Mesothelioma Blog

Coal dust inhalation has been linked to a handful of debilitating lung diseases, including pneumoconiosis (black lung) and silicosis. Despite the fact that these diseases are 100 percent preventable, countless coal miners and quarry workers continue to be diagnosed with these fatal illnesses each year.

Since 1995, the National Institute for Occupational Safety and Health (NIOSH) has recommended that coal mine dust exposure be limited to a concentration of 1.0 mg/m3 TWA for up to 10 hours a day over a 40-hour work week. Well over a decade after this recommendation was first made, the Mine Safety and Health Administration (MSHA) continues to mandate a concentration of 2.0 mg/m3.

It is estimated that even at the 1.0mg/m3 level, dozens of mine workers will continue to be diagnosed with black lung and related diseases each year. At the present heightened level, even more hard-working miners are being needlessly exposed to high levels of hazardous coal dust.

In an effort to urge the MSHA to lower acceptable coal dust levels, the Appalachian Citizens’ Law Center (ACLC) recently submitted a petition calling for improved miner safety. In support of the petition, numerous health professionals sent a letter to the MSHA. A key point of the letter states that:

“According to a 2008 report by NIOSH, the prevalence of CWP has more than doubled since 1995 among coal miners with more than 20 years of exposure. NIOSH has also identified advanced cases of respiratory disease in working U.S. miners as young as 39 years of age.”

The ACLC petition is just the most recent attempt to sway MSHA to reduce miner exposure to coal dust. Other petitions and lawsuits have been filed in the past. Despite these efforts, the MSHA does not plan to propose new rules on airborne coal dust and silica until April of 2011.

Resources:
 http://thepumphandle.wordpress.com/2009/…

One of the earliest chemotherapy drugs is showing positive results in bowel cancer patients that could signal a resurgence in its use. The drug, known as methotrexate, was first used during the 1940s World War II era.

According to UK researchers at the Institute of Cancer Research (ICR), the drug may find a new use as a tailored treatment for bowel cancer patients who have a specific genetic fault. In studies, it was shown that methotrexate effectively killed cells that carried the faulty gene, dubbed MSH2.

The MSH2 gene has been linked to a genetic condition known as HNPCC. For men who carry this gene, 90 percent will be diagnosed with bowel cancer by the time they are 70. For women, the probability is 70 percent.

In total, the gene is linked to approximately 5 percent of all cases of bowel cancer. 40 percent of all patients with HNPCC have a faulty MSH2 gene.

Though use of methotrexate has dropped significantly since the 1940s (newer chemo drugs are typically preferred), the drug is still frequently used as a leukemia treatment. Now, researchers are hopeful that it can also be used as a tailored treatment for bowel cancer.

As Dr. Alan Ashworth, leader of the ICR study, explains: “What’s exciting about methotrexate is that it selectively destroys the cells lacking the MSH2 function. This indicates that it may make an excellent treatment for patients with the genetic alteration.”

Clinical trials to confirm the safety and effectiveness of methotrexate as a treatment for bowel cancer have already begun. While the potential for the customized drug will only affect a small proportion of bowel cancer patients, the new findings are promising indeed. Methrotrexate is one of the antifolate class of chemotherapy agents.

Customized cancer treatment based on specific genetic mutations or cancer subtypes continues to be a promising field. Methotrexate is just one of many drugs currently being investigated for the use as a tailored cancer medication.

Resources:
 http://news.bbc.co.uk/2/hi/health/822344…
 http://www.hc2d.co.uk/content.php?conten…

The first major case study of workers contracting lung and heart illnesses as a result of nanoparticles was released in the September issue of the European Respiratory Journal. The case involves seven workers of a Chinese printing plant, who fed a chemical paste that contained nanoparticles into an auto-spray machine that coated polystyrene boards.

All seven workers developed serious lung and heart conditions, and two ultimately died from their illnesses. In the aftermath of the case study, questions continue to be raised about whether or not nanoparticles are to blame.

Certainly, the symptoms exhibited by the workers are remarkably similar to those exhibited by lab mice during earlier research efforts performed by NIOSH and others. In these studies, nanoparticles such as carbon nanotubes and metal oxides were deemed toxic to both the hearts and lungs of lab mice.

Unfortunately, the case study of the Chinese workers cannot adequately determine whether or not nanoparticles played a part in manifesting the illnesses. The results are inconclusive due to a lack of exposure data. Additionally, experts point to several alternative explanations that may have resulted in the development of these heart and lung conditions.

Beyond nanoparticles, the workers were exposed to a number of other hazardous chemicals, including butanoic acid, butyl ester, N-butyl ether, acetic acid, toluene, di-tert-butyl peroxide, 1-butanol, acetic acid ethenyl ester, isopropyl alcohol and ethylene dioxide. Thermodegradation fume products absent of nanoparticles have already been proven to cause illness in occupational settings. Additionally, traditional paint spraying has also been known to be hazardous.

While the case study is not conclusive, it does raise additional concern into the safety of nanoparticles. Regardless of whether or not nanoparticles contributed to the illnesses of the seven Chinese workers, NIOSH strongly recommends that safety precautions be enforced in occupational environments in which nanoparticles are present.

Resource: http://www.cdc.gov/niosh/blog/

Like any other industry, pharmaceutical companies are continually chasing profits. In recent years, companies like Pfizer have grown fat off of cardiovascular drugs such as Lipitor (used for lowering cholesterol).

However, it seems there’s a shift in Big Pharma’s business model. It seems nearly all the major players are jumping on the cancer bandwagon, and ramping efforts in the realm of cancer research.

The reason for this renewed interest in cancer is twofold. For one, recent cancer research has identified a number of new biomarkers and targets. These new targets help point pharmaceutical manufacturers in the right direction when it comes to developing effective drugs.

For two, annual earnings from cash cows such as Lipitor are beginning decline. The potential for high profits that is possible through cancer medications can help fill this gap in profitability.

For some experts, the shift to cancer is a bit surprising. In the past, Big Pharma largely eschewed cancer research because of the small population segments that are diagnosed with any one particular type of the disease. This results in a much smaller target consumer when compared to the millions of individuals who suffer from more widespread diseases.

Additionally, very few cancer drugs make it to market each year. For 2008, only two new cancer drugs were approved by the FDA.

Despite this, Pfizer plans to increase annual sales of cancer medications from $2.5 billion in 2008 to $11 billion by 2018. The reasoning comes in the exorbitant prices that often come along with cancer drugs. Despite small target audiences, cancer drugs accounted for three of the top ten medications in terms of annual sales for 2008. Cancer drugs as a whole also combine to be the largest category in terms of worldwide sales.

As Robert L. Erwin, a biotechnology industry executive at Marti Nelson Cancer Foundation, explains: ” As long as the health care system will pay the price, the money will flow in that direction.”

Resource:
 http://www.nytimes.com/2009/09/02/health…

Costs related to health care remain a strong topic of debate in the United States. As new medications and treatment technologies continue to become available, the costs associated with health care are expected to rise.

The American Society of Clinical Oncologists (ASCO) estimates that cancer care costs are growing at a rate of 15 percent each year. Given that 33 percent of families faced with paying for cancer care have difficulty making payments, ASCO has become increasingly concerned about these rising cancer care costs.

In an effort to minimize cost-related hurdles facing cancer patients, ASCO has established a Cost of Care Task Force. The goals of the Force will be to identify challenges concerning cost of cancer care, and subsequently develop solutions to overcome these challenges.

ASCO’s tactics for tackling costs of cancer care begin at the patient-physician level. The four main components of the Guidance Statement for the Task Force are as follows:

Promote patient-physician discussions of cost when discussing potential treatment options (presently, only 37 percent of oncologists “always” discuss costs with patients, according to a recent ASCO survey)
Promote the availability of educational and support tools for oncologists to aid in cost discussions with patients
Provide educational materials directly to patients, through such documents as ASCO’s Managing the Cost of Cancer Care Booklet
Address underlying factors related to rising costs of cancer care

In addition to working within the current system, ASCO is also a vocal organization in Washington D.C. Representatives of the organization are continually working with others in the cancer community to change legislation to improve insurance coverage and other key components related to cancer costs.

Resources:
 http://www.asco.org/ASCOv2/Public+Policy…
 http://www.asco.org/ASCOv2/Practice+%26+…

A couple months ago, the FDA approved Avastin for use in treating brain cancer. The new approval is just the latest in a growing number of applications for the drug. First approved in 2004 to fight colorectal cancer, Avastin is now considered an avenue of treatment for lung, breast and other forms of cancer.

However, the effectiveness of Avastin is highly variable on a case-by-case basis. While some patients experience a considerable increase in survival time thanks to the drug, Avastin only delivers a 2-month increase in expected overall survival when compared to other drug treatments.

Initially heralded as a breakthrough drug, doctors are now coming to realize a vast set of complexities behind the effectiveness of Avastin.

Avastin works by blocking a cancer’s ability to feed a growing tumor with new blood vessels. This is accomplished by inhibiting the function of a vascular endothelial growth factor (VEGF) protein that is responsible for stimulating formation of new blood vessels.

When successful, Avastin deprives a tumor of oxygen, limiting or reversing growth. However, for too many patients, the drug has no effect at all.

The variability of success is based on genetic variations present in a patient. Unfortunately, the responsible DNA has yet to be identified.

In absence of more targeted answers, doctors continue to dole out Avastin to a high number of cancer patients in the hopes that they will respond positively. However, a relatively low number of patients are favorably affected by the treatment. Add in the high cost of the drug (up to $55,000 for a single treatment), and doctors are clamoring to create a more focused means of identifying viable patients for the drug.

To achieve this, researchers at Genentech (Avastin’s manufacturer) have already sifted through 150 genetic markers in the hopes of identifying pertinent genes. The Susan G. Koman for the Cure advocacy group has also set aside $6 million to research the subject over the next five years. Hopefully, these considerable efforts will lead to genetic discoveries that doctors can use to predict the effectiveness of Avastin in future patients.

Resource:
 http://www.technologyreview.com/biomedic…

A number of substances used during historical war times have been known to be hazardous to veterans’ health, according to the U.S. Department of Veterans Affairs (VA). Oftentimes, veterans exposed to these substances develop cancer later in their lifetimes. Two such substances linked to cancer include ionizing radiation and Agent Orange.

Ionizing Radiation

Presently, ionizing radiation is used in a number of medical treatments and tests, including CT scans, x-rays and mammograms. However, high levels of ionizing radiation have been known to cause cancer. For some veterans, unhealthy exposure to ionizing radiation may have resulted from contact with nuclear weapons or fallout from such weapons.

Those who served in Japan during World War II or were present for nuclear weapons testing between 1945 and 1962 are at the highest risk for exposure to ionizing radiation.

A number of types of cancers have been linked to ionizing radiation, including, breast, thyroid, stomach, bladder, lung, colon and brain. For a full list of cancers linked to ionizing radiation, please view the VA’s Diseases Associated with Ionizing Radiation Exposure.

Agent Orange

Agent Orange is an herbicide that was used extensively during the Vietnam War. Approximately 20 million gallons of the substance was sprayed throughout the Vietnam jungle to kill plants and expose enemy hiding places. Among the many chemicals present in Agent Orange is dioxin, a substance recently linked to numerous long-term health conditions.

Several studies conducted by the VA, Centers for Disease Control and other agencies have linked Agent Orange to such cancers as lymphoma, lung cancer, prostate cancer, multiple myeloma, soft-tissue sarcoma and chronic lymphocytic leukemia. For a full list of illnesses related to Agent Orange, please see the VA’s Diseases Associated with Agent Orange Exposure.

Veteran Affairs Benefits

The VA offers health care benefits for those veterans exposed to either ionizing radiation or Agent Orange. If a veteran has been diagnosed with one of the cancers linked to these substances and documentation can be provided that indicates wartime exposure, then the individual is eligible for such benefits. Both medical and financial treatment may be available.

Additionally, veterans exposed to ionizing radiation or Agent Orange are eligible for free health examinations. These health examinations may help identify and diagnose any potential cancers so that proper treatment can be initiated.

Resources:
 http://www.cancer.net/patient/Library/Ca…
 http://www.cancer.net/patient/Library/Ca…

One in seven UK citizens are unaware of the symptoms related to cancer, according to a charity survey conducted by Cancer Research UK.

For the poll, nearly 4,000 people were questioned. Results show that 19 percent of men and 10 percent of women could not name a single symptom related to cancer.

The results are troubling to experts, who believe that as many as 5,000 cancer deaths could be prevented each year in the UK simply by diagnosing cancer earlier. Certainly, the inability to recognize early symptoms of the illness is counter-productive in the pursuit to diagnose cancer quickly.

As Sara Hiom, director of health information for Cancer Research UK, explains, “When cancers are detected earlier, treatment is usually more effective and often milder. We’re not expecting people to be able to recall every symptom, but being generally aware of changes that could be a sign of cancer could make a crucial difference for people who do develop the disease.”

Of those who were able to recall symptoms associated with cancer, more than half listed the presence of an unusual lump. Other commonly reported symptoms included moles (in relation to skin cancer), unexplained weight loss and bowel or urinary problems. Additional symptoms related to cancer include:

A sore that doesn’t heal after several weeks
Mouth ulcers that last longer than 3 weeks
Recurring cough
Difficulty swallowing
Unexplained pain that occurs for more than 4 weeks
Changes in menstrual patterns

To counter the troubling results of the survey, Cancer Research UK is presently running an initiative of National Awareness and Early Diagnosis.

Resources:
 http://www.cafonline.org/Default.aspx?pa…
 http://www.telegraph.co.uk/health/health…

Cancer stem cells are believed to be the driving force behind a tumor’s growth. It is also believed that the resistance of cancer stem cells is one of the major hurdles in formulating effective cancer treatment programs.

Now, researchers report that they have identified drugs that are specifically designed to kill these cancer stem cells.

Lead researcher, Piyush Gupta of the Massachusetts Institute of Technology and the Broad Institute, suggests that cancer stem cells are quite likely the cells responsible for cancer recurrences following treatment. As such, the promise of drugs that directly kill these kinds of cells would mean that cancer could one day be much easier to cure.

From the outset, the goal of Gupta’s team was to identify chemical compounds that specifically attacked cancer stem cells. Sifting through 16,000 contenders, they eventually found success via a chemical called salinomycin.

In tests performed on lab rats, the team found that salinomycin was 100 times more effective in killing breast cancer stem cells than paclitaxel, a common chemo drug currently in use.

While the news is promising, the team stresses that salinomycin may or may not lead to effective cancer treatment. Other compounds geared towards killing cancer stem cells have yet to be tested, and the safety of salinomycin in humans is unknown. As such, the next step in research involves additional tests in lab mice to determine if clinical trials among humans are safe enough to conduct.

If successful, Dr. Gupta foresees a future cancer treatment regimen that includes dual therapies – traditional chemotherapy that wipes out the majority of tumor cells, and drug treatment that kills resistant strains of cancer stem cells.

Regardless of the safety and effectiveness of salinomycin, the discovery provides researchers with a new avenue of research that could lead to additional insights into cancer treatment in the future.

Resources:
 http://www.reuters.com/article/domesticN…
 http://www.bloomberg.com/apps/news?pid=2…

Overwhelmingly, lung cancer is directly linked to cigarette smoking. However, every year a small percentage of people diagnosed with lung cancer are non-smokers (about 10 to 15 percent of all cases).

Little is known about how or why lung cancer develops in the absence of cigarette smoke, but a new study sheds some new light on the subject. Thanks to the study (headed by the Ohio State University Comprehensive Cancer Center and National Cancer Institute), it appears that a small molecule known as miR-21 may be a contributing factor.

The study, which involved examining lung tumors of patients who were non-smokers, found increased levels of miR-21. More over, the molecule, which is a microRNA, was exceptionally elevated in individuals who expressed a mutation in the epidermal growth factor receptor (EGFR) gene. The EGFR gene mutation is a commonality among many non-smoking lung cancer patients.

Elevated miR-21 molecules were not found to be present, on average, in lung cancer cases related to smoking patients.

Researchers note that they believe miR-21 is not just a biomarker of lung cancer, but rather a contributing factor. Due to this fact, researchers may eventually find effective treatment methods that inhibit the production of miR-21 molecules. Two early experiments – one attempting to disarm miR-21 production and another blocking the EGFR pathways themselves – have both already delivered promising results.

Doctors caution that there is a long way to go before a potential new treatment is available. Still they remain cautiously optimistic about the potential benefits of the new discovery.

Resource:
 http://www.sciencedaily.com/releases/200…
 http://health.usnews.com/articles/health…