January 15, 2007

Mesothelioma kills 2,000-4,000 Americans each year. This aggressive cancer with a grim prognosis is caused by exposure to asbestos and often attacks workers in the building trades. Cutting-edge research and treatment to detect and manage this illness is available right here in Los Angeles. The Pacific Heart, Lung & Blood Institute (PACHLAB) and its Punch Worthington Research Laboratory (PWR Lab), in collaboration with the David Geffen School of Medicine at UCLA, is at the forefront of treating this disease.

Dr. Robert Cameron, the surgeon and scientist who directs the PWR Lab, has put together an aggressive agenda to tackle mesothelioma head-on. By focusing on prevention, early detection, and treatment for workers with mesothelioma, Dr. Cameron has become one of the world’s experts on this disease.

The PWR Lab’s Risk Reduction Program is focusing on prevention of mesothelioma in workers exposed to asbestos and early detection through breath and blood tests. The Lab’s Mesothelioma and Asbestosis Treatment Program is seeking to improve therapies for people with already existing disease.

Since it can take up to 50 years for mesothelioma to develop, a golden opportunity exists to interrupt the asbestos-induced changes that progress to cancer. This same type of approach has helped improve the cure rate for colon cancer, cervical cancer, and possibly even breast and lung cancer. This approach likely holds the greatest promise for people at risk for mesothelioma.

Since asbestos inflames the lining of the chest (pleura), the lab’s premier prevention program is testing agents that inhibit inflammation as a means of preventing this dreaded disease. Interrupting the long cycle of inflammation could break the progression of changes that lead to cancer. Indomethacin, celecoxib, aspirin and other agents may hold the key. The lab is recruiting participants through the Asbestos Workers Union and affiliates, particularly workers and their families residing on the West Coast, to collect exposure, medical as well as other relevant information for health monitoring and to include in testing of promising agents. Dr. Jennifer Mao, one of PACHLAB’s scientific advisors, is collaborating with the PWR Lab to test celecoxib right now. This study is open for workers who have asbestos exposure and also who have smoked cigarettes in the past.

The lab will also study asbestos tumors in animals to better understand how chrysotile asbestos, which makes up 95% of all asbestos in North America, causes mesothelioma. With a better understanding of the changes that chrysotile asbestos produces, there is an improved chance of finding ways to treat and prevent mesothelioma and asbestosis, as well as ways to treat lung cancer, which also occurs as a result of asbestos exposure.

There is no reliable test to detect mesothelioma at an early stage. Imaging tests, such as x-rays and CT scans, are not satisfactory. Screening tests exist for breast cancer, colon cancer, prostate cancer, and lung cancer, and have resulted in better diagnosis of early disease and improved cure rates. Early detection for mesothelioma could lead to similar benefits: doctors could attack it early, rather than waiting until full blown symptoms develop.

The PWR Lab’s Early Detection Program is a high priority. One promising test involves identifying evidence of mesothelioma and even of asbestos exposure through markers in workers’ exhaled breath or blood. The breathing test is particularly exciting because it has already had positive results in lung cancer, studies which Dr. Cameron, PWR Lab’s director, has helped accomplish. Other early detection techniques use blood and possibly tissue specimens.

Treating mesothelioma is difficult and takes an experienced team of professionals. Combinations of surgery, radiation, chemotherapy, and immunotherapy offer the best chance to extend life in a meaningful way, but given the deadly nature of the cancer, much work remains. In patients with other types of diseases, such as high blood pressure and diabetes, survival has been extended significantly through the use of effective “chronic” maintenance therapy. Dr. Cameron has pioneered a similar approach in mesothelioma. Life-long maintenance therapy is included to prevent the cancer from returning following successful initial treatment or to stop progressing cancers dead in their tracks if initial treatment fails. Importantly, maintenance therapies that are used or currently are being developed have minimal side effects and do not significantly interfere with the person’s lifestyle. The Punch Worthington Lab is committed to extending patients’ lives without compromising their quality of life.

One type of maintenance therapy for mesothelioma that has shown particular promise is long-term treatment with low dose interferon alpha, a cancer fighting drug normally produced by the body in small amounts. Dr. Cameron has led the way in using this in selected patients, some of whom currently are living without evidence of any cancer more than five years following their initial treatment. To put the numbers in perspective, patients treated with a combination of surgery, radiation, and interferon alpha have an overall median survival of 38 months compared to only 9-12 months with chemotherapy alone and 18 months with other treatment, such as extrapleural pneumonectomy.

Additional new treatment strategies are in the pipeline. One such therapy is the use of an interleukin-4 (IL-4) immunotoxin. Other novel therapies use compounds that inhibit the formation of new blood vessels that mesothelioma and all tumors need to grow. The development of new treatment strategies that are immediately available for current patients is long overdue, and the Punch Worthington Research Lab at the Pacific Heart, Lung, and Blood Institute is pushing the envelope of research because the lives of America’s working people are at stake, not only in the future but today as well.

Contact:

Dr. Robert Cameron: (310) 267-4612 or (310) 231-2130, email: rcameron@phlbi.org
Roger G. Worthington, Esq., (800) 831-9399, email: rworthington@phlbi.org