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Mesothelioma Recurrence: Continuing to Fight and Finding Hope

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“We cannot wait two months, it will be too late.”

I was taken aback when I heard my patient tell me that was what the oncologist told her.   She was supposed to be cancer-free and now her lymph nodes are positive.

Mesothelioma recurrence is very difficult to avoid even after the most aggressive surgery. Recurrence happens because the mesothelioma tumor is located so close to vital organs.

At this time, physicians can only offer hope by delaying mesothelioma recurrence and keeping the mesothelioma under control.

My patient, Mary, thought she would have to have chemo, but so quick? Some days she felt like she was going to beat this and other days she felt like she got hit with a brick. After a month of chemo, she says her appetite is improving but not where it is supposed to be.

The part that is so scary is what if she waited or was not up to it. Will that god-awful tumor grow back? She just got rid of a large tumor that encapsulated her left chest. Her surgeon removed her lung diaphragm and reconstructed her pericardium. It really does not seem fair. Chemotherapy once every 3 weeks for 12 weeks- a total of 4 cycles.

Another issue is what will the chemo do to her body. She is a young woman of childbearing age. The oncologist explained that she may want to freeze her eggs for a later date when she would like to possibly have a child. So much to think about!

She is not thinking about children but now she is forced to consider this and other issues.

It makes her reflect upon her life.

Where is this all going to go? When is the treatment going to end? When will she be back to herself?

Fortunately, she has goals and would like to go school. It is good to have a focus about what lays ahead. Yes, we know any kind of treatment is not easy but the flipside is treatment will allow her to live her life.

Although this is a difficult disease to treat, as professionals, we remain hopeful. Nothing is more rewarding than having a group of patients come to clinic for follow up and not one patient has evidence of recurrence. Another reward is when we visit someone after discharge and see them living their life.

It is the little things that give hope. The idea that patients are able to move forward with their life is inspiring for us to fight this disease.

– Lisa

The Power of Positive Thinking for Mesothelioma Patients

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think positive mesotheliomaYou hear the expression all the time, “think positive”. What does that mean? What if you don’t usually “think positive”? Is there any scientific basis for this? Can you learn to “think positive”?

Mesothelioma patients and their caregivers are told from diagnosis to “think positive” about their disease and treatment options. Looking at the statistics for malignant mesothelioma it is very difficult to “think positive”.

Historically it has been thought by many people that positive thinking is healthy and can improve your quality of life. The qualities of optimism and pessimism have a marked influence on your psychological and physical well-being.

“The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty.” — Winston Churchill

In 1985 the psychologist, Michael F. Scheier and co-author Charles S. Carver published a landmark study, “Optimism, Coping, and Health: Assessment and Implications of Generalized Outcome Expectancies”. This paper helped bridge the gap between psychology and biology. The study included a test to measure the effect of a personality variable on a person’s physical health. By developing a tool that was simple and easy to use, scientists were then able to measure what was thought of “the power of positive thinking”. As a result of this work and many after this publication, there is now scientific proof of the positive benefits of positive thinking on your health.

To start on the path to positive thinking look at yourself and what goes on in your head. Self-talk is that stream of thought that goes through your head that is not spoken. These thoughts can be positive or negative. Some of the thoughts may be logical, others can be from lack of information, and misconceptions. If you find that the unspoken thoughts that you are saying to yourself are negative, you can change that with time and practice. Be nice to yourself and encouraging. Give yourself a break! Look at the thought and evaluate it and remind yourself what is good about yourself!

Increasing positive thinking in your life can be done by figuring out what makes you happy. Spending time with people who you enjoy – such as your children or grandchildren — or doing a hobby that you enjoy. These could all be ways to increase positive emotions. Recent studies have proven that meditation has a positive effect. People that meditate daily have more positive emotions than those who do not. Writing has also shown to help. A study was published that showed that writing about one positive experience a day had a lasting effect on moods, and results in fewer visits to health centers, as well as better overall health. Exercise has also proven to help, as has allowing yourself time to explore something new and having fun.

Optimism and pessimism are personality traits. Positive thinking comes from optimism and then is used effectively in stress management. By thinking positive it does not mean that you deny reality. Mesothelioma is a deadly cancer, to take the approach that you are going to “think positive” and all will be well is not realistic. Positive thinking means that you approach the challenge of a mesothelioma diagnosis in an optimistic and constructive way.
There are ways to become a positive thinking person. Look at a situation that did not turn out as well as you expected and ask yourself: “what have I learned from this”? Change does not happen overnight but it is possible. Positive thinking will only aid you and your family members along the journey with mesothelioma.

– Ellie

Mesothelioma Center Review – Moffitt Cancer Center

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Moffitt Cancer CenterWe recommend 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 help you become familiar with what a center can offer, we feature one center per month.

Moffitt Cancer Center

 12902 USF Magnolia Drive

Tampa Florida 33612

1-888-663-3488

Mission: The mission of the Moffitt Center is to contribute to the prevention and cure of cancer.

The Moffitt Cancer Center opened in 1986. In 2001, Moffitt became a NCI (National Cancer Institute) Comprehensive Cancer Center. The Moffitt Cancer Center is comprised of 19 operating rooms, a diagnostic radiology department with MRI, PET/CT, digital mammography and all other imaging capabilities and radiation therapy department. The hospital holds 226 beds.

Moffitt Cancer Center is the 3rd busiest free-standing cancer center in the United States.

Moffitt has an entire team designated to treat mesothelioma. This institution also has a large number of clinical trials. Their treatments include:

  • Extra Pleural Pneumonectomy
  • Pleurectomy Decortication
  • Robotic assisted surgery
  • IMRT intensity modulated radiation therapy
  • Tomography
  • Brachytherapy
  • HIPEC intraoperative peritoneal heated chemotherapy

You do not need a referral to meet with one of their oncologists. The team includes medical oncologists, anesthesia, pathologists, pulmonologists, radiation oncologists and thoracic surgeons.

Moffitt Cancer Center consists of five research programs. It is made up of over 600 faculty members working together to tackle cancer. The five programs are comprised of:

  1. Cancer Biology:   This team investigates cancer and includes mathematicians and theorists. Their research is based on evolutionary-first principles.
  2. Cancer Epidemiology:   This group of scientists focuses on identifying the risk factors associated with different cancers. The goal is to prevention of cancer by early detection and interventions.
  3. Chemical Biology and Molecular Medicine: This group focuses on therapeutic approaches that involve chemical biology and systems, and they develop therapeutic approaches to new cancer treatments.
  4. Health outcomes and Behaviors:   This is a program that contributes to the prevention, detection and control of cancer through the study of behaviors of specific cancers. There is a focus on the disease spectrum – from early diagnosis to survivorship.
  5. Immunology Program: The team seeks to understand why some tumors evade rejection by the immune system. This program attributes much of its success to the fact that immunology clinical specialists, translational specialists and basic scientists collaborate and facilitate rapid progression of novel immunotherapies from lab to bedside.

Director – Dr. Alan F. List, MD is the President and Chief Executive Officer of the Moffitt Cancer Center

Team- The mesothelioma team consists of oncologists, surgeons, interventional radiologists and radiation oncologists.

Dr. Jacques-Pierre Fontaine (see www.FloridaChestSurgery.com) is the thoracic surgeon and the Section Head of the Mesothelioma Treatment & Research Center.

Dr. Bradford A. Perez, MD is the radiation oncologist.

Dr. Tawee Tanvetyanon, MD, MPH is the medical oncologist.

Along with other support staff, these doctors are the dedicated mesothelioma specialists in their respected fields. All are widely-published and experienced with mesothelioma.

The Moffitt Center is the largest thoracic robotic surgery program in the U.S.

The Moffitt website currently lists a total of 4 mesothelioma clinical trials. One of these clinical trials is: “A Phase 2 Study of Transarterial Chemoperfusion Treatment with Cisplatin, Methotrexate and Gemcitabine in Patients with Unresectable Pleural Mesothelioma”. This clinical trial is only offered at Moffitt Cancer Center. For further information on the active trials:   www.FloridaChestSurgery.com

There are numerous services throughout the Moffitt Cancer Center. There is a social worker available to all and they encourage you to call 1-813-745-8407 with any questions or issues.

A calendar of support groups is available. Coffee hours with staff and previous patients and caregivers are offered to give an opportunity to help patients and their families get through this hard time.

They also have a list of recordings of teleconferences that provide valuable information, for example, on side effects of treatment or on assistance navigating social security and disability benefits..

Moffitt has a Patient and Family Advisory Council, which is a special program for the children of parents who have cancer. They help the families cope with different changes that may occur during this difficult time.

To contact the Moffitt Cancer Center, you can call the main number at 1-888-663-3488, or you can fill out a referral form electronically- www.Moffitt.org.

To directly contact Dr. Fontaine or the Mesothelioma Team go to: www.FloridaChestSurgery.com

Please do not hesitate to contact us with any questions.

Mesothelioma Specialist Spotlight – Dr. Jacques-Pierre Fontaine

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Jacques Fontaine, M.D.Dr. Jacques P. Fontaine is a thoracic surgeon and the director of the Mesothelioma Center at Moffitt Cancer Center in Tampa, Florida. He is an Associate Professor of Surgery at the University of South Florida – College of Medicine..

Dr. Fontaine attended medical school at McGill University in Montreal, Canada. He then traveled to Boston where he did his general surgery residency and thoracic surgery fellowship. In Boston, he trained as Chief Resident under Dr. David Sugarbaker at Brigham and Women’s Hospital completing his Thoracic Surgery Fellowship. Upon completion of his Fellowship, he returned to Montreal and worked as a thoracic surgeon at the University of Montreal. He was soon recruited to become a part of Brown Medical School and lead a thoracic surgery program at one of their teaching hospitals. In 2011, he joined Moffitt Cancer Center. Dr. Fontaine’s passion and expertise includes treating mesothelioma and robotic lung and esophageal surgery. He is the director of both programs.

Dr. Fontaine is devoted to helping mesothelioma patients improve their lives. Therefore, he is very selective in choosing the best treatment option with his patients. As an expert in the treatment of mesothelioma, he sees every patient as an individual and advises what is best for them in collaboration with them. In the operating room, his goal is to remove all the tumor which is visible to the naked eye. If this is best achieved by removing the entire lung (also known as an extra-pleural pneumonectomy), he will do so. His goal is to improve not only the quantity of life, but more importantly the quality of life of his patients. If you are not a candidate for surgery, he will have you seen during your same visit to Moffitt by the other expert members of the Mesothelioma team who can help you, such as, a medical oncologist or a radiation oncologist. Dr. Fontaine can also recommend clinical trials for mesothelioma patients. He is very involved with research into future treatments for mesothelioma. Dr. Fontaine is passionate about his patients, very approachable and easy to talk with.

To contact Dr. Jacques-Pierre Fontaine please call 813-618-5967 or visit www.FloridaChestSurgery.com

Mesothelioma Clinical Trial Review (Transarterial Chemoperfusion)

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We 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- NCT02611037

Transarterial Chemoperfusion: Cisplatin, Methotrexate, Gemcitabine for Unresectable Pleural Mesothelioma

Official Title- A Phase 2 Study of Transarterial Chemoperfusion Treatment with Cisplatin, Methotrexate and Gemcitabine in Patients with Unresectable Pleural Mesothelioma

Listing on www.clinicaltrials.gov

Sponsor: H. Lee Moffitt Cancer Study and Research Institute

Location: H Lee Moffitt Cancer Center and Research Institute Tampa, Florida

Principal Investigator: Bela Kis, M.D., Ph.D., H. Lee Moffitt Cancer Center and Research Institute

Contact: Malesa Pereira 1-888-663-3488 www.FloridaChestSurgery.com

Number of Participants: Expected to be about 36

Purpose:
This clinical trial is for patients who are not candidates for surgery, have disease progression, and pain. This is a palliative therapy to improve the quality of life of pleural mesothelioma patients who have unresectable recurrent pleural mesothelioma. The study is to determine whether transarterial chemoperfusion treatment with Cisplatin, Methotrexate and Gemcitabine in adult patients with malignant pleural mesothelioma is safe and at what dose.

Screening:
All baseline laboratory requirements will be assessed and should be obtained within 14 days of first treatment. Screening laboratory values must be met.

Must have histologically or cytological confirmed malignant pleural mesothelioma.

Have measurable disease, by a CT. scan or MRI. Radiological tumor assessment must be performed within 28 days prior to the first treatment.

Women must have a negative serum or urine pregnancy test within 24 hours prior to the start of transarterial chemo perfusion treatment.

Men must be surgically sterile or must agree to use adequate contraception prior to the study entry and for the duration of study participation and after for a certain amount of time (up to 14 weeks) after the last treatment

Eligibility Criteria:
• Must have histologically or cytologically confirmed malignant pleural mesothelioma (MPM)
• Have unresectable MPM or the patient refuses surgery for resectable MPM
• Have failed to respond first line standard of care chemotherapy or chemotherapy suspended due to toxicity or other reasons.
• The predominant burden of disease lies in the arterial distribution which is accessible for transarterial chemo perfusion treatment.
• Men and Women greater than 18 years of age
• Eastern Cooperative Oncology Group performance status 60%
• Ability to understand and the willingness to sign a written informed consent document
• Participants must have signed and dated an Institutional Review Board (IRB) approved written informed consent form in accordance with regulatory and institutional guidelines.
• Must be willing and able to comply with scheduled visits, treatment schedule, laboratory tests, imaging studies, and other requirements of the study.

The study permits the re-enrollment of a participant who has discontinued the study for a reason other than treatment failure or adverse event of the study treatment.

Patients with the 3 types of mesothelioma (epithelial, sarcomatoid and biphasic) are all eligible

Exclusion Criteria:
• Patients who have had chemotherapy within 4 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
• May not be receiving any other investigational agents
• Known brain metastases or leptomeningeal metastases. Patients with other extra pleural metastases are included in this study.
• History of allergic reactions to compounds similar to Cisplatin, Methotrexate, Gemcitabine
• Uncontrolled illness including other malignancy, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Women who are pregnant or breast feeding
• Potential participants who are compulsorily detained for treatment of either a psychiatric or physical (e.g. infectious disease) illness.

How the Research Study Is Designed to Work:
Patients are given chemotherapy directly to the blood vessels feeding the tumor via a small catheter into the arteries feeding the tumor. The small catheter is placed temporarily into the femoral artery usually the groin of the patient, the catheter is fed up to the area of the tumor and then the chemotherapy is infused locally. By targeting the vessels feeding the tumor with chemotherapy agents it is hoped that the side-effects of the chemotherapy on the rest of the body are less. The process is repeated once a month.

Sources:
www.FloridaChestSurgery.com
www.ClinicalTrials.gov

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 to progress to a cure for mesothelioma is through clinical trials.
Please do not hesitate to contact us with any questions.

Taking Inspiration from a Peritoneal Mesothelioma Survivor

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InspirationWhen diagnosed with mesothelioma or any cancer some of the questions that run through your mind are: Will I ever be able to work again? Will my life ever return to being my own? Is this the end of life as I know it? What does my future look like? A diagnosis of mesothelioma with its survival statistics can be overwhelming for many people.

Sometimes in life you meet people that make a life-long impression on you. Whether it be at school, work, or socially you just don’t forget them. Many years ago at my first nursing job as a R.N., Julie was one of those memorable people. Julie was outgoing, fun, friendly, kind, a role model, a co-worker that you looked forward to working with. We were both R. N’s on a busy surgical floor. The patients all loved her enthusiasm and her wit. After a few years Julie left to get married and move to another state. The grape vine over the years reported that she had two sons.

A few years ago one summer day, I received a call from a friendly nurse inquiring about a nursing position. After talking for about 20 minutes, I disclosed that in addition to the service she was inquiring about we also did another service that we were passionate about: we followed patients that have mesothelioma, a rare disease. The phone went quiet as the nurse on the other end of the phone revealed she had peritoneal mesothelioma. We talked about what the chances are for her to be calling about another position and stumbling on our other services with mesothelioma patients. Continuing our call, she talked about her work experiences. I made the connection when she said her name. “You are tall, blonde, pretty, but what I remember most is you are very funny.” She laughed and said she was still funny. It was Julie!   She had been diagnosed with peritoneal mesothelioma 5 years previously. She had surgery and now was living with mesothelioma. She had returned to work within 4 months of surgery because she wanted to. She now admits this was not such a good idea physically but mentally yes it was a great idea. She had control, she was living her life on her terms. Peritoneal mesothelioma would not define her. She has advocated for herself and for others and is active in the mesothelioma community. As for advice for patients who are diagnosed, “have a positive attitude, listen to your heart, listen to your gut, advocate for yourself, have fun and go out and dance!”

If you are interested in connecting with Julie who is and continues to be an inspiration, reach out to us. Chances are that she will become one of those people that you don’t forget many years later!

About Julie Russell R.N.

julie-russellJulie Russell is an experienced Registered Nurse who is also a mesothelioma cancer survivor. Julie’s clinical expertise in nursing is in the area of the Cardiac Intervention. She has also been an instructor of Advanced Cardiac Life Support (ACLS) and Basic Life Support (BLS) for many years. Her varied nursing background includes roles as a nursing supervisor, educator and staff nurse.

Diagnosed with peritoneal mesothelioma in 2008, Julie has undergone surgery, chemotherapy, and become an advocate for herself and others. A mesothelioma diagnosis effects the whole family. Her two sons became active in the mesothelioma community as well.   She is a passionate advocate for all patients, but peritoneal mesothelioma is a personal cause of hers.  She will be a guest blogger for us. Julie will be sharing her personal experiences with peritoneal mesothelioma as she continues to live and work a full life. Since diagnosis, Julie has also become a grandmother. We invite you to follow Julie’s journey and feel free to contact her for any questions or support.

Think Positive: Advice from an 8 Year Mesothelioma Survivor

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Think positive! Yes, those 2 little simple words. Simple words they may be but a difficult thing to do when your pathology report just came back “peritoneal mesothelioma”.

Well let me introduce myself, I am a 64-year-old nurse who was diagnosed with peritoneal mesothelioma in 2008. I had absolutely no clue what this meant, what organ was involved and what my prognosis would be. I should know something about this disease right? I’m a Registered Nurse for 40 years. Wrong. I knew nothing and after contacting many doctors at my hospital I still was in the dark. No cases ever treated or diagnosed at this hospital. “Be positive” I kept hearing from everyone. How do you be positive when you can’t even find information about a disease. Ok I’m trying to be positive. Yes, I am aware of all the positive outcomes if you remain positive. But it’s really hard!!!!

After doing much research I was able to find an oncologist in New York who was very knowledgeable about the disease. He referred me to a surgeon in New York who performed abdominal resection with heated chemotherapy. Actually I didn’t think the surgery was that difficult. I was out of the hospital in 6 days. Chemo via those abdominal ports did knock me down a few times but maintaining a positive attitude does really help. I know it is difficult to be positive when the chips are down but being negative definitely doesn’t help! So here I am 8 years later working in my same cardiac unit, rollerblading weekly, and teach BLS and ACLS classes. Did I get here without any set backs?? I would love to say no it was a walk in the park. BUT now I can hopefully help others by telling how I coped with the ups and downs of my diagnosis. Hopefully you will follow my journey with me.

About Julie Russell R.N.

julie-russellJulie Russell is an experienced Registered Nurse who is also a mesothelioma cancer survivor. Julie’s clinical expertise in nursing is in the area of the Cardiac Intervention. She has also been an instructor of Advanced Cardiac Life Support (ACLS) and Basic Life Support (BLS) for many years. Her varied nursing background includes roles as a nursing supervisor, educator and staff nurse.

Diagnosed with peritoneal mesothelioma in 2008, Julie has undergone surgery, chemotherapy, and become an advocate for herself and others. A mesothelioma diagnosis effects the whole family. Her two sons became active in the mesothelioma community as well. She is a passionate advocate for all patients, but peritoneal mesothelioma is a personal cause of hers. She will be a guest blogger for us. Julie will be sharing her personal experiences with peritoneal mesothelioma as she continues to live and work a full life. Since diagnosis, Julie has also become a grandmother. We invite you to follow Julie’s journey and feel free to contact her for any questions or support.

Reflections on National Asbestos Awareness Week

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As National Asbestos Awareness Week comes to a close we are left with a few points to reflect on.  Groups shared their knowledge, and patients and survivors shared their hopes and dreams, as experts weighed in on the possibilities in the future, and to remind us that asbestos containing products are still in use today.  Although mesothelioma is considered a rare disease, it is deadly. The world needs to be reminded that there is no ban on asbestos in the United States.  The U.S. Surgeon General, Dr. Vivek H. Murthy, issued a statement reminding the nation of the dangers of asbestos. The use of this naturally occurring mineral was so widespread that it was used in the construction of many homes.  According to the World Health Organization there are 125 million people that have been exposed to asbestos. Dr. Vivek H. Murthy, the Surgeon General, strongly urged that if an individual has concerns about being exposed to asbestos that they reach out to a health care professional. The U.S. Center for Disease Control and Prevention estimates that at least 10,000 people die each year from asbestos-related diseases.

A conference was held in the Washington D.C. area by the Asbestos Disease Awareness Organization (“ADAO”).  There were many speakers and many powerful messages. A couple of important points were: ”Everyone has a voice“ and “We are one”.  A survivor of pleural mesothelioma, Heather Von St. James, spoke about sharing your story and that everyone has one. Although you may think that no one wants to hear your story, you might be surprised about the impact you can make on others dealing with mesothelioma. Sometimes it may just help you to speak and say out loud what has happened to you and your family.  Ms. St. James encouraged all to call their representatives and spread the word about banning asbestos. Doing this simple thing could possibly make a difference and raise the level of awareness about this important issue to our elected officials.

The other aspect of the conference that caught my attention was their slogan: “We are one”. This slogan captures the necessity of all working together towards a cure.  Professionals, healthcare workers, patients and caregivers all share the common goal of improving the quality of life for patients and families as they fight this disease.

Dr. Raphael Bueno, the Director of the International Mesothelioma Program at the Brigham and Women’s Hospital, Boston MA, spoke about mesothelioma during a conference call. He suggested that we need to collaborate with our researchers, doctors and patients to fight this disease. He believes there are drugs out there that will be proven successful in combating this disease. The more information we share the more powerful we can become against mesothelioma.

As we mark the end of the National Asbestos Awareness Week 2016, we encourage everyone to remain active to raise our voices collectively to ban asbestos, and to support the victims of asbestos diseases across the country and the world.

– Ellie Ericson

 

Raising Awareness About Asbestos & Mesothelioma

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asbestos mesotheliomaThe leading cause of mesothelioma is exposure to the mineral known as asbestos.  Asbestos is a naturally occurring product that for centuries was used as a fire retardant, insulating product, used in boilers, and in the manufacturing of many products.  These products can be found in the home and workplace.

Global Asbestos Awareness Week is April 1st – 7th, 2016.  Asbestos is still imported into the United States.  Last year an estimated 4 million metric tons were imported.  Asbestos is a known human carcinogen.  Asbestos related diseases caused an estimated 300 deaths a day around the world.

According to the World Health Organization:

  1. All forms of asbestos are carcinogenic to humans
  2. Exposure to asbestos causes cancer of the lung, larynx and ovaries, and also mesothelioma.  Asbestos exposure is also responsible for other diseases such as asbestosis, plaques, thickening and effusion in the pleura.
  3. Currently about 125 million people in the world are exposed to asbestos in the workplace.
  4. According to the most recent WHO estimates, more than 107,000 people die each year from asbestos related lung cancer, mesothelioma and asbestosis resulting from exposure at work.
  5. Approximately half the deaths from occupational cancer are estimated to be caused by asbestos.
  6. All the asbestos imported into the United States comes from Brazil.  Russia is the largest producer of asbestos. China is second and Brazil is third.
  7. The users of asbestos in the United States are the chlorine- alkali industry, used in making of chlorine and sodium hydroxide, accounting for around 57% of the mineral.  The remaining approximately 41% is used in roofing products.
  8. Only 52 countries have banned asbestos- the United States is NOT one of them.
  9. Co-exposure to tobacco smoke and asbestos fibers substantially increase the risk for lung cancer- and the heavier the smoking the greater the risk.
  10. The countries that are the largest consumers of asbestos  products are Russia, China, India and Brazil.

Source :  World Health Organization- www.who.int/mediacentre/factsheets and www.allgov.com

In the United States the organization that is dedicated to being the voice of the asbestos victim is the Asbestos Disease Awareness Organization- ADAO-.  ADAO is a non-profit that is dedicated to preventing and eliminating asbestos- caused diseases.  Linda Reinstein is the founder of ADAO.  Linda lost her husband to mesothelioma. During this week ADAO has scheduled activities to increase awareness and knowledge of asbestos in 2016.  www.asbestosdiseaseawareness.org

Victims of mesothelioma and their families know first hand what the devastating effect of asbestos exposure can do to the health of their loved one.  This week spread awareness to the dangers of Asbestos.

Eleanor B. Ericson, RN

Mesothelioma Clinical Trial Review- Methoxyamine, Cisplatin And Pemetrexed

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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 participations in these trials.

CLINICAL TRIAL- NCT02535312

Methoxyamine (TRC102), Cisplatin, and Pemetrexed Disodium in Treating Patients with Advanced Solid Tumors or Mesothelioma That Cannot Be Removed by Surgery or Mesothelioma That is Refractory to Cisplatin and Pemetrexed

Official Title- Phase I Study of TRC102 in Combination with Cisplatin and Pemextred in Patients with Advanced Solid Tumors, With Expansion Cohort in Mesothelioma/ Phase II Study of TRC102 with Pemetrexed in Patients Refractory to Cisplatin and Pemetrexed

Listing on www.clinicaltrials.gov

Sponsor- National Cancer Institute

Location- University of Maryland/ Greenebaum Cancer Center Baltimore Maryland- Contact Martin J. Edelman 800-888-8823

City of Hope Comprehensive Cancer Center Duarte, California, Contact Marianna Koczywas 800-826-4673

University of California Davis Comprehensive Cancer Center Sacramento, California, Contact Karen L. Kelly 916-734-7946

University of Colorado Cancer Center- Anschutz Cancer Pavilion Aurora, Colorado, Contact Stephen Leong 720- 848-0650

University of Michigan Comprehensive Cancer Center Ann Arbor Michigan, Contact Bryan J. Schneider

Mayo Clinic Rochester, Minnesota, United States Contact: Aoron S. Mansfield 507-538-7623

Number of Participants-58

Purpose- Clinical Trial TRC 102 in combination with 2 chemotherapy agents Cisplatin and Pemetrexed. This trial is for advanced tumors with expansion to mesothelioma/ Phase II is TRC102 and Pemetrexed in patients with refractory to cisplatin and Pemetrexed. NCI 9837

Group 1 is for previously treated cancers. Different doses of the study drug will be distributed in conjunction with Pemetexed and Cisplatin in patients who have been previously treated. The first group will receive the lowest dose of TRc102. If this does not cause serious side effects the dose will be increased for the next group of patients. The dose will be increased for each group until the side effects require the dose to be lowered.

Group 2 is for newly diagnosed patients with mesothelioma or solid tumors. The study drug TRC102 will be given in addition to Pemetrexed and Cisplatin. This group will be patients who would have been prescribed Pemetrexed and Cisplatin for regular treatment. The solid cancers include malignant mesothelioma, non small cell lung cancer, ovarian and thymome. The dose of group one will be based on the study of group 1.

Group 3 is for newly diagnosed malignant mesothelioma. All study participants will get the same drug (TRC102) with Pemetrexed and Cisplatin. This is for 14 study participants with previously untreated advanced, inoperable malignant mesothelioma for which Pemetrexed and Cisplatin is the regular treatment. The dose of TRC102 will be based on group 1.

Pemextred and Cisplatin will be given in conjunction with TRC102 on the first day of each cycle for 6 cycles. A treatment cycle is 3 weeks.

Eligibility Criteria

1 Patients with advance tumors in which standard treatments are not available. (Arm A)

2.Patients who have advanced unresectable solid tumors that are chemotherapy naïve for which Pemextred and Cisplatin is an indicated regime. (Arm A)

3.Group 3 patients with chemotherapy naïve and unrespectable malignant mesothelioma. ( Arm A)

4.Patients who have been treated but disease has progressed within 3 months of being treated with Cisplatin and Pemetrexed as a frontline appointment. (pleural or peritoneal mesothelioma) (Arm B)

5.Prior Pemetrexed dose for treatment but Cisplatin does can be no more than 75mg/2.

6 Male or Females greater than 18 years of age

7.Perfomance status is 0-1 Karnofsky greater than 70%

8.Life expectancy is greater than 3 months

9.Patients must have normal organ and marrow function

10. For patients who are in Arm A or Arm B, the disease must be measurable (pleural effusions and ascites are not measurable disease)

11. Patients must be able to swallow whole capsules. Nasogastric tubes or G tubes are not acceptable

12. Since this is a clinical trial it is unknown the effects to unborn fetus. Patients must agree to adequate contraception for the duration of trial

Exclusion Criteria

  1. Patients who have received chemotherapy or radiotherapy within 4 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier. Patients who have targeted therapy will have to wait 2 weeks due to short life of drugs.
  2. Patients who are receiving any other investigational drugs
  3. Patient with active brain metastases. Patients with treated brain metastases and have remained stable for greater than 4 weeks, without steroid and anti -seizure medicine, are able to participate. History of allergic reactions to compound or similar ingredients to TRC102 or Pemextred and Cisplatin
  4. As part of the informed consent patients will be counseled on the risk of over-the-counter medication or new prescription medications.
  5. Uncontrolled illness
  6. Pregnant and breastfeeding
  7. HIV patients on anti-viral therapy are ineligible
  8. Patients with known disorders that have hemolysis
  9. Patients on anticoagulation and thromboembolic disease
  10. Uncontrolled malignant pleural effusion or ascites
  11. Patients who have a cumulative does of Cisplatin greater than 300M2

How the research study is designed to work- Methoxyamine, or TRC102 is a medication taken by mouth? It is a small molecule inhibitor with potential adjuvant activity. It works by binding apurinic / apyrimidinic (AP) DNA damage sites and inhibits base excision repair (BER) which may result in an increase in DNA strand break and apoptosis. Apoptosis equals cell death. This agent may potentiate the anti- tumor activity of alkylating agents. The different arms of the study are trying the medications with certain cancers at different points. This study is being done concurrently with other cancers as well as mesothelioma.

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 you are able.

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