A great deal of mesothelioma research takes place “in vitro” (in the glass) rather than “in vivo” (in the living). In vitro studies are preliminary studies that effectively test potential mesothelioma treatments without presenting risk to human patients coping with the cancer.  These studies take place in a test tube (in the glass) amid a laboratory setting.

This in vitro study sought to test the combination of various biological agents against the growth of malignant mesothelioma cells. Malignant mesothelioma (MM) is an aggressive cancer primarily caused by asbestos exposure. Mesothelioma cancer is notably resistant to current treatments and consequently much research is being conducted to find a cure.

The primary biological agents examined in this study include polo-like kinase-1 (PLK-1), short interfering RNAs (siRNAs), and zoledronic acid (ZOL).

PLK-1 belongs to the PLK family of kinases, which are enzymes that transfer phosphate groups to high-energy molecules. PLK-1 is involved in the regulation of cell division at several crucial points, and studies have shown that PLK-1 is overexpressed in cancerous tissue and that expression levels are tightly correlated with patient prognosis.

As such, PLK-1 is considered a pathway for effective cancer treatment and a number of studies have been conducted to better understand the biologic processes involved. Short interfering RNAs can work against PLK-1 and have been investigated in the past. Another biological agent observed in the study is zoledronic acid, which has shown to have direct anti-tumor effects against a variety of cancer cells.

The researchers found, “Our results show that these agents induce apoptosis [cell death] and inhibit the proliferation of MM cells. In addition, we found that ZOL enhances the inhibitory effects of PLK-1 siRNA.”

Additional information on mesothelioma and treatment options may be found through the Mesothelioma Center.

Thanks in large part to Senator Max Baucus (D-MT) and other cosponsors, the Senate was able to introduce the sixth annual resolution that declares the first week of April National Asbestos Awareness Week.

The ADAO, which was founded by asbestos victims and their families in 2004, aims to protect the rights of those affected by asbestos-related disease while raising public awareness about the hazards associated with asbestos exposure.

Malignant Mesothelioma, a rare cancer that typically develops in the lining of the lungs, will be one of the many topics discussed at ADAO’s upcoming International Asbestos Conference. The conference is scheduled to begin on April 10, 2010 in Chicago Illinois.

Linda Reinstein, Executive Director and Co-Founder of ADAO, said, “We are grateful to the U.S. Senate to have the opportunity to help raise the level of public awareness about the prolific dangers of asbestos and further unite doctors, scientists and public health advocates during National Asbestos Awareness Week for this important effort. During the past six years, ADAO has seen the progress and indeed, this confirms what Americans deserve and want. We know asbestos prevention and education will save lives and dollars.”

People are most commonly placed at risk of asbestos exposure when asbestos-containing materials are damaged or disturbed and the microscopic fibers that make up asbestos are released into the air. Once these fibers become airborne, the chances of inhaling them increase significantly as they can remain in the air for quite some time depending on conditions.

In addition to mesothelioma, inhaling asbestos fibers is also known to cause lung cancer and asbestosis. While the effects of these illnesses may take several decades to arise, prognosis is often poor because they are typically diagnosed during the latest stages of development.

Additional information about mesothelioma and asbestos exposure may be found through the Mesothelioma Center.

As part of the effort, several million dollars will provide funding for three mesothelioma research projects. The projects will focus on research into early detection of disease and the development of new treatments, including a clinical trial on a vaccine that may significantly improve the prognosis of patients with malignant mesothelioma.

Mesothelioma is a rare cancer that typically forms in the lining of the lungs after inhaling airborne asbestos fibers. However, the effects of asbestos exposure are not immediately felt as symptoms often take as long as 20 to 50 years to arise from the time someone is initially exposed.

In addition to mesothelioma, lung cancer and asbestosis are two illnesses that are known to result from exposure to asbestos. The amount of exposure a person receives will often determine which condition develops.

Some of those most at risk of developing mesothelioma or another asbestos-related disease have been veterans. In the past, especially in the shipyard industry, materials used for military purposes were often manufactured with asbestos.

Asbestos was considered an ideal material to use because of its insulating and fireproofing capabilities. The highest incidence of asbestos exposure in the military occurred between the 1940s and the 1970s, largely due to the heavy use of asbestos-containing materials for ship construction.

Areas and materials that commonly contained the hazardous mineral were boiler rooms, sleeping quarters, pipes and parts that needed to be insulated. During construction or repair, shipyard workers were routinely exposed to asbestos because there were no requirements for wearing equipment to prevent exposure.

Veterans who were exposed to asbestos between the 1940s and 1970s may just now be showing signs of an asbestos-related disease. It is important for those who may have experienced asbestos exposure to seek regular medical checkups for any development related to asbestos.

Additional information about mesothelioma and asbestos exposure may be found through the Mesothelioma Center.

The study indicated significant potential for a single microRNA to act as an independent prognostic factor for mesothelioma progression as well as survival in patients who have undergone surgery to combat the cancer.

MicroRNAs act as master regulators of protein synthesis and have been shown to be highly effective biomarkers in some cases. Rosetta Genomics and NYU Langone Medical Center tested for the presence of miR-29c in malignant mesothelioma tumors and found that varying expression levels had a direct correlation with prognosis and overall survival in patients.

The study evaluated 142 malignant pleural mesothelioma tumors for microRNA expression levels and results showed that higher levels of miR-29c dramatically improved prognosis in terms of both progression and survival.

When higher levels of miR-29c were present, the median Time to Progression (TTP) of the tumors after surgery changed from four months to 14 months during the training set. In the test set, the median TTP of tumors increased from 5.5 months to 12.8 months.

The median survival results changed from eight to 32 months for the training set and 9.1 to 21.6 months for the test set. Researchers conducting the study believe this new diagnostic capability may aid physicians in carrying out aggressive treatment options for patients with poor prognosis.

Dr. Harvey Pass, who is the lead investigator of the study, said, “This is an exciting discovery which may have significant clinical impact on the treatment of malignant pleural mesothelioma (MPM). While MPM is an aggressive cancer, our study showed that we can use a single microRNA to identify subgroups of patients who differ significantly in their time to progression and survival. When applied to a clinical setting, these findings may enable clinicians to apply multimodality therapy to the most appropriate patients. Furthermore, I think it is remarkable that a single biomarker can provide such insights into disease prognosis.”

The conclusion of the study found that the over-expression of miR-29c in mesothelioma cells decreased proliferation, migration, invasion and colony formation.

Additional information about mesothelioma may be found through the Mesothelioma Center.

Malignant mesothelioma is an aggressive cancer caused almost exclusively by asbestos exposure. Because of the aggressive nature of the cancer, treating it with only one mode of therapy usually returns a poor response. But when doctors combine therapies such as surgery, chemotherapy and radiation, an improvement in survival is commonly observed.

The study reviews three decades worth of data on pleural mesothelioma patients treated with a multimodality approach in the United Kingdom. Over the course of the three decades, a total of 217 patients were referred for surgical opinion. The 78 patients who only had pleural biopsies were excluded. A total of 139 patients underwent surgical procedure, with 49 undergoing extrapleural pneumonectomy (EPP) and 90 patients undergoing pleurectomy/decortication (PD). Post-operative adjuvant therapy involved chemotherapy and radiotherapy.

The longest survival rates (median 26 months) were observed among patients who underwent a pleurectomy/decortication followed by both chemotherapy and radiotherapy. The extrapleural pneumonectomy, whether or not combined with chemotherapy or radiation, provided no significant survival advantage when compared to the pleurectomy/decortication group. Additionally, EPP not followed with adjuvant therapy was an independent risk factor for decreased survival.

In conclusion, the researchers found that “cytoreductive surgery combined with post-operative adjuvant therapy provided a better survival despite either advanced disease or surgically less fit patients. Thus, pleurectomy/decortication may be the procedure of choice” since neither EPP or PD are curative.

Additional information on mesothelioma and treatment options may be found through the Mesothelioma Center.

Leroy Conway, Jr. was 10 years old when he was initially exposed to the toxic substance. At the time the exposure occurred, his father, Leroy Conway, was serving on the S.S. Baltimore Trader, an oil tanker that was owned and operated by ATTRANSCO, Inc.

During Leroy Conway’s three-year employment as an engineman on the ship, he often worked in areas that commonly contained asbestos materials. After coming home from work, Mr. Conway would carry asbestos dust on his clothes, which is how Leroy Conway Jr. was exposed.

Leroy Conway Jr. is now a 45-year-old husband and father of three. He was diagnosed with malignant mesothelioma in May 2007 and has undergone surgery to remove one of his lungs. Since receiving the diagnosis, Mr. Conway Jr. has been unable to work due to the symptoms associated with the illness. Exposure to asbestos is the primary cause of this fatal cancer.

During the case, former captain of the S.S. Baltimore Trader acknowledged that the presence of asbestos was known, but neither the company nor other members on board knew the dangers associated with asbestos until 1980 at the earliest.

Nonetheless, the jury found ATTRANSCO to be guilty after claiming the company acted with negligence by failing to warn workers and their families about the hazards of asbestos. ATTRANSCO was the only defendant named in the case.

The jury’s decision awarded Leroy Conway, Jr. $9.3 million for pain and suffering and an additional $636,688 for medical expenses.

Additional information about mesothelioma and asbestos exposure may be found through the Mesothelioma Center.

Malignant mesothelioma is an aggressive form of cancer caused almost exclusively by asbestos exposure. Pleural mesothelioma is the most common form of the cancer, affecting the pleural lining of the lungs. Other forms of mesothelioma include peritoneal mesothelioma (abdominal lining), pericardial mesothelioma (heart lining), and testicular mesothelioma (testicular lining).

Patients with pleural mesothelioma often experience compromised lung function and exercise capacity, but the effects of chemotherapy can also play a role in the cancer’s side effects. Since there has been little research on chemotherapeutic effects on lung function and exercise capacity in pleural mesothelioma patients, researchers out of Italy devised a study to examine the effects.

The study included 36 patients, 25 males and 11 females. Data regarding medical history, staging, histology and response to induction chemotherapy (the use of chemotherapy as the initial treatment when other treatments cannot be used) were collected for each participant. All the patients underwent pulmonary function tests (spirometry) before and after chemotherapy, which involved a platinum-based agent plus pemetrexed. A total of 23 out of the 36 participants also underwent a cardiopulmonary incremental exercise test.

Epithelial histology was recorded in 88.8 percent of the participants. Partial response to chemotherapy was seen in 44.5 percent of patients and 36.1 percent experienced grade two through three toxicity. Overall, performance status among participants following induction chemotherapy was better in 10 percent, stable in 18 percent and worse in 8 percent.

Pulmonary function testing involved a spirometry before and after induction chemotherapy. Results from the spirometry showed improvement in lung function in patients responding to chemotherapy. Data from the cardiopulmonary exercise testing suggested that induction chemotherapy does not compromise cardiopulmonary performance.

The overall results of the study showed that induction chemotherapy improves lung volumes, oxygen uptake and gas exchanges. A significant increase in lung volumes was observed primarily in patients that responded to induction chemotherapy. Researchers suggest this response could be attributed to a cytoreductive effect on pleural mass and thickening.

Researchers concluded from this study that induction chemotherapy has the potential to improve lung function and does not compromise cardiopulmonary performance. This data suggests that induction chemotherapy does not increase the risk of cardiopulmonary complications for surgery, but researchers note that the limited number of participants in this study requires further research to validate the findings.

Additional information on mesothelioma may be found through the Mesothelioma Center.

Many materials used on ships contained asbestos because of its ability to withstand high temperatures and fire. In addition to this, asbestos helped prevent corrosion, which made it an ideal material for ship construction.

However, any disturbance to asbestos-containing materials increased the risk for those nearby of inhaling asbestos fibers. The inhalation of asbestos is the primary cause of malignant mesothelioma, a cancer that often carries a very poor prognosis.

Once the fibers are inhaled, they typically become lodged in the mesothelial lining of the lungs. Overtime, usually anywhere between 20 and 50 years, enough irritation occurs and mesothelioma tumors develop.

Areas aboard ships that commonly included asbestos-containing materials were boiler rooms, sleeping quarters and areas that required insulation such as piping and walls.

Occupations within the shipyard industry that carried a higher risk of asbestos exposure included welders, painters, machinists and others who made repairs on board. Navy veterans who were crew members on these ships were also at risk of being exposed to asbestos.

Those who feel they may have experienced asbestos exposure within the shipyard industry should seek regular medical checkups for signs of asbestos exposure. Receiving an early diagnosis for an asbestos-related disease not only opens the door to more treatment options, but gives a patient a better chance of combating the illness.

Additional information about mesothelioma and asbestos exposure may be found through the Mesothelioma Center.

The most widely used staging system for malignant mesothelioma is the TNM system proposed by the International Mesothelioma Interest Group (IMIG) in 1995. The acronym refers to the factors that are considered in staging the cancer (‘T’ refers to the tumor, ‘N’ refers to lymph nodes and ‘M’ signifies metastases). Like most cancer staging systems, the TNM system uses four progressive stages to designate the extent of the cancer. Clinical staging aims to stage the cancer as accurately as possible with refined imaging scans, but pathological staging tends to be more accurate since it includes more data from surgical resection.

According to the authors, the “aim in the present study was to examine the association between clinical and pathological staging in a cohort of patients that underwent radical resection for MPM [malignant pleural mesothelioma] in the two surgical departments participating in this study and identify possible discrepancies between staging based on imaging and the one derived from post-resectional parameters.”

The study included 164 patients who underwent radical surgery for pleural mesothelioma. A total of 114 patients underwent an extrapleural pneumonectomy and 50 underwent radical pleurectomy/decortication. Prior to surgery, all participants were clinically staged with the TNM system using either computed tomography (CT scan) or magnetic resonance imaging. Following surgery, all participants were pathologically staged according to results gathered from the surgery.

Results revealed that clinical T staging (the tumor factor in TNM) proved to match 44 percent of pathological staging and was understaged in 46 percent and overstaged in 10 percent of patients. Clinical results for N stage matched pathological stage results in 56 percent of participants, and was understaged in 31 percent and overstaged in 13 percent.

Overall, pathological staging was the same as clinical staging in 44.5 percent of participants and disease was falsely understaged in 44.5 percent, only 11 percent of cases were overstaged. These results reveal the discrepancies between clinical and pathological staging, making a strong case for further research to improve mesothelioma staging.

In conclusion, the researchers report, “It appears that there are deficiencies in the current staging system for MPM and discrepancies between clinical and pathological systems. Clinical descriptors of nodal status and pathological descriptors of T stage appear to be less accurate; therefore, future improvements in these parameters are needed. Subsequent IMIG stage grouping also needs revision. The IASLC Mesothelioma staging project is ongoing and will lead to an evidence-based revision of the TNM staging for mesothelioma within the next 3 years.”

Additional information on mesothelioma and staging may be found through the Mesothelioma Center.

Jayne Menssen claimed she contracted mesothelioma after being exposed to asbestos during her employment as a secretary at Union Asbestos and Rubber Co. in the 1960s. The company was called Unacro Industries Inc. at a later date.

According to Menssen, the defendants Pneumo Abex LLC and Honeywell International Inc. knew about the hazards associated with asbestos, but failed to warn employees and customers that there was any danger.

Exposure to asbestos is the primary cause of malignant mesothelioma. For most patients, prognosis is poor as doctors often experience difficulty in treating the disease. Treatment options usually include palliative methods aimed at relieving pain rather than curing the cancer.

Diagnosing mesothelioma is also challenging for physicians. The latency period for development from the time someone was initially exposed to asbestos can range between 20 and 50 years. By the time mesothelioma is detected, patients are often already in the advanced stages of development.

According to the Environmental Protection Agency, there is no safe level of asbestos exposure. Those who believe they have been exposed should seek routine medical checkups with a qualified physician for signs of asbestos exposure.

The jury in the case reached their verdict after a four-week trial. Menssen received compensatory damages of $3.5 million, punitive damages of $4.37 million from Pneumo Abex and $10 million from Honeywell.

Additional information about mesothelioma and asbestos exposure may be found through the Mesothelioma Center.