Mesothelioma Help Cancer News
Imaging Tool May Guide Surgeons to Successful Removal of Mesothelioma Cells
Duke University and Massachusetts General Hospital oncologists are helping to bring a breakthrough cancer-fighting tool to surgeons. The two centers have partnered with Lumicell, Inc., in clinical trials to test the safety of an investigative tool that could help surgeons achieve total cancer resection in one attempt. For mesothelioma patients who have a very high chance of recurrence, this tool could be a life saver.
Developed by Lumicell, Inc., LUM015 combines a hand-held imaging device with an injectable agent that glows, or fluoresces, when cancer cells are detected. This gives surgeons instant feedback and guides them to remove all traces of the cancerous tumor.
According to Lumicell, the company “is addressing the number one challenge in cancer surgery – the need to remove all cancer cells within the tumor bed during the first surgery,” with its LUM015 technology.
“The unprecedented ability to see and remove all cancer cells during the initial surgery has the potential to significantly improve surgical outcomes and reduce healthcare costs by eliminating the need for repeat surgeries,” reports Lumicell.
Mesothelioma, an unusual form of cancer caused by exposure to airborne asbestos fibers, often has a complex growth pattern making complete surgical removal a very difficult task. Surgeons often have to guess how much tissue to remove, then send samples to the lab for confirmation that they got it all. If cancer cells are found in the margin of the tumor, that often means recurrence is inevitable and another surgery may be required.
LUM015 is unique in that it offers real-time visuals to the surgeons to ensure clean tissue margins, indicating all cancerous cells have been removed. This helps eliminate repeat surgeries to remove any missed cancer cells and, as a result, it can halt cancer recurrence and metastasis.
“In the operating room our goal is to take out 100 percent of a patient’s tumor, and the way we try to do that is to take out a margin of normal tissue around the tumor,” said Brian Brigman, M.D., Ph.D., chief of orthopedic oncology at Duke, in a Feb. 2 interview with ABC11 News in Raleigh, NC. “There are parts of the tumor that are microscopic that we couldn’t see even if we wanted to. What the probe does is allow us to see microscopic disease that was maybe left behind.”
Although Dr. Brigman is enthusiastic about the potential use for the tool, saying, “This is groundbreaking research in the way we treat sarcomas,” he admits it could still be 10 years before the tool is used on a regular basis with patients.
To the nearly 3,000 Americans who are diagnosed with mesothelioma each year, and who typically face a grim prognosis, this tool could extend their survival and improve their quality of life.
LUM015 is currently being tested on breast cancer patients. For more information on the clinical trial see ClinicalTrials.gov.
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“Disclaimers” Can Help Mesothelioma Patients Make Informed Decisions
On TV these days there are plenty of advertisements for medications. It is hard not to notice the long disclaimers at the end. Do not take if a, b, c, d! Notify your doctor immediately if you develop x, y or z. Who would take any of those medicines after they hear all that? When put in perspective, it is a very small percentage of people on these medications who develop the side effects. But the companies are required by law to inform patients with the disclaimers so they can make an informed decision.
Recently, while taking care of a mesothelioma patient after surgery, we talked about the balance of information. How much do you want to know versus how much you are told. What was the right amount of information for this patient?
Full disclosure is important so that people can weigh their options. Knowing from the outset that if you choose to have surgery, it will involve pain, it will be difficult, unpleasant and exhausting. You may or may not have a breathing tube in your mouth, a tube in your nose, tubes in the sides of your chest, and even a tube in your bladder. That it will be in your best interest to do things that you do not want to do, like walking. You will be restricted in your fluid intake. These are the basic facts. Not all of them, but important ones, about your surgical experience.
Should there be a lengthy disclaimer listing all the possible things that could go wrong? Would you feel better knowing all the possibilities ahead of time?
In my experience, most people want to know what is going on with them and their loved ones. They trust that there will be open communication and that everyone will do their best. It would be impossible to list all the possible scenarios that might happen before, during and after surgery. Everyone’s experience is unique.
Anyone with a question today about just about anything turns to Google to find the answer. During your mesothelioma journey, the information you find may or may not be pertinent to you. Sometimes the information can be confusing and complicated and not in the right context for your particular situation. If this happens to you or your loved one, ask your mesothelioma team. The journey with mesothelioma is a team effort, and hopefully, with open communication you will find the right balance of information, to make informed decisions.
My patient had found her balance, she and family members could concentrate on recovery, knowing that for her and her family, she had enough pertinent medical information, in the right context, to make her decisions.
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Researchers Find Way to Disrupt Cancer Stem Cell Growth That May Limit Mesothelioma Metastasis
The difficulty in successfully eradicating mesothelioma, an asbestos-caused cancer, is that even after many cycles of chemotherapy, the primary treatment protocol, many of the elusive cancer cells continue to thrive or regenerate. Now, researchers report that in order to successfully eliminate cancer they must first focus on eliminating cancer stem cells – and they know how to do just that.
A team of researchers from the Max Delbrück Center for Molecular Medicine (MDC) in Berlin, led by Liang Fang, report they have found a molecule that interrupts the stem cell survival mechanism, effectively killing off the cancer. The researchers report these errant stem cells are “Wnt-addicted cancer stem cells,” named for the Wnt signaling pathway on which they flourish. When functioning properly, the molecular network maintains the integrity of cells, according to the researchers, but when switched on inappropriately, it can lead to uncontrolled cancer growth and metastases.
According to various studies, metastasis is the cause of nearly 90 percent of cancer deaths. Even though cancer stem cells make up just one percent of cancer cells, according to one study, it is these cells that survive the effects of anti-cancer drugs leaving mesothelioma patients with a seemingly indestructible cancer.
Various researchers have reported that Wnt signaling is activated in mesothelioma cells. In one 2013 study reporting on the effect of the Wnt signaling pathway in mesothelioma, researchers concluded: “Modulation of Wnt signaling in MM [malignant mesothelioma] may prove a means of targeting proliferation and drug resistance in this cancer.”
In the recent study, the German researchers report they found a molecule that interrupts the “biochemical signals essential for the survival of a certain type of cancer stem cell.” They found that beta-catenin, one component in the Wnt pathway, and the TCF4 protein bind together and activate genes that then provide the stimulation cancer stem cells need to thrive. They then turned their research to finding a way to interrupt the connection between the two proteins.
Through trial and error testing by introducing different compounds one at a time, the researchers settled on the LF3 compound that “strongly inhibited binding” and was the “most potent inhibitor.”
When the compound was tested on tumor cells, they found “LF3 blocked several crucial features: it interrupted the cell cycle, preventing them from replicating, and strongly reduced their ability to migrate. LF3 didn’t seem to affect healthy cells at all.”
“We observed a strong reduction of tumor growth,” says Walter Birchmeier, leader of the Screening Unit and Medicinal Chemistry Group, of the results on a mouse model. “What remained of the tumors seemed to be devoid of cancer stem cells – LF3 seemed to be powerfully triggering these cells to differentiate into benign tissue. At the same time, no signaling systems other than Wnt were disturbed. All of these factors make LF3 very promising to further develop as a lead compound, aiming for therapies that target human tumors whose growth and survival depend on Wnt signaling.”
Physicians, oncologists and mesothelioma patients are anxious to find a new treatment for the incurable disease, and focusing on the Wnt pathway may be the breakthrough needed for increasing survival in mesothelioma patients.
The study was published Dec. 8 online in Cancer Research.
Mesothelioma Nurse Suggests “The Conversation Project” as End-Of-Life Resource
With the new year upon us, one resolution we should all have is to have a conversation with our loved ones about what we want to happen at the end of life. All the changes, medical breakthroughs, advances in care for diseases, do not change the fact that all of us, at some point, are still going to die. We are uncomfortable with this truth, and as a result do not make our wishes known, and most of us prefer not to talk about it.
During the last week of December, Blue Cross Blue Shield of Massachusetts announced they will begin offering “some of the newest and most comprehensive end-of life benefits in the nation, aiming to prod patients and health care providers to discuss death openly and expand services to help people live out their last days,” according to a Dec. 28 article in the Boston Globe. Medicare will also begin covering these conversations, no matter when patients want to have them.
Why are these conversations so important? If your loved ones know what your wishes are and what is important to you, it can make decision-making at a very emotional time easier for all. All our journeys through life are unique, as is a patient’s journey with mesothelioma. There are unexpected twists and turns. However, knowing what your loved one, and you want the end to look like, can make this time comforting.
To help start these conversations, there is a non-profit group called The Conversation Project. The organization’s goal is to have these conversations with our loved ones so that our wishes are followed. They offer a starter kit and suggestions on how to have these difficult conversations. The web site reports that 90% of people say that talking with their loved ones about end of life care is important, but only 27% have actually done so.
The Conversation Project would like to move these conversations from the ICU to the kitchen table. From experience I can tell you many conversations that have been held over the years in the ICU have included quotes such as: “We never discussed dying,” “He didn’t want to upset me with talking about death,” and “I always thought I would go before him.” And many more from family members too confused and frightened to be faced with this challenge.
Having these conversations before time is critical does not mean that you have stopped fighting mesothelioma, rather, it means you have taken control of an important part of your unique life.
Let’s make 2016 the year that we raise that figure from 27% to 100% and have an end-of-life conversation, in each of our own unique ways, communicating our end of life wishes to our loved ones.
If you have any questions regarding any aspect of your mesothelioma care, feel free to email me at [email protected].
Will President Obama’s “Moonshot” Bring an End to Mesothelioma?
Time and again, politicians, researchers and medical professionals have taken on cancer, pledging to eradicate the disease. Now, President Obama has joined the fray introducing the “moonshot” program saying, “let’s make America the country that cures cancer once and for all.” Could this be the start of the end to mesothelioma and other cancers?
During President Obama’s Jan. 12 State of the Union address he announced a national effort to “cure cancer.” Obama has allocated the money and put Vice President Joe Biden at the helm. The two of them believe this “moonshot” will bring about the breakthroughs needed to bring an end to the needless suffering of millions of Americans – and ultimately, people worldwide. The number of cancer cases in the U.S. is expected to rise to 22 million in the next 20 years.
“For the loved ones we’ve all lost, for the families that we can still save, let’s make America the country that cures cancer once and for all,” said Obama.
Last month, according to Obama, Biden worked with Congress to allocate an extra $2 billion for scientists at the National Institutes of Health, “the strongest resources that they’ve had in over a decade.” In addition, Biden and his team have met with hundreds of the world’s top cancer physicians, researchers, and philanthropists, including those at the University of Pennsylvania Abramson Cancer Center where Biden held the formal launch for the program.
“And the goal of this initiative — this “Moonshot” — is to seize this moment,” said Vice President Joe Biden in a Jan. 12 press release, on his blog on Medium, announcing the initiative. “To accelerate our efforts to progress towards a cure, and to unleash new discoveries and breakthroughs for other deadly diseases.”
“My commitment is not for the next 12 months,” Biden told the attendees at Abramson on Jan 15. “I’ve been stunned by the overwhelming response of welcoming me, to ask me to be the facilitator and convener….I plan on doing this the rest of my life.”
Biden selected Penn Medicine for “the cutting edge immunotherapy work done there.” The Mesothelioma Applied Research Foundation applauded the partnership due to Penn’s work with mesothelioma.
“We’ve had a long-standing partnership with Penn Medicine involving the work they’ve done in the field of mesothelioma,” the Mesothelioma Applied Research Foundation said on its Facebook page on Jan. 21. “We’re happy to see the cancer center at the forefront of the new initiative to find a cure with the spotlight on its work in immunotherapy.”
Penn Medicine is the home of Penn’s Mesothelioma and Pleural Program which, according to the website, “brings together internationally renowned experts in medical, surgical and radiation oncology and pulmonology who collaborate in the diagnosis, treatment and research of mesothelioma and pleural disease.”
Mesothelioma is diagnosed in approximately 3,000 people in the United States each year. The disease is incurable, though there are treatments that can improve the patients’ survival. Immunotherapy has recently taken the spotlight for treatment, with Keytruda and Opdivo, both anti-cancer drugs that boost the immune system, showing promise in the treatment of mesothelioma.
Mesothelioma is a rare form of cancer typically affecting the lining of the lungs. Caused by exposure to airborne asbestos fibers, most cases of mesothelioma are diagnosed 30 years or more after exposure.
In 2011, Michele Carbone, M.D., Ph.D., former director of the University of Hawaii Cancer Center, reported that more than 20 million people in the United States are at risk of developing malignant mesothelioma due to asbestos exposure. This moonshot initiative is critical for helping halt the onslaught of this disease.
“I know that we can help solidify a genuine global commitment to end cancer as we know it today — and inspire a new generation of scientists to pursue new discoveries and the bounds of human endeavor,” says Biden.
Sources :
- State of the Union
https://www.whitehouse.gov/the-press-office/2016/01/12/remarks-president-barack-obama-%E2%80%93-prepared-delivery-state-union-address - Penn’s Mesothelioma and Pleural Program
http://www.penncancer.org/patients/cancer-types/mesothelioma/ - Biden told the attendees at Abramson
http://news.pennmedicine.org/blog/2016/01/vice-president-biden-launches-moonshot-effort-at-abramson-cancer-center-photos.html - Vice President Joe Biden
https://medium.com/cancer-moonshot/inspiring-a-new-generation-to-defy-the-bounds-of-innovation-a-moonshot-to-cure-cancer-fbdf71d01c2e
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