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.

Mesothelioma Treatments

With new clinical trials being introduced on a regular basis, there are a variety of treatments being used on mesothelioma. The treatment used is dependant upon a variety of factors, including the extent of the disease, the age and medical history of the patient, and the location and type of the mesothelioma.

The most common treatments are:

• Surgery, where the tissue in the affected area is cut out. This may involve removing part of the organ depending on the size of the affected area.
• Radiation treatment, which involves the use of radiation treatment to kill off the cancerous cells in the affected area.
• Chemotherapy, which is the use of drugs in the body used to kill off the cancerous cells.

Pneumonectomy

A surgical procedure, known as pneumonectomy, can be used for pleural mesothelioma and involves the removal of the diseased lung. An extra-pleural pneumonectomy may be necessary depending upon the spread of the disease, and this may involve the removal of parts of the diaphragm as well as the lung. There is a high risk factor with this surgery, and its viability is dependant upon the patient’s overall health, smoking habits and the extent of the asbestos exposure. A pleurectomy is another type of surgery that may be used, and here part of the chest, abdominal lining and surrounding tissue may be removed.

Radiation treatment

Radiation treatment , which gives the benefit of treating the affected area without exposing the healthy cells and tissue, is another treatment used to treat mesothelioma. This is a speedy and commonly used method for many types of cancer, as well as mesothelioma. It works through the placements of radioactive sources in the affected area, which then give out radiation to kill off the abnormal cells. The radiation continues to transmit for around a year, working to destroy the tumour. Radiation therapy can be used alongside surgery, or if the patient is not well enough for surgery can be used alone.

Chemotherapy treatments

Chemotherapy treatments can be administered in the form of pills or injected medication. The downside of chemotherapy is that the drugs used can contain high toxicity levels and can therefore make patients quite ill. Side effects can include nausea, vomiting, hair loss, weight loss and physical fatigue. There are also a number of post-chemo drugs that are used to alleviate the side effects of the chemotherapy. Because chemotherapy drugs are not targeted towards a specific area, they are left to make their way through the body and find the affected area. This means that they are also able to affect tissue and cells that are unaffected by the disease, which can again cause side effects.

Palliative Therapies

Palliative Therapies may also be used on mesothelioma patients. These therapies entail draining excess fluid from the patient through the use of a needle and suction. To prevent further fluid accumulation drugs may be fed through a tube into the chest following the fluid drainage.

Often, a combination of treatments and a cocktail of drugs have to be used in order to treat mesothelioma patients. Again, the types of treatment used will be dependant upon the age and physical health of the patient as well as upon how far the disease has spread and where it is located.

The above are some of the most common treatments used for the treatment of mesothelioma, but they do not always work effectively on mesothelioma patients. Because of this, sufferers of mesothelioma may be offered treatment as part of a clinical trial as opposed to any of the traditional treatments.

With new mesothelioma cancer treatments are continually being tested through medical researchmesothelioma. And these clinical trials also give hope to the patients who allow themselves to be used as guinea pigs, enabling them to be a part of this important research and find a drug that may help them and others in the same situation. studies, it is hoped that an effective treatment will soon be discovered. These clinical trials enable professionals to asses whether the treatment being tested may one day be effective for general use to treat

Mesothelioma and the Law

Over recent years, we have seen many multi-million dollar compensation payouts to victims of mesothelioma, the asbestos exposure related cancer. This is a relatively new disease, both in terms of medical and legal awareness, and sufferers of mesothelioma are finding that they are entitled to a hefty compensation in many cases. And to help these victims get their dues, many lawyers and law firms have been trained and set up to deal with mesothelioma claims in order to get mesothelioma sufferers the compensation to which they are entitled.

Why are mesothelioma victims entitled to compensation? Well, most cancers not the fault of an outsider. Heavy smokers may get cancer through smoking, which is their own choice. Other types of cancer, such as breast, cervical and prostate are not anybody’s fault, although vigilance and regular check ups can help to identify these caners early on and therefore treat them effectively. However, mesothelioma is a totally different type of cancer. This is a cancer that could have been prevented, and it is the fault of outsiders – namely the irresponsible firms that made no efforts to protect their workers against the hazards of working with asbestos. You see, mesothelioma is the result of regular exposure the asbestos dust and fibres, which are ingested into the system and corrupt the cells of the protective lining that surround major organs – the mesothelium. The cancer lies dormant for many decades, and victims do not realise until thirty or forty years later that they have the disease. By the time tests have been done and a diagnosis has been made, it is often too late to do anything constructive about it, and the patient is left with just a short time to live – typically 4-24 months.

These mesothelioma lawyers are here to help victims of mesothelioma to get cold, hard cash from the companies responsible for their doomed fate. This compensation will help to cover medical expenses and pain and suffering. But, perhaps most importantly, it helps to provide financial stability and security for the victim’s loved ones after he or she has passed away.

The payouts for mesothelioma lawsuits have run from hundreds of thousands of dollars, to multi-million dollars. But the mesothelioma sufferer must ensure that the chances of success are optimised by seeking legal advice and assistance as soon as the diagnosis has been confirmed. Most states only provide a certain time within which you can file a mesothelioma lawsuit, so it is vital that you do this immediately. Your lawyer will also need the extra time to put your case together and carry out any necessary research. Time is of the essence where mesothelioma lawsuits are concerned, and just a few days could make the difference between financial security for your family and no compensation at all.

If you are concerned about not having any money up-front to pay for legal costs, don’t be. The vast majority of mesothelioma lawyers work on a contingency fee basis. This means that they do not take any money from you up-front. And if your case is unsuccessful they will not take any money from you at all. You only have to pay the lawyer if and when you receive compensation. Your lawyer will then be entitled to a percentage of the compensation. And, although the cut to which the lawyer is entitled can seem high – generally around the 35% mark – it does mean that you don’t have to worry about paying in order to file for compensation and you have nothing to lose if you don’t get any compensation.

Your mesothelioma lawyer will also be able to give you support and advice with regards to your illness. The experienced mesothelioma lawyers have already built up a network of contacts within the field; not only for legal support but for all types of support and advice. This network means that your lawyer can process your claim more quickly than a lawyer who has little or no knowledge or experience in dealing with mesothelioma lawsuits. The experienced lawyer will also be able to point you in the right direction for additional support services and support groups.

Mesothelioma Research

Mesothelioma is a disease that is still very hard to recognise, difficult to diagnose and virtually impossible to treat effectively. It is known that the disease is asbestos related and that there is a long latency period before symptoms become apparent. But with more and more cases coming to light each year, it is vital that further research is carried out in order to make this fatal disease more manageable for both patients and doctors.

Many organizations are involved in research in to mesothelioma. This includes the companies that are responsible for the use of asbestos. Many people that have been diagnosed with mesothelioma have now discovered that they can claim compensation for being exposed to hazardous asbestos by companies, which means that these companies have a responsibility to help with this research.

The National Institute of Cancer is also working hard to research mesothelioma, its symptoms, diagnosis and treatment. The rising number of mesothelioma cases means that it is essential to learn more about this disease in order to look into developing treatments.

With many mesothelioma patients now seeking legal advice, it has become essential for law firms to learn about and research the disease. It is the lawyer’s job to assist the mesothelioma patient and provide advice and resources from which the patient can get help and assistance. Therefore, law firms dealing with these types of cases also have a responsibility to learn about the disease and what can be done to help patients.

A great deal of research into mesothelioma goes into learning about the effects of asbestos upon cells, and how the cells are changed by exposure to this material. By learning how healthy cells and corrupted by asbestos, we hope to learn more about how this cell corruption can be prevented or minimised.

The National Institute of Cancer has also carried out clinical trials into the treatment of mesothelioma. The trials, which are performed with real patients who have been diagnosed with mesothelioma, should help to determine how effective the various treatments are, and hopefully will go some way to helping experts find more effective treatments for the disease.

Mesothelioma trials are based upon treatments that are thought to have some value to patients. But the trials are just that – trials. This means that there are no guarantees and that a great deal more work and research will be required before a conclusive and effective treatment is found. On the upside, many new trials are being carried out on a regular basis, and with the information and technology available to scientists today, the discovery of an effective treatment for mesothelioma patients is just a matter of time.

Medical professionals worldwide are currently involved in clinical trials, and each trial depends upon the extent of spread of the disease. Some trials are performed on those who have been diagnosed reasonably early, others on patients who were not diagnosed until the latter stages of the disease. It is important for scientists to find a treatment that is effective not only on those who are diagnosed early, but on all patients that suffer from this killer disease.

The research carried out into mesothelioma will hopefully mean that future generations of suffers can be saved, even if they are diagnosed with the disease. The research carried out is extremely costly, and is often sponsored by associated companies such as drug companies and research groups as well as by the government. Research into the contraction of the disease, and its subsequent development will ultimately enable professionals to devise the most effective treatment.

Several new methods of treatment have been used following research into mesothelioma. These include:

• Photodynamic therapy, which uses fixed frequency light to target abnormal cells and kill them off by the activation of photosensitizing drugs.
• Immunotherapy, which fights the abnormal cells through the use of the body’s own defence system through enhancement and development of the immune system.
• Intensity Modulated Radiation Therapy, which is a radiation treatment that targets just the affected area/tumour, thus avoiding contact with healthy cells and tissue.

Although there is no quick-fix answer to the treatment of mesothelioma, ongoing research and dedication from the medical profession means that the chances of finding an effective treatment are continually increasing.

Treatment

Pleural effusion caused by heart failure or infection can usually be resolved by directing treatment at the cause, however, when testing has realized no diagnosis, and fluid continues to build or recur, doctors may recommend chest tube drainage and chemical pleurodesis. Chemical pleurodesis is a technique in which a sclerosing agent is used to abrade the pleural surfaces producing an adhesion between the parietal and visceral pleurae. This will prevent further effusion by eliminating the pleural space. Talc appears to be the most effective agent for pleurodesis, with a success rate of nearly 95%. It is highly effective when administered by either poudrage or slurry. Poudrage is the most widely used method of instilling talc into the pleural space. Before spraying the talc, the medical team removes all pleural fluid to completely collapse the lung. After the talc is administered, they inspect the pleural cavity to be sure the talc has been evenly distributed over the pleural surface. Some doctors prefer to use talc mixed with saline solution which forms a wet slurry that can roll around the pleural cavity.

Diagnosis

Diagnosis of pleural effusion is usually accomplished with a simple chest x-ray, although CT scans or ultrasound may also be used. A special x-ray technique, called a lateral decubitus film, may be used to detect smaller effusions or to enable the physician to estimate of the amount of fluid present. If the underlying cause of the effusion is readily apparent (such as in the case of severe congestive heart failure), sampling of the fluid may not be necessary, however, because pleural effusion may be symptomatic of a number of disease processes from benign to malignant, a fluid sample is generally taken. Diagnostic thoracentesis, in which cells are extracted from the pleural cavity, is commonly done when the possibility of mesothelioma exists, however, in up to 85% of cases, the fluid tests negative or inconclusive even though cancer is present. It is ultimately a needle biopsy of the pleura (lining of the lung) or an open surgical biopsy which confirms a mesothelioma diagnosis.

Symptoms

As the volume of fluid increases, shortness of breath, known as "dyspnea", and sometimes pain, ranging from mild to stabbing, may occur. Some patients may experience a dry cough. When the doctor listens to the patient’s chest with a stethoscope, normal breath sounds are muted, and tapping on the chest will reveal dull rather than hollow sounds.

Types

Pleural effusion is broken down into two categories, transudates and exudates. A transudate is a clear fluid that forms not because the pleural surfaces are diseased, but because of an imbalance between the normal production and removal of the fluid. The most common cause of transudative fluid is congestive heart failure. An exudate, which is often cloudy and contains many cells and proteins, results from disease of the pleura itself, and is common to mesothelioma. To determine whether a fluid is a transudate or exudate, a diagnostic thoracentesis, in which a needle or catheter is used to obtain a fluid sample, may be conducted.

Pleural Effusion

One of the most common symptoms of mesothelioma is a pleural effusion, or an accumulation of fluid between the parietal pleura (the pleura covering the chest wall and diaphragm) and the visceral pleura (the pleura covering the lungs). Both of these membranes are covered with mesothelial cells which, under normal conditions, produce a small amount of fluid that acts as a lubricant between the chest wall and the lung. Any excess fluid is absorbed by blood and lymph vessels maintaining a balance. When too much fluid forms, the result is an effusion.

Follow-up testing?

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

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 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 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.

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.

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.

Asbestos scandal: 'Name the culprits'

A FORMER member of a council at the centre of a scandal which saw staff exposed to deadly asbestos has called for the senior officers in charge at the time to be named.

Employees at the Woodhouse Close Leisure Complex, in Bishop Auckland, were allowed to work unprotected with the dangerous materials for five years - even though their bosses had been given an official warning by inspectors that there was asbestos in the building.

Magistrates fined Wear Valley District Council £18,000 after the authority admitted six serious breaches of health and safety law. None of the executives who were in charge at the time appeared in court because they no longer work for the authority.

Now, a retired councillor has called for the officers responsible to be identified.

"These people should be named - even if they are no longer employees of the council," said the retired councillor, who served on the council as a Liberal Democrat member from 1999 until earlier this year.

The Health and Safety Executive (HSE) inspector who brought the case to court said staff would have been exposed to a "significant" health risk, but because no official action was taken to monitor the asbestos, it is unclear how many people were affected.

The council was first warned about asbestos in pipe lagging in the centre's boiler room in 2001, but ignored the information. The HSE began investigations in January last year when a council worker made an official complaint after finding out about the report.

The new regime in charge at Wear Valley has issued personal apologies to the people affected.

"None of us knew about this at the time - the full report should have gone before full council," said the retired councillor.

"The council has to accept responsibility because it owns the building, but at the end of the day those individuals are also responsible because they didn't act on this report.

"The council could only act on this sort of thing if the information is put in front of everyone."

Michael Laing, Wear Valley's present-day chief executive, said the council would not be naming the officers in case any further legal action needed to be taken.

He said: "It is not a case of anybody avoiding responsibility. We don't want to prejudice any further action the council may have to take."

Safety and Health Topics

Asbestos is well recognized as a health hazard and is highly regulated. An estimated 1.3 million employees in construction and general industry face significant asbestos exposure on the job. Heaviest exposures occur in the construction industry, particularly during the removal of asbestos during renovation or demolition. Employees are also likely to be exposed during the manufacture of asbestos products (such as textiles, friction products, insulation, and other building materials) and during automotive brake and clutch repair work.

OSHA and Environmental Protection Agency (EPA) asbestos rules are intertwined.