http://www.theage.com.au/articles/2003/09/13/1063341811321.html

Melbourne researchers have achieved a breakthrough that promises to significantly improve the treatment of people with asbestos-related cancer, which is tipped to reach epidemic proportions in a decade.

The researchers, at the Peter MacCallum Cancer Centre, have identified a pattern of gene activity in cancer patients that indicates whether they will survive longer with the disease or succumb earlier.

Dr. Andrew Holloway, who is heading the research at the centre, told The Sunday Age he was optimistic it would lead to the development of a test within five years to accurately diagnose how aggressive each cancer was, enabling doctors to prescribe appropriate treatment for each patient.

Doctors are now unable to tell how long a person might survive with mesothelioma, meaning that many patients with aggressive tumours are subjected to arduous courses of chemotherapy unnecessarily.

The breakthrough, using groundbreaking microarray technology, was achieved in collaboration with the Perth Mesothelioma Centre. The technology lets scientists identify which genes in a tumour are switched on or off, indicating how quickly the tumour will grow.

Reports of the breakthrough come a fortnight after The Sunday Age revealed that former Latrobe Valley power workers were contracting mesothelioma at a rate seven times the national average.

A report received three weeks ago by the State Government outlined the higher rate. It also highlighted the fact that cigarette smoking increased 20-fold the risk of contracting lung cancer in those exposed to asbestos.

Australia already has the highest rate of mesothelioma per capita in the world.

The increase in the rates of the disease is expected to rise in line with the peak of asbestos use in Australia in the late 1960s and early 1970s. Mesothelioma most commonly presents in patients about 35 years after exposure, and experts warn that the risk of developing the disease increases with time.

Dr Holloway said he expected to have tests in place in time for a predicted rise in mesothelioma cases over the next 10 to 20 years when rates of the cancer are expected to double to around 1200 incidences each year, matching current rates of ovarian cancer. "We want to be able to be working on the disease now so at least when the epidemic comes we know some better treatments to be able to give people," Dr Holloway said.

Maurice Blackburn Cashman mesothelioma litigator Andrew Dimsey said people who were indirectly exposed to asbestos by washing clothes or having close contact with people who worked with asbestos were now presenting more often with the disease.

This "third wave" of victims were part of a growing number of people seeking compensation for the disease, he said. The first wave of workers were those with "massive exposure" who mined or shipped asbestos, and the second wave those who worked directly with asbestos, most commonly in the power industry and construction.

Mr Dimsey said he expected the rate of people with mesothelioma to markedly increase over the next 10 years, adding to the number of patients who contract asbestos-related lung cancer.

"(The term) epidemic is not inappropriate," he said. "Increasingly the sorts of people who come through the door are people who have seemingly trivial exposures."

Dr Holloway said that while the research was "very preliminary", it could later help tailor appropriate treatment for victims of the disease, which was fatal and usually killed within 12 months of diagnosis.