February 2, 2007 Volume 108 Number 3
L.A. lab works
to improve odds against asbestos cancer
When
Olympic Gold medalist Terry McCann began having chest pains, he
knew something was wrong. He never drank or smoked. He worked out
daily in the gym and was a member of the San Clemente morning surf
“dawn patrol” in California.
The
chest pain went away, but mesothelioma, the deadly cancer within
his chest wall, did not. Before Terry passed away last year at age
72 — more than two years after his symptoms had surfaced —
he had already beaten the odds. Ten years ago, men and women with
mesothelioma faced a certain and swift death. The cancer, which
kills 2,000 to 4,000 men and women a year, oftentimes misdiagnosed
as pneumonia or as an inflamed lining of the lungs, would quickly
surround the victim’s lungs and heart sac with a concrete-like
sheath, and crush the patient to death.
People
with mesothelioma still face a tremendous struggle, but in Los Angeles
cutting-edge research and treatment to detect and manage the illness
is is being conducted at the non-profit Pacific Heart, Lung &
Blood Institute and its Punch Worthington Research Laboratory (PWR),
in collaboration with the David Geffen School of Medicine at UCLA.
Dr.
Robert Cameron, a surgeon and scientist who directs the PWR Lab,
has put together an aggressive agenda to tackle mesothelioma head-on.
The 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.
Mesothelioma
is caused by inhalation of asbestos fibers. It has a long latency
period (the time between first exposure to asbestos and the diagnosis
of the disease). In rare cases the latency period has been as short
as 10 to 15 years. Typically, however, mesothelioma occurs 20, 30,
40 or more years after the first exposure.
Workers
in the construction trades are particularly vulnerable to exposure,
but the illness itself doesn’t discriminate based on the color
of the collar. “This disease affects Olympic athletes, drywallers,
congressmen, pipefitters, admirals in the Navy, Hollywood icons,
insulators, young women college students, painters, interior decorators,
boilermakers and everyone in between,” said Roger Worthington,
an attorney and board member of the Pacific Heart, Lung & Blood
Institute. The Punch Worthington Laboratory was named in the memory
of Roger’s father, David “Punch” Worthington of
Salem, a union organizer and Ph.D. in genetics who died last year
from asbestos-related cancer.
The
Portland area is considered a hotspot for mesothelioma due to its
historic shipbuilding and paper mill industries, yet the closest
treatment centers with doctors who specialize in mesothelioma are
in Seattle (at the Swedish Cancer Institute) and Los Angeles, Worthington
said.
“It’s
too bad the local doctors haven’t responded to the asbestos
epidemic here in Oregon,” said Greg Deblock, a retired business
manager of Portland-based Steamfitters Local 235, which later merged
to become the United Association of Plumbers and Steamfitters Local
290. In November, Deblock was diagnosed with malignant mesothelioma.
He is struggling to find specialized care in Portland.
Worthington
says too many doctors are resigned to “doomsday” with
asbestos cancers. “They assume that mesothelioma cannot be
cured,” he continued, “ but the sad truth is neither
industry nor the government has invested in finding cures for this
orphan cancer. How do we know it’s ‘incurable’
if we don’t try to cure it?”
To
date, there isn’t a 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.
One
promising test under study at the PWR Lab involves identifying evidence
of mesothelioma and even asbestos exposure through markers in a
person’s exhaled breath or blood.
The
Institute is recruiting volunteers — particularly workers
and their families residing on the West Coast — for the early
detection breath and blood screenings, although the start date has
not been finalized, the Lab is taking names and will contact volunteers
once the trials begin.
Since
asbestos inflames the lining of the chest (pleura), the lab’s
prevention program also is testing agents that inhibit inflammation
as a means of preventing the disease. Doctors believe that 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
PWR Lab is testing celecoxib right now. This trial is for people
who have been exposed to asbestos and who have a history of smoking.
(The testing is free, but participants will have to go to Los Angeles
to participate.)
For
more information about the celecoxib test, call Jessica Like, executive
director of the Pacific Heart, Lung & Blood Institute, at 310-622-4960.
For more information about the early detection program, or for information
about meso treatment options, contact Dr. Cameron at 310-622-4960.
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