Mesothelioma Cancer Medical studies

Introduction to Mesothelioma Mesothelioma is rapidly effecting people who have been exposed to asbestos over the years learn how it alters lives....		Doctors on Mesothelioma Cancer As a patient of different types of mesothelioma you may feel distraught, with the right doctor and information your ordeal may be easier to bear and beat. .
Emotional Stories of Mesothelioma Seeing a loved one bear the pain and fear caused by someone elses negligence is hard, read about how people cope with mesothelioma.		State by State: Mesothelioma Cases Different states have different rates of mesothelioma, learn how individuals try to overcome the disease.

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Malignant Mesothelioma: A Case Presentation

Timothy J. Barreiro, DO; Philip J. Katzman, MD

From Ohio University College of Osteopathic Medicine, Northeastern Ohio Universities College of Medicine, Pulmonary and Critical Care Division of St Elizabeth Hospital (Dr Barreiro) in Youngstown, and the Division of Pathology and Laboratory Medicine of Strong Memorial Hospital at the University of Rochester School of Medicine and Dentistry (Dr Katzman) in New York..

Address correspondence to Timothy J. Barreiro, DO, Pulmonary and Critical Care Division, St Elizabeth Health Center, 1044 Belmont Ave, Youngstown, OH 44501-1006.

Diffuse malignant mesothelioma is the most common primary tumor involving the pleura. Unfortunately, it also poses the most difficulty for physicians to diagnose and treat. Latency from the time of initial asbestos exposure, clinical features of chest pain and dyspnea, and radiographic findings of pleural effusion or pleural thickening are the characteristic features. Pathologic verification remains challenging. The primary distinctions to be made are between reactive and neoplastic mesothelial processes and between malignant mesothelioma and metastatic adenocarcinoma. Adequate tissue sampling is important to help diagnose malignant mesothelioma. This article describes a rare subtype of mesothelioma and illustrates the difficulty in establishing the diagnosis. Also included is a discussion of the clinical features, diagnostic dilemmas, and unsatisfactory outcome associated with this disease.

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Malignant mesotheliomas arise from mesothelial cells lining the visceral cavities. Patients with this malignancy generally do not have a complete response; malignant mesotheliomas pose both a diagnostic and a treatment challenge. The extremely long latency from time of initial asbestos exposure to tumor development and the lack of effective modes of therapy are barriers to eradicating the disease. Diagnosis requires recognition of patients at risk and knowledge of the typical clinical features of the disease. Effective treatment is limited for most patients with malignant mesotheliomas. Without treatment, the median survival time is between 4 and 13 months. Patients in whom the disease is detected early have a survival benefit from a multimodality therapeutic approach. A variety of new treatment modalities is available, but few patients have a complete response.

Treatments of Mesothelioma

As with most types of cancer, there is no known cure for mesothelioma. Mesothelioma is a disease that lies dormant for decades before pouncing on the patient with sudden symptoms or with a diagnosis before symptoms even begin.There are a variety of treatment methods available to people who have mesothelioma and the treatment you receive largely depends on the type of mesothelioma you have and how far it has spread. In most cases the cancer has spread and advanced so far upon diagnosis that all doctors can do is keep the patient comfortable rather than working toward a full removal of the tumors.

Active Symptom Control for Mesothelioma treatment

When a patient presents with mesothelioma and it is widespread (which it usually is), doctors typically seek to control the symptoms and treat the disease as much as can be done in advanced cases. The ‘active symptom control’ method of handling mesothelioma includes:

Your Team – you will be assigned a team of doctors that have a variety of specialties related to mesothelioma who will give you all the information you need about combating the disease and a support system to guide you through the process.

Your team will include chest surgeons, nursing staff, oncologists (cancer doctors) with mesothelioma experience, radiologists (who analyze x-rays), pathologists (they can describe the type of cancer and advancement) and symptom control specialists who advise on drug and therapy treatments. You will likely also have a staff of counselors, social workers and physical therapists available wherever necessary.

Information Reviews – you will be given all the information you need and have all the questions you have answered about drug and therapy treatments. Your team will go over all aspects of the drugs you may be given and the treatments that are available.

Many people fear treatment because they know little about how it works, what side effects can be expected and what drugs will be given to counter any side effects. These reviews will let you know the potential benefits and problems associated with the treatment you receive and help you to decide which you think is the best route for your own treatment. You will likely feel much more comfortable about the entire process when you are well informed which is the ultimate purpose of information reviews.

In many cases, people who have mesothelioma have reached an advanced stage that responds to little treatment. For this type of patient, the doctors will discuss less about treatment with the aim of reduction of the cancer and more about treatments that make the remaining time bearable for the terminal patient. All aspects are discussed with the doctors and nurses on the team.

Consent – this is one of the most important aspects of the active symptom control process. You are given control over the way your cancer is treated. The doctors will explain all aspects of any treatments available to you for your type of mesothelioma and allow you time to review the information. You decide which treatment you think is best and give your formal permission to pursue the course.

No part of the treatment will be given to you without your consent and all information will be explained before the start of any segment of the treatment from therapies to drug treatments. The team has to be sure you understand all parts before they begin treatments and will often include family members and friends in the discussion to be sure the process and possible outcomes are clear.

Treatments of Mesothelioma

Since there is no known cure for mesothelioma, most of the treatments available are intended to control the symptoms, reduce pain and extend the expected life span. Treatments include:

Surgery – since mesothelioma affects the lining of the body cavities, one effective treatment involves the removal of affected sections of the mesothelium to remove the tumor(s). In case of widespread or large tumors, a section of organ will be removed from the patient. This option is available only to patients who are not in advanced stages of the disease.

Chemotherapy – chemotherapy drugs are injected directly into the affected cavity to reduce the tumors and rate of spread of the disease. This treatment can be used on its own or in conjunction with surgery.

Radiation Therapy – the cancer cells are targeted and infused with radiation to kill the cancer cells and reduce the rate of spread. It can also be used to control symptoms like shortness of breath and pain. This can also be used on its own or in conjunction with surgery.

Clinical Trials – various new treatments and experimental drugs are offered to mesothelioma patients who are interested in trying out new medicine or contributing to research in cancer treatments and a possible cure.

What is Mesothelioma?

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the pericardium (a sac that surrounds the heart) or tunica vaginalis.

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can be all that it takes. Unlike lung cancer, there is no association between mesothelioma and smoking. Compensation via asbestos funds or lawsuits is an important issue in mesothelioma.

The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.

Mesothelioma Legal History

The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos. The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker. The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.

In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.

Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.

By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims

Whirling Disease

Jerri L. Bartholomew and J. Christopher Wilson, editors

262 pages Published by American Fisheries Society Publication date: July 2002

Summary

Symposium 29

This book is a compilation of the latest whirling disease research findings, along with seven invited review papers in seven subtopics. It represents a peer-reviewed version of the proceedings of the 7th Annual Whirling Disease Symposium held in February 2001 in Salt Lake City, Utah. It is also much more than that, given the value of its extensive and thoroughly researched review papers. The volume will be a valuable resource for researchers in the field as well as a reference volume for managers who have to make decisions on controlling whirling disease. Table of Contents

Preface Symbols and Abbreviations

Section 1: Distribution and Dissemination

The History and Dissemination of Whirling Disease Jerri L. Bartholomew and Paul W. Reno

Potential for Introduction of Myxobolus cerebralis into the Deschutes River Watershed in Central Oregon from Adult Anadromous Salmonids H. Mark Engelking

Evaluation of Risk of High Elevation Colorado Waters George J. Schisler and Eric P. Bergersen

Section 2: Parasite Research

Recent Advances with Taxonomy, Life Cycle, and Development of Myxobolus cerebralis in the Fish and Oligochaete Hosts Ronald P. Hedrick and Mansour El-Matbouli

Detection of Glycoconjugates and Lectin-like Activities in the Causative Agent of Whirling Disease Mansour El-Matbouli, Christiane Anders, Rudolf Hoffmann, Hans-Joachim Gabius, and Herbert Kaltner

Extrusion of Polar Filaments of the Myxobolus cerebralis Triactinomyxon by Salts, Electricity, and Other Agents Eric J. Wagner, Quinn Cannon, Mark Smith, Ryan Hillyard, and Ronney Arndt

Section 3: Ogliochaete Research

The Role of Tubifex tubifex (Annelida: Oligochaeta: Tubificidae) in the Transmission of Myxobolus cerebralis (Myxozoa: Myxosporea: Myxobolidae) Willard O. Granath, Jr. and Michale A. Gilbert

Triactinomyxon Production as Related to Rearing Substrate and Diel Light Cycle Ronney E. Arndt, Eric J. Wagner, Quinn Cannon, and Mark Smith

Section 4: Salmonid Research

The Effects of Myxobolus cerebralis on the Salmonid Host E. MacConnell and E. Richard Vincent

Relative Susceptibility of Various Salmonids to Whirling Disease with Emphasis on Rainbow and Cutthroat Trout E. Richard Vincent

Relative Susceptibility of Selected Deschutes River, Oregon, Salmonid Species to Experimentally Induced Infection by Myxobolus cerebralis Sarah A. Sollid, Harriet V. Lorz, Donald G. Stevens, and Jerri L. Bartholomew

Laboratory Studies Indicating that Living Brown Trout Salmo trutta Expel Viable Myxobolus cerebralis Myxospores R. Barry Nehring, Kevin G. Thompson, Karen A. Taurman, and David L. Shuler

Effects of Myxobolus cerebralis Infection on Juvenile Spring Chinook Salmon in the Lostine River, Oregon Todd A. Sandell, Harriet V. Lorz, Sarah A. Sollid, and Jerri L. Bartholomew

Section 5: Ecology

The Ecology of Myxobolus cerebralis Billie L. Kerans and Alexander V. Zale

Modeling Myxobolus cerebralis Infections in Trout: Associations with Habitat Variables Monica Hiner and Christine M. Moffitt

Whirling Disease Among Snake River Cutthroat Trout in Two Spring Streams in Wyoming Wayne A. Hubert, Michael P. Joyce, Robert Gipson, David Zafft, David Money, Deedra Hawk, and Brandon Taro

Section 6: Diagnostic Methods

A Review of the Approaches to Detect Myxobolus cerebralis, the Cause of Salmonid Whirling Disease K. B. Andree, R. P. Hedrick, and E. MacConnell

A Brief Critique of Methods of Samplling and Reporting Pathogens in Populations of Fish Christopher J. Williams and Christine M. Moffitt

Section 7: Management and Control

Whirling Disease Prevention, Control, and Management: a Review Eric J. Wagner

The Effect of Water Characteristics on Viability of the Myxobolus cerebralis Actinospore Mark A. Smith, Eric J. Wagner, and Amy Howa

Efficacy of Fumagillin and TNP-470 to Prevent Experimentally Induced Whirling Disease in Rainbow Trout Oncorhynchus mykiss Linda Staton, Dave Erdahl, and Mansour El-Matbouli

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