Mediastinoscopy: International Mesothelioma Program (IMP) Pre-Op Test

Patients at the International Mesothelioma Program (IMP) at the Brigham and Women’s Hospital in Boston, Massachusetts who have a confirmed diagnosis of malignant pleural mesothelioma routinely undergo a series of tests to determine the type of surgery they need.  One of these tests is called a “cervical mediastinoscopy,” which is used to biopsy the patient’s lymph nodes.  This test helps assess how far the cancer has spread.  This information, in conjunction with other test results, is used to help determine if the patient is a candidate for either a pleurectomy or an extrapleural pneumonectomy.

Cervical Mediastinoscopy Used to Biopsy Lymph Nodes

The International Mesothelioma Program  is one of the leading treatment centers for malignant pleural mesothelioma.  According to Dr. David Sugarbaker, who is Chief of Thoracic Surgery at the Brigham and Women’s Hospital and the founder and Director of the International Mesothelioma Program, the IMP consulted with over 300 malignant pleural mesothelioma patients last year and performed over 160 surgeries.  As part of the screening process for surgical candidates, a cervical mediastinoscopy is performed at the hospital to determine if the cancer has spread to the mediastinal lymph nodes.

A cervical mediastinoscopy is a hospital procedure performed under general anesthesia used to biopsy lymph nodes in patients with malignant pleural mesothelioma.  The surgeon makes an incision in the patient’s neck at the top of the sternum.  The mediastinoscope, which is a thin tube with a light and surgical instruments, is then placed through the incision where tissue samples are taken from the mediastinal lymph nodes.  The patient’s biopsied tissue is analyzed by a pathologist to determine if the malignant mesothelioma has spread to the mediastinal lymph nodes.  The IMP’s surgical team, led by Dr. Sugarbaker, uses this information to determine whether the patient is a surgical candidate and if so, the type of surgery that will be performed.

Published Research on Importance of Cervical Mediastinoscopy

In 1999, Dr. Sugarbaker and his colleagues published an article entitled, “Resection Margins, Extrapleural Nodal Status, and Cell Type Determine Postoperative Long-Term Survival In Trimodality Therapy of Malignant Pleural Mesothelioma:  Results in 183 Patients” in the Journal of Thoracic and Cardiovascular Surgery. Dr. Sugarbaker described the importance of mediastinoscopy as a staging tool for patients with malignant pleural mesothelioma.  A similar conclusion concerning the importance of cervical mediastinoscopy was reached by British physicians in a published article entitled, “The Case for Routine Cervical Mediastinoscopy Prior to Radical Surgery for Malignant Pleural Mesothelioma” in the European Journal of Cardio-Thoracic Surgery in 2004.

Recent Research Developments May Lead to New Treatments for Cancer and Mesothelioma

Science advances daily as researchers learn more about how cancer develops and how normal cells turn into tumors.  With this knowledge, scientists and physicians develop new treatment plans that may eventually lead to a cure for cancer. A recent finding by researchers at the University of Pittsburgh Cancer Institute and University of Pittsburgh School of Medicine has shed light on a key aspect of tumor growth.

These researchers recently discovered a protein that may be the key molecule in controlling the balance between tumor growth and suppression.  Scientists have discovered that the Kruppel-Like factor 4 (KLF4) is one of the molecules known to play a role in transforming mature cells back into stem cells.  This molecule has been shown to promote tumor growth in some cases and suppress tumors in other cases.  Learning more about the role of molecules such as the KLF4 may lead to new cancer drugs and treatments for many cancers including mesothelioma.

New Cancer Discoveries and Clinical Trials

Clinical trails are borne from discoveries such as this.  Clinical trials offer the best hope for someday discovering a cure for devastating diseases such as mesothelioma.  These trials offer new treatments and medications that would otherwise not be available to patients.  Clinical Trials can help increase a patient’s quality of life and longevity.  The results from clinical trials often help to determine the future for cancer and mesothelioma treatments.  There are hundreds of clinical trials taking place every day.  If you have been diagnosed with mesothelioma, I urge you to discuss clinical trials with you primary care physician.  Based on your diagnosis they can recommend a clinical trial that may be right for you.

Closer to a Cure

Through my 30 years of representing clients with mesothelioma, I have been continually amazed at the advancements made each and every day in the field of mesothelioma and cancer research.  Each new discovery brings doctors and researchers closer to finding a cure for devastating diseases like mesothelioma.  I look forward to the day I can finally tell my present and past clients that a cure for mesothelioma has been discovered.

 

“The House” at the International Mesothelioma Program (IMP)

The housing options offered to mesothelioma patients is one of the most helpful avenues of support provided by the International Mesothelioma Program (IMP) at Brigham and Women’s Hospital in Boston.

Being diagnosed with mesothelioma is overwhelming enough, but worrying about where to seek treatment and where to stay while undergoing treatment only add to the stress these patients face.  Treatments can last weeks sometimes months and hotel bills can get very costly.  The IMP has made it a part of its mission to provide a solution to this problem for its patients.

“The House”

Across the street from Brigham and Women’s Hospital in Boston, Massachusetts is a triple decker house located at 48 Francis Street. Mesothelioma patients and their families commonly refer to it as “The House.”  The House which is owned by the hospital opened its doors in 2008.  The families of mesothelioma patients who are undergoing treatment can stay at the House for a small per night donation.

The House has three floors. The second and third floors can accommodate up to three families; the first floor up to two families.  The families share a comfortable living room, fully equipped kitchen, and back deck area.  Each family has their own fully furnished private bedroom.  Having the shared living spaces provides families with an area where they can congregate at the end of the day to share stories, talk or just silently support one another.

One of my clients who received his mesothelioma treatment at the IMP stayed at the House for three weeks during his surgery, treatment, and recovery.  He and his wife described the House as “their home away from home.”  They found the House to be very comfortable and convenient.  My client’s wife especially appreciated being able to get together with the other wives at the end of a long day.

I had the pleasure of visiting the House a number of times.  I was very impressed.  The House is a beautiful home for patients and their families who have to travel from far away for treatment.

Support System for Families and Patients

While staying at the House, families and patients have a chance to connect with others who are going through the same experiences and emotions.  Families and patients provide one another with support, encouragement, hope and comfort.

Families have the opportunity to gather at the end of the day, eat meals together, share stories or just relax.  My client and his wife became very close with the families with whom they shared the House.

Mesothelioma is a unique cancer and treatment can be strenuous.  Being surrounded by people who can relate to their experiences provides a special kind of support that patients and their families cannot find elsewhere.

The team members of the IMP are also a part of the support offered at the House.  Doctors, nurses, chaplains, social workers, and counselors are always available to cross Francis Street and tend to the needs of their patients and loved ones.

Not Just a House

The House at the IMP is not simply a house but it is a home, shelter and haven for mesothelioma patients and their families.  The House provides care, support and respite for patients and their caregivers.

For reservations, contact social worker Charlene Haouiliya at (617) 732-5500, ext. 32819.

International Mesothelioma Program (IMP) Patient Matching Program

Over the 30 years that I have represented mesothelioma clients, I have seen many advancements in the field of mesothelioma.  The treatment and care of today’s patients is much more focused on the whole patient not just the disease.  The International Mesothelioma Program (IMP) at Brigham and Women’s Hospital in Boston is one of the outstanding facilities that is in the forefront in its approach to treating the entire patient both physically and mentally.  The IMP provides comforting support for patients in many different ways, from offering social workers’ guidance to organizing support groups to developing its “Patient Matching” program.

“Patient Matching” Program at the International Mesothelioma Program

The “Patient Matching” Program connects current patients at the IMP with mesothelioma patients who are about to undergo similar treatment and experiences.  The program was designed to offer perspective and hope to patients who recently received a devastating diagnosis of mesothelioma.  Receiving such a diagnosis can leave a person with many frightening questions.  The “Patient Matching” program at the IMP is created to comfort patients through hearing information directly from someone who has been in their shoes.

I have seen the benefits of patient matching firsthand through the eyes of two of my clients who were connected through this program.  One client was just finishing his treatment at the IMP and my other client had just received the debilitating diagnosis of mesothelioma and was at the IMP for his first treatment.  They found a kinship and bond in sharing their stories and advice about their diseases.  My client who was recently diagnosed was reassured by his new found friend’s encouragement and explanations of the treatment he received at the IMP.

Dr. David Sugarbaker, Founder, Director and Chief of Thoracic Surgery of the International Mesothelioma Program, understands the devastating emotional effects this disease has on patients and their families.  Dr. Sugarbaker, explains ”  Mesothelioma takes an emotional toll on patients and their families that cannot be underestimated; it can be nearly as significant as the disease itself.”  The IMP has developed many programs including the “Patient Matching Program” to help deal with these emotional issues.

 

I firmly believe that a positive outlook and support can help one fight a devastating disease such as mesothelioma.  A healthy mental state is just as important as a strong physical state.  I have seen many of clients thrive due to emotional support they have received during their treatment.  The Patient Matching Program at the IMP provides patients with great encouragement and much needed support.  The IMP goes above and beyond to ensure every aspect of the mesothelioma patient is tended to.

Support for the Mesothelioma Caregiver at the International Mesothelioma Program (IMP

Mesothelioma is a very serious and aggressive disease which is why patients must focus on their treatment as their top priority.  However, it is also important to remember that once treatment at the hospital has ended, it will be family or friends that will become the primary caregiver for the patient.  These caregivers need to be armed with the right tools to not only care for the patient but to care for themselves.  At the International Mesothelioma Program (IMP) at Brigham and Women’s Hospital in Boston, they have developed many programs over the years to aid in support for caregivers.  Dr. Sugarbaker, Director of the IMP, and his team know that once the mesothelioma patient is discharged from the hospital, the caregiver is on call 24 hours a day 7 days a week to make sure their loved ones’ needs are taken care of.

IMP Support Groups

The IMP has created Support Groups to help patients’ families and caregivers.  The meetings give families and caregivers a chance to share their stories with others who are dealing with the same issues.  Many often feel that their own circle of friends and family does not understand what they are going through.  The Support Group meetings at the IMP allow caregivers to connect with others who are facing similar challenges.

One of my client’s whose husband was treated at the IMP for his mesothelioma attended these Support Groups.  She found them extremely helpful and it gave her time to reflect and discuss the events of the week.  She enjoyed and needed the camaraderie and compassion she received from the Support Group meetings.

Recommendations for the Mesothelioma Caregiver

Caregivers are encouraged to ask questions of the medical team and social workers.  It is suggested that they bring a journal to doctor’s appointment and meetings with medical staff and take notes of important information and any prescriptions or medical advice.  The process of mesothelioma treatment can often feel like a whirlwind.  Keeping a journal will enable caregivers to recall later what was discussed at meetings and appointments.

Family and caregiver Support Groups at the IMP are valuable and inspiring for patients and caregivers.  However, keep in mind when talking to other families that each patient is different in their type of mesothelioma, how they are being treated and how they are reacting to treatment.  While one treatment may be right for one patient, it may not be right for another.

The IMP provides wonderful support for the mesothelioma patient as well as their family and caregiver.  The IMP takes great care to not only treat the disease but to treat the whole mesothelioma patient physically and mentally.

Throughout the many decades I have been representing clients with mesothelioma, I have observed the many aspects to this devastating disease and how it effect each person involved differently.  I commend the IMP for the support they provide to mesothelioma patients, their families and caregivers.

New Research Technique Offers Hope In Cancer and Mesothelioma Treatments

The New Year brings new and hopeful discoveries in the field of cancer research.  I recently read about a revolutionary discovery that will allow scientists to compare the differences between normal cells and cancer cells. Up until now, this could not be done because researchers weren’t able to keep normal cells taken from patients alive, even though they could keep tumor cells alive. New research techniques like this will enable scientists to better understand mesothelioma and other types of cancer-leading to better treatment options and ultimately cures.

Focusing Cancer Treatments on Each Patient

Cell Culture in a Petri Dish

Previously, normal cell cultures for most organs could not be created in a lab.  This made it impossible for researchers to directly compare normal cells and cancerous tumor cells.  Being able to study these cells side by side will provide oncologists with the ability to find the right treatments for each individual and spare normal cells from the toxicity of cancer treatments.

This study will also revolutionize the work that pathologist can do.  Today, pathologist can only work with biopsies that are frozen, fixed or embedded in wax.  In the future, pathologists will be able to use the information obtained from the live cells to diagnose tumors and screen treatments for patients.

Treatment for Mesothelioma

Just as each person is unique so is their mesothelioma.  A treatment that works for one patient may cause severe side effects or have no effect on another patient.  Scientists are conducting clinical trials every day to test and refine personalized cancer treatments. Research such as the recent live cell study at Georgetown University is key to being able to focus treatment on individual patients. This will bring us one step closer to finding a cure for this devastating cancer.

Cancer Research and Mesothelioma

I am constantly encouraged when I read of new discoveries being made in the field of cancer.  These discoveries are the gateway to advances in the treatment of mesothelioma.  I am looking forward to the new promise 2012 brings to the cure for mesothelioma and other cancers.

Third Annual Translational Cancer Symposium Focuses On Mesothelioma

Dr. Michele Carbone, the Director of the University of Hawai‘i Cancer Center, chaired the Third Annual Translational Cancer Medicine Symposium on December 2, 2011 hosted by the University of Hawai‘i and Queens Medical Center.  The focus of this year’s discussion was the recent discovery of the BAP1 gene mutation which has been linked to mesothelioma and other cancers.  I was very interested to learn firsthand from the many world renowned physicians and researchers in attendance about the cutting edge research being done in the field of mesothelioma.

Dr. Carbone and his team of researchers announced their discovery of the BAP1 gene mutation back in August.  This remarkable discovery is the first step in understanding how the BAP1 gene affects those at risk of developing mesothelioma.  This discovery will lead to new genetic therapies and treatments for this devastating cancer.

Carbone was Joined by Other Mesothelioma Researchers

Dr. Carbone was joined by other notable mesothelioma researchers, surgeons and scientists from across the world, some of whom were Dr. Joseph R.Testa of the Fox Chase Cancer Center in Philadelphia and Dr. Harvey A. Pass, a thoracic surgeon at NYU Langone Medical Center.  Dr. Harvey Pass who has been operating on mesothelioma patients for several decades stressed the critical importance of early detection of the disease mesothelioma. Also making presentations were members of Dr. Carbone’s Hawai’i team – Dr. Giovanni Gaudino as well as Dr. Haining Yang.

Collaboration Among Mesothelioma Researchers and Physicians

The role of researchers and physicians in the medical world vary greatly.  Researchers focus on the science of new treatments and cures while physician focus on the patient.  However, researchers and physicians have the same goal in mind, new and better treatments and cures for devastating diseases like mesothelioma. When researchers and physician collaborate and share information it can lead to innovative new treatments and a better understanding of diseases.  Collaboration and open discussion will no doubt translate into positive medical benefits for the future.

Dr. Carbone’s mesothelioma-melanoma symposium encouraged lively discussion and exchange among researchers and physicians.  It was truly wonderful to witness scientists working together with clinical physicians for the betterment of patients diagnosed with horrific cancers such as mesothelioma.  It is forums like this that will someday lead to a cure for mesothelioma.

Remembering Pearl Harbor Day

December 7, 2011 will mark the 70th anniversary of the attack on Pearl Harbor.

Pearl Harbor Remembrance Day is a time to reflect on the lives that were lost that fateful day, as well as the sacrifices made in the following years as World War II raged on.

For over 30 years I have been representing workers who contracted mesothelioma caused by exposure to asbestos in their workplace.  The first mesothelioma victim that I represented in 1978 had worked as an electrician at Pearl Harbor Naval Shipyard. Over the years, I have represented thousands of people with asbestos-related diseases who had worked at Pearl Harbor.

In the early 1980’s many of my clients had worked at Pearl Harbor during World War II as part of a national effort to rebuild and maintain the US fleet after the tragic attack at this very shipyard. Because of their work, they were exposed to asbestos dust. Unaware of the deadly hazard this posed, they breathed this dust and some workers decades later contracted mesothelioma, a lung cancer caused only by asbestos.

Whenever I think of these former World War II Pearl Harbor workers, I am reminded of the sacrifice they made. They contributed to the same war effort as those who lost their lives on December 7, 1941. And sadly, they met the same fate as the 2,403 victims of the Pearl Harbor attack.

Tomorrow I will remember all of the victims of Pearl Harbor.

Thanksgiving Reflections

As we gather with family and friends this Thanksgiving holiday, it is a time to reflect on all that we are thankful for.  I am extremely thankful to be surrounded by wonderful people in my life and to have met many special clients through my work as a mesothelioma attorney.

When I think of my clients, I am especially grateful to all of the doctors and researchers who are working everyday to find a cure for this devastating cancer.  I have written many articles on the new and exciting medical and scientific advances that are on-going in the search for new treatments, and hopefully a cure, for mesothelioma and many other cancers.  I am continually astounded by the hard work, dedication, and creativity of these doctors and researchers.

It is their unrelenting determination that will someday lead to a cure for mesothelioma. I am thankful for their efforts and will be eternally grateful when this disease is finally cured.

New Treatment for Resistant Tumors Shows Potential for Mesothelioma Patients

Throughout the many decades that I have been representing clients with mesothelioma, I have seen many significant advancements in the field of cancer and mesothelioma research.  Most recently I read about a new therapy that has been tested in a Phase 1 clinical trial and has shown promise in the treatment of mesothelioma tumors.  Each new treatment and discovery that is made for this devastating disease takes us one step closer to someday finding a cure for mesothelioma.

A Promising New Therapy

One of the therapies used to treat cancerous tumors works by inhibiting the growth of blood vessels around the tumor thereby stopping the spread of the cancer cells.  This is called “antiangiogenic therapy.”

Despite the advances that have been made with this therapy, many tumors manage to escape this blockade.  Recently, a new study reported that targeting a novel antiangiongenic receptor may be a promising treatment for patients whose tumors do not respond to the current therapy. This finding was reported at an International Conference on Molecular Targets and Cancer Therapeutics. The American Association for Cancer Research, the National Cancer Institute and the European Organization for Research and Treatment of Cancer were all part of this international conference

The experimental therapy is called PF-03446962.  This therapy is aimed at targeting proteins in the body that grow and divide specialized cells such as the kinase 1 protein(ALK-1).  PF-03446962 is an antibody that has been developed for humans explicitly meant to stop the activity of ALK-1.

The Results of the Initial Study

Researchers tested this new therapy in a Phase 1 clinical trial which showed the treatment demonstrated anticancer activity in tumors.  Dr. Fillipo de Braud, was the director of the European Institute of Oncology when this study was conducted.  He and his colleagues tested eight different doses of PF-03446962 on 44 patients with cancerous tumors.  The patients who showed the most improvement had previously been treated with antiangiogenic therapy for lung, renal, or liver cancer.  The 2 patients who showed the longest response to this new treatment had been diagnosed with adrenocortical cancer and mesothelioma.

I am anxiously awaiting the results of more studies involving this new therapy, PF-03446962, and especially its effect on mesothelioma tumors.

Clinical Trials Offer Hope

Many of my clients suffering from mesothelioma have taken part in clinical trials. I encourage anyone who has been diagnosed mesothelioma to discuss clinical trials with their doctors to determine whether they may be a candidate for a clinical trial. Your doctor will explain the benefits and risks as they relate to your particular circumstances. There are new clinical trials taking place every day.  Clinical trials offer great hope to patients in finding new treatments and therapies for mesothelioma.  Clinical trials are also our best hope at someday finding a cure for this devastating disease.