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Having an accurate staging method for cancer is essential to developing evidence-based treatment plans for patients. The current staging system used for pleural mesothelioma is the TNM system produced by the American Joint Committee on Cancer.

Mesothelioma is staged based on these factors:

  • Tumor size – The size of the primary tumor, how far it has spread in the pleura, and if it can be surgically resected.
  • Lymph Nodes – The existence of malignant cells in the lymph nodes and how far they have spread.
  • Metastasis – The spread or metastasis to distant sites from the point of origin.

However, past editions of the staging manual have not included a metric for pleural thickness. If factored into the staging system, it can produce a vastly more accurate prognosis. Establishing a precise T descriptor is challenging since mesothelioma does not form like other malignancies.

Mesothelioma tumors grow in a non-uniform pattern that can be very complex, unlike other cancers which spread out from a central point of origin. Currently, the T stage for pleural mesothelioma is only based on the development of the tumor and its relation to surrounding organs and tissue.

In 2018, Dr. Taylor Ripley, a mesothelioma specialist out of the Baylor College of Medicine, was able to demonstrate the feasibility of using pleural thickness as a prognostic factor by measuring a 3-dimensional reconstruction of a tumor and its growth.

The inclusion of this new metric outperformed the 7th edition of the staging manual in use at the time. This prompted the International Association for the Study of Lung Cancer and the International Mesothelioma Interest Group to jointly recommend that a metric for pleural thickness be included under T descriptors in the TNM system.

Another study conducted in Japan found that the maximal tumor diameter and the sum of tumor thickness in different regions of the pleura were linked with overall survival. Specifically, the study showed that while tumor thickness before neoadjuvant therapy had no effect on prognosis, tumor thickness after neoadjuvant chemotherapy was indicative of longer survival rates.

Based on this result, the authors said that:

“Neoadjuvant chemotherapy strongly influenced the outcome in patients undergoing multimodality therapy.”

Dr. Ripley and his co-authors concluded their research by stating, in the future, pleural thickness will likely be incorporated officially into the TNM system to give specialists more objective criteria for assessing the body’s response to multimodal therapy. It will also provide doctors with the ability to offer a more accurate prognosis to patients.

If you have any questions about your unique diagnosis, treatment options, or clinical trials that you may qualify for, contact our registered nurse on staff, Jenna Campagna, RN. You can reach her by calling 888-385-2024 extension 102, or emailing jenna@mesotheliomaguide.com.

The post Pleural Thickness as a Prognostic Factor in Mesothelioma Diagnosis appeared first on MesotheliomaGuide.

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Over the years, asbestos exposure has caused thousands of people to develop mesothelioma cancer. The risks associated with this mineral have been known for decades and in the 1980s most asbestos applications were banned. However, the use of the substance still persists, which has caused the incidence of mesothelioma to remain constant even after many products containing asbestos were strictly limited.

The scientific literature on the subject focuses heavily on occupational exposure from the lack of safety regulations or the willful negligence of manufacturing companies. Now, there is a growing body of evidence that suggests non-occupational exposure is also a significant risk factor.

A systematic literature review conducted by the Perelman School of Medicine at the University of Pennsylvania was published in 2018 to study the association between mesothelioma and non-occupational asbestos exposure.

Researchers performed a meta-analysis on 27 independent studies to determine the summary relative risk estimate (SRRE) based on several factors. These factors include:

  • Neighborhood exposure (the distance of the residence from an asbestos source).
  • Domestic or secondhand exposure (whether there is an asbestos worker living in the house).
  • Household exposure (involving asbestos-containing home improvement projects).

They found that neighborhood exposure to asbestos caused by proximity to an asbestos factory or mine produced the highest SRRE or highest risk of exposure. Domestic or secondhand exposure from a family member or relative who works with asbestos products produced a medium SRRE, and household exposure from renovations had the lowest risk of exposure.

The data show that even if a person does not work in asbestos mining or manufacturing, they could still be at high risk of developing mesothelioma if they live in the vicinity of an asbestos mine or factory. This is consistent with the results of a 2013 study conducted by the Center for Disease Control (CDC) that looked at environmental asbestos exposure levels in all fifty states.

Their analysis, which spanned a five year period from 2003-2008, found that mesothelioma incidence was highest in these five states:

  • Alaska
  • Maine
  • New Jersey
  • West Virginia
  • Washington

The average rate in those states was three times higher than in states with the lowest incidence. The study also found that in states where the incidence was higher for men it also increased for women, though never exceeding the number of male mesothelioma cases.

Given the correlation between male and female mesothelioma incidence, and that female incidence varies depending on the regional location, this data supports the hypothesis that mesothelioma risk is increased by asbestos in the environment.

This is particularly noticeable in places that have experienced widespread community exposure in the past like Libby, Montana, where the local vermiculite mine was contaminated by deposits of asbestos. The strip mining operation spread blankets of vermiculite and asbestos dust over the town and miners tracked the fibers into their homes, exposing spouses and family members.

It is clear from these studies that the US population is still at risk of asbestos contamination. Eliminating asbestos use is the only guaranteed way to decrease the number of mesothelioma cases.  

If you or a loved one has worked in an industry that uses asbestos and if you live in a region that has higher than normal incidence of mesothelioma, it is important to educate yourself on the dangers of this substance and seek medical attention immediately if you are experiencing symptoms.

Substantial compensation may also be available for people diagnosed with mesothelioma due to their asbestos exposure. Mesothelioma Guide can help put you in contact with some of the top asbestos lawyers. If you have any questions about how you can receive legal help, contact our patient advocates today by calling 888-385-2024 or by filling out a form to learn more about legal services.  

The post Non-Occupational Asbestos Exposure Linked to High Risk of Mesothelioma appeared first on MesotheliomaGuide.

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The New Year is a time of reflection and planning for the future. Taking stock of some personal goals in the coming year can help you remain focused and tackle any challenges that may arise. For patients recently diagnosed with mesothelioma, the thought of planning for the future can be daunting.

It is especially important for those patients who have been diagnosed to know that those fears can be mitigated by making some simple but meaningful resolutions going into 2019.

Here are four possible New Year’s resolutions for mesothelioma patients, their families, and caregivers to help them through this difficult time:

  • M – Make an effort to understand your mesothelioma diagnosis and learn about the disease. Since mesothelioma is such a rare form of cancer, most people who have been diagnosed know almost nothing about it. Educating yourself and your loved ones can significantly reduce the uncertainty and fear involved in coping with mesothelioma.
  • E – Engage in fun activities with relatives and loved ones. Spending quality time with family is essential to your well-being. Good mental health is extremely important when dealing with a life-threatening illness and spending as much time as possible with the people closest to you is the best way to keep your spirits up.
  • S – Seek out encouragement from caregivers and mesothelioma support groups. There are support groups and organizations that patients can join to talk with other people who have been diagnosed with mesothelioma. Support is vital to recovery and having someone to talk to who is also experiencing the same symptoms can reassure you that you aren’t facing this alone.
  • O – Organize your documents so your caregiver has easy access to all important medical information. Worrying about trying to track down documents while you are undergoing treatment can cause unnecessary stress and can hinder your recovery. Having this information readily available can make visits to the doctor run more smoothly and can also help you and your family if you decide to file for legal compensation.

Our patient advocates can help educate you and your family on your diagnosis and answer any questions you may have. Jenna Campagna, R.N, is our registered nurse on staff who can discuss your unique diagnosis and refer you to specialists and centers that offer the best mesothelioma treatments available.

We also have retired LCDR Carl Jewett serving as our VA-accredited claims agent who can help walk you through the claims and compensation process and can connect you to the best VA doctors who specialize in treating mesothelioma.

If you would like to contact one of our patient advocates please call 1.888.385.2024 or email jenna@mesotheliomaguide.com or cjewett@mesotheliomaguide.com.

Happy New Year and best wishes for a healthy 2019!

The post New Year’s Resolutions for Mesothelioma Patients appeared first on MesotheliomaGuide.

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Following the Second World War, the United States continued developing atomic energy and conducted 230 above-ground nuclear weapons tests at the Nevada Test Site and the Pacific Proving Grounds between 1945 and 1962. Decades later, we are seeing the effects that these tests had on military veterans now diagnosed with mesothelioma, cancer caused by exposure to asbestos products used extensively in the military.

Military veterans make up over 30% of all mesothelioma cases in the United States, and studies have shown that the Navy has the highest incidence of mesothelioma. This is the direct result of shipbuilders utilizing large amounts of asbestos in ship design up until the 1980s.

A study was conducted in 2018 with the intent of exploring the relationship between rare cancers like mesothelioma and atmospheric nuclear testing. It involved analyzing roughly 114,000 veterans, many of whom worked on one of eight different series of weapons tests. They also focused on sailors who were likely working with asbestos products while aboard vessels stationed near the test sites.

Mesothelioma and Nuclear Testing

The primary goal of the study was to determine if proximity to the above-ground nuclear detonations had any marked effect on the development of mesothelioma cancer among veterans.

The Standardized mortality ratios (SMRs) used in the study were calculated by branch, rank, and occupation after 65 years of follow-up per 100,000. The ratio itself is found by dividing the observed number of deaths by the expected number of deaths based on the specific criteria.  If the figure is greater than 1.0, it indicates that there were “excess deaths” compared to what was expected.

Data provided by the Defence Threat Reduction Agency show that mesothelioma deaths were highest among naval personnel who served on ships in the Pacific Proving Ground, with a significant increase in mesothelioma incidence seen among the over 70,309 navy personnel who had an SMR 2.15.

Perhaps most notably, the risk of developing mesothelioma increased for all crew members serving on Navy ships. Enlisted sailors had the highest SMR of 6.47, with jobs that involved the highest potential of asbestos exposure:

  • machinist mates
  • pipefitters
  • boiler technicians
  • water tenders
  • firemen

According to the results of the study, researchers found that while only 20% of the enlisted sailors held one of the high-risk occupations listed above, they experienced 55% of the total mesothelioma deaths. The significantly higher mortality rates for veterans serving in these positions seem to have been caused by their direct exposure to asbestos and amplified by their exposure to higher than normal doses of radiation.

Contact Our VA Accredited Claims Agent Today

Since mesothelioma is a disease that affects a large number of military veterans, it’s important to file a claim with the VA if you have been diagnosed with mesothelioma from service-related asbestos exposure. If you are curious about what benefits you may qualify for or need help filing a mesothelioma claim with the VA, contact Lieutenant Commander Carl Jewett at Mesothelioma Guide.

LCDR Jewett is a retired naval officer and a VA-accredited claims agent who has been helping veterans and their loved ones over the past decade. He has assisted over 1,300 veterans with asbestos-related diseases file claims and get approved. You can get in touch with him by emailing: cjewett@mesotheliomaguide.com or by calling 844-VET-MESO.

The post Mesothelioma Mortality Rates Higher Among Atomic Veterans appeared first on MesotheliomaGuide.

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In October, Dr. Valerie Rusch, MD, FACS, an attending thoracic surgeon at Memorial Sloan-Kettering Cancer Center, an ACS Fellow, and mesothelioma expert, was elected president of the American College of Surgeons (ACS) for the 2018-2019 term.  

Dr. Rusch has served in a number of high priority positions at the ACS since the start of her Fellowship in 1986, including Chair of the Board of Governors from 2006−2008 and Board of Regents (B/R) from 2015−2016.

She has also been a major player in other committees including the Committee on Global Engagement from 2016−2017, the B/R Honors Committee from 2012−2016, the Executive Committee from 2013−2016, the Finance Committee from 2014−2016, the College’s Advisory Council for Cardiothoracic Surgery from 2002−2017, as well as several others over her long history of involvement at the ACS.

In addition, Dr. Rusch has been closely involved with the American Joint Committee on Cancer (AJCC) for the last 15 years where she helped to publish the sixth and seventh editions to the cancer staging manual. The most recent publication of the eighth edition of the AJCC Staging Manual includes several chapters on thoracic surgery authored by Dr. Rusch herself.

The most notable change made to the new staging system is the differentiation between stage III and stage IV disease. In order to mitigate some of the psychological toll a stage IV diagnosis takes on a patient’s morale, Dr. Rusch explains:

“For instance, right now, anything that’s stage T4 is considered stage IV disease, and stage IV disease for any patient automatically means ‘the end of the road.’ That’s now been moved to stage IIIb, and only metastatic disease is stage IV.”

Giving patients more hope, especially at advanced stages, is essential to improving their prognosis. It also gives patients, who previously were not candidates for treatment due to their stage IV diagnosis, the opportunity to receive treatment previously not administered to patients with cancer so advanced.

Her specialty is diagnosing and treating patients with lung cancer, as well as cancer of the esophagus, chest wall, mediastinum, and most notably, the pleura in the form of Malignant Pleural Mesothelioma. Along with this, Dr. Rusch was among the first few women to be a full board certified thoracic surgeon in the United States.

With the extensive research that has been conducted over the last few decades on mesothelioma, many doctors today, including Dr. Rusch, are favoring multidisciplinary approaches to treatment. By combining different fields of treatment and diagnostic methods, patients are given the best possible chance for a cure.

In her 30 years of experience, she has emphasized the importance of furthering research into minimally invasive treatments as well as the understanding of molecular behavior of asbestos cancers.

Dr. Rusch specializes in the EPP and the P/D procedures for the removal of mesothelioma tumors from around the lungs. The P/D surgery is becoming favored among surgeons because patients tolerate recovery better and have fewer complications. This is a focus for Dr. Rusch, as her mission during her time at Memorial Sloan-Kettering Hospital has been to develop treatments that require a minimally invasive approach.  

To read more about Dr. Valerie Rusch, visit her doctor page or contacting our Patient Advocacy Nurse, Jenna Campagna, RN, for any further questions. You may reach her by calling 888-385-2024 extension 102 or by emailing: jenna@mesotheliomaguide.com

The post Mesothelioma Expert Named President-elect of the American College of Surgeons appeared first on MesotheliomaGuide.

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November is National Caregiver Month and with Thanksgiving just around the corner, it is important to recognize all of the significant work that mesothelioma caregivers do for their family and loved ones.  

There are more than 44 million Americans who serve as cancer caregivers in some capacity according to the National Alliance for Caregiving. Being a caregiver can be full of ups and downs and can be emotionally draining, especially if the patient is a family member or close friend.

This year at Mesothelioma Guide, in the spirit of Thanksgiving, we are going to outline 5 reasons why we can be thankful for mesothelioma caregivers and their dedication to helping others:

Providing Support and Encouragement

Mesothelioma diagnoses are often sudden and do not give patients much time to adjust to the many new challenges that they may face. Caregivers are essential in keeping spirits high and showing their loved ones that they do not have to walk this road alone. Having someone who they can count on to help them through this difficult time is one of the most critical aspects of a caregiver’s job.

Monitoring Health

Patients diagnosed with mesothelioma often need someone to monitor their health for any sudden changes so that their doctors can treat accordingly. For pleural mesothelioma, one of the most common symptoms is pleural effusions. As the pleural membrane fills with fluid and the tumor spreads from its point of origin, it can restrict normal lung expansion and hinder breathing.

Having a caregiver nearby or as live-in help can be extremely beneficial since some patients require oxygen or the drainage of pleural effusions while they are at home and not in a medical facility.

Helping with Daily Tasks

Typically, once patients start undergoing treatment they won’t be able to complete all activities of daily living on their own. Most mesothelioma patients are given chemotherapy, which can cause fatigue, making it hard to care for themselves without the help of a caregiver. Small tasks such as food shopping or cleaning the house can be relieved by a caregiver.  

Assisting with Meals

Making sure patients maintain a healthy diet during treatment is essential to improving their prognosis. Chemotherapy and radiation can often cause nausea to the point where food is challenging to stomach. Caregivers help patients by providing meal replacement shakes or offering anti-nausea medication.

Handling Financial/Legal Issues

Mesothelioma, like most types of cancer, can be a costly disease to treat. Because of this, patients will likely not want to burden their family with out of pocket expenses. This is why most mesothelioma patients seek legal representation to gain access to Asbestos Trust Funds, which were set up to help patients diagnosed with mesothelioma to pay for healthcare costs and ensure their family financial security

Hiring a mesothelioma lawyer is also necessary to file a claim or lawsuit against the manufacturing company that exposed the patient to asbestos. Caregivers can handle the administrative details when communicating with the lawyer and make arrangements so that the patient can focus on their recovery and spend quality time with their family.

To all of the people who dedicate themselves to caring for others at their most vulnerable: Thank you.

If you or a loved one has been diagnosed with mesothelioma and are in search of answers to medical questions, support and caregiver services, or legal representation, our patient advocates at Mesothelioma Guide are here to help. Please contact our Patient Advocacy Nurse, Jenna Campagna, RN, for any further questions. You may reach her by calling 888-385-2024 extension 102 or by emailing: jenna@mesotheliomaguide.com

The post 5 Reasons to be Thankful for Mesothelioma Caregivers appeared first on MesotheliomaGuide.

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