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Mesothelioma Blog

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Your message to us will be held in strict confidence. All requests for information by mesothelioma patients and their family members will be answered within 24 hours. Mesothelioma Treatment and Care Guides are sent to mesothelioma patients and families by overnight delivery.

Mesothelioma Center Review – Brigham & Women’s Hospital

It is recommended that when you or your family member is diagnosed with mesothelioma that you be evaluated at an academic, multi-disciplinary mesothelioma center. In order to become familiar with what a center can offer, we feature one center a month.

Brigham & Women’s Hospital

Brigham and Women’s Hospital
75 Francis Street
Boston, MA 02115
International Mesothelioma Program- IMP-
www.brighamandwomens.org | www.impmeso.org

b-w-mesoThe International Mesothelioma Center (IMP) at Brigham and Women’s Hospital was founded by Dr. David Sugarbaker, an international expert on mesothelioma in 2002. It has grown to become the largest center for mesothelioma care in the world. The mesothelioma team of 80 caregivers, scientists, and support staff all work toward the mission of the IMP. According to the web site, www.impmeso.org, the three- part mission is :

• Our clinical team “goes for broke” to develop and employ the most effective, cutting edge treatment strategies to offer quality life extension for patients.
• Our scientists bring together basic, translational, and clinical research to understand how and why mesothelioma develops and translate their findings into improved patient care.
• Our supportive staff includes social workers, chaplains, and patient coordinators whose work helps improve the quality of life for our patients and their family and friends.

Dr. Raphael Bueno is the Chief of the Thoracic Surgery Division of the Brigham and Women’s Hospital. He is also the Director of the International Mesothelioma Program; Vice- Chair of Surgery for Cancer and Translational Research; Co-Director, Brigham and Women’s Hospital Lung Center; and Professor of Surgery, Harvard Medical School. Dr. Bueno has been with the IMP since its inception.

The team that works with the IMP includes oncologists from the Dana Farber Cancer Institute, radiologists with the Brigham and Women’s Hospital and Dana Farber. Support team members including chaplains, social workers, and nurses. All of these professionals have an interest in improving the lives of mesothelioma patients.

According to Dr. Bueno “We’re on the brink of incredible breakthroughs in the diagnosis and treatment of mesothelioma. Having been at the International Mesothelioma Program (IMP) since its inception, and now serving as director of this world-renowned program, I’m incredibly proud of our progress to date. Thanks to the incredible talent and dedication of our staff, we’re able to provide comprehensive, cohesive, life-extending mesothelioma care to our patients. Here at the IMP, we believe that mesothelioma should ultimately be treated as a chronic disease. This means taking a long-term view of the patient/provider relationship, knowing that, just like other chronic illnesses, patients’ symptoms must be managed on an ongoing basis. To that end, our staff remains involved with patients long after they leave Brigham and Women’s Hospital, maintaining strong ties to them and their families in the event that further treatment is needed.”

The International Mesothelioma Program has seen patients from all over the world. More than 2,200 patients representing all 50 states and many foreign countries have come to Boston to the IMP.

Research is a vital part of the IMP. The research focus of the IMP is collaboration. This is very important as mesothelioma is a very rare cancer, thus not commanding the funding of other cancers. The goal is to bring together researchers to help understand how and why mesothelioma develops and to translate the findings into improved patient care.

Scientists at the IMP are currently conducting research using the IMP Tumor Tissue Bank, which contains sample vials of about 1,000 patients. These scientists are able to perform genetic tests and genomic sequencing to aid in the diagnosis and prognosis of mesothelioma.

Clinical trials are the way that mesothelioma treatment advances. The IMP is involved, along with their partners in a number of collaborative clinical trials. Some of the partners are Verastem, Genetech and Castle Biosciences.

The IMP also provides a new patient orientation for patients and families, housing support while in the Boston area, support groups for caregivers, chaplaincy and social work support.

The number to call for new patients is 1-617-732-5922. This will connect you with the Division of Thoracic Surgery New Patient Coordinator, or request an appointment on line by going to www.impmeso.org and clicking on New Patient Appointment /Referral Form.

Mesothelioma Clinical Trial Review

c-trialsWe encourage participation in clinical trials for research leading to a cure for mesothelioma. It is known that nationally the statistics for participation in adult cancer trials is between 3-5% of adults who have a cancer diagnosis.

For mesothelioma patients and families who are interested in clinical trials, researching clinical trials and eligibility can be a time consuming barrier to participation.   The information about clinical trials is available on www.clinicaltrials.gov .

Our goal is to feature one mesothelioma clinical trial monthly and break it down to understandable terms, to decipher the eligibility requirements, and to possibly encourage participation in these trials.

CLINICAL TRIAL – NCT02004028

Window of Opportunity Study of VS-6063 (Defactinib) in Participants With Surgical Resectable Malignant Pleural Mesothelioma

Official Title- An Open Label Window of Opportunity Phase 11 Study of the FAK Inhibitor VS-6063 in Participants With Surgical Resectable Malignant Pleural Mesothelioma

Listing on www.clinicaltrials.gov

Sponsor-Verastem Inc.

Location- Brigham and Women’s Hospital Boston Massachusetts

Principal Investigator- Raphael Bueno M.D.

Contact- Julianne Barlow- 617-525-8541 jbarlow1@partners.org

Number of Participants- expected to be around 25

Purpose- This clinical trial is for people who have been diagnosed with malignant pleural mesothelioma and are a candidate for surgery. It is a drug given at specific times before surgery to participants who meet the eligibility criteria. The drug is a FAK inhibitor, named Defactinib. This drug will be given prior to surgery. Current therapy is surgery followed by chemotherapy and other treatments. The drug is a type of enzyme inhibitor that blocks the activation of specific signaling pathways in the body. The theory is that blocking these path ways may prevent tumor cells from growing and migrating to different areas of the body. After taking this drug, surgery will be scheduled about 7 days after completion.

Screening- Some of these tests you will undergo if you are considering surgery with or without this clinical trial.

  • A medical history
  • physical exam
  • vital signs
  • performance status
  • pulmonary function tests
  • quantitative ventilation-perfusion scan
  • PET scans
  • MRI for evaluation of your tumor
  • blood tests for biomarkers in addition to routine blood draws, biomarkers are genes or proteins that may predict how your body will respond to the study drug,
  • EKG
  • Pregnancy test if needed.

Eligibility Criteria

  • The patient must have a confirmed diagnosis of malignant pleural mesothelioma. The disease is confined to one side of the chest.
  • Be older than 18, male or female, not pregnant, be a candidate for surgery.
  • Tissue is required prior to enrollment. If patient was diagnosed outside and tumor tissue is not available, a pleural biopsy for frozen tissue collection is required.

Exclusions

  • Participants who have had chemotherapy or radiotherapy for mesothelioma any time prior to entering the study.
  • Patients receiving chemotherapy type drugs for benign conditions can participate in this trial. History of upper gastrointestinal bleeding, ulceration, or perforation within 12 months prior to the first dose of the study drug.
  • Known history of Gilbert’s Syndrome or any current hyperbilirubinemia of any cause.
  • Known history of stroke or cerebrovascular accident within 6 months prior to the first dose of the study drug.
  • Known infections with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS).
  • Confirmed Hepatitis A, B, or C.
  • Being actively treated for a secondary malignancy or any malignancy within the last 3 years, with the exception of nonmelanomatous skin cancer or localized, definitively treated cervical cancer.
  • Men under observation for local prostate cancer are also eligible if they have had stable disease for at least 1 year.
  • Uncontrolled or severe cardiovascular disease, including myocardial infarct or unstable angina within 6 months prior to study treatment.
  • Known history of malignant hypertension.
  • Uncontrolled intercurrent illness including symptomatic congestive heart failure, cardiac arrhythmias, or psychiatric illness/ social situations.

How the Research Study is Designed to Work

If you are eligible, a biopsy will be done if you don’t have previous tissue available to evaluate the specimens and biomarkers. After the biopsy- the participant starts taking the study drug by mouth twice a day for 35 days. The participant will have a study drug dosing diary. The tumor will be assessed by scans – CT, MRI, and a PET- CT at different points in the study. Different days will require clinic visits at specific times during the trial.

With any clinical trial, all participation is voluntary. Before enrollment a detailed consent form will be reviewed with the participant and signed.

The participant can withdraw from a clinical trial at any point in time. Think about participating if able, the only way progress to a cure for mesothelioma can be made is through clinical trials.

Mesothelioma Specialist Spotlight – Dr. Raphael Bueno

Dr. Raphael Bueno, Boston, BWH

bueno-2014If you go on the Internet and “Google” Dr. Raphael Bueno of Boston, you will find a host of bios and accomplishments. But Since Ellie and I have worked with him for years we would like to give an informal perspective prior to you reading all that he has established and accomplished. We both knew him as a young resident. As I remember he was always on top of his patients’ needs and their issues. He could remember the smallest details about his patients and always tried to provide the best medical care he could. These qualities are not easy in the stressful life of a young intern in a very competitive environment. He stood out as one of the brightest, interested, and, most importantly, compassionate resident.   As he progressed through his career as a young doctor he was very patient with other patients and professionals. He gave patients time to speak to him about their worries and concerns. About ten years ago I remember him caring for a particular patient who had been diagnosed with mesothelioma. It was a particularly busy time on the thoracic service, many sick patients and concerned family members. He would sit at his bedside and talk about life. Sometimes it was about the disease or just whatever the patient wanted to talk about. These are qualities that cannot be taught.

As a member of the medical team he is very well respected and offers the same to others. His colleagues know how committed he is to treating this disease and helping patient outcomes improve. If he is in Boston it usually is part of his routine to stop by and see each of his patients daily. If he is traveling there are usually phone calls from his fellow giving updates as needed. He checks with the patient and the nurses and listens openly. If there are issues to be resolved then he tries to offer solutions. If you need surgery and were to pick a surgeon this would be a great choice.   He is very invested and will work to give you the best care and outcome possible.

Dr. Bueno is the chief of Thoracic Surgery at Brigham and Women’s Hospital. He is a graduate of Harvard Medical School and Harvard University. His residency was also done at Brigham and Women’s Hospital. His thoracic fellowship was done across town at Mass General Hospital. After completing his fellowship he returned back to Brigham and Women’s Hospital in 1996 as an attending physician in the thoracic division. His most recent studies of mesothelioma involve the genetics of the tumor and the makeup of the disease. He has a wide variety of interests in the thoracic field, which include mesothelioma, lung cancer and esophageal disorders and minimally invasive surgery. He is very involved with the research of mesothelioma and how we can treat this disease. Dr. Bueno was awarded Professor of Surgery at Harvard Medical School in 2011. He also is board certified as a surgeon and critical care. Along with his many accomplishments he continues to passionately pursue better treatment option leading ultimately to a cure for mesothelioma.

 

Caregivers and Caregivers Health

post-thumbnailCaregivers and caregivers health is a major issue in taking care of mesothelioma victims. Overall, the figures are staggering regarding the effects on caregivers’ health short-term and in some cases long- term. Their physical, mental and emotional health can be affected for years.

Becoming a caregiver is not something that comes naturally to everyone. The timing in the caregiver’s life might not be optimal. Over the years we have seen people who could never have imagined themselves as caregivers do an outstanding job caring for their loved ones. One patient in particular had a rocky course, his wife was his caregiver. After a long difficult hospitalization and rehab stay, they went home. Three months later, walking down the corridor in the hospital they spotted me. I recognized him immediately- he looked well, said he felt well and was doing better than he could have imagined. His wife had lost weight, looked tired, and had aged since the hospitalization and recovery. It was clear when talking with them that she had given her all for her husband to get better, but had not taken care of herself. What would help her cope with being a caregiver? What resources are available?

One of the most important things that a caregiver needs to know is that they are not alone. Help and support are available. It is not a sign of weakness that you take care of yourself. According to the web site Family Caregiver Alliance- www.caregiver.org – “Caregiving can also result in feeling a loss of self identity, lower levels of self-esteem, constant worry, or feelings of uncertainty. Caregivers have less self-acceptance and feel less effective and less in control of their lives than non-caregivers.”

There are many positive benefits of being a caretaker. Caregivers need to realize that this is not something that one person can do effectively over the long-term, without support and taking time for themselves.

A suggestion for a caregiver who is feeling alone or needs some support is to reach out. Support groups are available online. Sometimes just having a place to communicate with others who are going through similar experiences is helpful. When friends and family offer to help, take them up on their offer and give yourself a break. Remember that you need to be healthy and strong physically and emotionally to continue to take the best care of your loved one.

Ellie Ericson

  • This field is for validation purposes and should be left unchanged.

Your message to us will be held in strict confidence. All requests for information by mesothelioma patients and their family members will be answered within 24 hours. Mesothelioma Treatment and Care Guides are sent to mesothelioma patients and families by overnight delivery.

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