Best Lawyers in America, New York Magazine’s “Best Lawyers in the New York Area” and in Super Lawyers. Mr. Belluck has won numerous cases involving injuries from asbestos, defective medical products, tobacco and lead paint, including a recent asbestos case that settled for more than $12 million.

Partner Jordan Fox i s a well-known asbestos and mesothelioma attorney who has been named to the Best Lawyers in America, New York Magazine’s “Best Lawyers in the New York Area” and to Super Lawyers. On two separate occasions his verdicts were featured as the National Law Journal’s Largest Verdict of the Year. He recently secured verdicts of $32 million and more than $19 million on behalf of individuals who had contracted mesothelioma from asbestos exposure.

In September, Belluck & Fox, LLP, won a coveted spot on a list of America’s best law firms, which was published jointly by U.S. News & World Report and Best Lawyers magazine. The listing showcased 8,782 different law firms ranked in one or more of 81 major practice areas.

For more information, contact the firm at (877) 637-6843 or through the online contact form.

A Simon Fraser University researcher and his colleagues believe that cholesterol-binding proteins, or oxysterol binding proteins (ORPs), may slow or stop cancer cell growth.   They discovered this while observing how cholesterol moves around inside cells in the fat’s journey to cell surfaces where it reinforces their outer membrane. 

The study was published in the Journal of Biological Chemistry. 

The researchers found that when they engineered genetic changes in the ORPs they continued to function and move around, but they did not bind to cholesterol.  Further, the altered ORPs activated other “regulator” proteins that triggered processes leading to cell growth. Typically, the cholesterol-binding interferes with the ORPs’ ability to bind to PI4P, which is needed for cell growth. 

“That told us that ORPs probably have nothing to do with moving around cholesterol within cells,” said Chris Beh, SFU associate professor of molecular biology and biochemistry, and co-author of the study. “Rather cholesterol-binding puts the brakes on ORP’s ability to bind to PI4P which, if left unchecked, could accelerate cell growth like crazy,” says Beh. 

“Given that uncontrolled cell growth is a key feature of cancer, this means gaining a better understanding of the true purpose of cholesterol-binding within cells could be important in cancer treatment,” said Beh. 

Pleural mesothelioma is a fast-growing cancer of the lining of the lungs.  Due to the delay in diagnosis, mesothelioma often lies dormant for decades, patients are left with limited treatment options. Stopping tumor growth and preventing metastasis in cancers, especially mesothelioma which is highly aggressive and is resistant to many standard cancer treatments, is critical for increasing survival in patients.  A discovery such as this could help scientists develop a treatment that can significantly slow the growth of mesothelioma cells, leading to extended survival. 

The researchers know cancer cells require ORPs to survive, so now they need to determine which proteins respond to ORP activation and under what circumstances does cholesterol turn off ORP’s activation of them.

The $32 million verdict obtained in the case of Dummit v. A.W. Chesterton (No. 190196/10) placed No. 4 on the list. The $19.5 million verdict in the case of Konstantin v. 630 Third Avenue Associates (No. 190134/10) placed No. 10 overall and first in the construction category.

The firm secured both verdicts in August 2011 in New York Supreme Court. Judge Joan Madden presided over both cases.

Founding partner and veteran New York mesothelioma attorney Jordan Fox led the Belluck & Fox legal team. Senior litigator James Long, partner Brian Belasky and associates Seth Dymond and William Papain assisted him over the course of the two nine-week trials.

“These verdicts represent a measure of justice for the mesothelioma victims and their families who suffered needlessly because asbestos continued to be used long after its dangers were recognized,” Fox said. “Our clients and their families, as always, motivated us.”

Mesothelioma is a cancer of the lining of the chest and abdomen caused by exposure to asbestos, a naturally occurring heat- and fire-resistant fibrous mineral. Asbestos has been used in a variety of industrial machinery and equipment, and in consumer products.

Mesothelioma victims typically show disease symptoms years or even decades after exposure to asbestos in an industrial or manufacturing workplace. The disease is eventually fatal, but aggressive therapy may prolong the lives of patients who are diagnosed early.

In Dummit, a jury found Crane Co. and Elliott Turbomachinery Co. responsible for the asbestos exposure that led to a U.S. Navy veteran’s diagnosis of pleural mesothelioma. Mr. Dummitt had worked in the boiler and fire rooms aboard seven U.S. Navy ships between 1960 and 1977. He claimed that he was exposed to asbestos from his work repairing valves.

In returning its verdict, the jury determined that Crane and Elliott acted with a reckless disregard for the safety of others in failing to warn. The jury apportioned 99 percent responsibility to Crane and 1 percent responsibility to Elliott. The award included $16 million in past pain and suffering and $16 million in future pain and suffering to Mr. Dummitt.

In Konstantin, the jury found Tishman Liquidating Corporation, formerly known as Tishman Realty and Construction Co., responsible for Mr. Konstantin developing mesothelioma of the tunica vaginalis, one of the rarest forms of cancer in the world. Like all cases of mesothelioma, this form of the disease is not curable.

Mr. Konstantin claimed that he was exposed to asbestos during the construction of a high-rise building in Manhattan. During a period between 1976 and 1977, he claimed, he had inhaled asbestos that was released from joint-sealing compounds that his co-workers were using.

The jury found Tishman 76 percent liable and to have acted with reckless disregard for the safety of others. The jury awarded Mr. Konstantin $7 million for past pain and suffering, and $12 million for future pain and suffering. The verdict amount also included $64,832 for past lost wages, and $485,325 for future lost wages.

Both Mr. Dummit and Mr. Konstantin were diagnosed with mesothelioma in 2010.

Verdict Search is a legal research database of verdicts and settlements from across the U.S. The database is often used as a reference for publications such as The New York Times and The National Law Journal.

About Belluck & Fox, LLP

Belluck & Fox, LLP, is a nationally recognized law firm that represents individuals with asbestos and mesothelioma claims, as well as victims of crime, motorcycle crashes, lead paint and other serious injuries. The firm provides personalized and professional representation and has won more than $500 million in compensation for clients and their families.

Partner Joseph W. Belluck is AV-rated by Martindale-Hubbell and is listed in Best Lawyers in America, New York Magazine’s “Best Lawyers in the New York Area” and in Super Lawyers. Mr. Belluck has won numerous cases involving injuries from asbestos, defective medical products, tobacco and lead paint.

Partner Jordan Fox is a well-known asbestos and mesothelioma attorney who has been named to the Best Lawyers in America, New York Magazine’s “Best Lawyers in the New York Area” and to Super Lawyers. On two separate occasions his verdicts were featured as the National Law Journal’s Largest Verdict of the Year.

In September, Belluck & Fox, LLP, won a coveted spot on a list of America’s best law firms, which was published jointly by U.S. News & World Report and Best Lawyers magazine. The listing showcased 8,782 different law firms ranked in one or more of 81 major practice areas.

For more information, contact the firm at (877) 637-6843 or through the online contact form.

Due to the rarity of mesothelioma, an aggressive form of cancer caused by asbestos exposure, and all other orphan diseases, managing the disease and trying to find appropriate treatment can be overwhelming to the patients and their families.  NORD offers vital services to the public through providing information about diseases, referrals to patient organizations, research grants and fellowships and other critical services for those battling a rare disease. 

NORD will honor members of the U.S. Congress, patient advocates, medical researchers, and companies that have brought new therapies to market on Tuesday, May 15, at Union Station in Washington, DC.  The award ceremony is part of NORD’s annual “Partners in Progress Celebration” that highlights how “stakeholders in the rare disease community work together toward their shared goal of improving the lives of patients.”

“This is NORD’s opportunity to celebrate excellence and to say thank you on behalf of the patient community to those who have advanced the cause during the previous year,” said Peter L. Saltonstall, NORD president and CEO.   “We look forward to this event each year, and we truly appreciate the accomplishments it honors.”

Some of the NORD awards include: 

National health leadership award, to honor leadership in public policy to improve the lives of patients and families affected by rare diseases, will be presented to North Carolina Senator (D) Kay Hagan, who introduced The Transforming the Regulatory Environment to Accelerate Access to Treatments (TREAT) Act, targeted toward getting treatments in a quick and safe manner to patients with orphan diseases.  

Partners in progress corporate awards, to honor companies that have brought important and innovative treatments to market within the previous year, will honor Pfizer, Inc. for Xalkori, known generically as crizotinib, approved by the FDA with a companion diagnostic test to treat certain patients with late-stage, non-small cell lung cancers, and potentially mesothelioma patients, who express the abnormal ALK gene. 

A disease is designated as an orphan disease when less than 200,000 Americans are affected by the disease at any given time.  Mesothelioma is responsible for approximately 3,000 new cases of cancer each year in the United States.  Although there is no cure for mesothelioma, it can be treated with varying degrees of success through the use of surgical procedures, chemotherapy and radiation. 

NORD is a unique federation of voluntary health organizations dedicated to helping people with rare “orphan” diseases and assisting the organizations that serve them. NORD is committed to the identification, treatment, and cure of rare disorders through programs of education, advocacy, research, and service.

However, according to a survey sponsored by the Center to Advance Palliative Care and the American Cancer Society, 70% of the adults surveyed indicated they were “not at all knowledgeable” about palliative care, and another 8% had never heard of the term.  Even non-palliative care physicians are not fully aware of what palliative care offers patients. 

Can this be good? According to Dr. Diane E. Meier, director of the Center to Advance Palliative Care and professor of geriatrics and internal medicine at Mount Sinai School of Medicine, New York, the lack of knowledge about palliative care offers a huge opportunity to educate the public and to increase the number of palliative care medical specialists. 

In a presentation at the annual meeting of the American Academy of Hospice and Palliative Medicine, Meier stressed that now is the time to educate physicians as well as the general public that palliative care is “actually about relieving the pain, symptoms, and stress of serious illness in patients of any age and at any stage of disease, and that palliative care can be delivered alongside curative or life-prolonging therapies.” 

After the survey participants were educated about palliative care, 95% of those surveyed said it’s important for patients with serious illnesses and their families to learn about palliative care.  Further, 92% of them admitted that they would likely consider palliative care for themselves and loved ones when needed.

Dr. Meier and her colleagues believe a nationwide campaign to educate Americans of the importance and effectiveness of palliative care will create a demand for palliative care, thus requiring a “big boost” in the workforce.   Meier believes the current staffing level of palliative care specialists is so small “as to constitute a major barrier to access.” 

To affect change in the perception of palliative care, and to grow the workforce, Meier and others are seeking funding for a 5-year, multimillion-dollar social marketing campaign to increase public awareness regarding palliative care.  Meier points out that there is one oncologist for every 145 cancer patients, and one cardiologist for every 71 myocardial infarction patients, but there is just one palliative care specialist for every 1,300 people with a serious illness. 

The American Society of Clinical Oncology (ASCO) released new guidelines in 2011 regarding palliative care.  ASCO encourages physicians to discuss a patient’s treatment options and preferences, including end-of-life care, immediately after their terminal diagnosis so the treatment can be individualized from the start.  The patient will better understand how palliative care can be used as a complementary treatment option with chemotherapy or radiation, or as the last step in their care. 

When stricken with pleural mesothelioma, patients and their doctors continually struggle to keep the patients’ lungs free of fluid while trying to shrink the tumors that constrict the lungs and limit the patients’ ability to breathe.  Palliative care treatment is intended to control pain, stop bleeding, and relieve pressure, while chemotherapy focuses on limiting tumor growth.  For many mesothelioma patients, palliative care offers them an opportunity to stay out of the hospital and spend more time with their loved ones.