Mesothelioma Mesomark Blood Test

Friday, January 29, 2010

The Food and Drug Administration (FDA) approved the MESOMARK assay to help monitor response to treatment in malignant mesothelioma patients. The MESOMARK test signifies the beginning of a new era in monitoring mesothelioma malignancies," said Dr. W. Jeffrey Allard, vice president and chief scientific officer of Fujirebio Diagnostics. "As the first in-vitro test for patients with this aggressive disease, it will enable doctors to more accurately detect recurrence and monitor treatment of patients." The MESOMARK Assay test kit was developed to measure levels of a biomarker, mesothelin, in serum. Biomarkers are substances found in higher-than-normal concentrations in the blood, urine or body tissues of patients with certain types of cancers. The test may be used to monitor patients confirmed as having mesothelioma, for recurrence in patients following surgery, or for measuring response to therapies. "Current diagnostic tests are less than ideal for quantification of changes in tumor volume, which is key to managing the disease," continued Allard. "As the MESOMARK results correlate with tumor volume*, it provides a much needed tool for monitoring patient status. It is our plan to collect additional data in the future to support the use of the test to detect mesothelioma."

MESOMARK test are now making it possible - with a simple blood test -to monitor response to treatment and to detect recurrence following treatment. This provides an important head start to patients racing against this aggressive cancer. "The Meso Foundation is the national research funding, patient support and advocacy organization dedicated to eradicating mesothelioma as a life-threatening disease. Those wishing to take part in MESOMARK testing will be asked to provide one or more samples of blood. The blood samples will then be sent to a national reference laboratory for testing. In conjunction with other clinical and laboratory data obtained by your doctor, decisions regarding your treatment and ca

re may be simplified. You may discontinue testing at any time.


Assembling Your First Aid Kit

Wednesday, January 6, 2010

Assembling Your First Aid Kit

Author: Michelle Bery

The first aid kit may seem like an old-fashioned concept but the truth is that today - just as always - an appropriately assembled, comprehensive first aid kit can save the most amount of time when treating injuries. Also, in the event of an emergency, a well-placed first aid kit can administer front line care until emergency services can arrive. A thoroughly stocked first aid kit should always be kept in your home as well as in each of your cars. Additionally, you should always keep a travel first aid kit handy to take with you on vacations, family outings, etc. The properly assembled first aid kit should include a number of important things. First and foremost, a first aid kit should include those items necessary for treating wounds; bandages of all sizes, gauze, tape, and small scissors, alcohol or other antiseptic to clean the wound, bottled water, clean, dry cloths, and antibacterial cream or spray. Those administering the first aid should also have sterile gloves and antibacterial wipes for clean up afterwards. In addition to these important items, your first aid kit should also include a variety of medicines - pain relievers, aspirin, anti-diarrhea medicines, a fast-acting allergy medication such as Benadryl, and extras of any medications you or your family take on a regular basis. In the event of accidental poisoning, contact poison control immediately - keep the number handy in your first aid kit - and be prepared to administer Syrup of Ipecac if necessary. There are small containers of this important medicine available in most stores that will fit nicely into a first aid kit. Also keep numbers of your doctors, pharmacy information, and pertinent health insurance information readily available in your first aid kit. This will save you quite a bit of time should you need information quickly. You can purchase pre-assembled first aid kits at most drug stores. These are convenient and compact and usually include most of what you need. But in order to assemble the most comprehensive first aid kit it is best to do it yourself. You can find a number of small kits available in drug stores. Make several first aid kits at a time and store then in the appropriate places. Being prepared can arm you with power. A comprehensive and well thought out first aid kit can be your insurance against sickness and injury no matter where you are.

About the Author: For easy to understand, in depth information about first aid visit our ezGuide 2 First Aid.

Article Source: - Assembling Your First Aid Kit


3 Tips To Help You Get Rid Of Acne

Monday, January 4, 2010

Author: velenciafoo

Most of us will have acne sometime in our lives. For some, it happens only during adolescence while there are others who are plagued by acne even as adults. There are many factors that cause acne. It can be caused by genetics, improper skincare regime, using the wrong products, hormonal changes, etc. Whatever the causes is, it still remains urgency for the sufferers to get rid of acne.

Contrary to popular belief, acne can be treated using natural and gentle products, without the use of harsh treatments and chemicals. As a matter of fact, it is best to treat your acne with natural products. The trick is to find the best acne product that is suitable for you and works.

There are some points to take note of when treating acne.

1. Use a gentle cleanser that is made for acne skin. As cleansing is a very important part of treating acne, you want to use a product that is made specifically for acne treatment and at the same time, is gentle.

2. Have a healthy diet and drink lots of water. There are herbal supplements that are made specifically to treat acne. This work by clearing up toxins from within so that ensures a clean up on your acne as well. One of the best acne products on the market for this is the Clear pores system.

3. Keep your face clean and don't pick on your acne. This is one of the worst things you can do. By picking on the acne, it may cause acne scarring which is another problem you will have to deal with.

The best way to treat acne and keep it under control is to use a natural acne treatment system daily.

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Watch a video that shows you exactly what you must Do in order to maintain your pores clear and clean, what you should do to find out how to get rid of acne marks and why at

You will also learn how to reverse the acne situation if you have already done those things that should NEVER be done.

About the Author:

Jimmy Low,, Freelance SelfEmployed Graduate

Article Source: - 3 Tips To Help You Get Rid Of Acne


Car First Aid Kit

Author: rory

Car First Aid the event of injury from work or play.

Many injuries are not life threatening and do not require immediate medical attention but Knowing how to treat minor injuries and having the equipment helps in an emergency. Having a First Aid Kit is essential and is a legal requirement in the workplace where any employees are at risk of injury. First aid kit supplies can help you stop bleeding, prevent infection and assist in decontamination.

First Aid Kits help to better prepare for situations where a loved one or any person is hurt. Having a First Aid Kit in an office, house or when camping is a must!. There are many different types of First Aid Kits.The following list is a basic car kit suitable for any vehicle. At you will find this kit listed as a Medium Soft pack but check out the complete range and you will find more comprehensive cover for higher risk situations

Your First Aid Kit should have a pair of Latex gloves, sterile dressings ,Wound dressings to stop bleeding and Antiseptic cleansing agents ( eg : iodine) in a wipe. Antibiotic and burn ointments are necessary to prevent infection. Let your first aid kit also have bandages in a variety of sizes, eye wash solution to flush the eyes or as general irrigation.A personal First Aid Kit also should have your prescription medications such as insulin, heart medicine and asthma inhalers and . You should periodically rotate medicines to account for expiration dates. In the content also keep prescribed medical supplies such as glucose and blood pressure monitoring equipment and supplies.Supplies it may be good to have in First Aid Kits:






Nylon Fully Enclosed Dustproof Zip Bag



Conforming Bandage 2.5cm x 1.5m



Conforming Bandage 5cm x 1.5m



Conforming Bandage 7.5cm x 1.5m



Heavy Crepe Bandage 7.5cm X 1.5m



Triangular Bandage Calico



Combined Dressing 10cm x 20cm



Dressing Lite Non Adhesive 7.5cm x 5cm



Dressing Lite Non Adhesive 7.5cm x 10cm



Micropore Tape 1.25cm X 9m



Zinc Strapping Tape 2.5cm x 5m



Eye Pad Dressing Sterile



Bandaids Plastic 20 box



Burnaid Antiseptic and Itch relief


Resuscitation Mask Non Return Valve



Survival / Shock Blanket



Sodium Chloride 15ml



Latex Gloves 1 Pair Pack Large



Tweezers Stainless Steel 11.5cm



Scissors Stainless Steel 12.5cm



Splinter Probes 5 card Sterile



Wound Dressing No 14



Antiseptic Sachet Pack



Cold Pack 180 x 110 Instant



Plastic Bags 150 x 200 6 pack



Safety Pins 12 pack



First Aid Book Small


In comparing First Aid Kits it's important to keep in mind the purpose. Are you traveling? If yes then consider the place where you are going. First Aid Kits for your house or office will contain slightly different supplies. A good First Aid kit is useful only if it is available. Therefore, the advice is to keep it with updated amount of supplies handy, in a place where you can access it when needed.

About the Author:

Rory McGeough has a lot of experience helping large vehicle fleets take care of their occupational health and safety requirements.

Article Source: - Car First Aid Kit


Home First Aid Kit: A Must Have!

A first aid kit is not just a set of items that you store in your washroom and contains only band-aids, alcohol and analgesics, it is something more. There are various types of First Aid Kits, the most common is the one stored inside the house. What do we mean if we have a complete set of first aid kit? What is that for and how or when to use it? What comprises each first aid kit? These are the questions we ask ourselves when we consider buying one for our home. A first aid kit is a set of supplies and equipments for giving first aid, hence the name. A variety of equipments are in it like: • Bandages - to control bleeding • Regular strength pain medications • Gauze • Disinfectants - like alcohol and Povidone iodine • Personal protective equipments - like gloves • Breathing apparatus - to protect you from performing the expired air resuscitation, EAR and cardiopulmonary resuscitation or CPR Moreover, the typical contents and most commonly used are the dressings which should be sterile. This comes in different types like sterile eye pads; adherent or non-adherent pads and burn dressings. These are sterile pad soaked in a cool gel. Bandages can be non-adhesive; examples are gauze roller, which should absorbent, breathable. The elastic type are the ones usually used for sprains and pressure bandages. Adhesive elastic roller types are very effective when it comes to applying pressure. They are also very durable and waterproof. Triangular bandages are commonly taught in Basic First Aid Course that was used as slings, tourniquets and to tie splints. Adhesive bandages are the straight adhesive type such as band-aids, sticking plasters. Butterfly bandage types are actually the two common examples as well. Instruments that should be present in your First Aid bag are the hypoallergenic tape because you don't want the patient to develop "Urticaria" or itchiness with reddish skin markings. Trauma shears can basically be used for cutting clothing and general use. An irrigation syringe can be used for cleaning wounds. Rubber suction bulbs are good for clearing the airways and can be applied to an unconscious patient. Equipments like Personal protective Equipments or PPE are important. This is especially in emergency cases where in hazardous materials can even hurt the rescuer. An example would be in organophosphate or insecticide poisoning. Eyecups, gloves, CPR mask or a face shield, sterile eyewash, emergency blanket, thermometer, penlight and even instant acting cold packs. Certain medications should be in your bag like antimicrobials. This would include antibiotic ointments and anti itch ointments. Examples would include Hydrocortisone cream, Antihistamine cream such as Benadryl and Calamine lotion among others. You also need pain killers or analgesics. These are essential for the fever to disappear. Examples are Acetaminophen, Ibuprofen (an anti-inflammatory drug, which is most of the time more valuable than the latter drug. Aspirin, for some, is also applicable. Diphenhydramine, which is anti-histamine, can lessen the allergic reaction seen in few patients. Aloe Vera gel can be used for a variety of injuries like burns, sunburns and dry skin. Burn gels are water based gels, which acts as a cooling agent and often has mild anaesthetic components. A good example is Lidocaine with antiseptics components like that of tea tree oil. Epinephrine auto-injector is also commonly included in this first aid kit, especially if you are in wild nature trips such as summer camps. This epinephrine injector is used for anaphylactic shock, which is commonly known as severe allergic attacks. Thus, activated charcoal and syrup of ipecac are electively placed in first aid kits because it is for poison treatment. A haemostatic agent that is called QuikClot is sometimes included especially in military kits; this is mainly to control severe and profuse bleeding. If ever you are trapped somewhere and you do not have anything else but your first aid kit you and you are wondering what you can do. Well, the first thing to do with your first aid kit would be to call help. It would also be helpful if you have a basic first aid manual, which can guide you in any type of situation. This is really necessary because in emergency cases, we get to panic easily. When this happens we cannot think straight. A manual will be able to help us go through it. It would also be advisable to list down the pages for specific cases. Just take note of the more possible accidents. Moreover, keep a number of your family and friends, as well as emergency hotlines on your mobile or near your landline. Make sure the numbers are visible to your children as well. Just let them know the importance of these numbers and when to place a call to these numbers. Thus, there are also some things you should know about the contents of your first aid kit. For an instance alcohol pads as well as ointments that are "petroleum-jelly based" can be utilized as a type of fire starter in an alarming emergency situation. It can also be utilized as a lubricant for adhesive tapes. Aside from this, for particular mechanical devices and bandages, it can also be utilized for repairs. These alternative uses of these things can help set your mind on the items you need and can only be used in the wilderness. First Aid Kits are important in every household. There are also first aid kits for pets, children, travel, disaster and soft sided situations among others. Having one doesn't mean that you are waiting for an accident to happen. Accidents are a fact of life, so whether we like it or not, it is always best to be prepared.

About the Author: For more information on First Aid Kits please visit our website.

Article Source: - Home First Aid Kit: A Must Have!


First Aid Kits

Author: sajith

Everyone must be aware of the necessity of a first aid kit in their home and car. Businesses corporations must have first aid kits with necessary first aid supplies, located somewhere in their facility. If the building is large, they should have first aid kits in each section.It is important to have first aid kits, because they allow someone who is injured, to be rapidly treated with basic first aid, before they can be properly treated at the local hospital. Therefore in emergency circumstances, someone should know where the nearest first aid kit is located and how to use the contents within it.

First aid kits are designed to treat non-emergency situations that do not need a doctor and to provide instant care in emergency situations. Kits can be small or large and the size of the pack is generally determined by the number of people who may access it over time. But every first aid kit has basic items that are used to treat minor injuries and hopefully stop or reduce the chances of infection.

There are also first aid kits for burns, kitchens and special industries. Having one first aid kit with you does not mean that you are waiting for an accident to happen. Accidents are a reality in life, so whether we like it or not, it is always best to be ready.

First aid kits for the office or home should be purchased in a size that meets the requirements of the number of people potentially using the kit. It can be large or small, but should always have crucial first aid items. A first aid kit can provide you with the assurance that minor injuries can be dealt with in a quick manner.

If you would like to find out more detailed information on first aid kits and fire extinguishers visit our website the Author:

If you would like to find out more detailed information on first aid kits and fire extinguishers visit our website

Article Source: - First Aid Kits


Get Rid Of Acne Scar

Saturday, January 2, 2010

By : Cesar Quinn If you are a someone with acne scars, don't stay in despair. In differentiation, the best acne scar treatment for acne is ready in leaping and limits. Scars could also be cosmetically handled with topical to red, removals, or taken to a advanced degree and style, with medical treatment. Medications of skin acne scars are: Microdermabrasion is comparatively different operation which takes away the real first layers of broken skin. The operation demands things like "sand blasting". It makes the skin formation finer. Usually this way is used on face or neck but it does not mean that you can't use this way on other pieces of your body. Chemical Peels. During this remedy a variety of chemical treatments are used to the skin. Peel (chemical agents), resolve the skin cells, and promote the growth of different tissue. Dermal Fillers operation is getting very favorite these days. The main things what this method do is it reduces or eliminates wrinkles, enhance lips etc. The cause why individuals skin becomes to situation when this operation is required is everyday stress. Punch excision is a way in which is Normally used when acne scar is very big and can't be easely fixed. It is one of the section of acne scar removal process. It is best acne scar treatment for ice pick scars. There are no great risks in treatment process. Laser medication - don't worry, it is not something terrible or danger. It is used only with professionals who helo you and consult you for the best result in shorter time of period. Lots of people use this operation because they don't want to wait long to look good. What's considered as the best acne scar treatment for acne scars? Of course everybody should analyze the according situation and seriousness of the scars but as the best acne scar treatment can be laser therapy. Not only the best but even people say that it is the best decision to choose this one and let the professionals do their job and you should just enjoy the result. Laser therapy involves many stages of intervention and there are many ways of laser treatment. Laser therapy Now is taken to very high stage and there are laser therapies like dye-laser pulse which is made only for the final placing of the color. Fundamentally it fixes the color of the skin. So it means that this method is used only for top degree skin layers. Unlike fractional laser method is used to fix very deep skin layer problems. So you just have to evaluate your condition and with the help of proffesionals choose the best acne scar treatment which is the most suitable for you. Of course I'm not in your position but I can tell you that everytime when I look into mirror and I see myself healthy, I feel much better. Chemical Peels similarly microdermabrasion is used to get rid of sun damage and fine lines. It is used on top layers of skin. The skin after process is wrinkly, and may be even in color. Web designer and developer from Malta. My lates work is Best Acne Scar Treatment
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Symptoms of Rosacea and its cure!

By : hei55

As everyone knows that skin is the largest organ of a human body. When you are afflicted by any skin ailment, the whole body suffers a lot and it becomes quite difficult to undergo such condition. So, you should always be very careful and keen regarding your skin and its proper care. There are many skin disorders like acne, inflammation, skin rashes and warts etc. Such skin diseases have a cure and they can be controlled easily but the most persistent skin ailment that takes a lot of time to heal is Rosacea. There can be many reasons of this skin disease like it can be transferred from one person to another unless you make a physical contact with the afflicted person. Saliva of the mouth also plays a vital role to transfer the virus of this skin disease and mainly this virus affects the face. The most common parts of face where the virus of Rosacea attacks are Nose, Cheeks, Mouth and forehead. You might be thinking about the symptoms of this disease and how it attacks an individual. Well, a virus starts reproducing in human body and it destroys the most crucial amino acids of the human body. In this way the immune system of human body becomes weaker and the disease totally overcomes the whole body by leaving its signs on the face. The age of victims of this persistent ailment lies between 30 - 60 years old people; so, you can say that the virus usually attacks adults. There are many symptoms of this disease like itching on skin, burning and irritation. After Rosacea is being diagnosed, it is highly recommended to take precautionary measures and apply cures for this skin disease. Symptoms of Rosacea are quite tricky because in initial stages it is quite difficult to recognize it. When the virus attacks the skin in its basic stage, it is quite similar to pimples and sunburn. Thus, thousands of people neglect these symptoms by considering it harmless but once the virus reaches to its final stage it becomes quite difficult to bear the pain and irritation of this disease. Once the germs of Rosacea totally overcome your immune system the victim starts feeling itchiness, flushing on the affected parts and irritation. To overcome such painful attributes of this disease it is recommended to clean the affected parts smoothly on regular basis, avoid hot and spicy foods, and apply proper creams.

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I hope you enjoyed the post, for even more check out my Get Rid Of Rosacea blog NOW!

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Friday, January 1, 2010

By : albertgrant

What is ABVD Chemotherapy for Hodgkin’s Lymphoma? Hodgkin’s Lymphoma is a type of cancer affecting the White Blood Cells (WBC), which are an integral part of the body’s immune system. “ABVD” stands for the chemotherapy drug regimen which is frequently used for the treatment of Hodgkin’s disease. This regimen is used for the management of patients in the early stages of Hodgkin’s Lymphoma. It is comparatively less toxic and doesn’t result in major bone marrow suppression, like the other stronger and high- dosage chemotherapy regimens. What does ABVD chemotherapy regimen include? ABVD chemotherapy comprises of four, (to a maximum of eight cycles) of drugs given intravenously, with each cycle lasting for four weeks. The number of cycles depends upon the stage of Hodgkin’s Lymphoma. The treatment is done on an out patient basis and doesn’t require hospitalization; unless the patient’s medical condition is critical. The regimen comprises of four drugs Adriamycin (A), Blenoxane (B), Velban (V) and Dacarbazine (D), which have effects on the different stages of cellular growth and retard or halt the rapid multiplication of cancer cells. Chemotherapy treatment outcome of Hodgkin’s Lymphoma Chemotherapy can completely cure Hodgkin’s Lymphoma, with medical studies indicating that more than 90% of the patients remain free from remission for a period of two to five years after the treatment. However on some occasions a relapse is observed which is treated with a higher dose of chemotherapy drugs or peripheral bone marrow transplant.

ABVD Chemotherapy side effects • Short term side effects include - alopecia ( hair loss), gastrointestinal disturbances( nausea, vomiting, abdominal pain, diarrhea, etc) , bone marrow suppression, and neuropathy which resolve after a few weeks of completion of the treatment • Long term side effects include infertility (i.e. inability to have children) and an increased risk of developing secondary cancers at other locations.

Chemotherapy treatment abroad Chemotherapy treatment in the United States is an expensive affair. However, leading healthcare institutions in several countries abroad, provide similar or better quality of medical care at significantly lower costs. These destinations include India, Mexico, Turkey, South Korea and Jordan.

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Notable people who died from mesothelioma

From :

Mesothelioma, though rare, has had a number of notable patients. Hamilton Jordan, Chief of Staff for President Jimmy Carter and life long cancer activist, died in 2008. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works also died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.

Bernie Banton was an Australian workers' rights activist, who fought a long battle for compensation from James Hardie after he contracted mesothelioma after working for that company. He claimed James Hardie knew of the dangers of asbestos before he began work with the substance making insulation for power stations. Mesothelioma eventually took his life along with his brothers and hundreds of James Hardie workers. James Hardie made an undisclosed settlement with Banton only when his mesothelioma had reached its final stages and he was expected to have no more than 48hrs to live. Australian Prime Minister Kevin Rudd mentioned Banton's extended struggle in his acceptance speech after winning the 2007 Australian federal election.

Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the U.S. Marines as a young adult—asbestos was then commonly used to insulate ships' piping—or from its use as an insulating material in car racing suits.[22] (It is also reported that he worked in a shipyard during World War II, where he might have been exposed to asbestos.[citation needed])

United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF Symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.

After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind including the song "Keep Me in Your Heart," which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.

Christie Hennessy, the influential Irish singer-songwriter, died of mesothelioma in 2007, and had stridently refused to accept the prognosis in the weeks before his death.[23] His mesothelioma has been attributed to his younger years spent working on building sites in London.[24][25]

Bob Miner, one of the founders of Software Development Labs, the forerunner of Oracle Corporation died of mesothelioma in 1994.

Scottish Labour MP John William MacDougall died of mesothelioma on August 13, 2008, after fighting the disease for two years.[26]

Canberra journalist and news presenter, Peter Leonard also succumbed to the condition on 23 September 2008.

Terrence McCann Olympic gold medalist and longtime Executive Director of Toastmasters, died of mesothelioma on June 7, 2006 at his home in Dana Point, California.

David Nicholls an actor from Armley, Leeds, West Yorkshire, England, passed away on June 23, 2008 of the condition mesothelioma,

Article Source :



Treatment of malignant mesothelioma using conventional therapies in combination with radiation and or chemotherapy on stage I or II Mesothelioma have proved on average 74.6 percent successful in extending the patient's life span by five years or more [commonly known as remission][this percentage may increase or decrease depending on date of discovery / stage of malignant development] (Oncology Today, 2009). Treatment course is primarily determined by the staging or development. This is unlike traditional treatment such as surgery by itself which has proved only be 16.3 percent likely to extend a patient's life span by five years or more [commonly known as remission]. Clinical behavior of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favors local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.


For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston.[18] Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.

Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.


Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery.[19] This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.

Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.[20]

In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.


Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.

Heated Intraoperative Intraperitoneal Chemotherapy

A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.[21] The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.

This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.

Article Source :


Pathophysiology Mesothelioma

From : The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibers in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fiber can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibers from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibers may be deposited in the gut after ingestion of sputum contaminated with asbestos fibers. Pleural contamination with asbestos or other mineral fibers has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).[8] However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.[9] Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibers. It has been suggested that in humans, transport of fibers to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localized lesions of accumulated asbestos fibers in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumor. Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibers remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibers has not yet been achieved. In general, asbestos fibers are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages. Analysis of the interactions between asbestos fibers and DNA has shown that phagocytosed fibers are able to make contact with chromosomes, often adhering to the chromatin fibers or becoming entangled within the chromosome. This contact between the asbestos fiber and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms. Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes: * Neurofibromatosis type 2 at 22q12 * P16INK4A * P14ARF Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms: * Inactivation of tumor suppressor genes * Activation of oncogenes * Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region * Activation of DNA repair enzymes, which may be prone to error * Activation of telomerase * Prevention of apoptosis Asbestos fibers have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences. Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres. [edit] Epidemiology [edit] Incidence Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate is approximately one per 1,000,000. The highest incidence is found in Britain, Australia and Belgium: 30 per 1,000,000 per year.[10] For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.[11] It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal. Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[12] Between 1973 and 1984, the incidence of pleural mesothelioma among Caucasian males increased 300%. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma. [edit] Risk factors Working with asbestos is the major risk factor for mesothelioma.[13] A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite. 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, gaskets, 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. Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.[14] [edit] Exposure Asbestos was known in antiquity, but it wasn't mined and widely used commercially until 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 publicly 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, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure. [edit] Environmental exposures Incidence of mesothelioma had been found to be higher in populations living near naturally occurring asbestos. For example, in central Cappadocia, Turkey, mesothelioma was causing 50% of all deaths in three small villages — Tuzköy, Karain and Sarıhıdır. Initially, this was attributed to erionite, a zeolite mineral with similar properties to asbestos, however, recently, detailed epidemiological investigation showed that erionite causes mesothelioma mostly in families with a genetic predisposition.[15][16] [edit] Occupational Exposure to asbestos fibres has been recognized as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum. The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure. Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia. [edit] Paraoccupational secondary exposure Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases.[17] 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 fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace. [edit] Asbestos in buildings Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or DIY activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials. Article Source :


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