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Malignant Mesothelioma is commonly diagnosed in people between the ages of 50 and 75 years old. There are 2,500-3,000 fatal Mesothelioma cases diagnosed each year in the United States.
Playskool crayons found to contain asbestos, advocacy group says
By Abha Bhattarai August 5, 2018 – Washington Post
A popular brand of crayons contains toxic levels of asbestos, according to a consumer advocacy group that is calling on retailers such as Dollar Tree and Amazon.com to pull the items from their shelves.
The U.S. Public Interest Research Group (U.S. PIRG) Education Fund says Playskool crayons tested positive for asbestos, which can lead to lung cancer and mesothelioma if inhaled or ingested. The group tested 36-packs of crayons purchased at a Dollar Tree store in Chicago but noted that they are also being sold online at Amazon, eBay and Dollardays.com. Jeffrey P. Bezos, the founder and chief executive of Amazon, owns The Washington Post.)
“There is no reason to be exposing kids to a known carcinogen, especially in crayons,” said Kara Cook-Schultz, toxics director for U.S. PIRG.
A spokeswoman for Playskool’s parent company, Hasbro, said it is conducting a “thorough investigation” into the claims. Leap Year Publishing, the Massachusetts-based manufacturer of the crayons, said it is also reviewing its lab tests.
Dollar Tree executives, meanwhile, said independent tests have indicated that its crayons do not contain asbestos.
The findings come three years after a report from the Environmental Working Group Action Fund found that four brands of crayons manufactured in China contained toxic asbestos fibers. Amazon, Toys R Us, Party City and Dollar Tree stopped selling the crayons as a result. (The affected brands were Saban’s Power Rangers Super Megaforce Crayons; Disney Mickey Mouse Clubhouse Crayons; Nickelodeon’s Teenage Mutant Ninja Turtles Crayons; and Amscan Crayons.)
The Role of Adjuvant Radiotherapy in the Treatment of Pleural Mesothelioma Survival Time
June 1, 2018 – Redjournal.org – Volume 101, Issue 2, Supplement, Page E34
Introduction
Pleural mesothelioma is a rare, but aggressive form of cancer. Local recurrence represents the majority of treatment failures and overall survival outcomes remain dismal. Because of this, adding locoregional treatment with radiotherapy after surgical resection has been considered but its role remains uncertain. The purpose of this study was to evaluate the outcomes of adjuvant radiation therapy (RT) for patients with malignant pleural mesothelioma, and to determine if patients benefit from adjuvant RT.
Materials/Methods
The National Cancer Data Base (NCDB) was queried (2004-2013) for patients with either localized or metastatic malignant mesothelioma. Patients were divided into two groups: surgery alone, and surgery followed by adjuvant RT. In addition, an observation group was kept to serve as a helpful comparison baseline for the two local intervention groups. Statistics included Fisher’s exact or χ2 to analyze categorical proportions between groups, Kaplan-Meier analysis to evaluate overall survival (OS), and Cox proportional hazards modeling to determine variables associated with OS.
Results
In the whole cohort, the surgery plus radiotherapy group had a higher median survival (21.4 months) compared to surgery alone (16.59 months) (p<0.001). A greater proportion of patients that received adjuvant radiotherapy had locoregional disease, private insurance, higher income, epitheliod histology, and lower Charlson-Deyo comorbidity score. Radiation therapy was more likely to be delivered after extrapleural pneumonectomy (EPP) than with lung-sparing surgical approaches. Patients who received adjuvant radiotherapy were more likely to receive chemotherapy. On multivariate analysis, receipt of surgery plus radiotherapy, chemotherapy administration, and higher socioeconomic status were associated with improved OS (p<0.0001).
Nivolumab Immunotherapy in Malignant Mesothelioma: A Case Report Highlighting a New Opportunity for Exceptional Outcomes
Riley G. Jones, Felix Karthik, Anushree Dugar, Karthik Kanagarajan, Kalpan Desai, Manish Bhandari – American Journal of Case Reports
(Department of Internal Medicine, University of Florida, Gainesville, OH, USA)
BACKGROUND: Malignant pleural mesothelioma (MPM) is a highly lethal cancer with a median survival of ~12 months even with aggressive intervention. Frontline therapy relies on systemic cisplatin and pemetrexed chemotherapy and has a response rate of ~35–41%; currently, there are no US Food and Drug Administration approved second-line therapies for MPM. Herein, we present a patient with MPM who experienced rapid disease progression after standard therapy but who had an exceptional and sustained response to immune checkpoint inhibition with single agent nivolumab.
CASE REPORT: A 68-year-old male with a history of work-related asbestos exposure was diagnosed with MPM. He was treated with primary resection followed by systemic chemotherapy with cisplatin and pemetrexed. When chemotherapy failed, he was switched to immunotherapy with nivolumab and achieved an exceptional response.
Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma and predictors of survival
Pages 578-584 | Received 04 Dec 2017, Accepted 28 Jan 2018, Published online: 12 Feb 2018
Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) benefits selected patients with peritoneal mesothelioma. We present the outcomes of this treatment strategy in a UK peritoneal malignancy national referral centre.
Methods: Observational retrospective analysis of data prospectively collected in a dedicated peritoneal malignancy database between March 1998 and January 2016.
Results: Of 1586 patients treated for peritoneal malignancy, 76 (4.8%) underwent surgery for peritoneal mesothelioma. Median age was 49 years (range 21–73 years). 34 patients (45%) were female. Of the 76 patients, 39 (51%) had low grade histological subtypes (mostly multicystic mesothelioma), and 37 (49%) had diffuse malignant peritoneal mesothelioma (DMPM; mostly epithelioid mesothelioma). Complete cytoreduction was achieved in 52 patients (68%) and maximal tumour debulking (MTD) was performed in 20 patients (26%); the remaining 4 patients (5%) underwent a laparotomy with biopsy only. HIPEC was administered in 67 patients (88%). Median overall (OS) and disease-free survival (DFS) after CRS was 97.8 (80.2–115.4) and 58.8 (47.4–70.3) months, respectively. After complete cytoreduction, 100% overall survival was observed amongst patients with low-grade disease. Ki-67 proliferation index was significantly associated with survival outcomes after complete cytoreduction for DMPM and was an independent predictor of decreased survival.
Global Asbestos Disaster Study Shows Significant Increase in Asbestos-Related Deaths
Int. J. Environ. Res. Public Health 2018, 15(5), 1000: 16 May 2018
Introduction: Asbestos has been used for thousands of years but only at a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos-caused cancer was identified in the late 1930’s but despite today’s overwhelming evidence of the strong carcinogenicity of all asbestos types, including chrysotile, it is still widely used globally. Various estimates have been made over time including those of World Health Organization and International Labour Organization: 107,000–112,000 deaths. Present estimates are much higher. Objective: This article summarizes the special edition of this Journal related to asbestos and key aspects of the past and present of the asbestos problem globally. The objective is to collect and provide the latest evidence of the magnitude of asbestos-related diseases and to provide the present best data for revitalizing the International Labor Organization/World Health Organization Joint Program on Asbestos-related Diseases. Methods: Documentation on asbestos-related diseases, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of asbestos-related diseases were examined. Results: Asbestos causes an estimated 255,000 deaths (243,223–260,029) annually according to latest knowledge, of which work-related exposures are responsible for 233,000 deaths (222,322–242,802). In the European Union, United States of America and in other high income economies (World Health Organization regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high; in the Western European countries and European Union, and equivalent of 0.70% of the Gross Domestic Product or 114 × 109 United States Dollars. Intangible costs could be much higher. When applying the Value of Statistical Life of 4 million EUR per cancer death used by the European Commission, we arrived at 410 × 109 United States Dollars loss related to occupational cancer and 340 × 109 related to asbestos exposure at work, while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but is used widely today; some 2,030,000 tons consumed annually according to the latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg of asbestos powder, e.g.,
Air in the Pleural Cavity Enhances Detection of Pleural Abnormalities by CT Scan
June 2018 Volume 153, Issue 6, Pages e123–e128
Detection of pleural abnormalities on CT scan is critical in diagnosis of pleural disease. CT scan detects minute parenchymal lung nodules, but often fails to detect similar-sized pleural nodularity. This is likely because the density of the visceral/parietal pleura and pleural fluid is similar. We hypothesize that an air-pleural interface enhances detection of pleural abnormalities. We describe six patients with pleural abnormalities that were not (or barely) detected on initial CT scan. However, pneumothorax (either ex vacuo or from a genuine air leak) after pleural fluid drainage permitted the visualization of small pleural abnormalities on CT scan, which would be amenable to imaging-guided biopsies. This case series provides proof-of-principle evidence that the sensitivity of CT scan detection of pleural abnormalities is dependent on adjacent tissue density and can be enhanced by intrapleural air. Future studies of the potential for artificial pneumothorax to improve the diagnosis of pleural disease are warranted.
Exudative pleural effusions are common clinical presentations. Malignant pleural effusion (MPE) is the most common cause of recurrent exudative effusions and affects 250,000 patients a year in the United States alone.1 Differentiating benign from malignant pleural disease and confirming the exact etiology is critical.2
Most Oncologists Have Discussed Medical Marijuana With Patients
Survey Shows Patients With Cancer Initiate Conversations About Medical Marijuana, but Knowledge Gaps Persist
The research published online today in the Journal of Clinical Oncology.
Andrew S. Epstein, MD, ASCO Expert in Patient Care May 10, 2018
“It’s clear from this study that patients and their families want to know more about medical marijuana for the treatment of cancer-related symptoms, and often initiate discussions with their oncologists. We need to be prepared to have these conversations, and that means having research to support our recommendations. This study highlights the important need for more research on the use of medical marijuana in oncology, so we can provide informed guidance and care that meets all of our patients’ needs.”
Data from a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally-representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state medical marijuana laws.
The impact of chemotherapy and its timing on survival in malignant peritoneal mesothelioma treated with complete debulking
May 2018, Samer A. Naffouje Kiara A. Tulla George I. Salti
Abstract
The current standard of treatment for malignant peritoneal mesothelioma (MPM) is cytoreductive surgery when the disease distribution is favorable. The role of chemotherapy, as an adjunct to surgery, remains unclear. The national database of mesothelioma was used to identify MPM patients who were treated with curative intent. Patients were divided into treatment groups: (1) chemotherapy only, (2) surgery only, (3) neoadjuvant chemotherapy + surgery, and (4) surgery + adjuvant chemotherapy. A negative control group of patients who did not receive any treatment was added (group 0). Totally, 1740 patients were included. Mean age was 63.04 ± 14.58 and 60.7% were males. The patients’ distribution into the treatment groups was 604, 684, 169, 55, and 228 patients in groups 0–4, respectively, with a median survival of 3.61 ± 0.37, 11.10 ± 0.73, 57.41 ± 11.91, 52.30 ± 7.20, and 55.00 ± 9.19 months. The addition of chemotherapy, in any setting, to surgery provided an improved survival at 1 year (p = 0.006). This survival benefit ceased at the 2-, 3-, and 5-year checkpoints. The multivariate analysis identified age, sarcomatoid/biphasic histologies, nodal and distant metastasis, and offering no treatment or chemotherapy only as poor prognostic factors for overall survival. No difference in overall survival was noted with the addition of chemotherapy to complete debulking regardless of the timing. Complete debulking remains the standard treatment for MPM. The addition of systemic chemotherapy provides a short-term survival improvement at 1 year only and was similar whether given in the neoadjuvant or adjuvant setting. Nevertheless, it did not add a survival benefit beyond the 1-year time point.
Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for the treatment of malignant mesothelioma
Published: 18 April 2018 – BMC Cancer volume 18, Article number: 442 (2018)
Abstract
Background
Patients with recurrent malignant epithelioid mesothelioma (MM) after surgery and standard chemotherapy with cisplatin and pemetrexed have limited treatment options.
Methods
We performed a retrospective cohort study of patients with recurrent MM undergoing Pressurized IntraPeritoneal/Thoracal Aerosol Chemotherapy (PIPAC/PITAC) with doxorubicin 1.5 mg/m2 and cisplatin 7.5 mg/m2. Data were retrospectively collected in a prospective registry of patients undergoing PIPAC/PITAC. Study outcomes were microscopic tumor regression grade (TRG), survival and adverse events (v4.0 CTCAE).
Results
A total of 29 patients (m/f = 17/12) with MM with a mean age of 62.4 (range: 42 to 84) years were analyzed. A total of 74 PIPAC and 5 PITAC procedures were performed. The mean number of PIPAC applications was 2.5 (range: 0 to 10) per patient. Twenty patients (69%) had > 2 PIPAC procedure and were eligible for TRG analysis. TRG 1 to 4 was observed in 75% (15/20) of patients. Major regression (TRG 3) or complete regression (TRG 4) was observed in 20% and 10%, respectively. PIPAC induced significant tumor regression in 51.7% (15/29) of patients with a cumulative effect after repetitive PIPACs (PIPAC #1 vs. PIPAC #2: p = 0.001; PIPAC #1 vs. PIPAC #3: p = 0.001; PIPAC #1 vs. PIPAC #4: p = 0.001). Postoperative CTCAE grade 4 complications were observed in two patients (6.9%) who had cytoreductive surgery (CC2) and intraoperative PIPAC. One patient (3.4%) died due to postoperative kidney insufficiency. After a follow up of 14.4 (95% CI: 8.1 to 20.7) months after the last PIPAC/PITAC application, median overall survival was 26.6 (95% CI: 9.5 to 43.7) months (from the first application).
its safety and efficacy to control malignant pleural effusion remain unclear.
Mesothelioma Statute of Limitations
If you have a family member that has died from Mesothelioma cancer, immediately consult with an experienced Mesothelioma lawyer about your available compensation from asbestos trust funds.
It is VERY IMPORTANT that you file your Mesothelioma claim within your states Statute of Limitations.
We have seen many families lose their right to file a lawsuit because their Statute of Limitations had expired while they were grieving. Although there is a tremendous mourning period with the loss of a loved one, it is crucial not to let your Statute of Limitations expire before filing a Mesothelioma lawsuit. In most states, the Statute of Limitations is 2-3 years. Some states have a 6-year Statute of Limitations.
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