Peritoneal Mesothelioma

There is a lot of depressing information on the internet about peritoneal mesothelioma and the survival associated with this cancer. Reading it you would think that no one has ever survived peritoneal mesothelioma beyond a year or so. This information is far from comprehensive. To help balance some of the negative information that is so prevalent on the Web, we present some case histories of long-term peritoneal mesothelioma survival as published in the peer reviewed medical literature.


9 Years +

In November 1979, a 73 year-old man had abdominal pain and distension and was found to have an abdominal mass. A laparotomy was performed that revealed peritoneal malignancy with ascites. A biopsy demonstrated that the tumor was malignant peritoneal mesothelioma. No special treatment was recommended other than draining of the ascites. In spite of the continuing ascites and the gradually-enlarging abdominal masses, the patient enjoys good health, and lives independently at home. How many more years (in excess of 9) this patient lived with peritoneal mesothelioma is not known.

See: Norman, P.E. and Whitaker, D., Nine-Year Survival in a Case of Untreated Peritoneal Mesothelioma, Med J Aust 1989; 150: 43-44.

15 Years +

A woman was diagnosed with peritoneal mesothelioma. She had surgery (“total excision”). Seven years later the peritoneal mesothelioma recurred and she had another surgery (“reexcision”). She remains well 15 years after the initial diagnosis. The patient did not receive chemotherapy.

See: Asensio, J.A., et al., Primary Malignant Peritoneal Mesothelioma: A Report of Seven Cases and a Review of the Literature, Arch Surg; Nov 1990, 125, 1477-1480.

17 + Years

In 1962, a 31 year-old woman had abdominal pain for several months and a mass was detected. She underwent exploratory laparotomy which found tumor nodules spread throughout her abdomen. The diagnosis of peritoneal mesothelioma was made. Complete surgical removal of the tumor was not possible. She was treated with radioactive phosphorus, radiation, and oral chemotherapy (cytoxan). She remained well for 17 years. In 1979 she had recurrent peritoneal mesothelioma. She was treated with cytoxan again and continued to live as of the writing of the published medical report.

See: Brenner, J., et al., Seventeen Year Survival in a Patient with malignant Peritoneal Mesothelioma; Clinical Oncology 1981, 7, 249-251.

Remember to sign up for the free teleconference with 10 year malignant mesothelioma survivor Paul Kraus. Paul wrote the critically acclaimed book Surviving Mesothelioma and Other Cancers: A Patient's Guide and is dedicated to inspiring other mesothelioma patients. Listen to how he handled his diagnosis, what he learned about the cancer, and the steps he took to heal his mesothelioma. Call 1-619-261-7922 to register. (Space is limited.)

Read More..

Pleural Mesothelioma

There is a lot of depressing information on the internet about pleural mesothelioma and the survival associated with this cancer. Reading it you would think that no one has ever survived pleural mesothelioma beyond a year or so. This information is far from comprehensive and can be misleading. To help balance the negative information that is so prevalent on the Web, we present some case histories of long-term pleural mesothelioma survival as published in the peer reviewed medical literature. These pleural mesothelioma case histories are instructional in two ways: 1) they remind us that, like Paul Kraus, there are long term survivors of this cancer; 2) they allude to the importance that the immune system may play in mesothelioma.
12 Years +

In 1994, a 58 year old man complained of chest pain and shortness of breath. He had been exposed to asbestos previously through his work and was eventually diagnosed with malignant pleural mesothelioma. The patient decided not to have any active treatment at that time and continued with his life. Five years later he had an enlarging painless mass on his chest wall. A needle biopsy confirmed it was malignant. The patient had a left thoracotomy, multiple pleural biopsies, and chest wall resection. Pathology reconfirmed that the mass was malignant pleural mesothelioma. Seven years after the chest wall resection and 12 years after the initial diagnosis, the patient has no symptoms and no evidence of recurrence. No chemotherapy or radiation had been given.

The doctors who wrote up this case history for publication noted that there was “moderate host inflammatory response” and that “spontaneous regression may be an immune-mediated phenomenon.” In other words, the doctors hypothesized that the patient’s own immune system may have played a factor in his survival.

See: Pilling, J.E., et al., Prolonged Survival Due to Spontaneous Regression and Surgical Excision of Malignant Mesothelioma, Ann Thorac Surg, 2007; 83: 314-5.

14 Years

In 1986, a 65 year-old women had pain in her left chest wall. A chest X-ray revealed a small pleural effusion on this side. The patient declined an open biopsy and no diagnosis could be reached. She was treated for tuberculosis because of the high rate of this disease in her area. Her symptoms partially improved. In 1988 she had increasing pain over her chest. A biopsy was performed and malignant infiltration of the pleura was confirmed. She turned down treatment. In 1998, 10 years after the diagnosis of malignant pleural mesothelioma she had an enlarging mass over her left chest wall. Biopsy confirmed the diagnosis of pleural mesothelioma. She had a course of radiation and died in January 2000, 14 years after her initial symptoms.

The doctors who wrote this report counseled their colleagues that long-term survivors can occur with pleural mesothelioma and “one should not hold the belief that it is always the intervention that prolongs survival.” In other words, these doctors suggested that in some cases the intervention (i.e. chemo, radiation, surgery) may not be the factor that prolongs survival in pleural mesothelioma, but other factors may be at work.

See: Wong, C.F., et al., A Case of Malignant Pleural Mesothelioma with Unexpectantly Long Survival without Active Treatment, Respiration March/April 2002; 69, 2: 166-168.

7 Years +

In 1970, a 53 year-old man had shortness of breath and a sharp pain on his right side. An X-ray revealed a right side pleural effusion. The patient had worked at a plant adjacent to the Brooklyn Navy Yard from1955-1966 where asbestos had been used. In 1972 a thoracotomy was performed and a pleural biopsy was taken. The patient was diagnosed with malignant pleural mesothelioma. The patient never received any specific treatment for pleural mesothelioma. The report was written up in 1977 and apparently information about the continued life of this patient was not published after. We do not know how many more years or decades he lived.

The doctors noted in their discussion that, “This unusual course may be explained either by the presence of low-grade malignancy or by the unusual host resistance…Our findings are consistent with the concept that normal immunological function may effectively impede dissemination of the disease (malignant pleural mesothelioma).” In other words, these doctors are again alluding to how the immune system may play a role in managing pleural mesothelioma.

See: Fischbein, A,. et al., Unexpected Longevity of a Patient with malignant Pleural Mesothelioma, Cancer 1978; 42:1999-2004.

Remember to sign up for the free teleconference with 10 year malignant mesothelioma survivor Paul Kraus. Paul wrote the critically acclaimed book Surviving Mesothelioma and Other Cancers: A Patient's Guide and is dedicated to inspiring other mesothelioma patients. Listen to how he handled his diagnosis, what he learned about the cancer, and the steps he took to heal his mesothelioma. Call 1-619-261-7922 to register. (Space is limited.)

Read More..

Malignant Mesothelioma

Paul Kraus is not the only long-term survivor of malignant mesothelioma. There are others. We have heard about them and spoken to some over the years. What is fascinating is that many of these malignant mesothelioma survivors have something in common - they have all taken steps to improve or enhance their immune system. Some used alternative or complimentary therapies (with guidance from licensed clinicians) while others participated in clinical trials of immune therapy.

This raises the question - does the immune system play a role in controlling malignant mesothelioma? Paul Kraus' experience and those of other long-term malignant mesothelioma survivors suggests that such a role may be possible. In other sections of this website we present case histories of malignant mesothelioma survivors who were diagnosed with either pleural mesothelioma or peritoneal mesothelioma. In some of the pleural mesothelioma case histories, doctors discuss the role that the patient's immune system may have played in their extremely long survival.

In 1986, an article appeared in a medical journal that discussed this very issue of malignant mesothelioma and immunity.(1) This research focused on the immune responses of 118 healthy people compared to 20 patients with malignant mesothelioma and 375 long-term asbestos workers who were cancer-free. The researchers wanted to know if there were any measurable differences in the immune responses of the mesothelioma patients. Their findings demonstrated a relationship between the immune system and malignant mesothelioma. For example:

The number of total T (T11+) and T-helper (T4+) cells were normal in asbestos workers with cancer, but were significantly reduced in patients with mesothelioma. T cells orchestrate, regulate and coordinate the overall immune response.

· Most patients with mesothelioma had a profound deficiency in Natural Killer cell (NK) activity which is suggestive of the role the immune system plays in the control of malignant mesothelioma. NK cells are a type of lethal lymphocyte that target tumor cells and protect against a wide variety of infectious microbes.

In the discussion section of the report, the researchers stated:

“These findings led us to speculate that biological phenomena generally categorized as chronic immunosuppression associated with the presence of asbestos fibers in the exposed workers may have caused the eventual breakdown of the host’s surveillance system and the onset of neoplasm [malignant mesothelioma].”

In other words, the researchers are suggesting that malignant mesothelioma may result from immune suppression. If this is true it would provide the biological basis for the role that the immune system and immune boosting approaches may play in the management of malignant mesothelioma.

Endnotes

(1) Lew, F., et al., High Frequency of Immune Dysfunctions in Asbestos Workers and in Patients with Malignant Mesothelioma, Journal of Clinical Immunology; 1986, 6:3, 225-232.

Remember to sign up for the free teleconference with 10 year malignant mesothelioma survivor Paul Kraus. Paul wrote the critically acclaimed book Surviving Mesothelioma and Other Cancers: A Patient's Guide and is dedicated to inspiring other mesothelioma patients. Listen to how he handled his diagnosis, what he learned about the cancer, and the steps he took to heal his mesothelioma. Call 1-619-261-7922 to register. (Space is limited.)

Read More..