Mesothelioma Help Cancer News
Study Shows Pleural Mesothelioma Patients Live Longer With Trimodal Therapy
One of the biggest challenges in pleural mesothelioma care is determining which treatments to use on patients.
Oncologists are faced with deciding if a patient will benefit from surgery, chemotherapy or radiation, or a combination of the three.
Although each case is different, when mesothelioma patients are candidates for all of the options, which approach is the best?
Researchers report the results of a recent in-depth review of thousands of mesothelioma patient records points to the best survival when all three therapies are used.
A team of researchers from The University of Texas MD Anderson Cancer Center selected 20,561 malignant pleural mesothelioma (MPM) patient records, from the National Cancer Database for the years from 2004 to 2014, to evaluate patient survival. Noting that MPM is an “aggressive and rapidly fatal disease,” the team set out to determine the key predictors of mesothelioma patient survival.
Specifically, the team wanted to assess the difference in patients who first had mesothelioma surgery, then went on to have chemotherapy and/or radiation versus patients who did not have surgery.
The team narrowed the number of patients evaluated down to 6,645 from the initial selection and compared the results of patients with the following breakdown of treatment approaches:
- 2,166 underwent no therapy
- 2,015 underwent chemotherapy alone
- 850 underwent cancer-directed surgery alone
- 988 underwent surgery with chemotherapy
- 274 underwent trimodality therapy
The remaining 352 patients underwent another combination of surgery, radiation, or chemotherapy.
Although the researchers found that while any of the treatments alone were associated with improved survival, when chemotherapy and radiation followed cancer-directed surgery the” largest estimated effect was realized.”
Most importantly, patients diagnosed with epithelioid mesothelioma, the most common and treatable histological subtype of mesothelioma diagnosed in more than half of all mesothelioma cases, who received trimodal care had a median survival of 23.4 months vs. 14.5 months.
The team concluded that for mesothelioma patients, “Surgery-based multimodality therapy was associated with improved survival and may offer therapeutic benefit among carefully selected patients.”
MD Anderson’s Mesothelioma Program is comprised of a team of more than 30 experts representing medical oncologists, surgeons, radiation oncologists, pulmonologists and pathologists who work closely together to customize the best treatment for each patient.
Everyone on the team is considered an expert in their field and in mesothelioma. The Center cares for more patients with mesothelioma than almost any other center in the U.S., according to its website.
Read the full study in the Aug. 17 issue of Journal Of Clinical Oncology.
Our Mesothelioma “Aha” Moments
From time to time, there are moments in your life where things just click. Everything falls into place and makes sense, for good or for naught. Throughout my family’s journey with mesothelioma, we all had these “Aha!” moments.
The first of these moments came from my Dad himself. We were visiting the Flight 93 Memorial together as a family. While we were walking, he had to stop because he couldn’t catch his breath. He had been having some trouble for a few months, but he later told me that this was the moment he realized that something was seriously wrong.
For me, this moment of clarity came after my father’s diagnosis when we were directed to NYU Langone for surgery by a complete stranger. I realized that this was the answer to my prayers and that God was truly in control, something I always believed, but saw in complete transparency that day.
There were many times when we thought we understood what was going on. Dad’s scans were clear for a while, so we thought that the fight was over. He participated in a clinical trial, so we assumed that everything was working perfectly. Then, when the cancer returned, we thought we knew what to expect. We were utterly wrong.
Radiation took a completely different toll on my father’s body than the chemotherapy. Ultimately, it was complications from treatment that took his life; he was cancer free when he took his last breath. We didn’t understand this. If he was “cured”, why would there be a problem? This lead to another “Aha” moment.
We realized, and more importantly, accepted, after some time, that God’s plan is perfect. The moment that Dad passed away, he was in the arms of angels and free of pain and sickness. All of this was God’s plan, and He always seems to get it just right.
Are You Hovering Over Your Mesothelioma Loved One?
Picture it… you’re sitting quietly in the room while your loved one sleeps peacefully. You start thinking that they might be a little cold, or that their breathing seems like it might be a bit off. You walk over to them, listening, carrying a blanket. Next thing you know, they’re looking at you, wondering what in the world is going on!
I am a “hoverer.” There, I admit it! When someone I care about is sick or hurt, all I want to do is watch them to make sure they’re alright. I constantly hound them with questions of, “Do you need anything? Are you ok? Should I call the doctor? Are you sure you’re alright?” And, just for good measure, “Do you promise you’re ok?”
When my father was battling mesothelioma, my hovering tendencies were heightened. The person I loved so much was facing something that we had never experienced. I didn’t know what to do, so I did what I do best. I asked a million questions every day. I was constantly calling to check in when I wasn’t there. I’m sure I drove my Dad up a wall.
But then, on the other hand, Dad knew me so well. He knew that I was spending my time worrying and wanting to help in any way I could. These are just ways that I show how much I care, and it’s not something that I can change. Dad took my hovering ways in stride, appreciating that I was there and thanking me for my concern. He answered all my questions patiently, always assuring me that he was fine.
I am grateful that my father was someone who had that patience, the patience of a saint if you ask me! Others may not be in the same mindset. Even when I tried not to take over Dad, I still ended up doing just that. It’s tough to find a balance. In this case, I think the balance has to be between the patient and the caregiver. Cultivate your relationship together and see what works for both of you. Your loved ones will let you know what they need… even if that turns out to be some space!
Could Locking Out a Protein Halt Development of Mesothelioma?
Given the staggering number of Americans who die each year from lung cancer, researchers from the University of Kentucky College of Pharmacy, Memorial Sloan Kettering Cancer Center, and St. Jude Children’s Research Hospital joined forces to find a way to turn those statistics around. The team may have done just that by discovering a way to block a protein that “leads directly to cancer formation.”
After more than 10 years of research, the team found that high levels of the DCN1 protein led to an increase in lung cancer cases, and in lung cancer patients the protein directly correlated to a shorter life span. They were determined to find a way to block that protein and stop it from leading to early death, according to a June 26 press release from the University of Kentucky.
The researchers realized they needed to get to DCN1’s partner protein, UBE2M, and intercept it before it underwent a small modification known as N-terminal acetylation, after which it would bind to DCN1 and control the formation of cancer. Previous studies have shown that DCN1 promotes some squamous cell head, neck and lung cancers.
They were able to develop a compound that kept the DCN1 protein isolated and safe from the modified UBE2M. Likening the result to a lock and key system, if UBE2M was the key, and DCN1 was the lock, the compound, in effect, jammed the lock and stopped the key from entry. Further testing found the compound “effectively blocked DCN1 from binding to UBE2M.”
“To have spent decades on this research and have such promising results is truly exhilarating,” said Dr. Bhuvanesh Singh, a physician-scientist at Memorial Sloan Kettering Cancer Center, who laid the groundwork for the research.
Expert Insight
Dr. Bhuvanesh Singh
“This work represents a very important step towards developing a new approach to treat the most difficult of cancers and hopefully increase cure rates.”
When teams from some of the greatest cancer research centers in the U.S. get together, there are bound to be groundbreaking results. The collaboration between these three labs, according to the press release, “could mean relief to many of those suffering from a variety of diseases.”
As with all breakthrough research for lung cancer, the mesothelioma community takes notice. Pleural mesothelioma is an asbestos-caused cancer of the lining of the lungs that is very aggressive, much like lung cancer, and fights off some of the strongest cancer-fighting agents. Prognosis is often less than one year for patients. However, finding a way to attack cancer growth agents, such as with this research, could mean increased survival for mesothelioma patients.
Lung cancer is the leading cause of cancer death in men and women with an estimated 222,500 new diagnoses and 155,870 deaths in 2017, according to the National Cancer Institute. According to the UK researchers, Kentucky leads the nation in incidence and death rates from lung cancer. Kentucky ranks 30th in number of deaths from mesothelioma. Nearly 3,000 Americans are diagnosed with mesothelioma each year.
“We are excited about the implications of this research, which offer us a meaningful solution for addressing diseases like cancer, neurodegenerative disorders, and infection,” said Brenda Schulman, PhD, Joseph Simone Chair in Basic Research, St Jude Children’s Research Hospital HHMI, Investigator.
See the full study in the June 5 issue of the journal Nature Chemical Biology.
http://www.nature.com/nchembio/journal/vaop/ncurrent/full/nchembio.2231.html
Mesothelioma Patients’ Treatment Plans Can Match Their “Wants”
Towards the end of the presentation about mesothelioma at the orientation for new patients, the doctor always pauses and asks one question: “What does the patient want?” This sounds like a simple question, but as we are fortunate to see patients at the beginning of their journey, during the journey, and at the end of their journey, it is probably the most important question that is asked. Thinking about what is important to you may make your decisions easier.
This past week, as I was taking care of a patient, she shared with me that her treatment plans for her cancer are determined by what is important to her. Her husband has been very supportive and one thing that is important to her at this point is dining out with him. She is unable to cook and he has been doing that for her. But she enjoys seeing him relaxing, not having to be the one to cook and clean, and just enjoying simple conversation with him.
Another favorite thing she likes to do is admire and care for her garden. Although she cannot physically get down on the ground and weed and dig, others help out, and she now just enjoys looking at it. One of the greatest joys she experienced recently was the celebration of her church’s 100 year anniversary. This is how she wants to spend her time.
Recently, I asked the daughter of a mesothelioma patient what her mother wanted. She replied, “She wants to live.” Yes, we all want to live, but the point of the question was to uncover what is really important to the patient. If the treatment, side effects and possible complications leave her weak and unable to watch her grandchildren, is it going to take away and prevent her from doing things that she enjoys? Ultimately, she wanted to live to see her godchild’s wedding, and she would go through any treatment if it would get her there. She had made it clear that was important to her.
We all have one thing in common – our time on this earth is limited. What do you do with your time? What do you want? Reflect on this simple question. We are all different. What is right for you may not be what your family thinks or agrees with.
When diagnosed with mesothelioma, only the patient can accurately answer: “What do you want?”
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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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