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Navigating the Maze of Malignant Mesothelioma

Malignant mesothelioma, a rare cancer that develops on the mesothelial membranes around internal organs, impacts an estimated 3,000 people annually in the US. It is considered incurable and is usually caused by occupational exposure to airborne asbestos.

Mesothelioma

Research has suggested that the size and shape of microscopic asbestos fibers make them highly biopersistent and carcinogenic. Asbestos’ toxicity has also been linked to its ability to alter the balance of iron in the body. Coupled with a person’s unique genetic makeup, the chronic oxidative stress brought on by these factors may give rise to mesothelioma many decades after exposure. The disease’s long latency period often causes delayed diagnosis and is believed to be partially responsible for the low Mesothelioma treatment response rates.

Types of Mesothelioma

Mesothelioma of the pleura is the most common form of Mesothelioma, accounting for as many as 75 percent of cases in the US annually. Although this form of Mesothelioma impacts the lungs and causes many of the same symptoms as lung cancer, it is typically less responsive to treatment than lung cancer. Most patients diagnosed with Stage IV pleural Mesothelioma have a life expectancy of less than 12 months or less.

Systemic chemotherapy with pemetrexed (Alimta) and cisplatin or carboplatin is the current standard of care for pleural Mesothelioma. Pleurectomy with decortication (P/D) and extra pleural pneumonectomy (EPP) are the primary surgical interventions. Both carry a significant risk of morbidity and mortality and Mesothelioma experts are divided as to which approach is preferable. Careful patient selection is critical for positive outcomes.

Peritoneal Mesothelioma is rarer but typically carries a slightly longer life expectancy. A combination approach including cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) is improving the outlook for many patients with this rare cancer.

Rarer sites for Mesothelioma include the testis and the pericardium around the heart.

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Learning from Mesothelioma Survivors

Despite the poor prognosis that usually accompanies a Mesothelioma diagnosis, there are a growing number of survival stories from patients who have used alternative, holistic, or combination approaches to combat their cancer.

Surgery Survival Story

Thirty-eight year old John Panza was diagnosed with pleural Mesothelioma after having been exposed to asbestos dust on his father’s work clothes as a child. Given his young age and otherwise good health, Mesothelioma experts at the Cleveland Clinic recommended the most radical type of Mesothelioma surgery for Panza – extra pleural pneumonectomy (EPP).

During EPP, surgeons remove the entire diseased pleura, the affected lung, the pericardium, all or part of the diaphragm, and any other tissues deemed to be at risk for new Mesothelioma tumors. Panza underwent three rounds of neoadjuvant chemotherapy prior to the 9-hour surgery and had 27 sessions of adjuvant radiation afterward. Despite having developed an infection in the space where his right lung had been and experiencing some one-sided sympathetic nerve damage, Panza remains cancer-free and is living today with few physical side effects from his ordeal.

“I am just someone who was diagnosed with an incurable cancer, who received an aggressive palliative treatment regimen, and who has lived longer than the average for Mesothelioma patients while still maintaining a good quality of life,” says Panza.

Immunotherapy Drugs

Immunotherapy drugs are designed to interrupt mechanisms that allow cancer cells to “hide” from attack by the immune system. As they have with other types of cancer, immunotherapy drugs have been the source of some of the best news for Mesothelioma patients in recent years.

One of the most promising appears to be pembrolizumab (Keytruda), a monoclonal antibody that blocks a cell protein named PD-1, that is expressed as a large percentage of Mesothelioma cases. Keytruda was okayed by the Drug Enforcement Authority in 2014 and gathered serious public attention as a prospective Mesothelioma remedy after what researchers called “unprecedented” response rates.

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In a pivotal trial, 76 %of Mesothelioma sufferers reacted to treatment with Keytruda. Mesothelioma tumors temporarily stopped growing in about half of the patients and around a 1/4of the patients actually saw those tumors begin to shrink. Keytruda also produced fewer serious side effects than conventional chemotherapy for Mesothelioma.

One man who credits his 4+ year survival, in part, to Keytruda is Jim McHutchison of York, Maine. McHutchison was diagnosed with pleural Mesothelioma in 2013 and given six months to a year to live. But after more than a year on Keytruda, McHutchison says the news is such a welcome relief.

Other immunotherapy drugs are in development for Mesothelioma and participation in clinical trials of these drugs has become a viable treatment option for many newly-diagnosed and relapsed Mesothelioma patients.

Alternative Therapies

Other Mesothelioma patients have taken a different and somewhat more radical approach to treating their asbestos cancer. Seven-year Mesothelioma survivor Andy Ashcraft of California was told he had just three months to live when he was diagnosed in 2010. After standard chemotherapy, the monoclonal antibody amatuximab, and surgery failed to stop the progress of his cancer, Ashcraft’s search for alternative therapies led him to experiment with cannabis oil.

Although there are few experiments looking into cannabis oil in cancer sufferers, evidence suggests that the primary active ingredients, tetrahydracannabinol (THC) and cannabidiol (CBD), cause a buildup of ceramide, eventually killing the mitochondria that Mesothelioma cells need for energy. The excess ceramide also disrupts the “digestive system” of cancer cells and their ability to metabolize calcium. The key to the success of the system seems to be maintaining a steady therapeutic dose of CBD and THC over time.

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In January of 2013, Ashcraft commenced on a very tiny dosage of cannabis oil, that he got through California’s Medical Marijuana Center. Within a couple of months, he incorporated an array of other natural oils intended to keep his Mesothelioma in balance and enhance his immune system .To this day, he has never experienced any Mesothelioma setback which was supposed to kill him many years ago.

A Tailored Protocol

Paul Kraus is known as the world’s longest-living Mesothelioma survivor and is the author of several books including the bestselling “Surviving Mesothelioma and Other Cancers: A Patient’s Guide”. In 1997, he was diagnosed with widespread peritoneal Mesothelioma during a minor abdominal surgery. Given little hope of survival, Kraus worked with his team of physicians to create the tailored protocol he credits with saving his life.

Kraus’ unique approach to his Mesothelioma included dramatic changes to his diet and lifestyle, experimental therapies, mind-body medicine, and other modalities, all of which he details in his book. Kraus continues to believe that “a diagnosis is not a destiny” and is sticking with his healthy lifestyle regimen.

Editorial

Editorial Staff at Healthable is a team of Writers and Experts.

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