Mesothelioma

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Mesothelioma Hope

Here is some very useful information on how to take a pro-active and hands-on approach in dealing with your illness and diagnosis, prognosis and treatment:
Be informed, have the most accurate, precise and detailed, in-depth, accurate and up to date information regarding the illness
At time of diagnosis, it is important to learn as much as you can about your condition. Be informed and prepared, empowered and make decisions based on facts, diagnosis, prognosis and more.
Regular contact with medical practitioners and care-givers remain of extreme importance
Ask any of the questions regarding the disease and treatment that you might have. Your medical treatment team is the best trusted sources for information and updates.
Explore and discuss all your options
Get as much information you can about the stage of development of your disease and focus on how to make you life most comfortable, how best to treat and deal with the illness (on your terms and preference, doctors advice and orders of course!)
Research and support resources, knowledge and interaction with key stakeholders can help you deal with this lung disease cancer diagnosis – even if the prognosis is grim.
Cancer patient resources are freely available to help you through this time and diagnosis.
American Cancer Society's Cancer Resource Center (ACS) has numerous valuable resources and links that can help you stay informed about mesothelioa.
Always remember that there are various different channels and avenues for dealing with looking at your symptoms and severity, coping and dealing with the reality, challenges as well as the aftermath and future treatments.
Realistic expectations, honesty and open discussion will assist you dealing with the emotions and complicated rollercoaster you will be left having to cope with
The National Cancer Institute also has various sources at your disposal. MEDLINE research and abstracts will keep the best that the market has to offer on research and treatment at your fingertips. Follow the link provided here for more details. http://www.ncbi.nlm.nih.gov/PubMed/fulltext.html.
There are also some toll-free helplines, like the Cancer Information Toll-Free Telephone Service (CIS). Contact the CIS, toll-free in the United States and Puerto Rico, at 1-800-4-CANCER (1-800-422-6237)
Oncolink is another well-cited online resource for cancer and other relevant science and topics.

Mesothelioma Oncologists and Cancer Treatment Centers

There are mesothelioma related hospitals and doctors located all over the country. These are normally located in areas with university teaching and research facilities and are dedicated to treating mesothelioma cancers as well as conducting research and clinical trials on treatment and pain management methods for mesothelioma patients.
You can find a mesothelioma related research facility in most states of the union from Alabama to Washington. University mesothelioma facilities are located in the University of Alabama at Birmingham, the University of Colorado in Denver, the University of South Florida in Tampa, Loyola University in Mayword, Illinois, the University of Maryland in Baltimore, the University of Mississippi in Jackson, and at Wake Forest University in Winston-Salem, North Carolina.
Specialized mesothelioma clinics and treatment centers are also located in many of the country’s most prestigious universities. They include the David Geffen School of Medicine at the University of Los Angeles, the Yale Comprehensive Cancer Center, Department of Therapeutic Radiology as well as mesothelioma treatment sections at the University of Chicago, John Hopkins University, the University of Michigan, the University of Minnesota, Creighton University and the Cancer Research and Treatment Center, University of New Mexico.
Another source of information, treatment and research of mesothelioma is the network of cancer clinics that is spread all over the United States. These cancer centers focus on all aspects of cancer research, treatment, education and support to cancer patients and their families. Some of these centers are generic cancer centers whose main role is to research the causes of mesothelioma and other forms of cancer. Others carry out specialized research which zeroes in on the basic causes of mesothelioma and carries out clinical trials to test medications and other treatments. Still others put their efforts towards not only research but concentrate on education, support and treatment.
These cancer centers are the hub around which all mesothelioma research and clinical trials rotate. They let individuals seek specialized treatment for their disease but they also serve as a connecting point for doctors, scientists and researchers who are seeking better treatments and ultimately a cure for the ravaging disease of mesothelioma. These centers house teams of experts in oncology, pathology and radiologists that can track mesothelioma from its root causes to its eventual impact on the human body.
The doctors who affiliate themselves with both the universities and cancer centers are then able to tap into this vast body of knowledge that is being developed and evaluated on a daily basis. This ensures quality and up to date diagnosis and treatment of mesothelioma patients and also provides the information and resources required to support their families and caregivers. This network of researchers and doctors provide the best possible source of information and treatment of mesothelioma that is available anywhere in the world today.

Mesothelioma Research

Mesothelioma is a malignant, cancerous terminal disease caused by asbestos exposure and inhalation, ingestion or handling. There are four main types of asbestos in question here: Amosite (brown fibers) Anthophyllite (gray fibers) White Christie Blue Crocidolite. What contributes to the spread of the disease is that the 'Chrysotile', curly fibers or even rod like fibers are so easily taken into our human system so easily through the air, even by dust particles, sticking to us, swallowed or even breathe in. Asbestos was seen as a useful mineral and a miracle element, versatile and was used in myriads of products. Health hazards, risks and threats continue as it was used in a vast variety of products post WW II, construction and engineering projects worldwide. Typical symptoms include coughing, lung damage, shortness of breath, and lung cancer. It takes a lot of time before the illness develops. Occupations that are at risk for asbestos exposure are mining, milling, manufacturing and even the building construction and engineering industries. Other higher risk occupations could include firefighters, demolition and destruction workers, drywall removers, and tradesmen and women that are involved in the destruction of buildings, ships, and automobiles. Tissues damage is common and over the years this cancer can develop and cause problems breathing, fluid builds up in the lungs and can even kill the patient in question. Latent for decades, not all who are exposed actually develops the diseases. Full-blown symptoms might take a couple of years to show up and once it does it is progressive and requires immediate treatment. The risk is also there of infection your family and loved ones due to transferal dust and particles on skin, clothing or work-clothes. As far as patient treatment and care after diagnosis (see elsewhere), there are also some key nutritional advice for Mesothelioma patients to follow to improve their quality of life and strengthen their immunity. Loss of appetite is typical and some of the side-effects of the medication, might have you in need of a specialty diet. Nutrients across the food-groups are important and patients should guide against sudden weight loss that is not helping their condition any. Other aspects of the illness that might affect, not only appetite, but also general well-being could include nausea, vomiting, constipation, dry mouth and a change in the sensory appreciate of food (smell and taste)

Mesothelioma Tests & Diagnosis

Like with any other illness or serious, terminal disease, the medical tests and confirmation of the existing condition, progression and prognosis, is actually the start of the process of identifying, addressing and effectively dealing with mesothelioma. A full and detailed review of the patient’s medical history will be taken to enable and effect, underscore and make an accurate diagnosis possible. Any occupational exposure to asbestos is placed under closer scrutiny. Any work I mines, with some of the products containing asbestos (insulation, cement, HVAC etc, as well as some other professions like construction, engineering and the like), will be considered. These factors will all contribute to a heightened ‘clinical’ hypothesizing about possible origin, root cause of the symptoms. Diagnostic testing will back up and follow any level of suspicion for mesothelioma. A full and comprehensive, physical medical examination will follow. Chest X-rays and lung-capacity testing is the logical next avenue of choice. Thickening and presence of fluid will be detected and clearly visible. These will all contribute to more than mere suspicion now for the dreaded mesothelioma. Next steps will be MRI, CT or CAT scan as they are commonly referred to in the medical community. Cytology might be performed where lots of the excessive fluids are ‘aspirated’ with a syringe, pleural taps or chest drain, paracentesis or ascitic drain or pericardiocentesis. The method will depend on the location and amount of fluid present – the feasibility of the test procedure. Even if the diagnosis is negative at this point, the data obtained can also be used to rule out other illnesses like TB or heart conditions. Biopsies are next in line to confirm the diagnosis. A tissue sample through thoracoscopy for example. Looking inside and taking a sample are the goals of this process and outcome. A Laparoscopy will be done if the lower abdomen or trunk cavity is in question. Sometimes going deeper would require exploratory diagnostic surgery to determine the nature and extent of the disease, also disease and diagnosis confirmation will be given upon a positive diagnosis.

Alternative Medicine Options

Given the relatively unsuccessful results of conventional medicine in treating mesothelioma and that there is still no mesothelioma cure, a number of persons have turned to alternative mesothelioma treatments. These have included holistic forms of treatment, such as acupuncture, homeopathy, herbs, and other forms of Eastern medicine to treat mesothelioma.
These alternative approaches can be used alone or in conjunction with conventional treatments for mesothelioma. Most hospitals, however, do not offer these forms of treatment, and insurance companies, generally, do not cover these treatments.
Certain mesothelioma doctors have used unconventional methods to treat mesothelioma patients.

Treatment Options For Patients

Mesothelioma treatment depends on several factors, including the stage of mesothelioma, the location of the tumor, and the age and overall health of the patient.
1. Surgery - Removal of Malignant MesotheliomaSurgical removal of the tumor and surrounding tissue may be used depending on how far the mesothelioma has spread (the stage). The more advanced the stage, the less likely that surgery will be effective in treating mesothelioma.
Surgery for malignant mesothelioma can be used for long-term control or to cure the disease (aggressive surgery) or can be used to relieve pain (palliative). a) Aggressive surgery Aggressive mesothelioma surgery involves removal of the pleura, lung, diaphragm, or pericardim. (The type involving removal of the pleura is called extrapleural pheumonectomy.) The goal is to remove as much of the mesothelioma tumor as possible. This type of surgery, also called extraplueral pneumonectomy, typically is performed on younger patients in Stage 1 of mesothelioma.
Because of the complexity and the high risks involved with this type of surgery, some mesothelioma hospitals do not perform the procedure. Also, different mesothelioma treatment centers may have different criteria for accepting patients for surgery. Therefore, it is important to check with a mesothelioma hospital to see if you meet its criteria.
b) Palliative SurgeryPalliative surgery is typically used in the more advanced stages of mesothelioma. The goal is to relieve or control symptoms caused by fluid collection or by the tumor compressing the lung or other organs. It is not intended to cure mesothelioma.
Pleurectomy/decortization is usually a palliative operation. It is used in situations where the entire tumor cannot be removed. It is effective in controlling the accumulation of fluid in the lungs (effusion), and the pain caused by mesothelioma.
Thoracentesis is also used to treat effusion in pleural mesothelioma. This treatment involves inserting a needle into the chest in order to drain the fluid. Thoracentesis does not involve surgical removal of the mesothelial cells.
2. RadiationRadiation therapy uses high-energy x-rays to kill mesothelioma cancer cells and to shrink tumors. There are two types of radiation therapy.
External radiation therapy uses a machine outside the body that beams x-rays to the location of the mesothelioma.
Brachytherapy involves putting chemicals that produce radiation directly into the site of the mesothelioma cancer. This is done by inserting a thin plastic tube into the chest or abdomen.
Because of the location of malignant mesothelioma, it is very difficult to deliver high-enough doses of radiation to kill the tumor without damaging surrounding organs. As a result, it is unclear whether radiation therapy is a successful method of treating mesothelioma. It has, however, been effective in killing remaining tumor cells after surgery has been performed.
Radiation therapy is also used as a palliative therapy to relieve symptoms of mesothelioma, such as shortness of breath, chest pain, and internal bleeding.
Radiation therapy has several side effects, such as fatigue, nausea, and vomiting. Although these side effects are sometimes temporary, you should let your doctor know, since they often can be controlled. 3. ChemotherapyChemotherapy uses drugs to treat mesothelioma cancer. It is administered either orally (through pills) or by injecting the drugs directly into the veins (intravenously), the muscles, the chest cavity (intrapleurally), or the abdominal cavity (intraperitoneally). The goal of mesothelioma chemotherapy is for the drug to enter the bloodstream and circulate throughout the body in order to destroy the cancer cells.
Several drugs have been used, either individually or in combination with others, to treat mesothelioma. Some of the single-agent drugs include:
Adriamycin (doxorubicin), which is the most studied and, currently, the most effective single agent;
epirubicin
carboplatin
detorubicin
pirarubucin
mitomucin
cisplatin.
Single-agent therapy has been only modestly successful in treating mesothelioma, with studies showing a response rate in the 10 to 20% range.
Because of the relatively low response rate of single-agent therapy in treating mesothelioma, combinations of these drugs have been used to increase their effectiveness. Although some researchers have reported high response rates to these therapies, these rates have not been consistent, and more research is necessary.
Chemotherapy drugs are generally very toxic. Therefore, a doctor must be very careful in monitoring the condition of a patient during therapy. Some of the more common side effects include nausea, vomiting, loss or appetite, hair loss, and fatigue. Chemotherapy can also result in low blood cell counts, which increases the risk of infection and bleeding or bruising.
Side effects vary depending on the treatment, and generally disappear after treatment is completed.

New Mesothelioma Treatments

New mesothelioma treatments are being evaluated in mesothelioma clinical trials in hopes of a mesothelioma cure. Mesothelioma clinical trials are research studies that evaluate new mesothelioma treatments for safety and efficiency. There are no guarantees that a treatment offered through a mesothelioma clinical trial will work, and because the treatments are in the trial stage, there are some risks. However, a mesothelioma clinical trial is not undertaken unless the researchers believe the treatment may have some value.
1. What is a clinical trial?A mesothelioma clinical trial is a research study used to evaluate a treatment for efficacy and safety. It generally involves a novel approach to treatment, and is conducted by a university-affiliated hospital.
2. What are the benefits of participating in a clinical trial?
Standard treatments for mesothelioma have not proved very effective, so you may not have much to lose
You may not qualify for certain standard treatments for mesothelioma, such as surgery, because of your condition
During the trials, doctors and nurses with expertise in treating mesothelioma will closely monitor your health for side effects and changes in your condition
Part of the cost of treating your mesothelioma may be free
Personal satisfaction in advancing the treatment of mesothelioma and, some day, in the development of a cure.
3. What are the risks involved?While strong efforts are made to ensure the safety of persons participating in clinical trials, some risks remain. As with all possible treatments of mesothelioma, discuss the risks with your doctor before you decide to participate.
Also, before you begin a mesothelioma clinical trial, you will be required to sign an informed consent form. By signing this document, you are stating that a healthcare provider has explained the risks and benefits associated with the mesothelioma treatment, and that you have agreed to the participation.
4. Some of the questions you might ask your doctor:
What does the mesothelioma trial hope to accomplish?
What are the chances of successfully treating my mesothelioma using standard therapies?
What side effects are expected, and are these worse than standard treatments of mesothelioma?
How long will the mesothelioma trial last?
What company or university is sponsoring the mesothelioma trial?
What will I have to pay for the mesothelioma treatment?
Will participating prevent me from being treated with other mesothelioma therapies?
5. Finding out about ongoing clinical trialsYou should be able to obtain information from the doctor treating you for mesothelioma.
Also, call 1-800-362-1479 for an updated list of clinical trials, or send us an email requesting a list of mesothelioma clinical trials.
6. Experimental Treatments of MesotheliomaThere are a number of experimental treatments for mesothelioma that are currently being evaluated. These include:
a) Drug Therapy - AlimtaAlimta (pemetrexed) is a new chemotherapy drug developed to treat pleural mesothelioma. A recently completed trial, one of the largest clinical trials for treatment of mesothelioma, was presented in 2002 at the annual meeting of the American Society of Clinical Oncologists. The results indicated that Alimta was the first treatment to significantly increase the length of survival, as well as relieve symptoms of mesothelioma. b) Photodynamic TherapyPhotodynamic Therapy (PDT) involves administering photosensitive drugs into the mesothelial cells. Doctors then use a laser light to activate the photosensitive drugs in order to destroy the surrounding cancer cells.
As yet, PDT has not shown success in improving the survival rate for mesothelioma patients. c) Gene TherapyGene therapy is used to correct disease at the DNA level by compensating for abnormal genes. Several types of gene therapy are currently being studied for the treatment of mesothelioma. Although this treatment has proved successful in animal studies, the results in human studies have been disappointing.
d) ImmunotherapyImmunotherapy seeks to improve the immune system's natural ability to fight cancer. Studies have shown that the immune system distinguishes healthy cells from cancer cells in order to eliminate the cancerous cells.
Immunotherapy uses biological response modifiers (BRMs) to improve the body's natural ability to fight disease. (BRMs currently used include interferons, interleukins, monoclonal antibodies, tumor necrosis factors, and cancer vaccines.) This first involves the removal of healthy cells, which are then exposed to cytokines and antibodies. These enhanced cells are then reinstalled into the peritoneum, where they will enhance the body's ability to fight cancer.
Preliminary studies have shown significant shrinkage of mesothelioma tumors at very early stages of the disease. Much more research, however, is necessary to determine its efficacy as a treatment for malignant mesothelioma.
e) Multimodality TherapyThis type of therapy simply means the use of any combination of surgery, radiation therapy, or chemotherapy to treat mesothelioma. The most common form combines surgery with intercavitary radiation or chemotherapy, both before and after, to remove and eliminate mesothelioma.

Mesothelioma Treatments

Significant pain often accompanies mesothelioma, particularly during the later stages of the disease. It is considered one of the major challenges facing patients and their doctors because of the impact pain has on the patient's quality of life and treatment of mesothelioma.
Fortunately, today more than ever, health-care workers who specialize in part control are employing state-of-the art techniques to successfully fight pain. One expert anesthesiologist recently pointed out that "our experience suggests a greater than 90 percent effectiveness rate . . . with the fewest side effects" in controlling pain caused by mesothelioma.
Progressive SymptomsPain associated with mesothelioma changes from mild, episodic, and localized, to severe and chronic as the disease progresses. The first symptoms of pain depend on the type of mesothelioma. For pleural mesothelioma, the initial symptoms are a nagging discomfort or mild pain in the chest area or in the back. For peritoneal mesothelioma, the first symptoms are abdominal or pelvic discomfort, and, in some cases, bowel obstruction and its resultant pain.
During the initial stages of mesothelioma, pain can be relieved with over-the-counter analgesics, such as aspirin, Tylenol or ibuprofen (Advil, Motrin).As mesothelioma progresses and destroys surrounding soft tissue and nearby nerve endings, the pain increases considerably. If the mesothelioma spreads into the chest wall, muscles or ribs, patients may experience severe pain.Pain Management TechniquesDoctors have several options for treating mesothelioma pain. Initially, with the assistance of the patient, the doctor assesses the pain and develops a treatment plan. a) Drug TherapyDrug therapy is the primary method for treating mesothelioma pain. There are 3 types of medicines used for pain relief.Non-Opoids are pain-relieving medicines such as acetaminophen (Tylenol) and NSAIDs, such as ibuprofin, which can be purchases over-the-counter and taken orally. These are usually the first choice for mild pain. Because of certain side-effects, however, doctors do not recommend anything greater than the maximum daily dosage.
Opoids are the strongest medicines available to treat pain. Opoids, such as codeine, morphine, oxcodone, fentany, and hydromorphone, are very effective in relieving mesothelioma pain. These drugs also have side effects, and managing these side effects is an important part of pain management. Opoids are administered orally or intravenously.
Adjuvant analgesics are medicines intended for purposes other than pain relief. A number of these are used to alleviate pain associated with mesothelioma, such as antidepressants, anticonvulsants, and steroids.
b) Epidural ImplantsIf orally or intravenously administered drugs are not effective in easing pain, mesothelioma doctors may prescribe a solution containing local anesthetics and opioid analgesics that is delivered epidurally, that is outside of the dural membrane of the spinal cord, but still within the spinal canal.The pain-management team surgically implants a thin catheter beneath the skin. Precise doses of the pain-killing mixture are programmed to flow through this tubing into the epidural area of the spinal canal at preset amounts and times. The drugs bind to receptors in the central nervous system at the level of the nerve roots, blocking pain signals.In addition to controlling pain, the epidural implant reduces the need for in-hospital pain care, permitting maximum mobility for patients. Doctors, in conjunction with trained technicians of a private home-health care agency, provide the medication and monitor the ongoing operation of the device.
For additional information on pain management, and to obtain a copy of "Cancer Pain: Treatment Guidelines for Patients," which was released in January of this year by the American Cancer Society and the Comprehensive Cancer Network, call us at 1-800-362-1479 or email us.
4. Emotional Support to Help Relieve PainAs with all aspects of mesothelioma, emotional support from family or professional counseling can play a key role in pain management. Improving a patient's mental health helps minimize the fear, anxiety and depression that can make the physical pain feel worse.

Types of Mesothelioma

About Pleural Mesothelioma - A Cancer of the Lining of the LungsPleural Mesothelioma is a cancer of the lining of the lungs, called the "pleura". The "pleura" are fibrous sheets that help to protect the lungs. They produce a lubricating fluid that allow the lungs to move smoothly as we breathe.
Because pleural mesothelioma is uncommon, some doctors misdiagnose the disease as lung cancer. Lung cancer, however, is different from pleural mesothelioma because lung cancer is a malignant tumor that originates in the lungs, whereas pleural mesothelioma occurs in the lining of the lungs.
Pleural mesothelioma is the most common type of malignant mesothelioma. It accounts for about 75% of all types of malignant mesothelioma.
Find out more about:
Pleural Mesothelioma Symptoms.
Articles / Case Studies on Pleural Mesothelioma or Diffuse Malignant Mesothelioma.
About Peritoneal Mesothelioma Cancer
Peritoneal mesothelioma is a cancer in the lining that surrounds the stomach or abdomin, called the peritoneum. The peritoneum are cells that produce a lubricating fluid that protect the stomach. They allow the stomach to move freely when, for instance, you are digesting food.
Peritoneal mesothelioma is much less common than pleural mesothelioma. It accounts for about 10 to 20% of mesotheliomas.
Find out more about:
Peritoneal Mesothelioma Symptoms.
Article / Case Studies on Peritoneal Mesothelioma / Abdominal Mesothelioma.
About Pericardial Mesothelioma Cancer
Pericardial mesothelioma is a cancer in the lining that surrounds the heart, called the pericardium. The pericardium are cells that produce a lubricating fluid that protect the heart. They allow the heart to move freely when, for instance, it is pumping blood to other parts of your body.
Pericardial mesothelioma is the least common form of malignant mesothelioma. It only accounts for 5 to 15% of all mesotheliomas.

Asbestos Exposure

1. Direct exposure to asbestosThe risks of developing mesothelioma increase with the intensity and duration of asbestos exposure. Most persons who develop mesothelioma were directly exposed to asbestos at their jobs for long periods of time. Following are a list of some of the higher risk jobs occupations:
Auto Mechanics - at risk of developing mesothelioma because brake pads and clutches contained asbestos
Boiler makers - at risk of developing mesothelioma because asbestos insulation was wrapped around the boilers
Bricklayers - at risk of developing mesothelioma because certain bricks, most notably firebricks, contained asbestos
Building Inspectors - at risk of developing mesothelioma from regular exposure to construction sites containing asbestos
Carpenters - at risk of developing mesothelioma because flooring, roofing, insulation, and joint compound contained asbestos
Drywallers - at risk of developing mesothelioma because joint compound contained asbestos
Electricians - at risk of developing mesothelioma because electrical wiring coverings contained asbestos and because often were required to cut insulation to do work
Floor Coverings - at risk of developing mesothelioma because tiles contained asbestos
Furnace Workers - at risk of developing mesothelioma because insulating firebrick and gunnite contained asbestos
Glazers - at risk of developing mesothelioma because glazing equipment contained asbestos material
Grinders - at risk of developing mesothelioma because grinding equipment contained asbestos material
Insulators - at risk of developing mesothelioma because virtually all insulation products contained asbestos
Iron workers- at risk of developing mesothelioma because insulating firebrick and gunnite contained asbestos
Laborers - at risk of developing mesothelioma to the extent they performed same work as tradesman exposed to asbestos
Longshoremen - at risk of developing mesothelioma because insulation of ships' boilers contained asbestos
Maintenance workers - at risk of developing mesothelioma to the extent job sites contained asbestos
Merchant marines - at risk of developing mesothelioma because insulation of ships' boilers contained asbestos
Millwrights - at risk of developing mesothelioma to the extent various trades performed by millwright exposed them to asbestos
Operating Engineers- at risk of developing mesothelioma because insulation of pipes contained asbestos
Painters- at risk of developing mesothelioma to the extent they painted in areas containing asbestos products
Plasterers - at risk of developing mesothelioma because joint compound contained asbestos
Plumbers - at risk of developing mesothelioma because pipes were insulated with asbestos material
Roofers - at risk of developing mesothelioma because roofing tiles contained asbestos
Sand blasters- at risk of developing mesothelioma to the extent they blasted metals containing asbestos products and in areas containing asbestos products
Steam or pipe fitters - at risk of developing mesothelioma because insulation of boilers and furnaces contained asbestos
Tile setters - at risk of developing mesothelioma because tiles contained asbestos
U.S. Navy veterans - at risk of developing mesothelioma because boilers were insulated with asbestos material
Welders - at risk of developing mesothelioma because welded through or cut pipes wrapped with asbestos material
2. Secondary exposure to asbestosAlthough much less common, family members of persons working at high-risk jobs may also have been exposed to asbestos. Generally, this exposure occurs when the person with direct exposure bring home asbestos fibers on his work clothes.
Although unlikely as well, persons working in buildings constructed before the mid-1970s, such as school buildings and hospitals, may be at risk if asbestos fibers from the insulation become airborne. Because much of the asbestos in these buildings has been removed or remediated, the risks today are much lower.

Mesothelioma and Asbestos

Asbestos is a combination of several minerals held together by silky strands of fibers. These fireproof fibers do not burn, and do not conduct heat or electricity. Because asbestos does not conduct heat well and is resistant to melting or burning, asbestos was used widely in all types of construction products up to the mid-1970s. Other products made with asbestos, such as insulation materials and automotive clutches and brakes, were designed principally to contain heat and sound.
Mesothelioma ChrysotileChrysotile asbestos is the main cause of malignant pleural mesothelioma. The three most common forms of asbestos are chrysotile, amosite, and crocidolite. Chrysotile or white asbestos accounts for approximately 95% of the asbestos used in US production of asbestos products and is the only member of the serpentine group of minerals. The fine fibers of asbestos made it a great source for insulation and as a fire retardant but they their entry into the human body can trigger the onset of mesothelioma. Sometimes the asbestos fibers enter the body through the air and are breathed into the lung area of the body. Once they are taken in through the respiratory passages these fibers lodge themselves in the mesothelial cells around the lungs. This can cause direct damage to the lungs by traveling to the ends of small passages and reach the pleura area around the lungs.Once lodged in the plural area these fibers can injure lung cells and cause lung cancer or asbestosis which is a term used to describe replacing healthy lung tissue with damaged or scar tissue. In addition, asbestos fibers can also be directly swallowed by people working in close of confined spaces with exposed asbestos. These fibers can go directly to the stomach and abdominal cavity and may lead to the development of stomach cancer or peritoneal mesothelioma.The most common way to get is through directly working with asbestos as part of a job or career. Many people get mesothelioma as a result of their jobs working in mining, construction, shipbuilding and any other job that required a regular exposure to asbestos fibers. It is possible as well to get mesothelioma from being exposed to asbestos fibers in your home of office. Many houses still contain asbestos lined insulation that can be a grave danger if it becomes opened or exposed to humans. As long as the asbestos remains in a sealed unit or wrapped around a pipe with its exterior sealant intact, there is little danger. But if any of these materials break out of their sealed units they could easily contaminate any one who comes into contact with them.Finally it is also possible to develop mesothelioma through direct physical contact with the clothes of someone else that has come directly into contact with asbestos. There are numerous cases of wives and spouses of miners and construction workers who have developed mesothelioma from breathing in the fibers that their husbands or wives brought home with them from the plant, mine or construction site. If that person worked in the insulation industry at a time when asbestos use was at its peak they have a much higher chance of developing this deadly disease than others who may have had minimal exposure to asbestos fibers as a result of their daily working activities.Today mesothelioma is one of the most commonly recognized industrial or workplace diseases and special programs have been developed to recognize mesothelioma symptoms and to provide support to those who suffer from this disease.

The Four Stages of Mesothelioma

After confirming a mesothelioma diagnosis, the next step is called staging. Staging is the process used to find out how far the cancer has spread. Imaging studies, such as CT scans and MRI's, help a doctor to determine the mesothelioma stage. This is important because it affects the treatment and prognosis of mesothelioma.
The most common system used for measuring mesothelioma staging is the Butchart Staging System. This staging procedure is only used for pleural mesothelioma (cancer of the lining of the lungs) because it is by far the most common type of mesothelioma.
A. Stage 1 - Localized Malignant MesotheliomaStage I mesothelioma is the initial stage of mesothelioma. Here, the cancerous tumor is found in the pleura (the lung lining), and may also involvesome tumors in the lung, pericardium (the lining of the heart), or the diaphragm.
B. Stage 2 MesotheliomaIn Stage II mesothelioma, in addition to the presence of mesothelioma in the pleura, mesothelioma has spread to the chest wall, esophagus, or heart. Also, mesotheliomamay have spread to the lymph nodes in the chest.
C. Stage 3 MesotheliomaIn Stage III, mesothelioma has invaded the diaphragm into the peritoneum (the lining of the heart), and may involve lymph nodes outside of the chest.
D. Stage 4 MesotheliomaIn Stage IV, mesothelioma has metastasized, spreading through the bloodstream to other organs of the body.

Malignant Mesothelioma

Mesothelioma is a rare form of cancer that develops in the mesothelial cells. These cells are tissue that surround or line the lungs, heart, and stomach. The mesothelial cells protect these organs by producing a lubricating fluid that allows these organs to move smoothly. There are 2 types of tumors of the mesothelium, "benign" and "malignant". A benign tumor is non-cancerous, which means it does not cause any damage or will not harm you. A malignant tumor of the mesothelial cells is called a malignant mesothelioma. Because tumors of the mesothelium are usually cancerous, malignant mesothelioma is usually just called "mesothelioma". At one time, malignant mesothelioma was considered very rare. The incidence of malignant mesothelioma, however, has increased at an alarming rate. Today, at least 14 cases per million persons in the United States develop malignant mesothelioma each year. This means that over 3000 persons are diagnosed with malignant mesothelioma annually. This number is probably understated because many cases of malignant mesothelioma are not properly diagnosed.
Mesothelioma takes a long time to incubate in the human body, sometimes occurring twenty to thirty years after people have been exposed to asbestos. Many trace the rise in mesothelioma rates to the great building booms of the sixties and seventies, before asbestos was known to be such a health hazard. Men and women who worked in the mining industry, shipbuilding, and construction, especially the insulating industry during that period are now presenting themselves to their doctor’s offices with symptoms of this deadly disease.
It is known as a deadly disease because most patients die within two years of being diagnosed with mesothelioma. They may have had symptoms of this disease before hand but likely thought it was just an asthmatic condition or lung infection. By the time they are properly diagnosed it is often too late. Mesothelioma is also a tragic disease because people were simply going to work without knowing the dangers they were facing and only many years later do they discover that their job in construction, the military or insulating pipes was actually killing them slowly from the inside out.
The only good news about mesothelioma is that scientists and doctors now know what causes mesothelioma and can ensure that hardly any future workers will be exposed to the dangers of asbestos fibers or the pain and suffering of mesothelioma. This is small comfort to the thousands of Americans who have already lost loved ones from this disease but at least future generations of workers are unlikely to suffer and die in these working conditions. Anyone who has worked in any industry that caused an exposure to asbestos should have their doctor check for the development of mesothelioma. In some cases early detection can provide alternative treatment procedures that can alleviate and even stop the spread of this dehabilitating disease. There are also many sources of information about mesothelioma within the Mesothelioma Medical website in which anyone can find out more about mesothelioma and the damage it is causing to the health and lives of thousands of Americans and their families.

Diagnosing Mesothelioma

Mesothelioma takes a long time to incubate within a human body before symptoms of mesothelioma may appear and cause suffering to the carrier. It can take fifteen to twenty years for this deadly disease to fully present itself and the damage it has done. This presents a very difficult challenge for doctors and the medical community in diagnosing mesothelioma and in many cases patients with this disease are either not aware that they have it or do not ask the doctor to specifically check for symptoms of mesothelioma. If a patient notes a history of asbestos exposure or contamination a doctor will immediately start looking for signs of the disease, most notably within the tissues and lining surrounding the lungs, heart and stomach areas. They will likely also begin with a full physical examination to determine the possible causes of patient discomfort. This will usually involve some lung and chest x-rays if the patient is reporting difficulty in breathing which is often a common ailment of mesothelioma suffers. The physician will also order a number of pulmonary procedures to test the area around the lungs in particular since three quarters of all mesothelioma cases occur in the lining and tissue around the lungs. Follow up CAT scans and MRI tests may also be ordered if the preliminary tests show the probability of mesothelioma and these tests should be able to confirm or deny the presence of mesothelioma. They can also aid the medical personnel in being to determine the exact size and location of any tumors that may have developed as a result of the progress of the mesothelioma.The next steps that a doctor may take are to request a biopsy of the affected area. This is a procedure to remove a piece of tissue from the area where mesothelioma is suspected and once that biopsy has been performed then the tissue sample can be tested further to determine the type of mesothelioma tumor that is present in the patient. Tissues that come back as benign usually mean that the tumor is not cancerous and while it may not be comfortable for the patient, benign tumors are rarely fatal. Malignant mesothelioma tumors however are cancerous and pose a great threat to the health and life of the patient.1. Physical ExaminationAs with all diseases, a doctor begins the mesothelioma diagnosis by doing a complete physical exam and reviewing your medical history. Because mesothelioma is almost always caused by breathing in asbestos exposure (see Causes of Mesothelioma), you should tell your doctor about your exposure to asbestos if you suspect you may have mesothelioma.
After performing the physical exam, a doctor should have x-rays of the chest performed and, in some cases, pulmonary function tests to determine if the symptoms are consistent with malignant mesothelioma.
2. CT Scans and MRI's to Diagnose MesotheliomaIn many cases, a doctor may order CT scans and/or MRI's to aid in the mesothelioma diagnosis. These tools allow a doctor to assess the size, location, and extent of the mesothelioma tumor in the chest or abdomen.
3. Biopsy to Diagnose MesotheliomaAll of the steps described above are only preliminary indications of mesothelioma. If, after performing these tests, a doctor suspects mesothelioma, a biopsy should be taken to confirm the mesothelioma diagnoses.
A biopsy is the procedure used for obtaining a tissue sample of the tumor. The two most common methods for removing tissue samples are a thorascoscopy and a broncoscopy.
A thoracoscopy is obtained by inserting a telescope-like instrument connected to a video camera (thoracoscope) through a small incision in the chest. The doctor then removes the tumor using special forceps with the aid of the camera. This procedure is used for diagnosing both pleural mesothelioma and pericardial mesothelioma.
A bronchoscopy involves inserting a flexible lighted tube through the mouth into the bronchi to remove tissue in the airway. This procedure is used for diagnosing pleural mesothelioma.
Although a biopsy is the most effective procedure for diagnosing mesothelioma, malignant mesothelioma cells can look like other types of cancer. Therefore, special laboratory tests are sometimes performed or electron microscopes are used to confirm a diagnosis of mesothelioma.

Symptoms of Mesothelioma

About 15% of Mesothelioma cases are found in the early stages, before the cancer has spread to nearby lymph nodes or elsewhere. The 5 year survival rate for people with Mesothelioma is 50% if there is no evidence of cancer in lymph nodes at the time of surgery. Unfortunately, in most cases, the spread of cancer has already occurred even if not detected by current medical tests. When all Mesothelioma stages are considered together, the 5 year survival rate is only about 14%. Many early Mesothelioma are diagnosed incidentally - they are found as a result of tests that are done for an unrelated medical condition. Although Mesothelioma does not cause any symptoms until it has spread too far to be cured, symptoms do occur in some patients with early Mesothelioma . Prompt attention to symptoms, leading to early diagnosis and treatment can result in a cure for some patients. For others, prompt attention to symptoms can improve the likelihood that treatment can extend their life and relieve many of their symptoms.
Common signs and symptoms of Mesothelioma include:
A cough that does not go away
Chest pain, often aggravated by deep breathing
Hoarseness
Weight loss and loss of appetite
Bloody or rust-colored sputum (spit or phlegm)
Shortness of breath
Fever without a known reason
Recurring infections such as bronchitis and pneumonia
New onset of wheezing
When Mesothelioma spreads to distant organs, it may cause:
Bone pain
Neurologic changes (such as weakness or numbness of a limb, dizziness)
Jaundice (yellow coloring of the skin and eyes)
Masses near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collection of immune system cells) in the neck or above the collarbone.
A. Pleural Mesothelioma SymptomsSome of the symptoms of pleural mesothelioma (mesothelioma cancer of the lung lining) include:
pain in the lower back or the side of the chest
shortness of breath
a persistent cough
difficulty swallowing food
fever and sweating
fatigue
weight loss.
These symptoms are also common to many minor ailments and, therefore, may not cause a doctor to suspect mesothelioma.Pleural Effusion-fluid in the LungsOne of the most common and specific symptoms of pleural mesothelioma is the accumulation of fluid between the lungs and chest cavity. This generally causes shortness of breath, and requires a doctor to drain the fluid, called fine-needle aspiration, to make breathing easier and relieve chest pain. This symptom is more unique to mesothelioma, making it more likely that you may have the disease.
B. Peritoneal Mesothelioma SymptomsSymptoms of peritoneal mesothelioma (abdominal mesothelioma - mesothelioma of the lining of the stomach) include:
stomach pain
nausea and vomiting
weight loss.
Like pleural mesothelioma, these symptoms are also common to many minor ailments and, therefore, may not cause a doctor to suspect mesothelioma.

Understanding Mesothelioma

Dealing with mesothelioma is a very difficult process. It will require a lot of physical and emotional endurance, a strong family and social network, and expert medical and professional advice and assistance. The best way to approach dealing with mesothelioma is to first learn everything that you can about the disease. This should include the causes, symptoms, diagnosis, treatment, and prognosis of mesothelioma.
Understanding all of the aspects of mesothelioma will help the patient and their family and caregivers feel less helpless during treatment and give them the hope they need to recover successfully from this terrible disease. There are many sources of information available to help with understanding mesothelioma. They include doctors, nurses and community health care workers. They also include cancer information centers and university teaching hospitals that specialize in mesothelioma.
There are also many books written about the subject of mesothelioma, including ones written by mesothelioma patients, survivors and their families. Some books written by specialists in the field also provide helpful tips for patients and families who are beginning their mesothelioma treatments on what to expect and how to maximize pain management tools and techniques. The Internet has a wide range of websites that promote education and information about mesothelioma and offer suggestions on where to find specialists and other resources.
The relationship between the doctor and patient should be the primary source of understanding mesothelioma for the patient. The doctor has made the preliminary diagnosis and has the experience of dealing with similar situations in the past. To make the most of this important relationship the patient should prepare a list of questions in advance of any meeting or session with the doctor so as to minimize the time required and to get the most accurate information and answers to their questions.
Other people who have been through mesothelioma treatments can also provide helpful suggestions from their own experience on not just what to expect but how to best assist in one’s own recovery. These suggestions will probably include tips on pain management but will also likely help the mesothelioma patient to physically and psychologically prepare for possible surgery and the recovery period that will follow.
Mesothelioma patients will require a lot of other support if they are going to successfully navigate the path to recovery. Some time and consideration will need to be given to financial concerns that will arise during the period of treatment and recovery from mesothelioma. This may include meetings and advice from a range of financial and insurance advisors in order to ensure that medical costs are covered and regular bills are paid during this difficult time.
It is certainly not easy to deal with all of the medical, physical, emotional, and financial issues that may be raised when dealing with a serious disease like mesothelioma, but it always better to be prepared.

MESOTHELIOMA TREATMENT OPTIONS

The treatment program for mesothelioma depends on many factors, including: the stage of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope and the patient’s age and desires.
TIME MATTERS
People diagnosed with this disease are often told the expected survival rate is only eight to twelve months. However, specialists in treating malignant mesothelioma at the leading cancer centers often have better statistics.
For instance, the five-year survival rate has approached 40% for selected patients of Dr. David Sugarbaker at Brigham and Women’s Center in Boston. To qualify for Dr. Sugarbaker’s treatment you must meet certain criteria. One of them is being in the early stages of the disease, so time is of the essence.
TRADITIONAL CARE
There are three traditional kinds of treatment for patients with malignant mesothelioma:
Surgery (taking out the cancer)
Chemotherapy (using drugs to fight the cancer)
Radiation Therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
Often two or more of these are combined in the course of treatment.

SURGERY
Diagnostic Procedures
As previously mentioned in the "Symptoms" section of this website, a diagnosis of mesothelioma from fluid is many times inconclusive. Given this fact, diagnostic surgery becomes a necessary next step in confirming and staging mesothelioma.
Thoracoscopy enables a physician to evaluate the pleural cavity and to conduct multiple tissue biopsies under direct vision. In up to 98% of cases, a definitive diagnosis can be obtained. Often, chemical pleurodesis aimed at relieving the accumulation of fluid in the intrapleural space, can be accomplished during the same procedure. It is also possible to gauge the extent of the tumor, and make a determination of surgical resectability. While less invasive than an open biopsy, it can only be performed on patients where tumor has not obliterated the pleural space.
VATS, or video-assisted thoracic surgery is an alternative to thoracoscopy, although because of its more invasive nature, concerns of tumor seeding increase. By utilizing small incisions, the physician can view the pleural space with the assistance of a camera, and obtain sufficient tissue samples for analysis by a pathologist. Extent of the tumor (i.e., pleural involvement, chest wall invasion) may also determined, and recommendation as to the type of debulking procedure necessary can be made at this time.
Mediastinoscopy is sometimes used as an aid in staging extent of disease when enlarged nodes are seen using imaging techniques.
Laproscopy is used in mesothelioma patients in cases where imaging techniques suggest possible invasion of the tumor through the diaphragm. This information can be important in evaluating a patient for potential pleurectomy or extrapleural pneumonectomy.
Palliative Procedures
Palliative surgical procedures are those which treat a symptom of mesothelioma, without aggressively treating the disease itself.
Chest Tube Drainage and Pleurodesis is considered the most common of palliative treatments. Fluid build-up, or pleural effusion, is most often the first symptom which will prompt mesothelioma patients to seek medical attention. Once this effusion has occurred, it is many times persistent, returning rapidly after initial thoracentesis (draining of the fluid). In order to eliminate this problem, the pleural space must be closed. This is accomplished by use of a talc slurry or other sclerosing agent which produces an adhesion.
Thoracoscopy and Pleurodesis is done in conjunction with VATS using a powdered form of talc versus talc slurry. Both this and chest tube drainage and pleurodesis will be only effective if there is no tumor encasing the lung which restricts its expansion.
Pleuroperitoneal Shunt plays a limited role in palliation for several reasons. It involves placement of a catheter run under the skin from the pleural to the peritoneal cavity. Obstruction of the catheter and possible seeding of the tumor into the abdominal cavity may be concerns.
Pleurectomy, used as a palliative procedure, may be performed where more extensive surgery is not an option. In these cases, it is understood that all visible or gross tumor will not be removed. It is considered the most effective means of controlling pleural effusion in cases where the lung's expansion is restricted by disease.
Potentially Curative Procedures
These procedures are performed with "curative intent". Their goal is removal of all gross disease, with the knowledge that microscopic disease will most likely remain. Adjuvant therapy (another form of treatment in addition to the primary therapy) is typically aimed at eliminating residual disease. For Pleural Mesothelioma:
Pleurectomy/Decortication is usually performed on patients with early stage disease (Stage I and selected Stage II), and attempts to remove all gross tumor. If it is found that all tumor can not be removed without removing the lung, this may be done at the same time and is called pneumonectomy.
Extrapleural Pneumonectomy is considerably more radical than other surgical approaches, and should be carried out by surgeons with great expertise in evaluating patients and performing the procedure itself. (See Finding Specialists.) Because in the past surgery alone has failed to effect a cure, or even to help prolong life for any extended period of time, it is currently being combined with traditional chemotherapy and/or radiation, or other new approaches such as gene therapy, immunotherapy or photodynamic therapy. For Peritoneal Mesothelioma:
Cytoreductive Surgery is aimed at removing all or nearly all of the gross or visible tumor in the peritoneal cavity. In order to treat any remaining cancer cells, Intra-Peritoneal Hyperthermic (heated) Chemotherapy (IPHC) is then delivered to the abdominal cavity. The type of chemotherapy drug used may vary according to the physician’s preference. Click here for more on treatment of peritoneal mesothelioma
CHEMOTHERAPY
Chemotherapy is defined as the treatment of cancer using chemical substances. When cancer occurs, abnormal cells continue to divide uncontrolled. Anticancer, or chemotherapy drugs, work to destroy cancer cells by preventing them from multiplying.
Purposes of Chemotherapy
Chemotherapy may be used to achieve different goals, depending on the stage of the cancer at the time of diagnosis and the age and health of the patient. Since chemotherapy for mesothelioma is not considered "curative", the goal is:
To control the cancer by stopping its spread or slowing its growth.
To shrink tumors prior to other treatments, such as surgery. This is called neoadjuvant chemotherapy.
To destroy microscopic disease which may remain after surgery. This is called adjuvant chemotherapy.
To relieve symptoms, such as pain. This is called palliative chemotherapy, and is given in cases when a drastic reduction in the tumor is not expected.
The most common use for chemotherapy in mesothelioma patients, is as an option for those who are not surgical candidates, however, various cancer centers are now conducting trials using the neoadjuvant approach. Alimta (pemetrexed) is a new drug recently approved by the Food and Drug Administration (FDA) for use with Cisplatin in the treatment of patients with malignant pleural mesothelioma whose disease is either unresectable or who are not candidates for curative surgery. Alimta is the first drug approval specific to mesothelioma.
The Alimta/Cisplatin chemotherapy regimen is the first Food and Drug Administration (FDA) approved treatment specifically for malignant pleural mesothelioma. This is currently considered the most effective first-line treatment for mesothelioma patients who are not surgical candidates. A multi-targeted antifolate drug, Alimta works by blocking the enzymes necessary for DNA copying and cell division. During the clinical trial process, Alimta/Cisplatin improved median survival for pleural mesothelioma patients by approximately three months over treatment with Cisplatin as a single agent. Eli Lilly's information on treatment with Alimta.
As with any medical treatment, it is important to discuss the use of Alimta with your doctor. This conversation should include all pertinent information regarding effectiveness, administration and possible side effects of the drug combination. It is also important to begin vitamin supplementation of B12 by injection during the week prior to treatment (to be repeated every 9 weeks), and folic acid by mouth daily (to be continued until 21 days after the last cycle of Alimta). Additionally, you will be given an oral steroid medication to minimize the risk of skin rash or other possible side effects. Your doctor will have information on the correct dosages of each medication. Be sure to tell your doctor of any other medications you are taking (including non-prescription drugs) so he may be aware of any adverse interactions.
Alimta/Cisplatin is administered to patients on an outpatient basis every 21 days. This cycle of treatment involves a 10-minute IV infusion of Alimta followed by a 2 hour infusion of Cisplatin. How many cycles of treatment you receive will be dependent on your response rate to the drug (regression of the tumor or halt to progression of the disease) and the side effects you might experience.
Side effects of Alimta/Cisplatin are mild to moderate for most mesothelioma patients, i.e., nausea, vomiting and fatigue, and can usually be managed by your doctor. For some patients, however, side effects may be debilitating, and may require a decrease in dosage or removal from the program. All potential side effects should be mentioned to your doctor. Never assume any complaint is minor.
Administration of Chemotherapy
The most common way to administer chemotherapy is intravenously, or through a vein. A thin needle is inserted into a vein in the hand or in the lower arm. Intravenous administration of drugs allows for rapid entry into the blood stream. Drugs may also be delivered via catheters and/or ports.
Catheters are soft, thin, flexible tubes placed into a large vein in the body. They remain in place for as long as they are needed.
The catheter may sometimes be attached to a port, a small round plastic or metal disc placed under the skin on the chest. Ports also remain in place for as long as necessary.
Intraperitoneal chemotherapy may also be delivered through a catheter or a port. The catheter is inserted through the abdominal wall. Chemotherapy drugs can then be infused directly into the abdominal cavity. Ports may also be placed under the skin of the abdominal wall and the catheter tunneled between the skin and muscle into the peritoneum.
Side Effects of Chemotherapy
Cancer cells grow and divide more rapidly than normal cells, but some normal cells also multiply quickly, particularly those in the digestive tract, reproduction system, and hair follicles. It is the damage done to normal cells that causes side effects. The type of side effects you might experience and how severe they are, depend on the type of chemotherapy you are receiving, the dosage given and how your own body reacts. Before beginning any chemotherapy treatment, you will be asked to sign a consent form. Before signing the form, be sure your doctor informs you of all the facts regarding the treatment he/she will be administering, including information about the particular drug or combination of drugs to be used, the possible risks or side effects, the number of treatments you will receive and how often, and whether it will be given during a hospital stay or on an outpatient basis

CLINICAL TRIAL BASICS

Clinical trials are studies of the safety and/or effectiveness of new drugs being tested on humans. For mesothelioma, trials are being conducted to find a better and more effective means of treatment. Anyone interested in participating in a clinical trial should discuss the particular trial thoroughly with their doctor before a making a decision on whether it is right for them.
All clinical trials carry potential benefits and risks, and it is important that you have a complete understanding of what you might expect. For instance, since clinical trials are often conducted at larger cancer centers, in many cases, travel may be necessary to receive treatment and routine tests. On the other hand, care is provided at top-notch facilities by physicians who are leaders in the field of cancer research. Another benefit would be having access to the new drug before it is widely available, however, the new drug may ultimately be proven not as effective as the “standard” of care.
Eligibility requirements for clinical trials are not the same; each study has specific guidelines to participate. Some trials allow participation after other treatments have failed, while others require that the patient have no prior treatment. Your doctor should be able to advise you which trial might be the best fit in your particular case.
Some treatment trials are “randomized”, meaning the new treatment is compared with a current standard of treatment. Depending on which arm of the protocol you are assigned, you may receive the new treatment or the standard. You should be informed in advance of this eventuality by the doctor conducting the trial. Placebos (pills that contain no active ingredient) are rarely used in cancer trials.
TRIAL PHASES
Though mesothelioma has no cure, there are clinical trials currently underway to test new drugs and procedures in the fight against the disease. All clinical trials or studies are divided into different phases:
Phase I trials usually enroll only a small number of people and test how new drugs or procedures should be administered.
Phase II trials give early information about whether or not a new drug or procedure works and also provide information about safety and benefit.
Phase III trials compare promising new drugs or procedures with the current standard treatment. Large numbers of people from across the nation usually participate in Phase III trials and receive either the new treatment or the standard treatment.
ELIGIBILITY
In order to be sure the study results are accurate, trial participants in all phases must fit a certain profile. Eligibility for mesothelioma trials are often specific as to age, how long it has been since therapy, stage of disease, and other characteristics. To find out about the eligibility requirements and other information for the trials listed below, click on the clinical trial web site listed after each trial or call one of our MW Coordinators toll-free at 1-877-FOR-MESO (367-6376).
CLINICAL TRIALS AND MEDICARE
If you choose to enter a clinical trial and are on Medicare, it is important that you have a complete understanding of the trial itself, and what costs will or will not be covered under your Medicare policy.
Clinical trials for cancer are currently covered if:
The trial is funded by the National Cancer Institute (NCI), the NCI-Designated Cancer Centers, the NCI-Sponsored Clinical Trials Cooperative Groups or other Federal agencies that fund cancer research.
The goal of the trial is to diagnose or treat cancer (cancer prevention trials are not covered).
Costs covered under Medicare for clinical trial participants include:
Doctor’s office visits.
Routine tests and/or procedures associated with a clinical trial.
Services associated with the administration of investigational drugs during a clinical trial.
Health care associated with a clinical trial, i.e., hospitalization for side effects.
Costs not covered under Medicare for clinical trial participants include:
Investigational drugs being tested in a clinical trial.
Services used only for the collection of data for a clinical trial.
Anything provided to a trial participant at no cost by the sponsor of a clinical trial.
Any coinsurance and/or deductibles.
If you are not sure whether the clinical trial you have chosen meets all necessary requirements, discuss your participation with your doctor, or contact the Medicare benefits office at 1-800-MEDICARE (1-800-633-4227).

CURRENT CLINICAL TRIALS
The National Cancer Institute states that the purpose of most listed clinical trials is to test new cancer treatments or new methods of diagnosing, screening for or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in each clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. At present, the following trials are actively testing new drugs or treatments for mesothelioma. They are listed by title with a short description and have no particular order or endorsement.