There was plenty of good news within the tight-knit mesothelioma community in 2013, but some of it was mixed with disappointment.
While significant advancements were made that continued hope for the future, there were reminders the fight against mesothelioma cancer remains an uphill battle. There is much work still to be done.
Surgical techniques improved. Therapies got better. Diagnostics moved forward. Yet the progress on all fronts has been too slow, requiring more diligence and more commitment to raising awareness about this rare, but aggressive cancer caused by exposure to toxic asbestos.
1. Robotics Changing EPP surgery
Mesothelioma patients began benefiting from robotics in a big way in 2013 when University of Arizona Health Network surgeon Farid Gharagozloo, M.D., started performing extrapleural pneumonectomies (EPP) using the da Vinci Surgical System.
Although robotic surgery has been used for more than a decade, it was for less invasive procedures. Gharagozloo became the first in the world to use it for the aggressive, open-chest EPP that removes an entire lung and parts of a patient's diaphragm.
The benefits are a safer procedure, a dramatic drop in blood loss, and a much-quicker recovery, all of which could alter the perception of the EPP, from which patients often struggle.
"Without a doubt, this is a game changer for mesothelioma," Gharagozloo told Asbestos.com
2. Feds Defund Key Mesothelioma Tissue Bank
Mesothelioma research took an unwelcomed hit in 2013 when the National Mesothelioma Virtual Bank lost its main funding source. The mesothelioma tissue bank, which includes more than 1,300 bio specimens and 1,100 annotated cases for researchers around the world, was the only federally funded program specifically designed for mesothelioma research.
The decision to drop the annual $1 million grant was made by the National Institute of Occupational Safety and Health (NIOSH) and the Centers for Disease Control (CDC). It could cripple the tissue-bank program. Many other cancer-research programs were only marginally reduced, while the mesothelioma funding was eliminated entirely.
"This was not good," said Michael Feldman, M.D., PhD, respected professor of pathology at the University of Pennsylvania School of Medicine. "We expected to take a cut and see funding reduced. But to have it just yanked with virtually no warning, it was pretty shocking."
3. Lauter, Sasser Join List of High-Profile Mesothelioma Victims
The list of high-profile Americans killed by mesothelioma cancer continued to grow in 2013 with the addition of veteran character actor Ed Lauter and MTV celebrity Sean Sasser.
Sasser, 44, and Lauter, 74, joined a list that includes Merlin Olsen (football player, actor, broadcaster, 2010), Hamilton Jordan (White House Chief of Staff, 2008), Warren Zevon (musician, 2003) Bruce Vento (U.S. Congressman, 2000) and Steve McQueen (actor, 1980).
Lauter appeared in more than 200 films and television projects. He was diagnosed with mesothelioma in May and died in October. Sasser rose to fame as an AIDS activist who appeared in the reality television show "The Real World of San Francisco," in the early '90s. He died in August, only six weeks after being diagnosed with mesothelioma.
4. Landreneau Brings Mesothelioma Expertise to Gulf South
Renowned thoracic surgeon Rodney Landreneau - who carved his reputation the last 20 years at the University of Pittsburgh Medical Center - filled a huge void in his home state of Louisiana by bringing his much-needed expertise in mesothelioma to the Ochsner Cancer Institute in New Orleans.
Louisiana has one of the highest rates of mesothelioma incidence in the country, but previously lacked a specialty center with expertise in treating it. Shortly after arriving, Landreneau performed the first surgical debulking/hyperthermic chemoperfusion for pleural mesothelioma in state history.
As the new director of the Ochsner Cancer Institute, Landreneau expects to build a program to serve the entire Gulf South region, where past shipping and ship building created an environment where mesothelioma thrived.
"There has been a large underserved population here for too long," he said. "I see this as a great opportunity to help a lot of people from my home area."
5. Promising Clinical Trial Involves Critical Mesothelioma Stem Cells
The start of a promising international clinical trial that involves the targeted killing of mesothelioma cancer stem cells and the inhibitor defactinib (VS-6063) has raised hopes for the future of therapy.
Stem cells represent only a small percentage of cells in a tumor, but they are the primary reason for recurrence of the cancer and a major cause of tumor resistance to chemotherapy.
Defactinib already has shown considerable promise with other cancers, but this is the first time it is being tested with mesothelioma. The trial includes 350-400 patients across 11 countries.
"The investigators working on this trial are excited about the promise," said oncologist James Stevenson, M.D., principal investigator at the Cleveland Clinic. "The potential is there. It could be a big step forward for mesothelioma patients. It could become the next drug to be used."
6. Mesothelioma Research Producing Better Treatment Options
Researchers at the National Cancer Institute uncovered a new drug combination in 2013 that unlocks a potent immunotoxin called SS1P, allowing it to work more effectively against mesothelioma cancer tumors, providing some hope for future treatment of the disease.
Although a strong immune system is often a good defense against serious illnesses, the ability to suppress the immune system with pentostatin and cyclophosphamide, in conjuction with SS1P, produced significant improvement during a recent clinical trial involving late-stage mesothelioma patients.
SS1P is known as a recombinant immunotoxin, a drug that links a bacterial toxin to an antibody fragment that can selectively target and kill cancer cells without harming healthy ones. In the past, a patient's immune system often produced antibodies that reduced the effectiveness of SS1P.
"We believe these findings were pretty significant," said NCI medical oncologist Raffit Hassan, M.D., lead researcher in the trial who detailed his findings at the World Conference on Lung Cancer in Sydney, Australia. "Everyone was pleasantly surprised."
7. Fear of Asbestos-Related Diseases Grows After 9/11
The 12th anniversary of the 9/11 terrorist attack on the World Trade Center rekindled the worries that many survivors have been feeling recently.
Although the years may have begun to dull memories of that horror, an uncertain future regarding asbestos-related diseases has grown even stronger for those who were engulfed in the toxic dust cloud that included more than 2,000 tons of pulverized asbestos and covered much of Manhattan.
Mesothelioma cancer, which is caused by inhaling or ingesting of microscopic asbestos fibers, normally has a lengthy latency period (10-50 years) before it is diagnosed.
"You can't really connect mesothelioma directly yet with 9/11 because of the long lag time that will be involved," Raja Flores, M.D., chief of thoracic surgery at New York's Mount Sinai Hospital, told Asbestos.com. "In 20 years, though, you'll see a bump (in the number of mesothelioma cases). It's common sense. Asbestos causes cancer. We're already been seeing it."
8. Mesothelioma Incidence Fails to Drop in 2013
Despite the dramatic drop in the use of asbestos in recent decades, the rate of mesothelioma cancer remained stubbornly steady, according to a 2013 report from the National Cancer Institute and its Surveillance Epidemiology and End Results (SEER) Program.
The report reiterated the need to strive for better therapy, earlier diagnosis and an eventual cure.
Although there was hope that a decline would begin soon, the annual incidence rate remained just above the 3,000 mark, where it has been the last 20 years.
The use of asbestos in America has dropped from a high of 803,000 metric tons in 1973 to a low of 1,180 metric tons in 2011. Experts believe the drop in mesothelioma has not started - and may even increase now - because of the lengthy latency period (10-50 years) between exposure to asbestos and a typical diagnosis.
9. Renowned Surgeons Step up to Help Veterans with Mesothelioma
U.S. military veterans will get the opportunity now to see some of the best mesothelioma specialists in the country through the VA Healthcare System if they are willing and able to travel.
Surgeons Avi Lebenthal, M.D., in Boston and Robert Cameron, M.D., in Los Angeles, both leaders in the mesothelioma specialty, stepped forward in 2013 and encouraged veterans everywhere to seek their services. Anyone in the VA healthcare system should be eligible to come to one of those specialty centers.
Along with their VA affiliations, Lebenthal is part of the Brigham & Women's Hospital and Cameron is with the UCLA Medical Center. He is part of a group lobbying to land the first federally funded mesothelioma research and treatment program at the West Los Angeles VA Medical Center.
10. Asbestos.com Expands its Reach to Provide More Help
Asbestos.com, already the Internet leader in support services for mesothelioma patients and families, expanded its reach in 2013 to provide help for those who need it the most.
There is a Mesothelioma Support Group now that meets online, or by phone once each month, to exchange ideas, share stories, ask questions and get answers about dealing with this disease. It is moderated by Dana Nolan, a licensed mental health counselor, and Karen Selby, the on-staff registered nurse.
The website also includes regular blogs to read from mesothelioma survivor Kasie Coleman, of Louisiana, and Lorraine Kember, former caregiver in Australia whose husband Brian died of mesothelioma. Both share helpful stories.
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