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Month: April 2016

Memorial Day to Remember US Veterans

Worker’s Memorial Day Is a Sad Reminder About the Dangers of Asbestos

April 28 is recognized as Worker’s Memorial Day. It is a day to remember those who have died or who have become ill because of their job, and is a time to look toward the future in building and requiring safer working environments for all.

You always hear on the news about tragic accidents that take employees’ lives far too soon. Unfortunately, as the mesothelioma community knows all too well, the workplace is not always the most harmless place to be. Many people who have been victims of mesothelioma were exposed to asbestos in the workplace. My Dad, Don Smitley, passed away at the age of 57 from mesothelioma. This disease is a direct consequence of exposure to asbestos.

Maybe this day is a good time to renew our commitment as well. By recommitting ourselves to the cause of removing all traces of asbestos from our lives, be it at work, at home, or at play, we can make a difference. The mesothelioma community has a goal to make this toxic substance illegal. Taking this on can be a key step in helping to eradicate mesothelioma.

My thoughts and prayers go out to all those who have lost a loved one in or because of an unsafe work space. Banding together, we can be the catalyst to make a change for the better.

Constipation Should Be Addressed Quickly Says Mesothelioma Nurse

Constipation Should Be Addressed Quickly Says Mesothelioma Nurse

Understanding what to expect from mesothelioma treatment can be confusing and difficult to understand. Patients and family members seek out the latest cutting-edge research and clinical trials in which to participate with the goal to increase quality time with their loved ones. But, regardless of the selected treatment, care comes with its own set of issues. Some of the common issues that mesothelioma patients face are pain, shortness of breath, fluid status issues, and depression.

One of the problems that occurs all too frequently for mesothelioma patients, but no one wants to talk about, is constipation. Constipation is emotionally upsetting and embarrassing to discuss. But, this common problem that can be daunting to patients and families dealing with mesothelioma treatment is vital to recognize and immediately address.

According to the National Institutes of Health and the National Digestive Diseases Information Clearinghouse, the definition of constipation is a “condition in which a person has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass.” Everyone is different, and for some people, not going once a day may make them think they are constipated.

This condition is very common with 15% of the U.S. population being affected, and is very common post-surgery. The most common causes for constipation are a diet low in fiber; a lack of exercise; medications, especially pain medications; and changes in daily routine. Post-surgery pleural mesothelioma patients, or any post-surgery patients, can have all of these factors.

Treatment for constipation can include a change in diet and exercise habits, or change of medication. When taking pain medication, it is very important to be aware of the possibility of constipation. Laxatives are usually ordered by your physician and should be taken along with the pain medications. Common laxatives are available by mouth and come in many different forms, including pills, liquid, and powder.

Constipation might seem like a minor problem, but left unrecognized and untreated, serious complications can arise. As an example, a patient I called recently was constipated with a distended abdomen and he felt miserable. He had to be readmitted to the hospital for care. He and his family had been so focused on pain and fluid restriction that constipation snuck up on them.

Mesothelioma patients and families need to realize how this common problem is one that they should be aware of and discuss with their mesothelioma team. When dealing with a complicated disease like mesothelioma it is important to remember the basics and the role they play in a successful recovery.

If you have questions about your mesothelioma treatment or any aspect of your mesothelioma care, please email me at [email protected].

Finding Cause of Cancer Metastasis May Lead to New Treatments

Metabolic Pathways, Key to Understand Mesothelioma Metastasis

The science behind understanding how mesothelioma cells continue to divide and spread despite being inundated with toxic treatments has confounded researchers for years. If cancer metastasis can be halted, patient survival will be improved. Now, researchers report they have uncovered a unique link between cancer pathways that leads to uncontrolled growth.

Researchers at Children’s Medical Center Research Institute at UT Southwestern (CRI), led by Dr. Ralph DeBerardinis, Associate Professor of CRI and Pediatrics, Director of CRI’s Genetic and Metabolic Disease Program, and Chief of the Division of Pediatric Genetics and Metabolism, found that two distinct metabolic cancer pathways are linked in such a way that cells adapt to the stress of cancer growth.

The researchers had a hunch that by focusing on “tumor-specific metabolic pathways” they could uncover a new, effective way to treat cancer. Building on previous findings by Dr. DeBarardinis, the team found cancer cells take advantage of the pentose phosphate pathway (PPP) and the Krebs cycle pathways to successfully fight off toxins.

In short, cells typically grow by “attaching to nutrient-rich tissue called a matrix,” according to the study, in order to manage growth and survival. When they detach, however, the cells perish. Not so for the cancer cells, though, say the researchers. Apparently, cancer cells have found a way to work around the process.

“We knew that both the PPP and Krebs cycle provide metabolic benefits to cancer cells,” said Dr. Ralph DeBerardinis in an April 6 press release announcing the findings. “But we had no idea that they were linked in this unusual fashion.”

According to various studies, metastasis is the cause of nearly 90 percent of cancer deaths. Halting tumor growth and preventing metastasis in cancers, especially mesothelioma which is highly aggressive and is resistant to many cancer treatments, is critical for increasing survival in patients. This research offers hope to mesothelioma and lung cancer patients that slowing or halting tumor growth is possible.

The researchers note that the study was conducted in a lab with cultured cell models. The next step is further research on living organisms.

“We are particularly excited to test whether this pathway is required for metastasis, because cancer cells need to survive in a matrix-detached state in the circulation in order to metastasize,” said Dr. DeBarardinis.

See the full report in the April 6 issue of Nature.

Know more about Mesothelioma and how you can deal with it.

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In the Future, When Cancer Cells Glow Green It’s A Go For Selected Mesothelioma Treatment

Nanotechnology is in the news again with a report that a new technique can determine within eight hours whether chemotherapy is effective for a patient. For mesothelioma patients, and all cancer patients, being able to quickly assess whether a treatment is effective can mean the difference in survival.

According to a March 28 press release from Brigham and Women’s Hospital announcing the findings, a team of researchers found that they can deliver a nanoparticle of a potential cancer treatment that will fluoresce green if the cancer cells die from the drug. The results rely on the enzyme caspase that is activated when a cell dies.

“We can determine if a cancer therapy is effective within hours of treatment,” said co- author Shiladitya Sengupta, PhD, a principal investigator in BWH’s Division of Bioengineering. “Our long-term goal is to find a way to monitor outcomes very early so that we don’t give a chemotherapy drug to patients who are not responding to it.”

One test used paclitaxel chemotherapy on a prostate cancer line. The test realized “an approximately 400 percent increase in fluorescence” in the tumors that were responsive to paclitaxel compared to those cells that were paclitaxel-resistent. The technology was also successful for monitoring the effectiveness of immunotherapy. The researchers yielded “a significant increase in the fluorescent signal” in tumors sensitive to the anti-PD-L1 nanoparticles after five days.

Determining the appropriate cancer treatment for a patient is a difficult and complex decision for patients and their oncologists. Finding an effective mesothelioma treatment is even more challenging due to the relative rarity of the disease. However, the ability to detect responders, as the researchers refer to an effective treatment, and non-responders, in real-time can spare patients needless treatment and allow the oncologist to quickly adjust the treatment protocol without losing precious time.

“Current techniques, which rely on measurements of the size or metabolic state of the tumor, are sometimes unable to detect the effectiveness of an immunotherapeutic agent as the volume of the tumor may actually increase as immune cells begin to flood in to attack the tumor,” said co- author Ashish Kulkarni, an instructor in the Division of Biomedical Engineering at BWH. “Reporter nanoparticles, however, can give us an accurate read out of whether or not cancer cells are dying.”

The researchers’ next step is to assess the safety and efficacy on humans. There was no indication as to the timeline of when this research can move into a clinical setting.

Brigham and Women’s is home to the International Mesothelioma Program. Managing over 300 mesothelioma consultations per year, the International Mesothelioma Program is the largest program of its kind in the world. The Program has a mission “to offer state-of-the-art treatment to patients with malignant pleural mesothelioma.”

The full report of the BWH study can be found in The Proceedings Of The National Academy Of Sciences.

Mesothelioma Patients May Question Their Mortality

He was in the ICU from a complication after his surgery. His journey with mesothelioma had begun just three months earlier. He had presented to his local doctor with what he thought was pneumonia- it wasn’t. Previously healthy, he was diagnosed with epithelioid mesothelioma. He and his family had researched mesothelioma, came to an academic center, had surgery. Things had been going well and then he had an unexpected complication – treatable – but unexpected.

Physically he was recovering, mentally he was devastated. He knew about the possibilities of complications since they had been explained in depth to him and he had accepted the risks of the surgery. Before the complication he was beginning to see that he and his family could cope with and live with mesothelioma.  He was beginning to feel that he had regained control of his life. Now, he lies in the bed wanting to know if death was imminent.

The psychological toll that the complication had taken on him was worse than the physical setback.

As the nurse, I know that he will get better from the complication physically, I can point out all the evidence that it will happen, he is ex-tubated, his vital signs are good, he is not on oxygen, he will soon be transferred to the step down unit.  All positive signs that he is on the mend.

What about his mental state?  He had done everything that was asked of him after surgery, and had landed back in the I.C.U- what does that say about his prognosis?  Once diagnosed with cancer, and when having treatment, finishing treatment, whether it be surgery, chemo, radiation, or clinical trial, in the back of every patient’s mind is the question, “When will I have a  recurrence?” Every patient needs to process and deal with this possibility.

The way to help is to listen and support the patient. Know that everyone responds to complications differently. Point out the positives in the patient’s situation, for example, physically you are better.  Acknowledge that it takes time to adjust to a diagnosis of cancer, and that there are ramifications. A cheery pep talk might not be appropriate, but simply pointing to the facts might help. Like every mesothelioma tumor is different, every patient’s reaction is different. It is important to accept that and adjust your approach.

I am happy to report that the mesothelioma patient in ICU did get physically and mentally better. He is adjusting – time, family love, and support can be the best medicine!

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It contains a wealth of information and resources to help you better understand the condition, choose (and afford) appropriate treatment, and exercise your legal right to compensation.

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