Author: Nancy Meredith
NYC Responders Show Pulmonary Disease
New York emergency personnel who responded after the World Trade Center attacks have shown an increased incidence of chronic pulmonary inflammation, researchers at Mt. Sinai reported in a recent clinical study. More than 50,000 men and women were exposed to products of combustion, asbestos and particulate matter after the terrorist attacks on September 11, 2001.
Mount Sinai researchers studied the medical records of almost 20,000 New York firefighters and emergency responders as part of a World Trade Center Monitoring and Treatment Program. The research, published in 2011 in the American Journal of Industrial Medicine, revealed an elevated number of cases of a pulmonary condition called sarcoid like granulomatous pulmonary disease. The average yearly occurrence of the disease among first responders more than tripled from 15 cases per 100,000 in health screenings before Sept. 11, 2001 to 54 cases per 100,000 in 2003 and 2004 —the peak years, according to the new study. Two other studies have reported similar findings.
Sarcoid Like Granulomatous Pulmonary Disease causes inflammation in one or more organs including the lungs and lymph nodes. Granulomas are small tumor-like nodules in the lungs, lymph glands, liver and salivary glands. Granuloma formation may lead to scarring of the lung, known as fibrosis. The cause of the disease is unknown, but it has been linked to multiple environmental and occupational exposures. A portion of those who develop the disease may suffer permanent lung damage.
“Our findings support the hypothesis that environmental exposures generated by the destruction of the World Trade Center may cause ‘Sarcoid like’ Granulomatous Pulmonary Disease,” said Laura Crowley, assistant professor of preventive medicine at Mount Sinai School of Medicine in a press release.
Some research has shown an association between sarcoid like granulomas, sarcoidosis and cancer, but exactly how they are associated remains unclear.
Crowley said monitoring of World Trade Center responders including periodic chest x-rays, must continue so that the NY responders health issues are identified and treated in the early stages.
Philip Landrigan, MD, chair of the Department of Preventive Medicine at the Mount Sinai School of Medicine, said the results of the study clearly support the critical need for ongoing monitoring and treatment for WTC responders.
A medical study published last year in the New England Journal of Medicine reported that New York firefighters and rescue workers who worked at Ground Zero after the 9/11 terrorist attacks still have significantly abnormal lung function years later. Some dust from the World Trade Center destruction contained asbestos and other contaminants, according to the Environmental Protection Agency. Inhaling airborne asbestos is closely associated with respiratory disease including lung cancer and mesothelioma, a cancer of the lining of the lung. Symptoms of mesothelioma typically take 20 to 40 years to appear after exposure to asbestos.
Asbestos Exposure Causes Cell Damage that Leads to Mesothelioma
Normal cells transform into cancer cells because of damage to DNA, the material within a cell that provides each person’s genetic blueprint. Most DNA damage is caused by abnormalities that occur while a normal cell is reproducing or because of obvious environmental factors such as cigarette smoking or asbestos, a human carcinogen.
Breathing asbestos dust allows microscopic fibers to penetrate the lungs and damage the mesothelial cells, the layer of specialized cells that cover many internal organs including the lungs, abdomen and heart. Asbestos exposure causes various kinds of DNA damage and eventually leads to a signature cancer called malignant mesothelioma.
Malignant mesothelioma produces tumors that grow uncontrollably in the lining of the lung or abdomen. If the tumors first appear in the lining of the lung, the cancer is known as pleural mesothelioma. If a person swallows asbestos fibers, the mesothelioma may appear initially in the abdominal cavity. It is called peritoneal mesothelioma. On rare occasions, mesothelioma tumors may appear in the lining of the heart, a form of cancer called pericardial mesothelioma.
Mesothelioma is typically classified as one of three subtypes depending on the appearance of the cell structure under a microscope. The most common cell subtype is epitheliod. About 50 to 60 percent of people with mesothelioma have this type and patients with this type of mesothelioma have a better prognosis, according to the American Cancer Society.
About 10 to 20 percent of mesotheliomas are sarcomatoid and 30 to 40 percent contain a mix of epitheliod and scarmatoid cells.
Most cases of mesothelioma are linked to exposure to asbestos in a workplace, though the symptoms may not appear until decades after exposure when the worker is retired or near retirement. About three out of four people with mesothelioma are older than 65 years old. The risk of developing mesothelioma corresponds to how much asbestos a person was exposed to and how long the asbestos exposure lasted. The risk of developing mesothelioma is a lifetime risk for people exposed to asbestos.
Asbestos In All Forms Including Chrysotile Causes Deadly Mesothelioma
The owner of the Jeffrey Mine in Quebec awaits a decision this month from the provincial government of Quebec on a request for $58 million in loan guarantees to reopen the asbestos mine.
In an article in The New York Times, G. Bernard Colombe, president of Mine Jeffrey, discusses his plan to revitalize the mine located in the town of Asbestos and export asbestos to nations such as India, Pakistan and Vietnam, countries that have weak worker safety laws. Colombe repeats the old asbestos industry canard that chrysotile asbestos is safe.
Asbestos describes a group of mineral fibers and all forms of asbestos cause cancer, according to the World Health Organization. Asbestos causes a signature cancer, mesothelioma that produces malignant tumors in the lining of the lungs or abdomen as well as lung cancer and asbestosis, a chronic scarring of the lung. About 3,000 Americans die of mesothelioma each year from exposure to asbestos decades ago. Asbestos-containing products such as pipe, insulation, roofing and cement are still widely used in many Asian countries and workers saw and hammer the building materials without knowing that they are breathing deadly asbestos.
Given the recognized health hazards of asbestos, medical and health organizations in Canada, the United States and Great Britain have condemned the proposed reopening of the mine and export chrysotile asbestos. Canada is one of the world’s leading exporters of asbestos and has blocked attempts by the United Nations to increase awareness of the dangers of asbestos among developing nations.
The World Health Organization says that all forms of asbestos cause cancer in humans including mesothelioma, lung cancer and cancer of the larynx and ovary. According to the most recent WHO estimates, more than 107,000 people die each year from asbestos-related lung cancer, mesothelioma and asbestosis. One in every three deaths of cancer contracted in the workplace is caused by asbestos.
The World Health Organization says the most efficient way to eliminate asbestos-related disease is to stop the use of all forms of asbestos.
New Leaders Committed to Seeking Cure for Mesothelioma
A woman who lost her 33-year-old son to mesothelioma and a doctor whose work led to the only chemotherapy drug approved to date to treat asbestos-related cancer will lead the national organization that provides patient support and funds peer-reviewed research on mesothelioma.
Hanne Mintz and Dr. Axel Hanauske will serve as 2011 co-chairs of the Mesothelioma Applied Research Foundation, the non-profit national organization announced. Malignant pleural mesothelioma is a cancer of the lining of the lungs caused by inhaling asbestos particles. The symptoms of the disease typically appear decades after exposure to asbestos, a mineral fiber used in building materials and insulation. About 3,000 Americans die each year of mesothelioma.
Dr. Hanauske is global brand development leader for Eli Lilly & Co., and is a professor of medicine at the Technical Institute in Munich, Germany, where his team of researchers discovered the effectiveness of chemotherapy using Alimta/Cisplatin in treating mesothelioma. Alimta, which is given in combination with Cisplatin, another cancer drug, works by blocking enzymes that are believes to spur growth of mesothelioma tumors. Alimta is distributed by Eli Lilly & Co.
Dr. Hanauske said he has seen advances in mesothelioma treatment and feels a responsibility to keep developing new treatments option until a cure is found for mesothelioma.
Hanne Mintz, whose son Adam died of mesothelioma, is owner of Paragon Language Services, Inc., a professional translation and interpreting agency in Los Angeles, CA. Ms. Mintz began seeking a cure for meosthelioma when her son was first diagnosed and has pledged to support the Meso Foundation in its efforts to advance mesothelioma research and save lives.
“It instills hope that researchers around the world are choosing to concentrate their efforts on the underfunded, under-recognized and not-so-glamorous world of mesothelioma,” Ms. Mintz said in a statement. “Research holds the answers while funding is its lifeblood; this is why the Foundation relies heavily on its generous supporters to ensure that promising research is rewarded with adequate funding. I look forward to seeing the pieces of the puzzle fall into place during my tenure.”
Blocking Cell Proteins That Fuel Mesothelioma
Conventional chemotherapy, radiation treatments and surgery have shown only limited effectiveness in improving the survival of patients with mesothelioma, a malignant cancer caused by asbestos exposure. Patients typically die within a year of diagnosis because mesothelioma is notoriously resistant to chemotherapy and other treatments. A better understanding of the biology of mesothelioma, which produces tumors in the lining of the lung or abdomen, may prove helpful in identifying targets for new therapies. In a January 2011 article in the journal Neoplasia, researchers at Harvard Medical School and Brigham and Women’s Hospital in Boston discuss their cancer research and efforts to “switch off” proteins that contribute to growth of malignant mesothelioma cells. The occurrence of pleural mesothelioma has increased in the United States and abroad since 1970, reflecting the heavy consumption of asbestos starting around World War II. About 3,000 people a year die of mesothelioma in the U.S. Some studies have suggested that certain cell surface proteins—known as Receptor Tyrosin Kinases—are involved in the complex transformation of normal cells into cancer cells in many types of human cancer, including apparently mesothelioma. But it’s still unclear whether the cancer cell transformation depends on a single kinase protein or multiple kinases. The researchers say that blocking tyrosine kinases has proven effective for treating certain human cancers including breast cancer, gastrointestinal tumors, leukemia and non-small cell lung cancer. But therapies targeting tyrosine kinases have not produced notable successes in treating mesothelioma. The researchers cultured 10 lines of mesothelioma cells. The mesothelioma cells showed coordinated expression of elevated levels of certain receptor proteins that cause cells to divide. The elevated protein levels were not present in normal cells. The researchers then treated the mesothelioma cells with drugs that interfered with cell communication by blocking the receptor proteins. The coordinated activation of multiple receptor proteins may allow mesothelioma cells to resist chemotherapy drugs targeting single proteins. The researchers reported that the greatest reduction in the viability of the mesothelioma cells occurred when they blocked multiple types of receptor proteins rather than singling out individual proteins. They hypothesized that inhibiting heat shock protein 90, which belongs to a class of proteins called chaperones that help other growth proteins function properly, might interfere with multiple receptor proteins. HSP 90 is associated with proteins linked to growth and development. The researchers reported that the growth of mesothelioma cells was significantly reduced after HSP 90 was blocked by an inhibitor drug. The results of their research suggest that blocking heat shock protein 90 deserves further study as a new therapy for treating mesothelioma. Further study is needed to determine if the lab results can be replicated in a clinical setting.
Free Mesothelioma Patient & Treatment Guide
We’d like to offer you our in-depth guide, “A Patient’s Guide to Mesothelioma,” absolutely free of charge.
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.
Download Now