Mesothelioma Help Cancer News
Tool to Help Diagnose Dangerous Weight Loss in Mesothelioma Patients May Improve Survival
Mesothelioma patients face surgery, chemotherapy and radiation treatments when battling their cancer. This multi-mode approach typically offers the longest survival for patients. However, patients suffering from extreme weight loss may not see any benefit regardless of the treatments they undergo. Now, researchers want to give oncologists a tool to help them determine the extent of their patients’ cachexia to make a difference in survival for these patients.
According to researchers from McGill University Health Centre (MUHC) in Quebec, nearly one-third of dangerously under-nourished patients will die because of this condition and not the cancer.
https://muhc.ca/newsroom/news/race-against-time-diagnose-deadly-weight-loss-cancer-patients
In a Nov. 4 press release from the University, the researchers report that due to the metabolic changes that take place as the patients waste away, treatment is not as easy as simply increasing food intake.
“We are losing many cancer patients, not because of their cancer, but because their bodies have undergone important metabolic changes,” said Dr. Antonio Vigano, lead author of the study and Director of the Cancer Rehabilitation Program and Cachexia Clinic of the MUHC. “In other words, they have simply stopped functioning correctly.”
Identifying cachexia is not as obvious as it seems, and according to the MUHC researchers, it is still “largely overlooked and untreated.” Mesothelioma patients with cachexia, or a profound state of general poor health and malnutrition that leads to loss of body weight and muscle mass, according to the American Cancer Society, respond poorly to chemotherapy agents and may suffer increased toxicity from the drugs leading to poor survival. Patients suffering from cachexia typically see increased hospitalizations and are “a major burden to family caregivers,” notes the researchers.
The team from MUHC looked at nearly 300 patients with GI and lung cancers. They grouped the patients into three classifications of cachexia – pre-cachexia (PCa), cachexia (Ca) and refractory cachexia (RCa) – as determined by five clinical criteria. The criteria they based the staging on were biochemistry, food intake, moderate weight loss, significant weight loss, and performance status.
Based on the results of their research, the team concluded: “Five criteria can be used to stage cancer cachexia patients and predict important clinical, nutritional and functional outcomes.” They turned their research into a tool to diagnose cachexia, which they predict could be available within the next few years.
“In order to save more lives, we need practical and accessible tools that can be effectively used by clinicians in their routine practice to identify patients with cachexia,” said Dr. Vigano.
Mesothelioma is a unique form of cancer, caused by asbestos exposure, where tumors develop on the lining of the lungs. The aggressive cancer quickly leads to other life-threatening complications, including cachexia in some patients. Nearly 3,000 Americans are diagnosed with the incurable cancer.
“Cachexia gets worse with time and the longer we wait to address it, the harder it is to treat,” said Dr. Vigano. “Effectively diagnosing cachexia when still in its early stages can make an enormous difference for a cancer patient’s prognosis and quality of life.”
For the full study, see the Oct. 2016 issue of Clinical Nutrition.
http://www.clinicalnutritionjournal.com/article/S0261-5614(16)31246-8/fulltext
Sea Cucumber Ingredient, a Promising Treatment for Mesothelioma
Once again, researchers are touting nature’s bounty as an effective way to treat cancer. Last year, MesotheliomaHelp reported on several natural cancer-fighting treatments, including ginger, onions and turmeric. Now, researchers report that sea cucumbers could hold the key to fighting mesothelioma.
Researchers from the Comprehensive Cancer Center of MedUni Vienna and Vienna General Hospital report they have proven that the active agent, trabectedin, found in the Caribbean sea cucumber, already being used in treating ovarian cancer, may be a “promising new therapeutic option for MPM [malignant pleural mesothelioma],” according to an Oct. 25 article in Medical News Today.
http://www.medicalnewstoday.com/releases/313580.php
The study results, where researchers looked at combining trabectedin with existing anti-cancer drugs, showed that not only is trabectedin effective against cancer cells, but it also has minimal impact on healthy pleural cells. The researchers went on to confirm further success when trabectedin was used with another drug that tackles the protein bcl-2, known to prevent cell death. They found “a significant improvement in destruction of malignant pleural mesothelioma cells.”
“Trabectedin therefore seems to be a new, effective and safe treatment option for this disease [mesothelioma],” concluded the researchers.
Mesothelioma patients often combine conventional treatments, such as chemotherapy, with alternative therapies, like natural supplements. However, researchers are working hard to create anti-cancer drugs based on naturally-occurring elements, such as trabectedin, that can be synthetically manufactured for medicinal uses.
Nearly 3,000 Americans are diagnosed with mesothelioma each year. Although survival is often less than 18 months, continued breakthroughs in novel therapies give many hope that extended survival is possible.
See the full study in the Oct. issue of the American Association for Cancer Research journal.
http://www.aacr.org/newsroom/Pages/default.aspx#.U-5djWOWZv4
Researchers Identify Proteins to Target to Increase Sensitivity of Mesothelioma and Lung Cancer Treatments
As MesotheliomaHelp has reported countless times before, researchers focus much of their time on biomarkers in mesothelioma and lung cancer patients to help increase the effectiveness of treatment. By targeting the unique characteristics of a patient’s cancer the researchers aim to increase survival. Now, researchers believe ALK, a key gene often targeted with anti-cancer drugs, can be more effective when other proteins are also targeted.
Everyone has the abnormal anaplastic lymphoma kinase (ALK) gene in their cells, but when a part of it breaks off and reattaches in the wrong way, it becomes an abnormal ALK gene leading to out of control cell growth and ALK-positive lung cancer. By blocking the action of the abnormal ALK gene, crizotinib (Xalkori), an ALK-inhibitor, may shrink or slow the growth of tumors, according to Pfizer, the makers or Xalkori. However, some tumors do not respond to the drug or develop resistance to it.
Researchers from Moffitt Cancer Center focused on increasing the sensitivity of lung cancer tumors to ALK inhibitors. The team turned to proteomics to allow a large scale review of proteins so they could “identify potential drug targets that could boost ALK inhibitors and improve patient outcomes”, according to an Oct. 19 article in Medical News Today.
http://www.medicalnewstoday.com/releases/313580.php
They found a host of proteins, 64 of them, could be used to increase sensitivity to crizotinib, and nine of them could do the same for alectinib, another ALK-inhibitor. They eventually narrowed the list down to two “adaptor proteins FRS2 and CC2D1A” that can increase the sensitivity of lung cancers to ALK inhibitors.
“Knocking down either of these two proteins, the scaffolding proteins FRS2 and CC2D1A, sensitized cell lines to the ALK inhibitors crizotinib and alectinib,” wrote the researchers. “Thus, a clinical strategy that inhibits FRS2 or CC2D1A might enhance the efficacy of ALK inhibitors in some patients.”
Crizotinib, or Xalkori from Pfizer, is intended for the treatment of metastatic non-small cell lung cancers (NSCLC) in patients who express the abnormal anaplastic lymphoma kinase (ALK) gene. Approximately 3%-5% of people with NSCLC may test positive for the ALK fusion gene. There is a potential that the marker is also present in certain pleural mesothelioma cases making it a target for treatment.
Pleural mesothelioma is a rare form of lung cancer that invades the outer lining of the lungs called the mesothelium. The only known cause of mesothelioma is through inhalation or ingestion of airborne asbestos fibers. Both NSCLC and mesothelioma are aggressive cancers following equally aggressive, and similar, treatment protocols.
“Collectively, our data set provides a resource that enhances our understanding of signaling and drug resistance networks consequent to ALK fusions and identifies potential targets to improve the efficacy of ALK inhibitors in patients,” concluded the researchers.
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For the full study see the Oct. 18 issue of Science Signaling.
http://stke.sciencemag.org/content/9/450/rs12
Nurse Raises Awareness of Atrial Fibrillation
Many patients in their journey with mesothelioma suffer from atrial fibrillation. Commonly known as a-fib or AF it is the most common form of heart arrhythmia. Heart arrhythmia is when “the heart beats too slowly, too fast, or in an irregular way,” according to the Centers for Disease Control and Prevention.
The heart is divided into four chambers: the two upper atria and the two lower ventricles. When a person has AF, the beating in the atria is irregular causing the blood to pool, leading to ineffective heart beats. Blood pooling can cause clots to form. The clots can then cause strokes, if they block the circulation to areas of the body.
Sometimes people do not know they are in AF, but describe feeling a fluttering sensation in their chest. Other symptoms can include heart palpitations, lightheadedness, extreme fatigue, shortness of breath, confusion, and chest pain.
Generally the risk for AF increases with age. Some other risk factors are high blood pressure, obesity, diabetes, heart failure, ischemic heart disease, hyperthyroidism, chronic kidney disease and heavy alcohol use.
The figures most often reported are that AF affects 1.5% to 2% of the general population, and this increases to 10% at age 80 and 18% at age 85. The evidence is limited in the association of a cancer diagnosis and AF. The most common time that AF occurs with cancer patients is after surgery, with the highest incidence being after lung surgery. In other studies, AF occurs in 6% to 32% of patients.
AF is treated with medication, blood-thinners, surgery, and lifestyle changes. The treatments are specific to each patient, and there are treatment guidelines and criteria that your doctor will follow to determine how to treat your AF effectively with your mesothelioma.
We have seen many mesothelioma patients with AF. Some patients do not realize they are in AF, others are symptomatic with low blood pressure and weakness. After surgery and during your journey with mesothelioma it is important that you not ignore any new and different symptoms that you may experience. Your medical team is experienced in managing AF and they can help you deal with your symptoms.
Some Hospitalizations for Mesothelioma Patients May Be Avoidable
Nearly every mesothelioma patient will be hospitalized at some point during their care. The cancer and treatments often leave patients with debilitating symptoms that require medical intervention to help manage the issues. However, new research reports that a significant number of cancer patients’ hospital visits could be avoidable.
Researchers at the University of Chicago looked at 72 terminal cancer patients’ ICU admission records and found “nearly half of terminal oncology ICU hospitalizations in our study population were potentially avoidable,” according to an Oct. 13 article in Oncology Practice.
http://www.mdedge.com/oncologypractice/article/115520/hospice-palliative-medicine/almost-half-terminal-cancer-patient
This “high-intensity end-of-life care,” according to the colleagues, “does not improve survival or quality of life for terminal cancer patients.” The researchers noted that the National Quality Forum, a non-profit organization that works to catalyze improvements in healthcare through measures and standards, referred to “ICU admissions in the last 30 days of life as a marker of poor-quality cancer care.”
Mesothelioma is a rare form of cancer typically affecting the lining of the lungs. Primarily caused by exposure to airborne asbestos fibers, mesothelioma has an extended latency period – symptoms can sometimes take decades to appear. However, once symptoms become apparent, mesothelioma may rapidly progress to cause life-threatening complications. The treatment at this point is no longer curative, rather palliative, and is aimed at relieving the symptoms and improving the patient’s quality of life. For many mesothelioma patients, palliative care offers them an opportunity to stay out of the hospital and spend more time with their loved ones.
Upon reviewing the data, the Chicago researchers identified the following factors associated with avoidable hospitalizations in the terminal cancer patients:
- Likely to be residing in an institutional setting;
- Worse performance status prior to admission;
- Most recent treatment of chemotherapy;
- Fewer days since diagnosis;
- Cancer symptom care;
- Recent palliative care consultation, potentially indicating the severity of illness.
Sadly, the researchers found that many of these patients would pass away in the ICU setting. This, they said, leaves the family with more stress. A separate UK study found that patients who die at home do so more peacefully than hospitalized patients but suffer no more than patients in a hospital. In addition, family members experience less intense grief with their loved one at home.
“ICU deaths often create a traumatic experience for patients and families,” the researchers note. “Health care leaders should test strategies to prospectively identify patients at high risk for avoidable terminal hospitalizations and formulate interventions to improve end-of-life planning and care.”
Many medical professionals advocate for terminal mesothelioma patients to look more closely at hospice care as their cancer becomes more aggressive and symptoms become more acute. According to the Hospice Foundation of America, hospice is designed to improve the quality of a patient’s last days by offering comfort and dignity. Hospice care neither prolongs life nor hastens death, reports the organization, however, it does allow for patients to remain in their own home surrounded by their loved ones.
“This study serves to highlight terminal ICU hospitalizations as an area of focus to improve the quality and value of cancer care,” concluded the researchers.
See “No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations” for the full report.
http://ascopubs.org/doi/abs/10.1200/jop.2016.012823
When a mesothelioma patient no longer responds to a prescribed treatment plan, and the primary caregiver needs support caring for their loved one, turning to a hospice program is one option to explore. Visit the Hospice Foundation of America to find out more about hospice care.
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