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Mesothelioma Updates : New Technology To Detect Asbestos-Related Lung Disease

Sunday, July 12, 2009

Michael Harbut, M.D., MPH, co-director of the National Center for Vermiculite and Asbestos-Related Cancers (NCVAC) at the Barbara Ann Karmanos Cancer Institute in Detroit, MI, and chief of the Center for Occupational and Environmental Medicine Wayne State University, announced the use of a new technology to aid in the diagnosis of asbestos-related lung disease. The announcement was made at the Asbestos Disease Awareness Organizations annual conference, Saturday, March 28, in Manhattan Beach, CA.

"Radiographic approaches developed by Carmen Endress, M.D., FACR, Associate Professor of Radiology, Wayne State University School of Medicine and radiologist at the NCVAC, allow us to visualize lesions caused by asbestos exposure in three dimensional detail and often at a much earlier stage than that of the current standard radiographic techniques," said Harbut.

This new approach involves taking images obtained on the 64-slice high resolution CT scan and enhancing them using the Vitrea imaging software program developed by Vital Images, Inc.

Harbut explained, "The benefits of this new approach include the possibility of earlier detection; better differentiation between patients with scarring on the lungs and other diseases; assistance in determining why some people who have thickening on the covering of the lungs have uncontrolled, unrelenting pain; and potentially increased success in the overall diagnosis and treatment of asbestos-related disease.

According to Harbut, this approach could also have a significant public-health impact.

If we can identify the sentinel or first cases of asbestosis or lung cancer at an early stage, then we can help identify asbestos exposures in places where it might not have previously been suspected. Such identification of early detection could help to reduce the death rate from asbestos-related diseases."

Harbut added that this new technology approach to chest radiography could also help reduce cases of fraud which have been reported in asbestos litigation, due to the clarity and sophistication of the images that can help identify which cases are asbestos-related and which are not.

Dr. Endress added, "Its my sincere hope that with this new approach and enhanced technology we will help reduce the death rate caused by asbestos-related diseases, reduce the suffering by patients and their loved ones, and make a significant contribution to medicine."

The use of this technology in the diagnosis and treatment of asbestos-related cancers and high-malignancy potential asbestos-related diseases represents another first for Karmanos Cancer Institute scientists and physicians. Previously, NCVAC researchers were among the first to discover the value of osteopontin a tumor marker of mesothelioma and published this finding in the New England Journal of Medicine. Karmanos workers have also reported the potential value of soluble mesothelin-related peptide, another tumor marker, in screening for mesothelioma.

Michael Harbut, M.D., MPH, Chief of the Center for Occupational and Environmental Medicine, is co-director of the National Center for Vermiculite and Asbestos-Related Cancers at the Barbara Ann Karmanos Cancer Institute, in Detroit, MI. In response to the United States Environmental Protection Agency's (EPA) identification of major sources of public asbestos exposure in Michigan, and to address the need for early diagnosis and aggressive treatment of asbestos-related diseases, the Barbara Ann Karmanos Cancer Institute and the Center for Occupational and Environmental Medicine (COEM) affiliated with Wayne State University, joined forces to establish The National Center for Vermiculite and Asbestos-Related Cancers (NCVAC). COEM has had a long interest in asbestos-related diseases and the Karmanos Cancer Institute is heavily involved in both clinical and basic research on asbestos-related cancers enabling the two centers to rapidly bring together the expertise and resources necessary to study the problem immediately.

Source: Karmanos Cancer Institute

Scientific And Medical Facts About Chrysotile Asbestos Will Be Presented To US Congress

The Environmental Information Association (EIA) and the Asbestos Disease Awareness Organization (ADAO) today announced the development of the Chrysotile Asbestos Fact Sheet (CAFS). The EIA and ADAO concluded, along with the majority of scientific agencies, that there is sufficient evidence to support that all forms of asbestos, including chrysotile, are carcinogenic and are responsible for asbestos-related lung cancer, mesothelioma, laryngeal and ovarian cancers.

The CAFS provides clear, easily digested information on the dangers of chrysotile, compiled by asbestos medical experts and scientists with a collective 300 plus years of experience and hundreds of peer review scientific publications on asbestos among themselves.

The Chrysotile Asbestos Fact Sheet will be presented to the United States Congress as a scientifically developed paper in support of the continued efforts to ban asbestos. The Environmental Information Association and the Asbestos Disease Awareness Organization continues to educate the public and government representatives to the dangers of asbestos.

"The Environmental Information Association is proud to collaborate with the Asbestos Disease Awareness Organization to produce the EIA/ADAO Chrysotile Asbestos Fact Sheet, in an effort to clarify the misinformation released on the very real dangers of asbestos exposure," said J. Brent Kynoch, Managing Director, Environmental Information Association. "We will continue our endeavor for full acknowledgement by the asbestos industry, and widespread education of the public, of the risks associated with asbestos."

"Somberly, we honor and remember victims today on Worker's Memorial Day who have died from asbestos exposure," said Linda Reinstein, Executive Director, Asbestos Disease Awareness Organization. "Asbestos exposure is the world's leading cause of cancer in the workplace and the United States Congress must act now and ban asbestos. Prevention is our only cure for asbestos-caused diseases."

The contributors of the document include: Michael Breu CIH, Dana Brown, Dr. Ronald Dodson, William Ewin, Joy Finch, Sean Fitzgerald, Dr. Arthur Frank, Steve Hays PE CIH, Dave Hogue, Brent Kynoch, Tom Laubenthal, Dr. Richard Lemen, Dr. James Millette, Linda Reinstein, Andreas Saldivar, and Dr. James Webber.

Source: Asbestos Disease Awareness Organization

Mesothelioma Treatment Centers In USA


Learn Mesothelioma And Its Statistics

From 1965 - 1999 there are already 159,000 recorded deaths due to asbestos exposure and it's increasing each year. This number represents approximately 4,000 deaths per year. Starting in 1965, the number of deaths increases by 400-500 a year and by the mid-1900s it is approximately 9,700 deaths per year.

Why the steady increase?
Asbestos-related diseases are typically diagnosed 15 to 40 years after initial exposure to asbestos. In the 1960s, there was a spike in the number of asbestos- related diseases reported by shipyard workers who had worked in close contact with asbestos during WWII.

What does the future hold?
The definitive 1982 epidemiological study projected that between 1999 and 2030 there would be approximately 166,000 additional asbestos-related deaths.

Annual Projected Deaths From Asbestos-Related Lung Cancer (selected industries**)
Year 1972 1982 1992 2002 2012 2022 2027
Total 3,286 5,055 5,497 4,693 2,987 1,254 646

Annual Projected Deaths, Asbestos-Related Gastrointestinal/Other Cancers (selected industries)
Year 1972 1982 1992 2002 2012 2022 2027
Total 1,034 1,376 1,494 1,274 812 340 176

Annual Projected Deaths From Asbestos-Related Mesothelioma (selected industries)

Year 1972 1982 1992 2002 2012 2022 2027
Total 1,082 1,775 2,748 3,060 2,661 1,495 917

Note: 80 percent of mesothelioma (the most lethal form of asbestos-related disease -- cancer of the chest cavity lining) cases are caused by asbestos exposure, and these cases are usually fatal.

**Primary asbestos manufacturing, secondary manufacturing, insulation work, shipbuilding and repair, construction trades, railroad engine repair, utility services, stationary engineers and firemen, chemical plant and refinery maintenance, automobile maintenance, and marine engine room personnel.

Note : The above was provided by the Association of Trial Lawyers of America, 1999

What Are The Stages Of Mesothelioma?

Doctors often determine treatment options depending on the stage of mesothelioma. Doctors currently use one of three staging systems. Each system measures somewhat different variables.

Doctors most often use the Butchart System, the oldest staging system and t. The more recent TNM system . The Brigham System,
  1. Butchart System ( the oldest staging system and the one that mainly considers the extent of primary tumor mass and divides mesothelioma into four stages)

    Stage I consists of the presence of mesothelioma in the lining of the right or left lung and may also involve the diaphragm on the same side. Stage II includes the invasion of mesothelioma into the chest wall or esophagus, hear, or lung lining on bother sides. In addition, lymph nodes in the chest may also be involved. The onset of Stage III begins when the mesothelioma penetrates through the diaphragm into the lining of the abdominal cavity or peritoneum. In this stage the cancer may also affect lymph nodes beyond those in the chest. Doctors identify Stage IV, the final stage, when evidence of metastasis or the spread of cancer to other organs exists.

  2. TNM System (considers tumor in mass and spread, lymph node involvement, and metastasis)

    Stage I involves the lining of the right or left lung, pericardium, or diaphragm on the same side. At this stage, lymph nodes are not involved. Stage II begins when mesothelioma spreads from the lining of the lung on one side to a lymph node on the same side. At this stage, the cancer may also spread to the lung, pericardium, or diaphragm on the same side. Stage III begins when mesothelioma exists in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side as the primary tumor. In the final stage, Stage IV, the mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends into the lung opposite the primary tumor, or directly into the organs in the abdominal cavity or neck. Metastasis is included in this stage.

  3. Brigham System (the latest system, stages mesothelioma according to resectability or ability to surgically remove and lymph node involvement)

    The Brigham System concerns itself primarily with the resectability or the ability surgically remove the mesothelioma mass. In Stage I the tumor is resectable and lymph nodes are unaffected. In Stage II the tumor remains respectable but the mesothelioma affects the lymph nodes. In Stage III the tumor becomes unresectable and extends into the chest wall, heart, or through the diaphragm, peritoneum. Stage III can occur with or without lymph node involvement. Stage IV occurs when doctors discover metastasic disease of distant organs.

    Once doctors identify the stage of a patient's malignant mesothelioma, the patient and doctor can discuss and consider the various treatment options available. The treatment program for mesothelioma depends on many factors, including: the stage of the cancer, the location of the cancer, the spread of the cancer, the characteristics of the cancer cells under a microscope and the patient's age and desires.

What Are The Treatments Available For Mesothelioma?

Once the doctor has finalized the diagnosis of mesothelioma, treatment can be done accordingly. Treatment is based on the location of the cancer, the stage of the disease, and the patient's age and general health. However, standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

  • Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
  • Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).
  • Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).
To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. This procedure is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.


What Are The Diagnosis Of Mesothelioma?

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.


Learn The Symptoms Of Mesothelioma

Do you know that symptoms of mesothelioma may only appear 30 to 50 years after exposure to asbestos? This is very dangerous, however here are the symptoms that we should know:

For Pleural Mesothelioma (These are due to an accumulation of fluid)
  • Shortness of breath
  • Pain in the chest
For Peritoneal Mesothelioma
  • Weight loss
  • Abdominal pain
  • Swelling due to a buildup of fluid in the abdomen.
  • Bowel obstruction
  • Blood clotting abnormalities
  • Anemia
  • Fever.
If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include:
  • pain
  • trouble swallowing
  • swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Because only a doctor can make a diagnosis.

Who Are At Risk For Developing Mesothelioma

Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

The risk of asbestos-related disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma. On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.

There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.

Learn The Major Risk Factors For Mesothelioma

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos.

Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.

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