A recent method of treatment for mesothelioma and other cancers is the intensifying of biological defense mechanisms natural to the body itself. Normal cells produce substances that can block tumor growth, or stimulate the immune system and other natural defenses to attack the cancer. The agents that focus or strengthen natural defenses are called biological response modifiers or BRMs.

Intuitively, most of us have known that the human body had it's own mechanisms for fighting cancer and other diseases. BRMs however, are a medically high tech way of encouraging our natural body defenses to charge into action. These biological agents are often used side by side with other cancer treatments, including radiation, surgery, and chemotherapy.

BRMs can prevent cancer from spreading, reverse the process whereby normal cells change to cancer cells, stop cancer cell growth, boost the immune system's attack on cancer, and make cancer more susceptible to being killed by the body's immune system. Her are some of the major BRMs under research.

1. Interleukins are cytokines which are found naturally in the human body. Interleukins stimulate the growth of immune cells which destroy cancer cells. Research is under way using interleukins to treat a variety of cancers.

2. Interferon, which is also a type of cytokine, can be isolated and given in cancer treatment to boost the immune system. Interferon can slows cancer growth or alter cancer cells so that they grow more like normal cells. Researchers are exploring the use of interferon in the treatment of many cancers

3. Colony stimulating factors act differently. Colony stimulating factors affect the bone marrow, by stimulating the production of white blood cells, platelets, and red blood cells. During chemotherapy, bone marrow can become suppressed, causing anemia and fatigue. The use of colony stimulating factors allows higher doses of chemotherapy than might be tolerated without it.

4. Monoclonal antibodies(MOABs) are produced in a laboratory and are specific for a particular antigen. Research is now focusing on creating monoclonal antibodies that target cancer types. Some MOABs have the ability to stop cancer cell growth factors, and some can attach to cancer cells and deliver poisons that kill the cancer cells.

5. Gene therapy inserts genetic material into cells. The genetic material may be designed to be inserted into immune cells in order to increase their cancer fighting abilities. It may also be placed into cancer cells, causing them to produce cytokines which stimulate the immune defense against the cancer itself.

6. Cancer vaccines expose the body to weak of killed versions of the organism that causes the disease, and stimulate an immune response to protect from future disease. Another approach using vaccines, is to give a vaccine during the time of the disease. This is called therapeutic vaccination. These vaccines are under research in combination with other BRMs.

Just because these therapies are biological does not mean that they are without side effects. Side effects for these agents can vary from allergic reactions to nausea, and vomiting. Each of the BRMs have it's own associated possible side effects. The research is quite promising, however, and has been progressively adding to the arsenal of weapons for fighting mesothelioma, and other cancers.



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If ever a reminder was needed of the damaging impact exposure to asbestos has had on industrial workers in the UK, it came in the form of new research published in the British Journal of Cancer recently. Funded by Cancer Research UK and the Health and Safety Executive, the largest global study of its kind into the affects of asbestos exposure found that in some professions, such as carpentry, up to 1 in 10 workers could be expected to develop asbestos related cancers, such as lung cancer or mesothelioma.

The study interviewed more than 2000 people born in the 'baby boomer' generation in the 1940's to determine the rates of asbestos-related disease in various professions. For those who worked as carpenters for more than 10 years before they were 30, the researchers calculated that the risk of developing mesothelioma over their lifetimes was about 1 in 17. When the likelihood of developing lung cancer caused by asbestos was added in, the overall risk to this group of developing some form of asbestos related cancer was 1 in 10.

It was not just carpenters in this age range who had an elevated risk of mesothelioma and lung cancer, the risk for plumbers, electricians and decorators was also well above the rate for the rest of the population. Perhaps one of the most worrying findings of the study was that during the post war period, around two thirds of men and a quarter of women had worked at some point in a job where there was a potential for them to be exposed to asbestos dust.

Speaking about the findings of the study, the lead researcher, Professor Julian Peto, who is based at the London School of Hygiene and Tropical Medicine, said: "The UK has the highest death rate from mesothelioma in the world. The risk is highest in people who were exposed to asbestos before age 30. By getting some information on all the jobs people had ever done we have shown that the risk in some occupations, particularly the building industry, is higher than we previously thought. New regulations introduced in 1970 reduced exposure to asbestos in factories but heavy exposure to the much larger workforce in construction and various other industries continued."

As the press release from the Health and Safety Executive announced, there are currently around 2100 new diagnosis of mesothelioma each year in the UK, with around 5 times as many cases in men as in women. This number is expected to rise in the next few years, as cancers such as mesothelioma often take many decades to develop. Government compensation schemes have been set up so that those affected by exposure to asbestos who go on to develop cancer will receive some financial assistance, although in many cases by the time these claims are processed, the sufferers have already succumbed to the cancers.

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Chemotherapy is often one component of mesothelioma treatment that is difficult for the lay person to grasp. Part of the problem is that the literature dealing with this subject is jargon intensive. The other problem is that the science and research are ever advancing. Understanding chemotherapy is truly a moving target. As a nurse, I can assist in cutting through some of the medical jargon, but I would be remiss if I didn't inform patients at the beginning that the principle source of information should be their oncologist, or cancer specialist doctor.

Your oncology doctor is reading all the latest research, and is highly motivated to defeat your cancer, and extend your life. Ask all of your questions without holding back.

All three of the basic approaches to treating mesothelioma; surgery, radiation therapy, and chemogtherapy, are potentially frightening to a patient. Chemotherapy is perhaps a little more difficult to penetrate rationally, and weigh the risks, versus rewards. Certainly, the list of possible side effects is quite intimidating. Mesothelioma, however, is a killer and you must trust your oncologist as he will want to throw everything that he thinks can work at this disease.

If surgery is an option for you, it may be followed by radiation therapy, and/or chemotherapy in order to try to kill the microscopic cancer cells that remain in your body.

The chemotherapy agents that your doctor selects will often be a combination or recipe of drugs that when used together have better outcomes than when used by themselves.

One of the medications that you may encounter is Cisplatin. Cisplatin messes up the DNA strands inside cancer cells by crossing them during cell division and causing these abnormal DNA-crossed cells to die. Another medication , doxorubicin forms free radicals that fracture the DNA strands inside cancer cells. Pemetoexed slows or stops tumor growth by blocking cell enzymes required for the production of RNA and DNA. There are many others, and there are treatment programs that combine medications with radiation. Your treatment will be customized for your specific needs.

All chemotherapy agents have some possible side effects. Remember though, drugs affect different people differently. Fatigue affects many cancer patients, often due to anemia. You will probably be taking high potency vitamins to help combat this. Other blood changes that may occur are low platelets, affecting blood clotting, and low white blood cells, which can affect your resistance to infection. You may experience various gastrointestinal problems, such as vomiting, nausea, diarrhea, or constipation. You may also develop yeast infections, and sores in the mouth. There is also a condition known as "chemo brain". "Chemo brain" is difficulty concentrating, focusing, fuzziness, and poor memory. Side effects may cause you to make some lifestyle changes during the chemotherapy treatment. These side effects ease and go away after the round of chemo is complete.

When you are receiving chemotherapy, what is happening is that the chemo is attacking the cancer cells. Unfortunately, some of the normal cells are also affected. This is why most of the side effects occur. The normal cells that are affected are primarily the fast growing cells. Cancers themselves are fast growing cells. Normal fast growing cells are the bone marrow, where blood cells are produced, the blood cells themselves, the digestive tract including the mouth and stomach, and the hair follicles. Some drugs affect vital organs as well.

Your close relationship with your oncologist is very important. Defeating mesothelioma is a team effort, and he is your quarterback. You are the team owner, so you must play an active role.



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