Nobel Prize in Medicine

This year’s Nobel Prize in Medicine or Physiology has been announced and the joint winners are literal life-savers.

Dr. Jim Allison is currently the Chair of Immunology and the Executive Director of the Immunotherapy Platform at the University of Texas MD Anderson Cancer Center. He is being recognized for work he conducted while at the University of California at Berkeley and the Memorial Sloan Kettering Cancer Center in New York.

Dr. Tasuku Honjo is being honored for work conducted at Kyoto University, where he is still a professor. He has also worked at Osaka University, the University of Tokyo, and the National Institutes of Health in Washington.

Although Dr. Honjo is a medical doctor, Dr. Allison is not. Both men have had long, successful research careers in the field of immunology. Each independently discovered ways of helping the immune system attack cancerous tumors in the 1990’s. They, and other researchers and medical doctors, then used the discoveries to develop immunotherapy drugs. It wasn’t long before at least one recipient previously considered terminal was declared cancer-free.

Immunotherapy was an old idea, even in the 1990’s, but no one had succeeded in turning the immune system against cancer, and the prospect that anyone might have had success in this approach had come to seem very dim. Dr. Honjo and Dr. Allison each found a way while researching one particular aspect of the immune system, the T-cell.

T-cells are are a class of blood cells that are part of the adaptive immune system. But excessive production of T-cells, or excessive T-cell activity, is bad for the body, so there are various mechanisms or “checkpoints” that inhibit them. Unfortunately, some types of cancer can deliberately activate those mechanisms and turn the T-cells off. Others simply take advantage of the system’s natural limitations. Dr. Honjo discovered one such mechanism, and how to block it. Dr. Allison discovered and blocked another. By blocking one or the other mechanism, the new immunotherapy treatments dramatically increase the chance that the T-cells will successfully attack the cancer.

No one treatment works on all cancers, nor do all types of cancer have their own form of immunotherapy yet. The list of cancers that can be treated with one or another of the newly-developed drugs includes melanoma, Hodgkin’s lymphoma, and cancers of the lung, kidney, bladder, liver, cervix, digestive system, head, and neck. Immunotherapies have the potential to cure at least some forms of metastatic cancer, a stage otherwise considered incurable.

Still, while immunotherapy offers hope to some who previously had none, not everyone responds to the new drugs, which can also have serious side effects. Dr. Allison acknowledges the problem, explaining that “One challenge is that the clinical success has outrun our scientific knowledge of how these drugs work and how they might best be combined with other therapies to improve treatment and reduce unwanted side effects. We need more basic science research to do that.”

Dr. Allison is continuing to work, both as a researcher and in a leadership capacity, on that needed research, developing new possibilities for cancer treatments and an increasingly better understanding of the immune system.

In a press conference after the announcement, Dr. Allison expressed shock and gratitude, thanked the students and colleagues who had assisted his research, and gave a “shout out” to current cancer patients, reminding them that more treatments are being developed. He also explained that cancer is a very personal issue for him, since several members of his family have had cancer, and his mother died of it while he was still very young.

He did not get into immunology in order to cure cancer, he explained. He was simply doing research in order to better understand how the human body works. However, he was always aware that there could be a practical application, and would often stop to review his work and consider whether anything he discovered could be applied to fighting cancer. Eventually, of course, the answer turned out to be yes.

“It’s a great, emotional privilege to meet cancer patients who’ve been successfully treated with immune checkpoint blockade,” Dr. Allison said. “They are living proof of the power of basic science, of following our urge to learn and to understand how things work.”

Dr. Honjo expressed a similar sentiment, saying at his own press conference at Kyoto University, “It is really, really an honor,” and that he hopes his winning the Nobel “will give encouragement to many researchers in basic studies.”

That basic science—research conducted for the sake of knowledge, without an obvious practical objective—can become the key to a major advance in medicine is an important part of the story for both men.

Dr. Honjo, like Dr. Allison, did not set out to work on cancer. He, too, was simply curious as to the functioning of T-cells, especially the process by which the cells die. His insight was that what he called “programmed cell death” is a control mechanism or checkpoint that can be turned off. Curiously, drugs developed based on his work have milder side effects than those that use Dr. Allison’s checkpoint blockade.

Dr. Honjo, too, is now focused on further developing the potential of his work.

“I want to continue this research so that in the future, this therapy will contribute to curing as many patients as possible,” Honjo explained. “We need to determine why this immune therapy does not work in certain cases.” As regards the future of immunotherapy, he is optimistic, saying “I believe this disease will be cured by the end of this century.”

Both men are highly decorated and well-respected scientists, with the duo also sharing in the Tang Prize in 2014 for their work with T-cells. But awards are not the most important thing.

Dr. Honjo told the story of being approached by someone at his golf club.

“He told me, ‘Thanks to you I can play golf again.’ That was a blissful moment. A comment like that makes me happier than any prize.”

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Mesothelioma Awareness Day

September 26 marks an important day in the lives of mesothelioma survivors, their families and caregivers, and those still in treatment; Mesothelioma Awareness Day.

Mesothelioma is an incurable cancer caused by exposure to asbestos. It is aggressive and deadly and has different types based on which part of a patient’s mesothelium is affected. Presently, there is no safe amount of asbestos to be exposed to and there is no cure for this disease which can take up to 20 years to develop in a person’s lungs or pleura.

This Thursday, many will take a moment to consider the impact this disease has had on their lives and the lives of their loved ones. Some have banded together to form groups to spread awareness of this horrible disease and provide information on how to prevent it for future generations while others still are working to make sure asbestos, the cause of mesothelioma itself, is not allowed back into the United States on construction sites or in automotive plants by signing petitions to be delivered to the EPA. No matter the course of action you choose to promote awareness, both are positive and informational in fighting the spread of this horrific disease. One such organization inviting individuals and their families to get involved is the Asbestos Disease Awareness Organization. They are currently gathering signatures for a petition to present to the EPA to ban asbestos with no loopholes nor exemptions including children’s crayons and women’s makeup. ADAO’s petition can be found here:

There will be many events held on social media for users to meaningfully participate as well. A #ENDMeso Twitter Chat from 12 – 1 p.m. EST as well as infographics and a Facebook frame from the Mesothelioma Applied Research Foundation. Allowing users to share ideas and virtually show their support to others in their communities.

Many may also choose to wear “Meso Blue” shirts and wristbands on the day to begin conversations with those seeking knowledge about this vitally important topic. Or volunteering their time at local hospitals or hospice facilities to hear the stories of those suffering or to help the families who have lost a cherished member. We encourage readers to find ways to help in their own communities because all voices and efforts lent to this cause are tremendously helpful.

Thankfully, there are many ways to share information and gain information, no matter which arena you choose.

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Mesothelioma Treatment Pioneer, Dr. David Sugarbaker Passes Away at Age 65

Incredibly rare, malignant mesothelioma (pronounced: me-zoe-thee-lee-O-muh), is an uncommon type of cancer impeding the thin outer layer of tissue (mesothelium) covering most of your internal organs.

Cancer of the mesothelium is caused by exposure to an industrial agent called asbestos and is both aggressive and deadly, and while treatments are available, cure is not typically possible.

The Loss Of A Great Medical Visionary

For nearly three decades thoracic surgeon Dr. David Sugarbaker led the way in advancing the way we medically approach and treat pleural mesothelioma.

We regret to report that at the young age of 65, Dr. Sugarbaker has departed this world and the world of medicine that he devoted his life’s work to.

Among a long list of accolades and accomplishments, Sugarbaker served proudly as the director of the Lung Institute at the Baylor College of Medicine in Houston, Texas.

A Storied Past

For 26 years Dr. Sugarbaker proudly and expertly served at Brigham and Women’s Hospital in Boston. Dr. Sugarbaker worked diligently and with purpose, spearheading and establishing the most noteworthy and prestigious mesothelioma cancer treatment program in America.

While in Boston Sugarbaker invented and perfected surgical techniques that resulted in lowered mortality rates and extend the lives of countless patients diagnosed with this debilitating and ultimately fatal cancer from which there is no cure.

His findings and treatment modifications earned him the respect and admiration of his colleagues and won the hearts of patients, many of which traveled across the country to work with him.

In 2014, Sugarbaker proudly joined the Baylor College of Medicine in Texas.

A Teacher and a Mentor

Dr. Sugarbaker wasn’t just a highly experienced and innovative surgeon, he was also a respected mentor and facilitator of knowledge. The teachings and impact he had on countless prominent thoracic surgeons trained under his watch will keep his legacy alive for decades to come.

Dr. Jacques Fontaine, a thoracic surgeon who started the Mesothelioma Research and Treatment Center at Moffitt Cancer Center in Tampa, remembers Dr. Sugarbaker as a “mentor of mentors”. Fontaine holds that “His vision, focus and dedication to advancing the treatment of mesothelioma have influenced an entire generation of thoracic surgeons.”

Steadfast and Unwavering Dedication to His Patients

Dr. Sugarbaker was full of ambition to help change the world for the better. He joined Baylor College of Medicine with the intent to develop the Lung Institute, and the ambitious program he had hoped would surpass even that which he had established in Boston.

His following within the mesothelioma community was unmatched by any other in his field, with word of patient success stories spreading far and wide. A small group of his patients that had passed the 10-year mark after surgery continued to see him regularly even if that meant traveling long distances to his new base of operations. A following of patients that lived for five years beyond their prescribed life expectancy only aided in furthering his notoriety.

Another thoracic surgeon trained under Sugarbaker, Dr. Abraham Lebenthal, noted that, “In the field [of mesothelioma], he is the gold standard.”

Gone But Never Forgotten

One thing is certain, while the world lost a great man and a highly respected clinician, his patients, their families and the surgeons he has trained will never forget the gift of life and knowledge he gave them.

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Mesothelioma Support

You’re Not Alone

If you or a loved one has recently been diagnosed with Mesothelioma, always remember, you’re not alone. It’s not a life vs. death fight with this terrible cancer. There are many support groups to help you cope with your problem. Of course there will be lots of grieving, sadness and struggle, but there are many people you can reach out to for help dealing with this catastrophe. There’s foundations you can reach by phone, the internet, in person, whatever works best for you. There’s no point in just moping and grieving until the very end.

Believe it or not, there are people out there just like you, in your exact situation. Just because they aren’t in your shoes doesn’t mean they don’t know how you feel and haven’t been where you are before. In fact, these support groups can give you a sense of relief, warmth and happiness. It’s important to have that one person who you can talk to and instantly feel better about life, or really anything. If you don’t have someone like that, these support groups can help you find that exact person you need to make you simply feel better.

Care Centers and Counseling

There’s absolutely nothing wrong with choosing a alternate housing option for individuals with cancer. This will ensure that they are in good hands, and surrounded by people who want them to feel good and know how to make them happy. Besides friends and family, it really is amazing how just the presence of another person can really make a difference in someone’s life after receiving such terrible news.  Care centers are also especially helpful for patients who are forced to travel out of state for their treatment, which really isn’t fair at all. They are made and designed specifically for patients who are in need of help from others to feel better about themselves. These care centers include full living arrangements as well such as a kitchen, shared living rooms with other patients and laundry facilities. These care centers are generally even cheaper and nicer than staying at a hotel, which is how it should be for someone who is forced to cope with mesothelioma.

In addition to care centers, there is also multiple forms of counseling. These can be made up by either hospitals or a side party program designed to give patients the highest support for their needs. Even if it isn’t a counseling session in person, over the phone still makes someone feel good to hear their loved ones voice or a professional counselor (someone trained to make people feel better).  A lot of these professionals are trained to be the best counselor they can be, meaning they are available 24/7 to their patients.

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Diagnosis of Mesothelioma

Symptoms of Mesothelioma

People begin to see signs of Mesothelioma before they begin to do tests to see if they actually have this form of cancer. The tests to see exactly which type of Mesothelioma you may have are quite intricate and extreme, so its best to wait until you think for sure that you are experiencing signs of this form of cancer. Signs may include coughing, shortness of breath, or chest pains. If you are feeling any of these symptoms it’s important to see a doctor as soon as you possibly can before it gets even worse. Once you have set up a meeting with a doctor or a physician with a high level of expertise on the subject, it’s important to ask them as many questions as you can think of to get the full picture on what symptoms mean which type of mesothelioma.

Different Types of Mesothelioma

Your mesothelium is the thin membrane that covers the inside of the body and lubricates the cavities of the body as well. It’s an important part of your lungs, and cancer can form in this area from exposure to asbestos, the inside of the walls of your home. This is what is known as mesothelioma. Not many people outside the medical field know this, but there are multiple different types of mesothelioma that you could be unlucky enough to have. There’s Pleural Mesothelioma, Peritoneal Mesothelioma, and Pericardial Mesothelioma. Each of these types are different, concerning which part of the body has the cancerous tumor.

Pleural mesothelioma is where the cancer has developed in the lining of your lungs. Most of the diagnosed cases of mesothelioma (about 75 percent) are pleural mesothelioma cases. This is due to the asbestos of your home being inhaled into your lungs, which causes fibers from the asbestos to become lodged or stuck inside the lining of your lungs.

Your abdomen is another significantly vital part of the body, which is why you never want to have to hear that you have peritoneal mesothelioma. This type of mesothelioma is also caused from mistakenly breathing in asbestos fibers, and the cancer begins to develop in your abdomen and take over your organs. While this isn’t quite as common as pleural mesothelioma, it is in fact still somewhat popular with about 20% of diagnosed cases with this type of cancer in the abdomen.

Meeting the Experts

A mesothelioma prognosis is extremely difficult, even for the highest qualified and top rated physicians and doctors. Most likely the first person you will meet with is a general practitioner, who isn’t really qualified to fully diagnose you yet. This general practitioner will look to the help of radiologists, surgeons, oncologists, pathologists, pulmonologists, and other higher-level experts who probably have greater knowledge on the symptoms of mesothelioma, which is also related to lung cancer. Hopefully your general practitioner will even be able to call one of the experts in to discuss the symptoms you are having and diagnose you in person, instead of just simply relaying the information to the general practitioner and then back to you in a less informative and reliable translation.

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