Our bodies are continuously exposed to germs, viruses, bacteria, and carcinogens. Every day the body’s immune system effectively suppresses these numerous assaults—unless the assault is too strong and/or the immune system is too weak to destroy the affected or damaged cells. Normal cells will grow, divide and die in an orderly fashion. However, abnormal cancerous cells begin to multiply out of control and do not die. They develop into a lump, tumor, or growth that invades healthy tissue and can spread unhealthy cells to other parts of the body.

There are some factors that are generally accepted and known to be carcinogens which cause cancerous growth. Two good examples of this are: tobacco use and air pollution. However, there are many cancer triggers that are generally accepted by researchers but are not as obvious to the general public. The following are 8 things that researchers have determined can measurably influence your cancer risk.

#1 – Meat:   Study after study has concluded that vegetarians are 50% less likely to die from Cancer. Animal fats contain hormones that humans absorb during consumption. There are also chemicals that attach to the food as the fats are cooked. These chemicals can be carcinogenic.

#2 – Goodies:   The consumption of excess fats and sugars will impact the body’s insulin production & hormone production which impacts cell damage and the immune system. Cancerous cells have an affinity to sugars.

#3 Excess Weight:   There are a few reasons why being overweight dramatically increases cancer risk. First of all for the same reasons listed in #2. But also many environmental chemicals that we are exposed to daily tend to store more in fat cells. These chemicals are lipo-philic. They like fat tissue. Many of these can be “chemicals of concern” and carcinogenic.

#4 Flame Retardants:   PBDEs are chemicals used as flame retardants. While flame retardant products are all around us and have been promoted as “safety” standards, we must acknowledge the collateral toxicity of this consumer “safety.”

#5: BPA (Bisphenol A):   BPA is a chemical that has been used for decades in the production of plastic food containers such as baby bottles, water bottles, cans and in some dental sealants. BPA can leach into food and liquids as containers are heated or damaged.

#6 Sunscreen:   Researchers now know that some ingredients in sunscreens (heavily promoted to prevent skin cancer) may actually increase cancer risk by mimicking an estrogenic effect and may trigger free radical development and possible cell damage. PABA (para-aminobenzoic acid) and oxybenzone have been linked in some research to cell damage that can lead to cancer cell development.

#7 Antibacterial Products:   Triclosan (used in antibacterial and antifungal products) is widely used in soaps, lotions, cleaning supplies and a variety of consumer products. However, triclosan is chemically similar to a dioxin that can act as an endocrine disrupting chemical. EDC’s can disrupt hormonal function and trigger cell damage.

#8 Alcohol:   Alcohol in itself is not characterized as a carcinogen. However, it functions as a co-carcinogen which can enhance the dangerous impact of other carcinogens in the body. This is especially true for tobacco users whose risks are multiplied when tobacco and alcohol are combined regular habits.

Another interesting study is called, “Phase I study of paclitaxel as a radiation sensitizer in the treatment of mesothelioma and non-small-cell lung cancer” by LL Herscher, SM Hahn, G Kroog, H Pass, B Temeck, B Goldspiel, J Cook, JB Mitchell and J Liebmann
Radiation Oncology Branch, Division of Cancer Treatment, National Cancer Institute, Bethesda, MD 20892 – Journal of Clinical Oncology, Vol 16, 635-641.  Here is an excerpt: “PURPOSE: To determine the maximum-tolerated dose (MTD) and dose- limiting toxicities of paclitaxel with concurrent thoracic irradiation in patients with malignant pleural mesothelioma and locally advanced non-small-cell lung cancer (NSCLC) using a 120-hour continuous infusion regimen. A secondary objective was to assess the effect of paclitaxel on the cell cycle through serial tumor biopsies. PATIENTS AND METHODS: Paclitaxel was administered as a 120-hour (5-day) continuous infusion repeated every 3 weeks during the course of radiation therapy. The starting dose of paclitaxel was 90 mg/m2. Doses were escalated at 15- mg/m2 increments in successive cohorts of three patients. In NSCLC patients, radiation was delivered to the primary tumor and regional lymph nodes for a total tumor dose of 6,120 cGy. In mesothelioma patients, hemithoracic irradiation was delivered as the initial treatment field with a conedown to the tumor volume for a total dose of 5,760 to 6,300 cGy. Tumor biopsies were obtained, if possible, before and during paclitaxel treatment. RESULTS: Thirty patients were entered onto this study through three dose levels (from 90 mg/m2 to 120 mg/m2). The MTD was determined to be 105 mg/m2. The dose-limiting toxicity was grade 4 neutropenia (two patients). Grade 2 gastrointestinal (GI) toxicity (nausea and vomiting) was also observed at 120 mg/m2. Three of 30 patients developed a hypersensitivity reaction. Six patients had grade 2 lung injury manifested by a persistent cough that required antitussives. Five patients underwent tumor biopsies. None of the patients showed a significant block of cells in mitosis (G2/M) after paclitaxel infusion. CONCLUSION: The MTD of paclitaxel, when administered as a 120-hour continuous infusion with concurrent radiotherapy, was determined to be 105 mg/m2. The dose-limiting toxicity was neutropenia. Continuous infusion paclitaxel administered with large field irradiation of the lung is well tolerated and deserves continued evaluation.”

Another interesting study is called, “Photodynamic therapy for human malignant mesothelioma in the nude mouse” – Journal of Surgical Research Volume 49, Issue 4, October 1990, Pages 311-314 by Richard H. Feins M.D., Russell Hilf Ph.D, Howard Ross B.S. and Scott L. Gibson B.S.  Here is an excerpt: “Abstract – Photodynamic therapy (PDT) utilizes a photoactivatable preparation, Photofrin II, which selectively localizes in cancerous tissue and produces substances toxic to that tissue when activated by light. Whether PDT would be able to selectively destroy human malignant mesothelioma was investigated by using a human-derived malignant mesothelioma tumor subcutaneously implanted in nude mice. Human malignant mesothelioma was grown subcutaneously to a size of 0.2 – 0.4 cm3. Selective retention of Photofrin II was studied by measuring light-induced inhibition of cytochrome c oxidase activity in tumor, heart, and lung. Photofrin II was retained in greater quantities in tumor than in heart or lung at 24 hr after injection. Using laser light at 630 nm under varying conditions, tumor growth was measured every 2 days following PDT for 18 days. All PDT regimens were successful in destroying malignant mesothelioma. Photofrin II at 5 mg/kg was superior to 2 mg/kg (P < 0.005), light delivered at 50 mW/cm2 × 2 hr was superior to that delivered at 200 mW/cm2 × 30 min (P < 0.05), and a total fluence of 180 J/cm2 was equivalent to 360 J/cm2 in affecting tumor growth. Ten of 12 mice treated at 50 mW/cm2 became tumor-free and remained so for 30 days following treatment. We concluded that PDT was effective against human malignant mesothelioma in a nude mouse model without adversely affecting the animal. A role for PDT in treating patients with malignant mesothelioma may exist.”

Another interesting study is called, “Diagnostic significance of carcinoembryonic antigen in the differential diagnosis of malignant Mesothelioma” by J Mezger, R Lamerz and W Permanetter – Department of Internal Medicine III, Klinikum Grosshadern, Munich, Federal Republic of Germany. The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 860-866.  Here is an excerpt; “The histologic and cytologic distinction of malignant mesothelioma from carcinomas metastatic to the pleura or peritoneum is often problematic. For this reason immunologic methods are being increasingly used as diagnostic adjuncts. This review summarizes 40 studies on the expression of carcinoembryonic antigen in mesotheliomas and in lung and other carcinomas involving the pleura or peritoneum. Carcinoembryonic antigen was identified immunohistochemically in 11% of mesotheliomas and in 84% of carcinomas examined and immunocytochemically (in serous effusions) in 4% and 58%, respectively. In serum and in pleural or ascitic fluid, significantly elevated levels of carcinoembryonic antigen are commonly associated with (lung) carcinomas but rarely with mesotheliomas. Thus, together with identification of the antigen in serum, pleural fluid, or ascitic fluid, immunohistochemical and immunocytochemical techniques for detecting carcinoembryonic antigen provide a valuable aid for distinguishing malignant mesothelioma from metastatic carcinomas.”

We all owe a debt of gratitude to these fine researchers.  If you found any of these excerpts interesting, please read the studies in their entirety.

Another interesting study is called, “Efficacy of CD40 Ligand gene therapy in malignant Mesothelioma” – American Thoracic Society, New York, NY, ETATS-UNIS  (1989) (Revue).  Here is an excerpt: “Abstract – Gene delivery of CD40 Ligand (CD40L) has shown promise in murine models of melanoma and adenocarcinoma; however, its potential for thoracic malignancies such as malignant mesothelioma remains unclear. In this study, we investigated the hypothesis that CD40L gene therapy would be effective in local and distant tumor suppression in mesothelioma using an immunocompetent murine model. Using a recombinant adenovirus encoding murine CD40L (AdCD40L), we demonstrated no suppression of in vitro cell growth for the AC29 (mesothelioma) cell line. However, inoculation of immunocompetent CBA/J mice with AC29 cells treated ex vivo with AdCD40L resulted in significant suppression of tumor formation in vivo when compared with controls (P < 0.001). Intratumoral inoculation of AdCD40L into previously established AC29 tumors yielded similar antitumor results and was associated with increased recruitment of intratumoral CD8+ T cells. Adoptive transfer of CD8+ T cells from AdCD40L-treated tumor bearing mice conferred protection to naive mice given an AC29 tumor challenge. Finally, in mice with two synchronous tumors, treatment of one of the tumors with AdCD40L resulted in a regression of both tumors. These findings demonstrate the development of tumor specific CD8+ T cells by AdCD40L and support the further development of AdCD40L for the treatment of malignant mesothelioma.”

Another interesting study is called, “The Use of Chemotherapy in Patients with Advanced Malignant Pleural Mesothelioma: A Systematic Review and Practice Guideline” by Ellis, Peter MBBS, PhD, FRACP; Davies, Angela M. MD, FRCPC; Evans, William K. MD, FRCPC; Haynes, Adam E. BSc; Lloyd, Nancy S. BSc; the Lung Cancer Disease Site Group of Cancer Care Ontario’s Program in Evidence-based Care
Journal of Thoracic Oncology: July 2006 – Volume 1 – Issue 6 – pp 591-601.  Here is an excerpt: “Abstract – Background: This clinical practice guideline, based on a systematic review, was developed to determine which chemotherapeutic agents (or combinations of agents) show the highest response rates, improved survival, quality of life, or symptom control in patients with advanced malignant pleural mesothelioma.

Methods: A thorough systematic search of the literature was conducted for published articles and conference proceedings for applicable abstracts. Relevant trials, published as articles and abstracts, were selected and assessed. External feedback was obtained from Ontario clinicians, and the guideline was approved by the provincial Lung Cancer Disease Site Group.

Results: One hundred nineteen studies were eligible, including eight randomized trials and 111 phase II trials. The pooled response rates from phase II trials suggest that response rates with combination chemotherapy are higher than with single agents. Data from the largest randomized controlled trial demonstrated that chemotherapy with cisplatin and pemetrexed significantly improves response rates (41% versus 17%, p < 0.001), time to progression (5.7 months versus 3.9 months, p = 0.001), and overall survival (median, 12.1 months versus 9.3 months, hazard ratio = 0.77, p = 0.020) in comparison to single-agent cisplatin. A second trial demonstrated cisplatin and raltitrexed significantly improved median survival compared to single-agent cisplatin (11.4 months versus 8.8 months; hazard ratio = 0.76, p = 0.0483). Overall response rate (24% versus 14%, p = 0.056) was greater in the combination treatment arm, but this difference was not statistically significant.

Conclusions: There is good evidence to recommend chemotherapy with pemetrexed and cisplatin for adult patients with symptomatic advanced malignant pleural mesothelioma. Such treatment should be administered with supplementation of vitamin B12 and folic acid. If pemetrexed is not available, cisplatin plus raltitrexed is a reasonable alternative.”

Another interesting study is called, “New Agents in the Management of Advanced Mesothelioma” by Nicholas J. Vogelzanga, Camillo Portabd, Luciano Mutticd –
Volume 32, Issue 3, Pages 336-350 (June 2005).  Here is an excerpt: “Malignant pleural mesothelioma (MPM) is a seemingly uncommon tumor whose incidence has in fact increased steadily and progressively over the last 30 years. Indeed, an actual “epidemic” is expected in Europe over the next 20 years. Despite unquestionable improvement in the diagnostic methods at our disposal and the availability of new treatment strategies, the prognosis of MPM patients remains dramatically poor (12 to 18 months’ median survival from diagnosis), although exceptional cases of long-survivors are reported in all literature series. The current review will cover the dramatic improvements in the treatment of this rare disease that have been recently achieved, as well as the promise that new, molecular-targeted therapies, such as bortezomid, mTOR (mammalian target of rapamycin) inhibitors, and Met inhibitors, seem to offer for the next few years. With pemetrexed we now have a drug that is able to impact patient survival. Together with the newer drugs, rapidly emerging from the laboratory to be applied in the clinic, we have the hope of making further advances in the struggle against this disease.”

We all owe a debt of gratitude to these fine researchers.  If you found any of these excerpts interesting, please read the studies in their entirety.

Lung cancer is a benign tumor in the lungs.  It is the leading cause of cancer related deaths among men and women.  

Patients affected with this type of cancer usually exhibit the following symptoms:

•    A cough that do not go away
•    Changes in cough
•    Coughing out of blood or hemoptysis
•    Shortness of breath
•    Chest pain
•    Wheezing
•    Hoarseness
•    Sudden weight loss
•    Pain in the bones
•    Severe headache

An x-ray is usually done to screen for possible lung CA.  However, diagnostic procedures like sputum cytology and tissue sample biopsy can also be done to confirm results.

The choices of therapy will be dependent to you and to your doctor.  The stage of your cancer will be likewise considered.  Typical options can include one or more treatment.

Lung cancer therapy depending on the stage of cancer will be as follows:

•    STAGE1 – Surgery and chemotherapy
•    STAGE2 – Surgery, chemotherapy and radiation
•    STAGE3A – Combined chemotherapy and radiation, surgery depending on results
•    STAGE3B – Chemotherapy and at times radiation
•    STAGE4 – Chemotherapy, targeted drug therapy, clinical trials, rehabilitation

SURGERY – This involves the surgical removal of a portion of your lungs infected with cancer.  It includes Wedge resection where a small section of your lungs with the tumor is removed.  Segmental resection is removing a larger part of lungs but not the whole lobe.  Lobectomy is removing the whole lobe of the lungs and pneumonectomy is removing the entire lungs.

CHEMOTHERAPY – This technique uses drugs to kill cancer cells.  This can be a primary line therapy for lung cancer of supplementary management after surgery.

RADIATION THERAPY -This treatment uses high-powered beams to kill cancer cells.

TARGETED DRUG THERAPY – This works by targeting specific cancer cells.  Drugs may include Bevacizumab (Avastatin) and Erlotnib (Tarceva).

Breast cancer is a form of cancer which affects both men and women, and is widespread in the UK. Many Cancer Charities UK are funded and devoted solely to the area of cancer research for its has already become widespread disease.

There are many ways to raise money from this cause, and they usually meet success because so many people are touched by the disease. There are a variety of high profile campaigns you can take part in if you want to help.

These include high profile walking fundraisers where women wear decorated bras, to running a marathon in the name of a particular breast cancer charity, or you can do your own smaller ventures.

Walk the Walk

Walk the Walk is one of many charities to use sponsored walks to raise a great deal of funds for the charity. By getting women who support the cause to do a walk of a certain distance, for example 5 kilometres, or around a particular city, such as the SunWalk event in Newcastle, much money and media attention can be raised.

If you wish to raise money in this way, it is likely to be effective as previous events of this type have been so successful in raising money and awareness. To make the event even more fun, the walkers can be encouraged to decorate their bras in the most inventive ways possible in order to win a prize. The event, however, is for everyone, so those who are not comfortable walking around in only a bra can wear a decorated bra over their clothes.
Breast Cancer UK run the Pink Ribbon walk, which is for men and women to wear pink and show their support for the charity’s work. These kind of fundraising events are not only good for securing sponsorship from your family and friends for your walking, but can attract enough attention for the charity to encourage larger benefactors to give large donations.

Smaller scale ideas

As well as participating in these large organised events, you can run your own smaller campaigns and events in your locality to raise money for breast cancer charities. Many breast cancer website provide useful tips, for example Breast Cancer Care suggest getting you and your friends or family to donate an hour’s wages each. This is a simple but effective way of raising a substantial sum of money. other ideas, which are both practical and possible, are to have a penny pot which is kept at home or in the workplace, so that spare change can be put towards your Breast Cancer charity of choice.

Many breast Cancer Charities UK have chosen to theme their charity’s emblem pink, such as the well known breast cancer ribbon. With this in mind, you could host a pink fancy dress party, or encourage everyone to wear pink to work for a day. Other fundraising ideas include packing supermarket shopping bags for donations, car boot sales, cake sales or sponsored swims.

Visit for more info: Cancer Charities UK

Arthritis is not a single disease it is a term which covers more than 100 medical conditions and has different underlying causes of their occurrence. Arthritis affects musculoskeletal system and specifically joints, it restricts the movement of the joints, can reduce the range of movement, it can also cause pain every time joint is moved, numbness and softness in the joints. It is one of the major reasons of disability amongst elderly people above age of 55 years.

Read more on Home Remedies for Joint Pain and Yoga for Bach Bone. Also visit on Baba Ramdev Medicines

Joint pain can be caused for a variety of reasons. The most common joint pain cause that people tend to think of is osteoarthritis. Osteoarthritis most commonly occurs in people who have led a long and productive life for good reason – they have systematically throughout the years put intense pressure on their joints. Even if they did not play an intense sport or work in a factory assembly line, elderly people can develop arthritis. It is often just the fact that they spent years living and moving normally that ends up causing joint pain. On the other hand, one should not blame osteoarthritis solely on the day to day elements of living. Scientists have identified several hereditary, metabolic, chemical and other factors that tie into the occurrence of osteoarthritis.

Symptoms of Joint Pain

As the name itself indicates, the most obvious symptom of Joint Pain is mild or severe pain and stiffness in the one or more joints. Knee Pain, Back Pain, Elbow Pain, Neck Pain, Jaw Pain, Wrist Pain, Foot Pain, Hip Pain, and Shoulder Pain are some common forms of Joint Pain. Joint Pain due to Arthritis is often accompanied by inflammation as well.

Arthritis Causes

1.    Hereditary and genetics of the sufferer can be the cause of arthritis.

2.    Skin infections and bacterial infections.

3.    Obesity.

4.    Physical stress on joints and other damages on joints.

5.    Aging and hormonal changes in the body.

6.    Old physical damage caused due to accident or fracture, etc., can be the cause of arthritis.

7.    Ecological factor may be the cause of arthritis.

8.    Metabolic and nervous tissue problems.

Treatment for Arthritis

There are various treatments available for arthritis, like surgical, pharmaceutical, various therapy, ayurvedic, and different home remedies.

Acupressure relieves joint pains and is very helpful in arthritis treatments. Different therapy like aromatherapy, steam therapy produces effective results on arthritis treatment. It is better to go for natural home remedies as they are effective with no side effects.

Arthritis Diet

1.    Food rich in proteins, minerals, vitamins are good for arthritis patients.

2.    Take fibrous fruits, green vegetables, sprouts, and raw vegetable juices.

3.    Ginger juice is also very beneficial in arthritis treatments.

4.    Drink water in copper glasses is good for curing arthritis.

5.    Avoid junk foods.

6.    Raw potato juice provides an effective arthritis treatment.

7.    Good balance between work and rest is necessary, so take proper rest.

8.    Maintain a healthy physical environment that let arthritis patients feel comfortable and happy. It has positive affects in arthritis treatments.

9.    Fish contains omega-3 fatty acids which is an effective diet for arthritis patients.

Natural Home Remedies for Joint Pain

1.    Performing hot and cold fomentations is one of the most widely used Joint Pain home remedies.

2.    Drinking a combination of two teaspoons of apple cider vinegar and two teaspoons of honey mixed in a glass of water is a highly beneficial natural remedy for Joint Pain.

3.    Eating garlic loves fried in butter is a highly beneficial remedy for relieving Joint Pain in a natural way. The anti-inflammatory properties of garlic are highly beneficial in healing Joint Pain and swelling due to Arthritis.

4.    Having some warm water mixed with half a teaspoon of turmeric powder is one of the most valuable Arthritis home remedies for Joint Pain and stiffness. Regularly consume this mixture at least three times per day.

Legitimacy of Online Pharmacies

Why would the United States allow the Food and Drug Administration to seize the operation of some online pharmacies?  Let see, there could be any number of reasons, and some you may not appreciate!

The Food and Drug Administration has stopped, seized the operation of some online drup stores and pharmacies.

Why? Because of the shipment or transport of controlled medications, that’s why.  But is this really legal or fair?

It’s true, and this is cool enough that the Food and Drug Administration and DEA require, absolutely require, a personal, body exam before they can prescribe controlled drugs.

You must get a prescription by a licensed American physician before ordering any controlled drugs from out of the country.  That’s easy enough. Get your prescription then head North across the border to Canada where prices are actually fair.

It is unlawful to obtain a prescription, a written prescription even, from an online exchange.  It’s a way to work around the laws, but it could also be dangerous to get your prescriptions online like this.  You do need to see a Doctor right?  The only reason you wouldn’t want to see a Doctor is if you’re trying to obtain drugs that possibly wouldn’t be prescribed to you otherwise, and that’s just not “clear thinking”.

A prescription from an online exchange is just not an acceptable way to obtain a prescription by any measure of good “common sense”.  We all need accurate prescriptions from a reputable physician.  Once you get your actual “needed” prescription you can then fax it to an online Canada Pharmacy to have your prescription filled, fast, affordably and with sound reason.

For well-being, always see a doctor before buying any prescription drugs or medications from the web.

Medicines delivered to the US will instantly be seized by customs if you do not order responcibly.  Many individuals still manage to obtain their medications because international pharmacies are smart enough to have Doctors here in the States that are able to prescribe and deliver products without going through “Customs”.  Customs will be extra, overly strict if the confiscated drugs are controlled drugs even if they are prescribed.  It’s just not fair. True enough the American goverment needs to control the flow of drugs to America, I get that.  But if an online pharmacy is legal, have high quality medications, and offer services here in America then it’s totally legitimate and rightly so.

No one should be able to tell us where we can purchase a legal product from, not even the sometimes oppresive American government.

Another note about the legalities of Canada Pharmacies, a draw on the maximum prescription drug re-fill of three months is the only legal quantity for shipment in the United States. 

Many Americans are ordering their legal prescriptions medicines from legal Canadian pharmacies. Online pharmacies from Canada do in fact run legal, legitimate businesses.  Getting the facts can save you huge amounts of money. No it is not illegal to order from a Canada Pharmacy. In fact it’s just the opposite, it is indeed legal to order from a Canada Pharmacy, providing the pharmacy is following the strict quidelines placed on them by our beloved American goverment.

The only problem with ordering from countries like Mexico is that past consumer complaints sky-rocketed regarding the repots of vast counterfeit medications.  Sell something real and legal won’t you!?

Canada is a far leap from Mexico, not the same policies at all regarding almost everything!  Order your prescriptions from a country that cares and appreciates staying legal and legit.

This October is the month of the Breast Cancer Awareness. Lots of people are going to cooperates in this event through wearing pinks. It is very important that we became a part of this kind of events, to educate people around the globe about this kind of illness.

Over 1.3 million of women are diagnosed who acquired this kind of disease every year. Wherein almost half a million of its patients died, on its record 40,000 of them came from the US.

Many of us are unaware about the signs of breast cancer, and it is very important to know the early signs of this illness for early treatments and medications.

Most of the times, there are no outer signs that you can see or feel to know if you have acquired the illness. However, we can say that the only sign that you can recognize is the occurrence of a lump or a thickening area in the breast. Other signs to recognize are enlargement of the underarm lymph node, breast swelling and redness of the area.

Even you experienced all of this signs of breast cancer; it does not mean that you already have the cancer. In most cases, having breast lumps does not ensure you that you have an acute kind of cancer, it usually turn out to be benign, a not cancerous type of lumps.

If your major concern is to know whether these lumps are cancerous, it is very important for you to visit your doctor immediately to ease your worry. Having a physical breast examination can help you find if you do have lumps that have big potential of becoming cancerous.

Women who are in their late 40’s are the most affected and at risk of having this kind of illness. Having annual mammogram and monthly physical examinations can help you for easy detection and diagnosis of breast cancer.

Another interesting study is called, “Extrapleural pneumonectomy in the setting of a multimodality approach to malignant mesothelioma.” By Sugarbaker DJ, Mentzer SJ, DeCamp M, Lynch TJ Jr, Strauss GM. – Chest. 1993 Apr;103(4 Suppl):377S-381S.
Harvard Medical School, Brigham and Women’s Hospital, Boston 02115.  Here is an excerpt: “Abstract – The use of extrapleural pneumonectomy in a multimodality treatment setting for malignant pleural mesothelioma is described, presenting first the right-sided approach and then the left-sided. This technique used in a multimodality approach with CAP chemotherapy (cyclophosphamide 600 mg/m2, doxorubicin 60 mg/m2, cisplatin 75 mg/m2) 5 cycles at 3-week intervals, and radiotherapy (55 Gy radiation to sites of previous bulky disease or residual disease) to treat 44 patients with malignant pleural mesothelioma resulted in improved operative mortality and decreased length of hospital stay.”

Another interesting study is called, “Surgery followed by intracavitary plus systemic chemotherapy in malignant pleural mesothelioma.” By Colleoni M, Sartori F, Calabro F, Nelli P, Vicario G, Sgarbossa G, Gaion F, Bortolotti L, Toniolo L, Manente P. – Tumori. 1996 Jan-Feb;82(1):53-6.  Here is an excerpt: “Abstract – AIMS AND BACKGROUND: Malignant mesothelioma is associated with a median survival of 4 to 12 months. Data from the literature indicate that single modality treatment (surgery or intrapleural and/or systemic chemotherapy) does not significantly affect survival.

METHODS: We therefore evaluated a combined approach consisting of surgery (pleurectomy + diaphragmatic or pericardial resection), intrapleural chemotherapy with cisplatin (100 mg/m2) and cytarabine (1,000 mg/m2) for 4 h immediately after pleurectomy, and systemic chemotherapy consisting of epirubicin (60 mg/m2) and mitomycin-C (10 mg/m2) day 1 every 4 weeks for 4 cycles.

RESULTS: Twenty patients were enrolled in the study and were evaluable. Thirteen cases had residual gross disease after pleurectomy and 7 patients only minimal disease. Median time to disease progression was 7.4 months, and median survival was 11.5 months (range, 2-25+). No treatment-related death have been observed. Side effects after intracavitary chemotherapy included renal toxicity, anaemia and pain. Myelosuppression and alopecia were recorded during systematic chemotherapy.

CONCLUSIONS: The results of the study indicate that the schedule is feasible, with encouraging results in terms of survival for patients with minimal residual disease after surgery.”

Another interesting study is called, “Early Prediction of Response to Chemotherapy and Survival in Malignant Pleural Mesothelioma Using a Novel Semiautomated 3-Dimensional Volume – Based Analysis of Serial 18F-FDG PET Scans” – Journal of Nuclear Medicine Vol. 48 No. 9 1449-1458 by Roslyn J. Francis, Michael J. Byrne, Agatha A. van der Schaaf, Jan A. Boucek, Anna K. Nowak, Michael Phillips, Richard Price, Andrew P. Patrikeos, A. William Musk and Michael J. Millward – The aim of chemotherapy for mesothelioma is to palliate symptoms and improve survival. Measuring response using CT is challenging because of the circumferential tumor growth pattern. This study aims to evaluate the role of serial 18F-FDG PET in the assessment of response to chemotherapy in patients with mesothelioma. Methods: Patients were prospectively recruited and underwent both 18F-FDG PET and conventional radiological response assessment before and after 1 cycle of chemotherapy. Quantitative volume-based 18F-FDG PET analysis was performed to obtain the total glycolytic volume (TGV) of the tumor. Survival outcomes were measured. Results: Twenty-three patients were suitable for both radiological and 18F-FDG PET analysis, of whom 20 had CT measurable disease. After 1 cycle of chemotherapy, 7 patients attained a partial response and 13 had stable disease on CT assessment by modified RECIST (Response Evaluation Criteria in Solid Tumors) criteria. In the 7 patients with radiological partial response, the median TGV on quantitative PET analysis fell to 30% of baseline (range, 11%–71%). After 1 cycle of chemotherapy, Cox regression analysis demonstrated a statistically significant relationship between a fall in TGV and improved patient survival (P = 0.015). Neither a reduction in the maximum standardized uptake value (P = 0.097) nor CT (P = 0.131) demonstrated a statistically significant association with patient survival. Conclusion: Semiquantitative 18F-FDG PET using the volume-based parameter of TGV is feasible in mesothelioma and may predict response to chemotherapy and patient survival after 1 cycle of treatment. Therefore, metabolic imaging has the potential to improve the care of patients receiving chemotherapy for mesothelioma by the early identification of responding patients. This technology may also be useful in the assessment of new systemic treatments for mesothelioma. “

We all owe a debt of gratitude to these fine researchers.  If you found any of these excerpts interesting, please read the studies in their entirety.