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Monday, 19 September 2016

3 Ways Mesothelioma Patients Can Boost Their Nutrition

Our nutritional status can either strengthen or weaken our bodies. When diagnosed with a cancer like mesothelioma, we want to make our bodies stronger. It can help to provide support to mesothelioma treatments like chemotherapy. More importantly, it helps with the healing process after surgery.

Ultimately, the three main goals you want to achieve when diagnosed with mesothelioma, are:

    Maintain a healthy weight
    Reduce treatment-related symptoms
    Improve your quality of life

Nutrition plays a very important role in achieving those goals. A well-balanced diet gives you 100% of your daily recommended nutrients. It is understandable that treatments, as well as the cancer itself, may cause a change in appetite or nutritional needs. I am going to provide you with some suggestions and helpful tips to follow to achieve those goals.

    Manage Your Calories

    Research shows that people who maintain their muscle and a healthy weight have fewer side effects and feel better after treatment is completed.
        Consider having a liquid replacement meal if you feel a decrease in appetite or are fatigued. This way you are still taking in calories without having to expend the energy to chew your food.
        Eat a substantial meal when you feel hungry.
        Eat small, frequent meals throughout the day to reduce bloating and keep up calorie intake.
        You may want to increase use of sauces and gravies to help aid in swallowing and reduce the amount of energy needed to chew if you are fatigued.
 2. Protect Your Immune System

    Certain treatments, like chemotherapy, may lower your immunity and make you prone to infection.
    Follow these tips:
        Consume “clean” foods. These would be foods that do not contain antibiotics, chemicals, or toxins.
        Wash your hands and food prep surfaces often. Dedicate an area in your kitchen for raw foods. This is especially helpful in reducing the chances of infection or spreading of disease.
        Be mindful of consuming raw or undercooked foods like meat, eggs, and fish. Buy a thermometer to check the temperature of your foods before eating. You want to try and reduce any chance of foodborne illness.
3. Increase Protein Intake

    Your doctor may tell you to increase protein in your diet. Protein is essential for healing.
    Here are a few simple ways:
        Add hummus and/or avocado to your diet
        Increase your egg intake and add cooked lean meats and cheese to omelets
        Eat desserts made with eggs like custards and puddings
        Snack on roasted nuts
        Use nut butters instead of butter on toast, crackers, or apple slices
        Add powdered milk to mashed potatoes, milkshakes, and soups

New Mesothelioma Drug Discovered in Sea Squirt Toxin

A unique drug derived from the Caribbean sea squirt shows impressive effectiveness in stopping the growth of mesothelioma tumor cells.

Researchers at the Medical University of Vienna in Austria discovered that trabectedin, a toxin the coral-like animal uses against predators, might soon be applied in the treatment of mesothelioma.

“It has looked very promising to this point,” Walter Berger, group leader at the Institute of Cancer Research, University of Vienna, told Asbestos.com. “It’s a fascinating new substance — from its origins to its mode of action.”

A European pharmaceutical company has been harvesting the bottom-dwelling marine organism and extracting the toxin to produces the potentially life-extending drug.

The Molecular Cancer Therapeutics journal published the study earlier this month. Berger’s team, which includes thoracic surgeon Dr. Alireza Hoda, focuses on the development of novel strategies for therapy-refractory cancers such as mesothelioma, brain tumors and lung cancer.

In the recent study involving mesothelioma, trabectedin served as an effective chemotherapy-like agent that targeted DNA and delivered an immune response. It also showed great synergy when combined with cisplatin, the current standard-of-care chemotherapy.

“We found excellent activity, compared to many drugs that have been tried,” Berger said. “Mesothelioma, as you know, is very difficult to treat. This was encouraging.”

The U.S. Food and Drug Administration in October 2015 approved trabectedin for the treatment of advanced or inoperable soft tissue sarcomas. Although the National Cancer Institute sanctioned the drug under its Natural Products Branch, the drug chemically synthesized in the U.S.
Trabectedin as a Mesothelioma Treatment

Trabectedin could be a new development in the treatment of malignant pleural mesothelioma.

Doctors diagnose an estimated 3,000 new cases of mesothelioma, a rare and aggressive cancer caused by exposure to asbestos, annually in the U.S. The disease typically carries a prognosis of 6-18 months.

In the preclinical study, researchers tested trabectedin on 13 mesothelioma surgical specimens, six mesothelioma cell lines and two nonmalignant pleural tissue samples. Trabectedin prompted a dose-dependent cytotoxic effect on all mesothelioma cell cultures but a considerably lesser effect on the nonmalignant samples.

The drug generated a better response when combined with cisplatin, and then with a group of proteins that typically regulate cell death by inducing apoptosis.
Drug May Treat the Sarcomatoid Mesothelioma Subtype

The research showed a surprisingly impressive response with the sarcomatoid cell type of mesothelioma. The sarcomatoid subtype — the least common of the cell types and the most resistant to today’s therapies — often leaves patients with little hope.

Trabectedin prompted a significant improvement in the effectiveness of cisplatin against sarcomatoid cells in the lab.

Doctors in Europe and Japan are administering lurbinectedin, another version of trabectedin, in combination with other chemotherapy drugs to treat inoperable ovarian cancer.

Swiss researchers, in an earlier study published in the journal Lung Cancer, reported lurbinectedin effectively reduced tumor size and limited the usually harsh chemotherapy side effects.

Currently, five sites in Italy are conducting the only clinical trial involving trabectedin and mesothelioma today.

Early results are promising, according to Dr. Diego Cortinovis, who presented the drug’s effectiveness at the annual American Society of Clinical Oncology meeting in Chicago.

ACTION ALERT: Mesothelioma Bill in Congress for Patient Registry

We have big news and need your help! Today, the ‘Mary Jo Lawyer-Spano Mesothelioma Patient Registry Act of 2015’ was introduced in Congress by Congressional Representatives John Katko (R-NY), Jan Schakowsky (D-IL), Chris Collins (R-NY), Peter King (R-NY), Betty McCollum (D-MN), Joe Kennedy (D-MA), and Leonard Lance (R-NJ). This bipartisan bill would establish the nation’s first formal federal registry to track mesothelioma patients. This would provide scientists with adequate clinical data to assist in their research.

This bill came about as a result of our March 2015 Symposium’s Advocacy Day when Meg Meccariello and her mother Elizabeth Lawyer met with Congressman Katko. The Lawyer family has been greatly impacted by mesothelioma. Meg, who is a mesothelioma patient herself, has lost her father Charles Lawyer and her sister Mary Jo Spano (after whom this bill is named) to mesothelioma. Another one of her siblings has also been recently diagnosed.

“Unlike many chronic and rare diseases, there is currently no national registry available for mesothelioma patients,” said Rep. John Katko. “These registries collect and consolidate information about individuals who suffer from the disease and provide health care professionals, researchers, and patients with the ability to search information about diagnosis, as well as track disease trends, risk-factors, and treatment availability.”

While the introduction of this bill is an important accomplishment for the mesothelioma community, our work is not yet done – we need your help! In order to ensure passage of the bill through the House of Representatives, it is critical for other Representatives to announce their support for the legislation as well.

Please use our Action Center to email your congressional representative and urge him/her to co-sponsor the ‘Mary Jo Lawyer-Spano Mesothelioma Patient Registry Act of 2015’. If you prefer to call your representative, you can use our website to find their contact information.

Below are some brief talking points that you can use:

    Mesothelioma is a deadly form of cancer linked to exposure to asbestos for which there is no cure.
    The five year survival rates are less than 10%.
    Currently, there is no formal federal registry to keep track of mesothelioma patients.
    The ‘Mary Jo Lawyer-Spano Mesothelioma Patient Registry Act of 2015’ would establish the first ever federal mesothelioma registry, providing clinical trial information, clinic information, and reports to help researchers identify and develop a cure to this deadly disease.
    I urge you to co-sponsor this important legislation. Linked here is a ‘Dear Colleague’ letter circulated on Capitol Hill to garner further Congressional support that includes more information about the bill. Again, thank you very much for your support. Please do not hesitate to contact me with any questions you may have.

Community, Friendship Through Fundraising For Mesothelioma

Throughout February, we posted blogs about how to host your own fundraising event, the importance of event sponsors, and how to sustain your audience. We’re continuing this series of fundraising posts with a blog by Jill Waite, a Fundraise for Meso event planner, on how fundraising has impacted her life:

Jill WaiteFive years ago, I was determined to undertake an endeavor – to host a 5k to honor my Dad’s legacy and to raise money for mesothelioma research. I had no expectation of the amount we could raise, just a fierce determination to somehow help make a difference in the lives of those still fighting mesothelioma. I could not fully understand how healing the race would be for me until I stood at the finish line and watched everyone cross. As we were tearing down, I was already planning how we would improve the next year.

The four years we have held the race, we have raised almost $40,000 for mesothelioma research. As imperative as that is, we have watched something beautiful happen. People are coming from all over to run and walk in memory of, or honor of, someone they love. We have grown from 200 runners to 328, which, for our little town, is amazing. What has transpired is a celebration of lives, in the midst of pain. We have become a community of people, brought together by a commonality we would rather not have, but do. And in that, we have found one another. Friendships have forged, and lives have been touched. People continue to come, in growing numbers, because we are more than a race, we are a place of healing, of celebration, and of love.

And as I begin to plan the 5th annual Bruce A. Waite Miles for Meso 5k, I am energized by those who travel to Ontario, Ohio in September to be a part of something bigger than we can understand. We run, walk, volunteer, and donate to give honor to those we love. And their legacy is the greatest gift we can give others, by doing what we can to eradicate this disease. As long as there is a need, we will do our part to help raise money for mesothelioma research, through the work of the Mesothelioma Applied Research Foundation.

The 5th annual Bruce A. Waite Miles for Meso will be held Sunday, September 18, 2016, at 2:00pm in Ontario, Ohio. Registration opens March 25 at www.brucewaite5k.com.

BREAKING NEWS: Avelumab Results for Mesothelioma Treatment Released

Dr. Raffit Hassan of the National Cancer Institute, and former chair of the Mesothelioma Applied Research Foundation’s Science Advisory Board, announced results of the Phase 1 clinical trial of avelumab at the most recent ASCO (American Society of Clinical Oncology) meeting in Chicago.

Avelumab, an anti-PD-L1 antibody, works on the basis of boosting the immune system. PD-1 inhibitors have already shown great promise in melanoma, renal cell carcinoma and lung cancer, demonstrating both tumor shrinkage and durable responses.

The study included 53 patients with pleural and peritoneal mesothelioma.

The main goal of this study was to determine a safe dosage, and overall assess the safety of the drug. In this case, identified side-effects were mostly minor and included infusion-related reaction, fatigue, and fever. In 7.5% of patients, more serious side-effects were identified, including 1 patient with colitis.

The analysis of the response of patients in the study yielded the following:

    Objective response rate (ORR) was 9.4%, with five partial responses (four confirmed);
    response was ongoing in four of five of those patients;
    the median duration of response was not reached;
    25 patients had stable disease (47.2%), and the disease control rate was 56.6%;
    the median progression-free survival (PFS) was 17.1 weeks; at 24 weeks, the PFS rate was 38.4%.

The study had no treatment-related deaths.

“Though it was a negative study, there is a role for PD-L1 inhibitors in mesothelioma. We will soon begin to see new combinations surface that combine PD-L1 inhibitors with other agents,” said Mary Hesdorffer, NP, Executive Director, Mesothelioma Applied Research Foundation.

Mesothelioma Diagnosis and Family Planning: Are They Mutually Exclusive?

“I can’t believe we’re at a point at which we’re discussing fertility at a meeting about mesothelioma,” said a moderator during a session at the International Mesothelioma Interest Group’s (IMIG) meeting at the beginning of May, in Birmingham, United Kingdom.

The speaker at the podium who elicited such a response was Gleneara Bates, MSW, a researcher at Columbia Presbyterian in New York City, and a community education and outreach volunteer for the Mesothelioma Applied Research Foundation. For anyone who knows about mesothelioma, the reason for such a response is clear: With a median overall survival of 12 months, it is commonly accepted that a mesothelioma patient, especially a female one, does not have enough time for parenthood.

Ms. Bates begs to differ.

In her presentation at IMIG, Ms. Bates acknowledged that within the mesothelioma medical community, it is generally known, though not fully understood, that women tend to live longer than men. As she delved further into data, she also explained that that’s only half of the story. In fact, when it comes to peritoneal mesothelioma, premenopausal female patients can live three times (or more) longer than postmenopausal women or men. Some female patients at Columbia Presbyterian in New York City, where Ms. Bates works, are still alive and doing well 8 and 9 years after diagnosis.

“What happened is they were diagnosed, they were very sick, they underwent aggressive treatment, and now, several years out from diagnosis, they find themselves wanting a child but no longer have that option available to them,” said Ms. Bates in an interview with the Mesothelioma Applied Research Foundation.

Ms. Bates became interested in cancer research after watching her mother battle the disease. Following the completion of her master’s degree in social work, Ms. Bates accepted a position at Columbia University Medical Center where she began to study quality of life issues in peritoneal mesothelioma patients treated at that clinic. That line of research, however, only helped to amass a whole new set of questions that she felt needed answers.

“From there, I spent about two years just focusing on creating cell lines from our patients, then treating those cells with the same regimens the patients had received in the clinic. I looked at tissue penetration, how long the platinum lingers in the blood and in the tissue. That got me on the path of seeing differences between mesothelioma in males and females.”

“We then informally reached out to many of our female patients to hear their story. The common thread was that their doctors insisted on immediate treatment without any fertility counseling, something commonly offered to male patients.”

In our conversation, Ms. Bates would only venture to guess as to why such a double standard might exist. One guess is that when survival from an incredibly aggressive cancer is at stake, fertility simply isn’t a priority for the doctor, as much as the patient. The reality is that harvesting and freezing eggs is a more complicated and lengthy process than harvesting and freezing sperm. Some clinicians have argued that the time it takes to complete one such egg harvesting cycle is valuable time that the patient could be undergoing treatment. Ms. Bates disputes this notion by observing that the time between diagnosis and first treatment is rarely less than 10.6 months for premenopausal women, a lengthy window of opportunity to work out any fertility issues of interest to the patient. Not to mention that fertility technology has seen monumental advances in recent years, some possibly beyond the expertise of mesothelioma clinicians.

Another guess is that perhaps certain antiquated social biases related to child rearing, combined with the fact that women make up a very small percentage of mesothelioma patients, might be the cause behind the lack of urgency in updating treatment guidelines to include family planning.

Whether or not her suggestions can become accepted in clinic is yet to be seen, but for Ms. Bates, research continues. She plans on furthering her study into the possibility that certain sex hormones are the reason why women are living longer.

“If that’s true, and if we can identify the cause of prolonged survival in women, we can take that knowledge and apply it to men. Taking a deeper look into this phenomenon can be beneficial for everybody.”

BREAKING NEWS: Peritoneal Mesothelioma Surgery Specialist to Join University of Chicago Team

As of June 1, Dr. Kiran Turaga, a surgeon from the Medical College of Wisconsin, will be joining Dr. Hedy Kindler and the University of Chicago Medicine’s mesothelioma team.

Dr. Turaga began his career at the Medical College of Wisconsin in 2010. His interest has focused on peritoneal surface malignancies and regional therapies, which includes HIPEC.

HIPEC is short for hyperthermic intraperitoneal chemoperfusion, a treatment usually performed after debulking surgery in peritoneal mesothelioma patients where heated chemo is pumped into the abdominal cavity.

“I started at the Medical College of Wisconsin in 2010, with an interest in peritoneal surface malignancies and regional therapies. HIPEC is a prime way of applying regional chemotherapy. With it, we met an unfulfilled need in the state of Wisconsin since there wasn’t anyone doing it in a formal way. As our program grew we brought along a lot of research and a lot of data,” said Dr. Turaga in an interview with the Mesothelioma Applied Research Foundation.

Although Dr. Turaga has been working closely, in a partnership, with the University of Chicago team and Dr. Kindler over the years, he is excited about the progress they will be able to make being on the same platform.

“Hopefully, together, we can make a big difference for patients with mesothelioma,” he added.

Dr. Turaga’s new position as the vice chief of surgery in the section of general surgery and surgical oncology will allow him the opportunity to shape the work of the center as well as supervision over the university’s fellowship program.

“We’re going to be training surgical oncology fellows. It’s a great opportunity to train leaders of the future,” Dr. Turaga said.

Dr. Turaga and his wife were married in Chicago, so this move is a bit of a homecoming as they move their family of four to the Windy City.