Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
A patient with this cancer typically demonstrates mesothelioma symptoms between 15 and 50 years after initial exposure to asbestos. Unfortunately, the cancer can take decades to develop and symptoms do not arise until after the cancer is present. So many patients are unaware of the severity of their condition because mesothelioma symptoms often resemble those of less serious illnesses.
Mesothelioma symptoms rarely arise at an early stage, which is why the disease is commonly diagnosed at a late stage of development. Anyone who has been exposed to asbestos should undergo chest X-rays or pulmonary function tests to check for signs of asbestos inhalation.
Defeating Mesothelioma – There Is Cause For Hope
But, this is a message of hope which brings us to our case study: a 27-year-old female white-collar worker who was diagnosed in 1998 with mesothelioma eight and one-half years following her first exposure to asbestos as a bystander to debris in a site in which asbestos-containing building materials were being dismantled and rebuilding work took place. She began to suffer back pain for a year and a half. Eventually, she underwent surgery and special treatment (extrapleural pneumectomy and received an intrapleural infusion of cisplatin post-operatively). Following a careful study, exposure to asbestos was verified by contemporary reports and lung biopsy, which demonstrated asbestos bodies and microscopic interstitial fibrosis – confirming evidence that she suffered from asbestosis. Twelve years after diagnosis and fourteen years after onset of mesothelioma symptoms, the patient is alive and well. The combination of an extremely short latency period and long survival following occupational exposure to asbestos dust is unique.
Asbestos Exposure From Demolition Construction
The 27-year-old female patient recalled her first asbestos exposure to dusts during intensive demolition/construction activities at her workplace, an airport office. This was the first job in her life, when drafted into the military, and the work began in 1989 when she was 20 years of age. She continued with this job for approximately 6 years. Co-workers under judicial investigation recalled seeing asbestos wallboard and debris at the site. Her work routine included excessive work hours, sleeping on site and irregular work shifts (approximately 5000 hours of passive, intermittent, exposure to airborne dust). During the fourth calendar year, she became pregnant and got post labor permission for 3 months. No measurements of concentrations of asbestos, constituents of environmental tobacco smoke, man-made-vitreous-fibers and respirable particulate, dusts or gasses were carried out. Information was not available on the mix of fibers in the dusts which she inhaled during demolition at her work site. However, Dr. Joseph Ribak, chief of occupational medicine at a major national health care provider, did report in a newspaper article in 1989 during the same time the patient was exposed stated that her work site was one of several with acoustic ceilings sprayed with asbestos fibers [1]. It is also commonly known that in Israel, the fiber mix of most asbestos construction products was approximately 90% chrysotile -10% amphiboles [2].
The patient’s history of exposure to asbestos and questions concerning her exposure as bystanders to asbestos or talc in family, work, home, or hobbies were all negative. For example, her father worked as a police officer and her mother as a housewife, partially self-employed in sewing jobs. No other working adult lived in the household. Based on an official list of all her past addresses, research double-checked those obtained by detailed anamnesis confirming no history of residency near asbestos cement plants or brake lining plants from infancy onward. She denied having contact with Thorotrast. The patient had only been exposed to asbestos at her work site.
Conclusion
This patient was diagnosed with asbestosis and mesothelioma eight and one-half years following asbestos exposure independently reported at the time of its occurrence. She has survived twelve years post diagnosis and resection. Although unexpected longevity has been reported elsewhere [3,4], in this case there is no scientific explanation for the long survival despite the very short latency.
Hope For A Mesothelioma Cure
For patients who have not had the opportunity of a short latency, there is still hope for a mesothelioma cure found in the research of Dr. Parkash Gill and the soon to be launched FDA controlled national Phase III clinical trials of Veglin on mesothelioma cancer patients.
Many oncologists project the average post-diagnostic malignant mesothelioma survival time in sufferers between one and two years. Also, traditional mesothelioma treatments have had no success in eradicating the disease and have produced limited success in extending patient survival time. Therefore, new and experimental mesothelioma treatments have become increasingly popular as an option for cancer sufferers.
A new approach in finding a mesothelioma cure is a drug called Veglin being studied by Dr. Gill at the USC/Norris Comprehensive Cancer Center. Veglin is one of several newly developed non-chemotherapy drugs being tested in the ongoing struggle to combat malignant mesothelioma. The new drug is an anti-angiogenesis agent that works by cutting off the blood supply that cancer cells need in order to grow. Veglin is currently in the last part of Phase II Clinical Trials with the FDA and Phase III trials should begin sometime in 2011. More information on Veglin and the trials to be had nationally can be found at http://www.mesorfa.org/treatments/veglin.php. Patients interested in taking part in the next clinical trial should talk with their doctor, and contact Dr. Parkash Gill.
References
- Valentin A: End of asbestos era. Haaretz, Weekend Magazine; 1989:12.
- Richter ED: Asbestos exposure in Israel: Findings, issues and needs.
Israel J Med Sci 1984, 20:89-97. PubMed Abstract
- Fischbein A, Suzuky Y, Selikoff IJ, Bekesi JG: Unexpected longevity of a patient with malignant pleural mesothelioma: report of a case.
Cancer 1978, 42:1999-2000. PubMed Abstract | Publisher Full Text
- Neuman V, Müller KM, Fischer M: Malignant Mesothelioma-German mesothelioma register 1987-1999.
Int Arch Occup Environ Health 2001, 74:383-395. PubMed Abstract | Publisher Full Text
