Clapper, Patti, Schweizer and Mason

Mesotheliomais a malignant tumor that arises in the mesothelium, more simply known as the thin lining on the surface of the lungs or abdominal cavities.  Malignant mesothelioma (MM) is typically due to exposure to asbestos.  Asbestos is a fire-resistant material once commonly used in insulation, ceiling and roofing products, cement, and brake linings. 

Most diagnosis of mesothelioma do not occur until the patient is in their 50’s to 70’s as there is a latency period of ten to forty years between the time of exposure and development of symptoms of the disease.  However, more cases of pediatric patients developing the deadly disease are being reported and studied.  Between 1999 and 2002, there were only nine pediatric cases of mesothelioma reported in the United States.  One research study identified and selected four young patients who all had been diagnosed with peritoneal mesothelioma.  Peritoneal mesothelioma is when the cancerous tumors affect the membrane or lining of the abdominal cavity.

The patients in the study involved a 16-year-old female, 16 year-old male, 17 year old female, and 20 year old male.  All patients were non smokers.  None of them had any known connection to direct exposure of asbestos, however three of the four had fathers who had worked in the construction industry and may have been exposed indirectly.  There was speculation from the researchers that perhaps the reason that all four had the same kind of mesothelioma was due to the manner in which they were exposed, second-hand versus direct. Of the four patients, three are still alive.  The survival rates of the three range from 24 to 57 months, and two show no signs of progression of the disease.

The researchers were hoping results from their study might help others to learn more about the factors that lead to mesothelioma and what treatment options might extend the survival rate of those diagnosed.  As far as treatment, the researchers recommend patients consider surgical debulking. 

Surgical debulking, also known as cytoreduction surgery, is performed in patients where cancer has spread to the lining of the abdomen.  The goal of the surgery is to remove as much of the cancer from the abdomen as possible, removing or reducing the number of cancer cells.  The surgery is performed not necessarily to cure the cancer, but to prepare the body for later therapies that might improve patients length of survival, such as drug therapy or radiation.  The operation is often long and can cause complications after surgery and a painful recovery.  However, especially if all cancerous tumors can be removed, the chances of longer survival time increases. 

Researchers also recommend following up the surgical debulking with chemotherapy combined with drug therapy.  Specifically they recommend regimes of cisplastin combined with pemetrexed or gemcitabine.  Cisplastin is a chemotherapy drug given intravenously over the course of several sessions of treatment over a few months.  Pemetrexed and gemcitabine are drugs used in with chemotherapy that may stop the growth of tumor cells by blocking some of the enzymes needed for the cells to grow.  Drugs used in combination with chemotherapy can work in multiple ways:

o        Killing tumor cells

o        Stopping cells from dividing

o        Blocking tumors from growing or spreading

o        Blocking blood flow to the tumor

o        Carrying tumor-killing substances to the tumors

There are over 2,000 mesothelioma cases in the United States each year, although the numbers seem to be on the rise worldwide. 

There is no known cure for mesothelioma, and survival from time of diagnosis has been short, usually less than 12 months.  Recent diagnosis techniques and treatments have extended survival time in some cases, up to 50 or 60 months.  Studies such as this one may help to further the time of survival even more or lead to a cure.