Neutropenia in mesothelioma patients

Chemotherapy drug treatments reduce the number of neutrophils, also known as white bloods cells that protect the body against infection. This causes a condition known as neutropenia. Cancer patients that suffer from neutropenia have an increased risk of bacterial infections and could be fatal if left untreated. Some symptoms of neutropenia include body aches, fever and fatigue. Doctors normally find neutropenia when conducting a complete blood count (CBC) to determine the number of red and white blood cell counts.

Physicians determine the risk of neutropenia by calculating the neutrophil count, called the absolute
neutrophil count (ANC). The absolute neutrophil count is calculated by
multiplying the total white blood count by the percent of neutrophils.

The following scale shows the risk of infection based on the ANC:

Risk of Infection based on Absolute Neutrophil Count (ANC)

ANC greater than 1500: No increased risk of infection

ANC 1000-1500: Slight increase in risk of infection

ANC 500-1000: Moderate increase in risk of infection

ANC 100-500: High risk of infection  

ANC less than 100: Extremely high risk of infection 

Drugs That Cause Neutropenia 
 
Overall, most chemotherapy drugs can cause neutropenia because they tend to lower the number of neutrophils. They grow quickly but only survive three days.  
 
Drug Treatments for Neutropenia 
 
Physicians treat cancer patients that suffer from neutropenia with a drug called Neupogen (filgrastim). This substance recreates blood growth factors that boost the number of white blood cells. It is given by injection every five to seven days, but due to the inconvenience of this frequency, another type of drug called Neulasta (pedfilgrastim) was developed. It lasts longer and needs to be administered every 21 days. These drugs have side effects of their own that causes bone and joint pain.

Other Precautions to Reduce Risks of Infection

The following precautions should be taken by patients with neutropenia to reduce risk of infection:

  • Avoid people that might be sick with a cold, flu or infection
  • Keep skin moist to prevent dry, cracking skin
  • Don’t scratch sores and keep them clean with antiseptic and a bandage
  • Don’t eat raw foods
  • Keep mouth clean, brush regularly and use alcohol-free mouthwash

Sarcomatoid Mesothelioma Treatment

Sarcomatoid mesothelioma is the least common histological type of mesothelioma, but it is the most aggressive.

http://www.ncbi.nlm.nih.gov/pubmed/20081811?dopt=Abstract

Even more than epithelial mesothelioma, the sarcomatoid form is difficult to diagnose and to distinguish from other diseases. Just looking at the cells under a microscope is not enough, and doctors employ immunohistological tests to distinguish Sarcomatoid mesothelioma from true sarcoma and pulmonary sarcomatoid carcinoma.

 

http://www.ncbi.nlm.nih.gov/pubmed/18199156?dopt=Abstract

The general treatment plan for sarcomatoid mesothelioma focuses on:

  • Managing pleural effusions
  • Administering radiotherapy to intervention sites
  • Evaluating suitability for radical surgery
  • Evaluating suitability for chemotherapy and clinical trial entry

Epithelial Mesothelioma – Clinical Presentation and Diagnosis

Epithelial (or epithelioid) mesothelioma is the most common histological type of mesothelioma.  Epithelial mesothelioma is a subtype – both pleural and peritoneal mesothelioma may be epithelial or sarcamatoid or biphasic (including both cell types.)

Epithelial mesothelioma has a better prognosis than other subtypes.  Average life expectancy after diagnosis is longer.

As with all types of mesothelioma, asbestos is the cause.  Most people who get it are men past age 50, although it does occur in younger people and in women.  This is largely because the illness typically does not manifest until decades after initial asbestos exposure.  A significant percentage of patients diagnosed at relatively younger age have experienced asbestos exposure during their childhood.  Approximately 70 to 80 percent of mesothelioma cases involve a male patient. This is due to the fact that men are more likely to be employed at jobs that have a heightened risk for asbestos exposure. Common industries linked to asbestos inhalation include construction, auto repair, shipbuilding and naval employment.

 

Diagnosing Epithelial Mesothelioma

Performing a concurrent bronchoscopy may be vital for making a differentiation between mesothelioma and metastatic adenocarcinoma of the lung, since endobronchial lesions are seldom seen in mesothelioma.

A new approach to differentiate between mesothelioma and adenocarcinoma of the lung is currently under development. This new approach relies on gene expression profiling, by identifying specific genes that are expressed in malignant mesothelioma but not in case of adenocarcinoma or normal lung tissue.

World’s First Cancer-Killing Pill May be Available Within the Decade

Thanks to advancement made possible through the Human Genome Project, British researchers believe the world’s first cancer-killing pill may be on the horizon. According to the team’s timeline, such a pill may be available in as few as ten years.

The success of this future pill will work by exploiting a specific gene flaw that is present in cancer’s DNA. In lab tests, the British team was able to show that a mutation of specific cancer cells effectively blocked the disease’s ability to repair damaged genetic material. As such, a pill or injection could potentially be made that switches on this mutation and shuts down important repair mechanisms that cause the illness to grow uncontrollably.

Since such a drug would not affect the health of normal human cells, it is believed that treatment will not only be more effective, but also result in far fewer side effects.

A research team led by Professor Ghulam Mufti at Kings College London announced the findings on October 24th. Mufti summed up the findings by saying, “The genetics of cancers are being rapidly unraveled. We are soon going to have a library of what genetic abnormalities lead to which cancers. If these are specific, we can target these abnormalities using new treatments.”

Many researchers not affiliated with the study agree that all cancers are moving towards a targeted treatment process. Thanks in large part to the Human Genome Project, various research teams are now identifying potential genetic markers that may eventually lead to a cure for cancer.

One of the first of such drugs is currently being tested at the Breakthrough Breast Cancer Research Centre in London. This drug works in exactly the same manner as described by Mulfti – by altering a tumor’s cells so they cannot successfully repair DNA properly.

In early trials, the research team was able to show that breast cancer cells are killed while healthy cells are largely unaffected. The team also notes a complete lack of noticeable side effects.

Similar methods are also currently in the works for curing such illnesses as cystic fibrosis. Current medical trials that utilize gene therapy could lead to an effective cystic fibrosis treatment in as little as five years.

Sources:
http://www.express.co.uk/posts/view/207376/New-drugs-to-target-cancer
http://www.dailymail.co.uk/health/article-1323481/Cancer-killing-pill-exploits-flaw-diseases-DNA-close-development.html

New Diagnostic Technique Could Result in Test for Mesothelioma

Reuters is reporting a new blood test that could identify mesothelioma at an early stage. The biotech company Somalogic, which specializes in developing diagnostic tests, announced a new technology that could allow doctors to identify mesothelioma in patients before they show visible symptoms.

Somalogic scientists used blood samples from mesothelioma patients and were able to develop aptameters (oligonucleic acid or peptide molecules) that bind to proteins expressed by mesothelioma cells. These biomarkers are present in the blood at extremely low concentrations, so conventional chemical analysis cannot find them. The use of proteomics array technology and genetic material specific to the protein allows discovery of the disease early in its development.

According to HealthDay News, Somalogic scientists identified 19 biomarkers for mesothelioma. They found a specificity of 100% for those markets. Sensitivity was 80%. If these numbers hold through further development, the diagnostic process would be able to identify the large majority of mesothelioma cases with some false positives.

If this technology proves reliable it could be used in a screening process for people with a history of asbestos exposure. Asbestos is known to cause mesothelioma, but the latency period is very long and the symptoms often don’t manifest until the disease has progressed to a point at which treatment options are limited. Early discovery of mesothelioma would give doctors and patients more options and improve the prognosis of those afflicted with this cancer.

Read more at http://www.doctorslounge.com/index.php/news/pb/14384

http://www.reuters.com/article/idUSTRE68R5T220100928

http://www.eurekalert.org/pub_releases/2010-09/aafc-nbd092110.php

Improving Adoption Rates of Orphan Drugs for Mesothelioma and Other Rare Diseases

Recently, research on a promising drug for a disease that currently affects 1,500 people in the United States annually was halted due the financial reasons, according to Peter Saltonstall of the National Organization for Rare Diseases. The root of these financial reasons stems from the cost of research versus the expected amount of profits that the pharmaceutical company can expect over the long term.

Saltonstall declines to name the particular illness in question, but the identity is hardly important. Such financial issues have long been a difficulty when it comes to spurring interest in research for virtually all rare diseases. Sadly, drug development is a profit-driven business – a fact that has long proven detrimental to “small potatoes” illnesses that affect less than 200,000 people annually. However, it should be noted that combined, more than 7,000 rare diseases affect 20 to 30 million people in the United States each year.

In an effort to improve interest in such research, the United States passed the Orphan Drug Act (ODA) in 1983. The ODA serves to increase incentives for pharmaceutical companies to pursue research within the rare disease sector. Such incentives include federally funded grants, tax credits on costs associated with clinical trials and a 7-year exclusive marketability of any drugs that eventually come to market.

In a lot of ways, the ODA has been very successful. Since 1983, the FDA has approved 357 rare-disease drugs. Additionally, 2,100 products entered the testing pipeline. In comparison, only 10 drugs for rare disease achieved FDA-approval prior to the Act.

However, many experts on the subject claim additional measures need to be taken. The Food and Drug Administration’s Office of Orphan Products Designation is responsible for reviewing studies that may or may not be eligible for orphan status. According to Tom Cote, who heads the department, “[Pharmaceutical companies] frequently come out with press releases saying how important orphan products are to them…[but] they infrequently pass anything substantive over my desk.”

In an effort to further bolster interest in rare diseases, a 2010 appropriations bill is calling for a review process for orphan drugs. The review may result in additional measures that can decrease the cost of cancer research for rare illnesses. For example, initiating statistical models that require fewer patient participants may drop research costs significantly. Of course, the concern is that shallower pools of data may reduce the efficacy of results. Still, Cote is willing to be flexible when it comes to spurring initial research.

As a complement to the proposed revisions, the FDA is already attempting to spur interest by holding on-site workshops that help provide guidance for maximizing current ODA incentives. Hopefully, these and other measures will result in a renewed interest in research for rare diseases.

Resource:

http://www.scientificamerican.com/article.cfm?id=adoption-agents

Survival Statistics and Prognosis for Mesothelioma

Mesothelioma is a rare lung cancer that has been linked to the inhalation of asbestos. While each case of mesothelioma is unique, the general prognosis for the illness is poor. However, the ultimate outlook for a patient will vary depending on the type of mesothelioma he or she has been diagnosed with, as well as other factors.

Survival Averages for Mesothelioma

Like most cancers, the survival rate of mesothelioma can vary depending on the stage in which it is diagnosed. Unfortunately, the nature of the illness typically results in late-stage diagnosis. As one might expect, this reduces the average length of suvival. This fact, combined with the fact that mesothelioma is a rare disease, has resulted in a lack of reliable statistics beyond 5-year survival rates.

However, there is a fair amount of statistics present for shorter diagnostic time frames. From the date of diagnosis, the general prognosis for a mesothelioma patient is in the range of 12 to 14 months of survival. If the cancer is caught early enough to warrant surgical removal of the tumor, then this time frame may be extended.

Regardless of the initial prognosis, statistics show that:

  • 4 out of 10 mesothelioma patients survive more than one year past diagnosis

  • 2 out of 10 mesothelioma patients survive more than two years past diagnosis

  • 1 out of 10 mesothelioma patients survive more than three years past diagnosis

  • 8 out of 100 mesothelioma patients survive more than five years past diagnosis

Again, these statistics are generalizations. Factors such as patient age, health and extent of cancer growth can all affect survival rates significantly.

Making National Mesothelioma Awareness Day A Reality

Since 2005, the Mesothelioma Applied Research Foundation (MARF) has promoted September 26 as Mesothelioma Awareness Day. The day is meant to serve as both a day to honor and remember those who have suffered from this rare lung disease, as well as promote awareness so that future generations might see fewer instances of the illness.

In an effort to bring further awareness, mesothelioma advocates have been pushing to have the day recognized by the U.S. government as a national day of awareness. A bill linked to this goal – H. Res. 771 – is scheduled to be added to the legislative calendar for the House of Representatives. If passed and signed by the president, it would serve as a major victory for raising awareness about the hazards of asbestos – the natural fiber that has been linked to mesothelioma formation when inhaled into the lungs.

To help bring national awareness, MARF is urging people to get involved to help raise awareness for making Mesothelioma Awareness Day official in your city, state or country. Ways that individuals can help include:

  • Contact your city council and ask what needs to be done in order to get a proclamation declaring September 26 as Mesothelioma Awareness Day

  • Contact your state governor’s office and ask for a permanent State resolution

  • Contact House representatives and senators in your state to ask for national recognition

  • Contact local media about proclamations and ask them to help raise awareness

  • Get the word out by presenting the proclamation to surrounding communities

Regardless of national recognition, September 26 has come to be a special and important day for those personally affected by mesothelioma. Mesothelioma is a rare lung disease that has no cure. An estimated 2,000 to 3,000 Americans die from the illness each year.

Mesothelioma in Pets Can Provide Insight Into New Treatments

Mesothelioma is a rare type of cancer that accounts for approximately one percent of all cancer deaths worldwide. The cancer is caused through the inhalation of asbestos – a naturally occurring fiber that is often used for insulation or heat-resistant purposes.

Just as asbestos exposure affects human health, so too does it affect the health of pets and companion animals. In rare cases, asbestos exposure among dogs and cats does occur. Sadly, such exposure may eventually lead to mesothelioma.

Prolonged breathing problems, coughing or difficulty breathing witnessed in a dog or cat may be warning signs of mesothelioma. If a family member works around asbestos, fibers may remain on their clothing when they come home. These fibers may be inhaled or licked by the pet. Additionally, asbestos has been commonly used in building construction, and may be present in home walls.

When mesothelioma in pets occurs, it is of course a tragedy. However, these pets may serve as important pioneers in new mesothelioma treatments. Oftentimes, these dogs and cats undergo experimental mesothelioma treatments that may one day be approved for use in humans.

One such study, reported in the May 2008 issue of the Journal of Experimental & Clinical Cancer Research, found promising results for a mesothelioma treatment regimen that combined the use of piroxicam and platinum-based intracavity chemotherapy.

Three companion animals took place in the study – two dogs and one cat. All participants experienced variable remission times. Most notably, one dog continues to be in remission three years following treatment. This is incredibly promising, given the fact that most human patients to do not survive more than a year following a mesothelioma diagnosis.

The other dog survived for eight months following treatment, while the cat survived 6 months. While this is less encouraging, treatment did result in a 90 percent reduction in excessive fluid buildup.

The researchers who published the paper suggest that the treatment results are promising enough to warrant future tests in animals, and possibly humans. However, they note that mesothelioma is more likely to follow a benign course of advancement in dogs than in humans. This may be a hidden factor in the 3-year survival time of the one canine participant.

Resources:

http://www.jeccr.com/content/27/1/6