UK Researchers Identify Gene That May Limit Metastasis

Hawaii Researchers’ Efforts to Crack Mesothelioma Code Aided by $3.5m Gift

Michele Carbone, director of the University of Hawaii Cancer Center and his colleagues, have made a series of recent scientific breakthroughs in understanding the mechanism by which asbestos triggers mesothelioma, an aggressive cancer of the lining of the lung and abdomen.

In recognition of that groundbreaking research, an anonymous donor has given the University of Hawaii Cancer Center a $3.58 million gift to support mesothelioma research, the university announced this month. The gift is the second largest in UH Cancer Center history.

“Mesothelioma is a serious public health problem,” said Virginia Hinshaw, chancellor of the University of Hawaii Manoa. “We’re proud that Dr. Carbone’s team is leading the world in this area of discovery. This gift validates their efforts and will help them remain at the forefront of thoracic oncology research.”

Closely associated with inhaling airborne asbestos fibers, mesothelioma produces an aggressive type of tumor. The current median survival from diagnosis is just 12 months, creating a need for more effective therapies to extend mesothelioma patients’ lives. Approximately 2,500 to 3,000 people in the U.S. are diagnosed with mesothelioma each year. Most were exposed to asbestos decades before cancer symptoms appeared.

Dr. Carbone and colleagues including Assistant Professor Haining Yang and Adjunct Professor Giovanni Gaudino have studied asbestos-related disease for more than a decade, analyzing how genetics, environmental carcinogens and viral infection interact to cause malignant mesothelioma.

In an article in the Proceedings of the National Academy of Sciences, Carbone and colleagues described how asbestos killed cells through a process called programmed cell necrosis that leads to the release of a protein molecule HMGB1. People exposed to asbestos have elevated levels of the protein in their blood. The protein begins an inflammatory chain reaction in tissue that causes the release of mutagens that promote tumor growth. Cancer often occurs in the presence of chronic inflammation. By interfering with the inflammatory reaction, it may be possible to decrease the occurrence of mesothelioma.

Many of the UH researchers’ findings have been based on work conducted in the villages of Capadoccia, a region of Turkey that has an extraordinarily high rate of mesothelioma deaths. Nearly 50 percent of the region’s residents develop and die of mesothelioma from exposure to eronite, a naturally occurring mineral fiber found in rock formations that is even more toxic than asbestos. Eronite has been used in the U.S. in road paving.

Drs. Carbone and Yang plan to conduct a clinical trial co-sponosored by the U.S. National Cancer Institute in Cappadocia to validate the serum biomarkers they discovered for the early detection of mesothelioma.

Their findings may have applications far beyond the villages of Turkey and lead to new ways to prevent and treat the disease. In the future, treatment approaches aimed at identifying people who are likely to develop mesothelioma based on elevated biomarkers and blocking chronic inflammation could reduce the risk of mesothelioma among workers exposed to asbestos.

“This generous gift is critical to support our efforts to generate discoveries that will aid in the prevention of mesothelioma and the development of new therapies,” Dr. Carbone said in a statement.

Asbestos Exposure Asbestosis and Mesothelioma

NY Medical Center Cited For Asbestos Workplace Safety Violations

One of the primary ways that workers today are exposed to cancer-causing asbestos is during demolition and remodeling activities. A workplace safety investigation at a Brooklyn medical center serves as a cautionary tale of the need to train workers to prevent asbestos exposure.

Many older buildings and houses, constructed before 1980, have asbestos-containing ceiling tiles, floor tiles, insulation, or plumbing. Demolition and remodeling activity can raise clouds of asbestos dust, jeopardizing the health of workers who breathe the microscopic mineral fibers floating in the air. Inhaling asbestos is associated with mesothelioma, an incurable cancer of the lining of the lungs, as well as lung cancer and asbestosis, a chronic scarring of the lung that causes shortness of breath and breathing problems.

Last week, inspectors with the federal Occupational Safety and Health Administration cited the Interfaith Medical Center in Brooklyn, New York with 14 violations of workplace safety and health standards and proposed $48,000 in fines.

Kay Gee, OSHA’s NY area director for Brooklyn, Manhattan and Queens, said that federal work safety standards require that employees whose jobs bring them into contact with asbestos or potential asbestos-containing materials should be trained about the hazards of asbestos and the required safety precautions to protect their health.

According to a U.S. Department of Labor news release, an OSHA inspection found that the medical center failed to provide adequate asbestos training for environmental staff and employees in the engineering department who perform demolition and renovation. Asbestos exposure is an occupational hazard for demolition and renovation workers. In addition, the hospital failed to label properly asbestos-containing insulation and floor tile and allowed the disposal of asbestos-containing materials in the hospital dumpster. The hospital also failed to train trade workers about the hazards or inform outside contractors of the presence of potentially asbestos-containing materials, the inspectors said.

The OSHA inspectors issued citations for 10 serious asbestos violations and proposed a total of $48,000 in fines. A serious violation is defined as one where there is a substantial probability that serious physical harm or death could result from a hazard that an employer knew about or should have known about.

Interfaith Medical Center has 15 business days to comply or contest the findings before the independent OSHA review commission.

Robert Kulick, OSHA’s regional administrator in New York, said creating and maintaining an illness and injury prevention program to identify and eliminate hazards is a means of addressing such workplace hazards.

Approximately 3,000 people in the U.S. are diagnosed with mesothelioma each year. Many are workers and veterans exposed to asbestos in the 1960s, 1970s and 1980s. The symptoms of mesothelioma typically take 20 to 50 years to appear after the initial exposure.

Asian Asbestos Tsunami Forecast

The number of people in Asia who develop mesothelioma and other asbestos-related diseases will increase sharply in the next two decades new research projects.

According to the study in Respirology, the journal of the Asian Pacific Society of Respirology, the increase in asbestos use in Asian countries since 1970 is likely to trigger a surge in asbestos-related disease in the next 20 years. Mesothelioma, a cancer of the lining of the lung, is a signature disease of asbestos. But workers exposed to asbestos typically take 20 to 50 years to experience symptoms of mesothelioma or lung cancer after inhaling microscopic asbestos fibers.

Dr. Ken Takahashi, the lead author and acting director of the World Health Organization Collaborative Center for Occupational Health, said that Asian governments should brace for an “asbestos tsunami” in the years ahead.

Asia’s share of worldwide asbestos use has steadily increased from 14 percent in the decades before 1970 to 64 percent from 2001 to 2007, the study said. Yet, the 12,882 deaths attributed to asbestos-related disease in Asia account for only 13 percent of the overall deaths linked to asbestos during the period.

In Asia, asbestos, a mineral fiber, is still widely used in building materials, roofing, cement and power plants. Many Asian countries that import asbestos have weak or non-existent workplace safety laws, leaving workers exposed to asbestos.

In the United States and Europe, most uses of asbestos have been banned since the late 1970s and workers must wear safety equipment to prevent inhaling asbestos.

The World Health Organization identifies asbestos as a dangerous workplace carcinogen and occupational hazard. It called for a worldwide ban on asbestos. An estimated 107,000 people die from asbestos-related diseases annually including approximately 3,000 in the U.S.

New York Case Serves As Reminder of Hazard of Asbestos Demolition Debris

The owner of a New Jersey solid waste management company, a New York farm owner and two associates have been arrested on federal charges of conspiring to dump thousands of tons of asbestos-contaminated demolition debris at an upstate New York farm, according to the U.S. Department of Justice. Exposure to asbestos can cause serious respiratory disease including mesothelioma, a cancer of the lining of the lungs and abdomen.

According to the June 3 press release, Dominick Mazza, of Tinton Falls, N.J., owner of the solid waste company Mazza & Sons Inc., Cross Nicastro II, owner of a farm in Frankfort, N.Y., and two others were arrested for illegal dumping of 30,000 tons of asbestos debris in Frankfort in 2006.

Asbestos fibers are highly toxic if inhaled and can cause asbestosis, lung cancer and mesothelioma. To prevent exposure, the New York Department of Labor and federal workplace safety regulations strictly prescribe how trained workers should handle asbestos materials during demolition of older buildings and disposal. Asbestos removal workers must be certified to handle asbestos safely to prevent public exposure.

The seven-count indictment details an alleged scheme to illegally dump thousands of tons of asbestos-contaminated pulverized construction and demolition debris that was processed at Eagle Recycling and Mazza & Sons Inc,’s solid waste management facilities in New Jersey. The asbestos contaminated debris was transported to Frankfort, N.Y., and dumped at Nicastro’s farm near the Mohawk River. Much of the farm’s lands are federally-designated wetlands.

According to court documents, Julius DeSimone, of Rome, N.Y., who was also indicted, oversaw the excavation and asbestos debris dumping on the farm. Another defendant, Donald Torriero, of Wellington, Fla., concealed the illegal dumping by fabricating a New York Department of Environment Conservation permit and forging an official’s signature on the fraudulent permit.

The indictment charges the defendants with conspiracy to defraud the United States, violate the Clean Water Act and environmental laws and commit wire fraud.

The defendants have entered pleas of not guilty, according to The Wall Street Journal. Earlier this year, Eagle Recycling of North Bergen, N.J., which produced most of the truckloads of asbestos-containing debris, pleaded guilty to conspiracy and agreed to pay $500,000 and comply with environmental laws. A waste trucking broker Jonathan Deck also pleaded guilty in 2009.

The use of asbestos is now strictly regulated in the U.S. But until the late 1970s, asbestos was widely used in many types of building materials. Many older buildings and factories still contain asbestos materials. Asbestos exposure is an occupational hazard of remodeling and demolition workers and a primary way that workers may be exposed to asbestos today.

Apps for Doctors Treating Mesothelioma Patients Offer Quick Access to Critical Information

By Nancy Meredith

Physicians are known for keeping long hours and for being on call and available to their hospital, their patients, and even their families. In the past, that meant dropping whatever they were doing to immediately head to the hospital for a consultation. However, in this day of Wi-Fi, smartphones and iPhones, doctors can use the technology to stay where they are and access critical medical information including patient records, patient monitoring systems and key medical reference material. The use of mobile phone apps is making a difference in the ability of physicians to be responsive, and can be extremely beneficial for oncologists maintaining watch over their critically ill patients with mesothelioma, lung cancer or other cancers.

Mesothelioma is an asbestos-caused cancer that is highly aggressive and is resistant to standard cancer treatments. As a result, patients are often closely monitored to allow their oncologist to quickly change treatments to prevent the disease from progressing to causing life-threatening complications. Since the doctor cannot always be near the patient or the hospital, a phone app with a patient monitoring capability is the next best thing.

Doctors Readily Adopt the New Technology

In a study by Manhattan Research, the authors found that seventy-five percent of U.S. physicians own some form of Apple device, and that they are quickly embracing the technology for use in their practice. “Physicians also express strong interest in being able to access electronic medical records through the iPad – as more EMR [electronic medical record] providers offer this ability, iPad accessibility may be a deciding factor for some practices when selecting an EMR provider,” said Meredith Ressi, president of Manhattan Research.

The ability to use mobile devices in their profession to assist their patients and colleagues has spawned a plethora of apps. In fact, over 6,000 medical apps are available today, according to Dr. Itifat Hussain, founder of iMedicalapps.com. Apps exist for patient support, educational purposes, drug references, to use as medical calculators and even to translate medical terms to foreign languages. While not all of them are useful or practical for physicians, it is important that physicians stay aware of the latest offerings.

Apps Provide Help to the Oncologist

As support to the “untethered physician,” Hussain and his team of physicians and medical students provide commentary and reviews of mobile medical technology and applications on iMedicalapps.com. The top app they recommend is from MedScape.

The app is critical for physicians treating mesothelioma patients to stay abreast of the latest clinical information, to learn more about the disease from key medical articles and to use the “powerful drug interaction checker” to help prevent patient toxicity. With the number of medicines a mesothelioma patient often takes, a pocket drug reference guide can allow the doctor to make quick decisions should an issue arise.

Some apps specific to oncology and useful for mesothelioma patients and their physicians, listed on iMedicalApps.com, include:

Cancer.net – this app is for the cancer patient and offers reference material and the ability to store questions, as well as suggesting questions for the patient to ask.
Mobile MIM viewer – the first FDA approved mobile DICOM (CT & MRI) images viewer.
Mobile mini NMR (nuclear magnetic resonance) device – operated by a smart phone to detect cancer cells in under one hour (from Harvard and MIT researchers).
Cancer Trials App – oncologists can find information on cancer clinical trials that could be relevant to their patients.

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