Mesothelioma Help Cancer News

Matthew Hadfield Essay Contest Submission

• Nancy Meredith
• Scholarship

Essay by Matthew Hadfield

Prior to attending medical school, I worked as a research coordinator on clinical trials for new oncology drugs. Through this position I was fortunate enough to meet many patients suffering through their cancer diagnosis. It was in this position I met Jack, a man in his mid-fifties who had stage four, metastatic mesothelioma. Jack was a very proud man from East Boston, and had worked his entire life as an auto-mechanic. It was only a year before I had met Jack when he had found out he had mesothelioma. He had been at the car garage he was employed at when a dry hacking cough started producing blood. He was referred to an oncologist the very next day.

Within a week Jack transitioned from his life of fixing cars to support his family to deciding which treatment options he would choose. I don’t believe anyone can understand the emotions and feelings that a person experiences when they find out they have cancer, unless they’ve lived through it. The disease starts with one mutated cell smaller than can be seen with the human eye. Yet it creates shockwaves through a person’s life, rocking the world of everyone they care about. Cancer can decimate the health of a person, strain relationships and threaten financial security. It does all of this without discriminating.

By the time Jack was referred to the experimental oncology group his mesothelioma had metastasized from the pleural lining around his lungs where it had begun. The chemotherapeutic agents he had been started on failed to hinder the cancer’s growth. We placed Jack on a highly experimental drug combination that had some evidence that it may work in his cancer type. He no longer qualified for surgery. There were no other conventional chemotherapeutic options for him. Our trial would be his last hope at beating his disease.

Jack’s wife was teary eyed as our oncologist explained his likely prognosis. There was an extremely unlikely chance this treatment would help. It was explained that phase 1 trials are designed to determine the safety of medications and not to study their efficacy. The reality was that Jack would be helping future cancer patients with his participation far more than he was helping himself. Jack kept his proud demeanor through the entire conversation and consented to the trial.

“I hope I help someone by doing this” he told the oncologist as he signed his name.

Phase 1 trials were often discouraging to work on. With the purpose of the study being to determine safety, the dosages used are very small. The doses are so small they don’t typically illicit clinical responses in the patients. When Jack began the trial, he had a CT scan done of his lungs. The scans showed very large lesions where the cancer had spread. He would return to the center weekly for check-ups and would be rescanned in six weeks.

The combination of experimental drugs was difficult for Jack to tolerate. At his weekly appointments, he complained of extreme nausea and vomiting. He felt extremely fatigued. He was discouraged. Each week he needed reassurance from the nurses to continue the trial. At each week’s visit, it appeared the treatments were getting less and less tolerable. Finally, week six came. Jack would be rescanned and the physicians would review his images. When the final report was available I impatiently waited for it to load on my computer. I had to read through it three times to fully comprehend the report.

“All lesions have regressed by over 90%” the report read.

I was in disbelief. The experimental drugs were melting the mesothelioma away. I had felt more hopeful than I had in months. I thought these drugs would cure Jack’s mesothelioma. The team’s oncologist was even more excited and could not wait to share the news with Jack later that day.

Jack didn’t share the enthusiasm. He was pale and weak. When he learned of the improvement of his cancer he hardly reacted. The cancer was being treated, but our drugs were literally killing his body. He pleaded with the team to reduce the dosages of the medications.

The team hesitated.

He was responding to the treatment so well and to dose reduce him could jeopardize that. Jack left them no option, either go down on the dose or he would remove his consent from the trial.

We reduced the dosages of both medications he was taking. His demeanor started improving at each of his weekly visits. His nausea and vomiting started to get better and he was no longer fatigued. He was visibly better each week we saw him. Soon another six weeks had passed and the team held their breath when he got his CT scan. It felt like it took a lifetime for the report to load on my computer. After opening it, my heart sank. The lesion’s in Jack’s lungs had grown back and new lesions had formed. Several lymph nodes had expanded in size.

The cancer had exploded.

Jack’s mesothelioma had progressed so rapidly that we had to take him off the trial. Within three weeks he was placed on hospice care. Within one month he had passed away, with his wife and children by his side.

I didn’t have much knowledge of mesothelioma until I was fortunate enough to meet Jack. I learned an enormous amount about the science and the pathological features of the cancer. Even more importantly I learned that Jack likely developed mesothelioma from his years of working on car brakes. The asbestos he was exposed to every single day lead to this horrible disease. He was exposed to a toxin that caused cancer at the place he worked so hard to make a living.

I think of Jack often. He is the reason I came to medical school to become an oncologist. He was a courageous man who willingly entered a clinical trial so that others could learn from his sacrifices. He was a man who worked hard every single. I feel very passionate about the field of oncology. Cancer is truly a disease we have not fully come to understand. People like Jack are the reason I work hard every single day to become a physician. I hope to someday contribute to the knowledge of cancer, and help to find a cure for this devastating disease.

About

Matthew Hadfield

I am currently a third year medical student and aspiring medical oncologist. Prior to medical school I worked as a clinical research coordinator at the Dana Farber Cancer Institute in Boston, MA.

Make your bed

• Nancy Meredith
• Scholarship

By: Landon Poe

In small-town USA 1965, Dewey Poe was 20 years old when he failed out of state university and left to face his disappointed father. As the first of four children to attend college, anything short of graduation would have been unacceptable. Confused and demoralized, my grandfather found sanctuary at a Columbus Marine Corps Recruiting Office. At 21 he took the only option he felt possible and enlisted in the Marines. A move to simply save face ended up being a 27-year long career. He retired with the rank of Gunnery Sergeant, after travelling the world by ship.

It started with his daily morning runs. His breathing became difficult and sometimes he would stop, his hands on his knees, bending over because he was dizzy and he was seeing spots. He did not appear to be the formidable drill instructor he was a few years ago. He went to the doctor who referred him to a surgeon up in Charleston, just in case. My mother told me that she thought ‘just in case’ meant nothing. He was supposed to drive up, see him and be just fine the next day. When the doctor delivered the news, “we think it’s mesothelioma”, she began crying quietly. She was in the middle of her medical degree and pregnant with his grandson.

In 1994, the doctors told him that they could not operate and gave him a year to live. Once again, confused and demoralized, Dewey turned to the military. If he learnt anything from being a Marine, he learnt the value of making his bed. He told me that if you did not accomplish anything all day, then at the very minimum at least you would come home to a made bed and you would have done one thing for the day. He turned to his principles to change his lifestyle completely. He cut out refined sugars, and all fried food from his diet. When once, he would have practically inhaled a plate of fried oysters, he now juiced fruits and vegetables for nutrients. With enormous pain, he let go of everything he cherished about southern cuisine – the hardest to eliminate was his wife’s pulled pork. He loved everything about the succulent, smoky flavorful meat, capped with coleslaw and just a little too much mayonnaise. But he took everything into his stride, turning each one into his one accomplishment a day. He began to meditate and read Pat Conroy’s books voraciously. If he had known that Pat Conroy would fight a battle with pancreatic cancer himself, he would have thought he had found a soul friend.

By the time I was five, I had begun to understand that there was something different about the man I visited after school every day. He made it a point to come to every single one of my hockey practices and even as a small child, I understood the emotional importance of the regimen he had made for himself. Dewey never stopped to ask why him. He woke up every day and felt he had a purpose – to nourish his body the best he could, to spend as much time with his friends and family as he could. When he finally gave in to mesothelioma, he had it easier than most. He woke up in the middle of the night and told his wife he was going to use the bathroom. He came back to bed and simply passed away then. I remember my father commenting that “no man could have died better”. He had battled mesothelioma for seven years and he spent the weekend right before he died fishing with his grandson.

I was glad he didn’t have much pain. The first line of the last book he read was “the water is wide, and he has now passed over”, written of course, by Pat Conroy. I was seven years old, and he had been my role model and best friend growing up. I knew when I got older, I wanted to be just like my Vietnam War hero “Popop” Dewey Poe. I choose to go to The Citadel Military College of South Carolina. It was here I developed my own daily routine much like my granddad. Instead of drinking beer and experimenting with drugs like my high school friends at other universities, I was shining my shoes, marching in parade, and of course, making my bed. After my freshman year and wanting to follow in his footsteps as a soldier in the U.S military I accepted a scholarship to commission as an officer in the Army. The military has a long tradition of having older enlisted soldier who acted as a mentor give a newly commissioned officer their “first salute”. He was not there, but I know he would have been so extraordinarily proud.

Today, U.S. Veterans make up one third of mesothelioma diagnoses in the United States – a disquieting statistic published by the U.S. Department of Defense. By the time my grandfather had become a Marine, fighting in Vietnam, asbestos was being used everywhere on board the ships he worked. It was being used to insulate pipes and boilers, line tanks and ovens and it had made its way into nearly every construction material for its resistance to electrical, fire and chemical damage because it was cheap. The surprising thing is that we had conclusively known the risks of asbestos for three decades by the time my grandfather became a Marine. In 1930, Merewether and Price found that a quarter of the 363 workers handling asbestos in mills around Great Britain showed signs of lung scarring from when the micro-particles from asbestos fibers would literally smother their lung tissue, causing chronic inflammation and scarring. This fibrosis because so closely associated with asbestos, it was called asbestosis.

It is not enough for us to give veterans benefits after the fact. There is still so much we can do to remove asbestos from military equipment, it makes no sense to choose the cure over prevention. The problem goes beyond veterans, and is truly nationwide. Too often, race, poverty and environment converge to pollute communities of people of color disproportionately. I hope to become an urban planner, making sure that industries do everything they should to prevent their workers from being exposed to toxic chemicals and pollutants unnecessarily and prevent their negative externalities from harming the communities around them as much as possible. Jan Egerton and Don Smitley were true warriors in the fight against their mesothelioma and I hope their strength inspires others and changes the minds of legislators around the nation. Survivors of mesothelioma and their families have an enormous potential role in this debate, and I aspire to be a part of that change.

On the first conclusive study of asbestosis
Merewether, E. R. A., & Price, C. W. (1930). Report on Effects of Asbestos Dust on the Lungs and Dust Suppression in the Asbestos Industry. Part II. Processes giving Rise to Dust and Methods for its Suppression. Report on Effects of Asbestos Dust on the Lungs and Dust Suppression in the Asbestos Industry. Part II. Processes giving Rise to Dust and Methods for its Suppression.

On a description of the prognosis of mesothelioma
Lynch, K. M., & Smith, W. A. (1935). Pulmonary asbestosis III: Carcinoma of lung in asbesto-silicosis. The American Journal of Cancer, 24(1), 56-64.

On environmental racism
Cole, L. W., & Foster, S. R. (2001). From the ground up: Environmental racism and the rise of the environmental justice movement. NYU Press.

About

Landon Poe

I am Landon, a cadet at the Citadel Military College of South Carolina. I major in both Business Administration and International Relations and following graduation, I will be pursuing a masters in Planning, Growth and Regeneration at the University of Cambridge. Too often, race, poverty and environment converge nationwide to create communities near polluting industries, concentrating disadvantage within the community. I hope to become a policy maker, rejuvenating disadvantaged communities to create equal access to healthy living and working environments.

Jade Golden – Essay Contest

• Nancy Meredith
• Scholarship

Essay by Jade Golden

All of my life, my mother had always been exceptionally healthy – almost unusually so. She was in great shape, she ate well, and she was busy, much too busy to even have the sniffles. However, one evening while we were having dinner, my mom casually mentioned that she had been feeling winded while climbing up and down the stairs. She attributed her shortness of breath to a nagging “chest cold” she had been suffering from for the past month. It was an odd thing for her to complain about anything, so I suggested she see a doctor.

At first, her health providers thought she had pneumonia. Her symptoms were vague and easily attributable to common and mostly benign respiratory conditions. She didn’t have a remarkable past medical history or occupational history that would cause suspicion or draw any red flags. In spite of this, further workup and a lung biopsy revealed the insidious cause of her breathing difficulty.

Stage IV mesothelioma. I vividly remember my brother coming into my room to tell me her diagnosis. My mom’s physician had just called about the biopsy results. At the time, I didn’t know what mesothelioma was. Confused and worried, I searched online for any information I could find. The one thing that stood out amongst the blur of panic was “poor prognosis” and disease mortality charts indicating my mom would have only a few months to live.

Despite a prognosis that would have crushed those with less of a will to survive, my mom charged forth with a tenacity and positivity that astounded me. For the next four years, she fought hard, going through round after round of life zapping chemotherapy as well as invasive surgeries. Although she did enjoy some happy years of remission, her cancer eventually returned and progressed rapidly. During this time, we spent endless hours in hospitals, consulting professionals, searching for solutions to a problem that we could not fix.

Words cannot accurately describe the helplessness I felt in watching my mom suffer. How could someone who had been so independent, vivacious, and vibrant all her life suddenly become this frail shell of the person she once was? She had lost the ability to complete even the simplest of tasks and was unable to walk unassisted. Her abdomen was like a giant watermelon, hard and swollen from ascites. Her legs were edematous and trunk like. Even her once soft, flawless olive skin was ashen, tented and fit loosely on her bones. I did what I could to make her feel her best – I dressed her, bathed her, put her makeup on, prepared her meals. However, her health continued to decline. On a warm afternoon in late June, my mom passed away.

My mom’s battle with mesothelioma truly gave me an appreciation for the sanctity of human life and encouraged me to seek ways where I could help other people in a medical setting. Because of her, I chose to go to graduate school to become a physician assistant, because I knew I could make a positive impact on the lives of others. I hope to use my education to help patients with cancer and give them the resources they need to head into battle with the positivity and determination to beat this devastating disease. Treating cancer is not just a physical battle. It is a mental and emotional one, too. I don’t want any one of my patients to feel alone or alienated by the challenges they face. I want to ensure that they have strong support system – family, friends, a support group, myself – ready to listen to their fears, share their concerns, and cheer them on.

To this day, we are unsure when or where my mom was exposed to asbestos – this is why raising awareness for mesothelioma and educating the public about the dangers of asbestos is crucial. Asbestos exposure is the primary carcinogen linked to the development of mesothelioma. Asbestos has been used in a wide array of products including insulation, car brakes, paints, adhesives, and ceiling tiles to name a few (“Asbestos”). When asbestos-containing products are damaged, asbestos fibers can be released into the air. If a person inhales these fibers, the fibers can get caught in the lungs causing damage to lung tissue, which potentiates the risk of developing cancers, like mesothelioma (“Asbestos”). Although the most commonly affected organ system is the lungs, asbestos can also become trapped in the abdomen or pericardium, which is the lining around the heart (“Mesothelioma Cancer”). Groups recognized as high risk for asbestos exposure include individuals who have worked in industries such as shipbuilding, textiles, construction, and asbestos mining (“Asbestos”); however, this does not exclude those who have not worked in such fields. Even people who do not work in such industries should be aware of asbestos containing materials at home, school, or work and be mindful to avoid those materials.

Physicians had difficulty diagnosing my mom with mesothelioma because she did not fit the typical demographic of most mesothelioma patients. It can take up to 10-40 years before symptoms of asbestos exposure occur (“Asbestos”), so identification of exposure is often difficult unless the patient has had significant occupational history in one of the previously mentioned industries. The most common presenting symptoms in mesothelioma are shortness of breath and chest wall pain, but patients can also present with fatigue, weight loss, fever, and sweats (“Mesothelioma”). It is important that people presenting with these symptoms seek medical care, especially if they have known asbestos exposure.

To someone who has lost a loved one to mesothelioma, I would say don’t ask the “what ifs”. I have often asked myself, “What if I knew then what I know now about mesothelioma? What if I had told her to see a doctor sooner? What if I could’ve changed what happened?” The “what ifs” do not change what has happened. It took me a long time to realize that. Now, I focus on the happy moments. I think about my mom dancing at my brother’s wedding. I think about her laugh and her smile. Mesothelioma took so much, but it has not taken away all the loving memories I have of my mom that keep her spirit alive.

References:

• “Asbestos Exposure and Cancer Risk.” National Cancer Institute. N.p., n.d. Web. 17 Feb. 2017.
• “Mesothelioma Cancer.” Mesothelioma.com Resources for Patients and Their Families. N.p., n.d. Web. 20 Mar. 2017.
• “Mesothelioma.” Practice Essentials, Background, Etiology. N.p., 08 Jan. 2017. Web. 23 Mar. 2017.

About

Jade Golden

I am currently studying at MCPHS University to become a physician assistant. My mom was diagnosed with mesothelioma when I was a senior in high school and passed away shortly after I graduated college. She inspired me to pursue a career in healthcare. I hope someday to share my knowledge and compassion with patients and their families who are dealing with difficult situations like the one my mom and family went through during her battle with cancer.

Heather Johnson – Mesothelioma Essay Contest

• Nancy Meredith
• Scholarship

Essay by Heather Johnson

When I was a small child and would hear that someone had cancer, I couldn’t comprehend what that meant and in my case, it was always old people. So initially I began to equate it to the elderly and death. These people that contracted cancer were also sort of mythical to me while I was growing up. I was never a direct victim back then in my early years. Oh, how I yearn for the ignorance of youth at times.

My first dance with the big C was in my early twenties. It should be described more as a “scare.” I had for the first time in my life had a pap smear that gave me abnormal results. That then lead to a biopsy and then a procedure called a LEEP. I was educated on the wonderful HPV virus and told how lucky I was that I didn’t need additional treatments, so I moved on with my life just feeling a little less invincible.

Cancer decided it would leave me and people close to me alone for a while and then suddenly it decided to change my life and the lives around me drastically. To tell the story, I need to go back to before I was even born.

Imagine spending your childhood in the 50’s and 60’s on a big farm. Having a mother that made fresh breakfast every day with the eggs from the chickens on the farm. You drank milk from what the cows produced on the farm. Everything was green and fresh. You would play outside barefoot with the barnyard kittens and your farm dog would follow you all around when he wasn’t sleeping under a tree or chasing a tractor.

Your family owned several farms in the area and hundreds and hundreds of acres, so when it was nice and you got older you and your younger sister would go on bike rides to visit and play with other relatives that lived on the other farms. Sometimes even with all that excitement you would get bored and even though your Mother would get cross at you; you would ride to the outer borders of the town that was close by and play there.

That was extremely entertaining. There was a huge factory there with a huge parking lot that after the day shift workers went home would get very empty. Lots of fun for kids and their imaginations. Back then, cops wouldn’t kick children out for trespassing because the businesses weren’t worried about the next law suit that might occur yet. So, this left for hours of entertainment. Four square games, tennis matches and different hop scotch games would take place just to name some examples. Then tired and tuckered out, everyone would return home to get the sweat off their bodies, maybe evening chores, or dinnertime.

Everything seemed so simple and pure back then. No one was worried about the billows of white, gray, and black smoke that came out of the factory. They didn’t worry about how they disposed their waste and the fact that this factory bordered a creek and the Kreider’s Dairy Farms. It brought jobs and industry to a small town in Lancaster. It was Manheim’s Raymark Asbesto’s plant.

The factory opened in 1906 bringing more than 500 jobs to the small country town. It was mostly shut down by the 1980’s and totally closed by 1998. Asbestos has been linked to cancer and mesothelioma. Mesothelioma is sometimes even called the “asbestos cancer.” It affects the thin lining that encases our organs. Of course, only people that worked at the factory would be at risk for this type of cancer. Wrong!

My mother-in-law, Patricia Kreider Johnson was that child mentioned above. Living and growing up in that pure country life. She grew up with fresh food straight from the farm and had no lack of exercise. Who knew that just living a little over a mile from the asbestos plant would have such a horrendous effect on her life 50 years later.

In 2011, my husband and I were driving when we got a call from Brian’s (my husband’s) grandmother. The typical grandmother checking up on her grandson conversation.   During this conversation, she asked him if he talked to his mother. He responded, “No, why.” She then told him that his mom, who was a hospice nurse, hasn’t been at work for three days. She had been ill and not sure what was making her sick. At this point, they suspected a bad case of the flu.

A week later, still no answers. Now we were all very worried and concerned. Bloodwork was coming back normal. How could this be? The woman was so fatigued she could barely lift her head. She was sleeping two-thirds of the day. This was not normal for anyone who knew her. To say she was active is an understatement. She could be a whirlwind.

Two more weeks later, she finally had her diagnosis. Stage 4 mesothelioma with approximately 6months to a year life sentence. We were in shock. Incurable. We were in denial. The family opted to try to extend her life with no avail. The treatments just made her weak. They made her even more immunocompromised so she couldn’t be around the grandchildren. She slept all the time and had so much pain. Pat passed away almost 9 months after her diagnosis.

At the same time my grandmother, who also had cancer but of a different kind also passed away. This was my first real time with any loss and not only did I have to grieve my Nana but also my mother-in-law. How was I supposed to be there for my husband and children as they lost their mother and grandmother? Those weeks and months are a blur.

It was about six months later, November 2013 I enrolled in my first class to take that spring semester with the goal of a nursing degree. My Nana always would say to me “you should have been a nurse” when I was taking care of her and I could honor my mother-in-law at the same time. I will never be able to fill Pat’s shoes. She was an incredible nurse.

I have one more year left. In the beginning, I was taking classes part-time and working full-time, but I started to get so eager about fulfilling my dream that I enrolled at PA College of Health Sciences for the fall of 2016 full-time. My daughter and I are freshman simultaneously at a different school. I also have three amazing boys and am trying to pay for the rest of school by only taking out the federal loans. This has been difficult, going from a two-income household to one income. My husband has been super supportive. I thank God for him every day.

Finally, this is what cancer did to me. It took away two amazing people in my life in a short period of time, but it let me say goodbye. It taught me that each day is a gift and to respect time and make the most out of it. It taught me that every chance you get to see or talk to someone you love, you express it and never say goodbye to them without “I love you” attached. It taught me to look at life differently and I can’t quite explain that but I just know I do; I look at it so much differently now.

About

Heather Johnson

I’m a wife and mom of 4 wonderful children and currently working on my RN. My oldest is also in college. I love to live life to the fullest. My favorite saying that I learned from my Dad is “Living the Dream” when anyone asks how I am doing. When I talk with people about mesothelioma, it amazes me, in my area especially, how many people have not heard of it.

Is It Just A Cough Or Is It Mesothelioma?

• Nancy Meredith
• Featured News

Not everyone who has been exposed to asbestos will develop mesothelioma, but it is important to be aware of the symptoms and to know when to contact a doctor. A cough is one symptom that many pleural mesothelioma patients share, yet it can also simply be a cold or the flu. Knowing the difference can impact a patient’s long-term health.

According to a Sept. 18 article in Medical News Today, while coughing is a “protective action” that helps clear the lungs of germs or harmful objects, when the cough lingers, it may be time to take note. Specifically, the authors note, if a cough is associated with coughing up blood or rust-colored phlegm, shortness of breath, or chest pain you should call a doctor.

Mesothelioma is a terminal, asbestos-caused cancer that may not be diagnosed until decades after the patient was first exposed to the carcinogen. Many times the patient will not even realize he or she was exposed to the mineral, and chances are the deadly asbestos cancer is the last thing on a doctor’s mind when trying to understand why their patient cannot get rid of their cough, why their lungs are filling with fluid and why the antibiotics are not helping.

Expert Insight

“A cough that is associated with lung cancer can be either dry or wet. It can occur at any time, and even be so severe that it interferes with sleep at night.”

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However, early detection of mesothelioma is critical and can positively influence a patient’s survival by increasing treatment options and improving their quality of life while battling the cancer. An accurate diagnosis that distinguishes between a temporary illness, such as pneumonia,  and mesothelioma is critical for ensuring an appropriate treatment plan is established from the onset.

There may be other symptoms that go along with your cough, that should also sound an alarm, such as wheezing or hoarseness of the voice, problems swallowing, loss of appetite, and returning bronchitis or pneumonia.

Mesothelioma can be challenging to diagnose, and often before an accurate diagnosis there are multiple misdiagnoses. It is not uncommon for a diagnosis to take months and many trips to the doctor’s office and even the emergency room. Pleural mesothelioma symptoms can mimic other diseases such as the flu, pneumonia, and other cancers, making it very difficult to diagnose.

If you have been exposed to asbestos in the past and are suffering from a lingering cough, do not hesitate to contact a doctor. Nearly 3,000 Americans are diagnosed with a form of mesothelioma each year.