Cancer Clinical Trials – What You Need to Know

For someone facing a diagnosis of malignant mesothelioma, cancer clinical trials often present the best chance for improving their prognosis and living a longer, more comfortable life. This is especially true now, as researchers and doctors around the world are making fundamental discoveries about the role that genetics plays in both the development of cancer and the possibility of developing effective, targeted and individualized treatments for mesothelioma and other cancers. There are currently dozens of clinical trials exploring new options for treating cancer, including all forms of mesothelioma, but not all clinical trials are appropriate for every cancer patient. Understanding how cancer clinical trials work, how patients are selected for them, and how to learn more about them can help patients and their families evaluate their treatment options and decide on the best course of treatment for them.

Cancer Clinical Trials

Cancer Clinical Trials 101

The U.S. Food and Drug Administration requires that all new drugs, treatments and diagnostic methods undergo a schedule of testing before they will grant approval and release it to the general public. The clinical trials help detail how effective the treatment is, what side effects patients may encounter, and the best methodology for implementing the treatment. They are a vital tool in developing and releasing new drugs, treatments and diagnostic methods for cancer and other diseases and conditions.

New drugs and treatments generally go through three phases of clinical trials, each expanding the number of human patients participating. In general, by the time a new treatment reaches the clinical trial phase, it has already been in development for an average of six years. Those six years will include studies, animal research and other types of research to determine whether the drug or treatment is likely to be useful in treating humans. Once the pre-clinical phase is complete, according to the American Cancer Society (ACS), it takes an average of eight years between the beginning of clinical trials and final approval. Each step of the way, the researchers and developers must follow specific protocols to ensure that their data and findings are correct and useful for human patients.

Understanding Clinical Trial Phases

Each phase of a clinical trial is designed to answer specific questions about the new treatment, and carries different benefits and risks to people who agree to take part in them. Knowing the phase of the clinical trials being considered can help patients decide whether they want to participate in them.

Phase 0 Cancer Clinical Trials – How Does It Work?

Phase 0 trials are not a required part of all testing, and there are few openings for volunteers to participate. These earliest stages of testing are designed to find out if an how a new drug or treatment works in human patients. They are usually very short term, and only involve a few participants. The ACS notes that participants in Phase 0 trial are unlikely to benefit personally from their participation. The information learned in this phase, however, can eventually benefit others. At the same time, the risks of participating in a Phase 0 study are minimal, since the dosages are generally very low, and the duration of treatment is short.

Phase 1 Cancer Clinical Trials – Is It Safe?

The focus of Phase 1 clinical trials is the safety of the treatment. It is the first phase of the studies that involves a significant number of patients, and the researchers focus on possible side effects and dangers, as well as attempting to determine the highest and most effective dosages of new drugs and/or proposed treatments. Phase 1 studies are usually carried out at major medical centers, which may limit the possibility of participation. In addition, this early phase carries the largest potential risk for participants, and is not designed to test how effective a new treatment is against cancer. They usually only involve a few dozen participants, and are generally open to people diagnosed with many different types of cancer.

Phase 2 Cancer Clinical Trials – How Well Does It Work?

In Phase 2 trials, researchers are looking for evidence that the new treatment or drug actually works against specific cancers using specific measures. They may be looking for reduction or elimination of tumors and other evidence that the protocol being tested actually has a benefit in fighting cancer. They usually involve 100 or so volunteer participants, and are most often carried out at major medical centers and cancer treatment centers, but may also be carried out in doctors offices and community hospitals. Researchers also continue looking for side effects, since the larger number of participants increases the possibility that they will find specific interactions that may not have been evident in smaller groups. Participants may receive the actual treatment, or a placebo.

Phase 3 Cancer Clinical Trials – Is It Better than Existing Cancer Treatments?

Phase 3 clinical trials are designed to measure the effectiveness of the proposed treatment, and compare it to current standard treatments for cancer. They generally include several hundred participants, and are carried out in settings across the country and around the world. While participants in Phase 3 trials may receive a placebo, if there is a current standard treatment for their type of cancer, the placebo will be given along with the standard treatment. This increases the chance that participants will benefit from the new treatment. Phase 3 trials are safer than the earlier stages because researchers already know how to limit and eliminate those who are most likely to have adverse reactions to the new treatment.

Phase 4 Cancer Trials – What Else Can We Learn?

The safest of the phases, Phase 4 clinical trials are designed to answer important questions beyond safety and effectiveness of a new treatment. They happen after a new drug has been approved by the FDA, and generally involve thousands of patients in hundreds of settings. The risks of participation are low, since earlier stages have established the safety of the treatment, the most effective dosages and durations, and potential interactions that may height risk or improve the effectiveness of the treatment.

What to Consider

When deciding whether a particular clinical trial is right for you, it’s important to consider a number of factors, including these:

  • Is it appropriate for the type of cancer you have?
  • Is it being held at a location near you, or to which you can travel?
  • Are the risks ones that you are willing to accept?
  • Do the possible benefits outweigh the risks?
  • What does your oncologist think?
  • How will the proposed treatment affect your family?

Cancer clinical trials are especially important for those diagnosed with one of the forms of mesothelioma because so few effective treatment options exist. The current clinical trials, and ones that will open in the foreseeable future, include treatments as well as new diagnostic methods that could identify mesothelioma at earlier stages, opening the door to using more effective drugs and conventional therapies against this deadly form of cancer.

Asbestos Around the House

Asbestos continues to be a concern because of its widespread use during the 1900s for both residential and commercial construction. While the dangers of asbestos have been widely known for centuries, the asbestos industry conspired to hide its hazards from the government and consumers for decades. Because of this – and because of the building booms of the early and mid 20th centuries – asbestos made its way into millions of homes. In 2011, The Guardian, a UK newspaper, estimated that more than 50% of homes in the UK harbored asbestos-containing materials. In the U.S., any home built before 1974 is likely to have been built or renovated using materials that contain asbestos. Here’s what you need to know about how and where to find asbestos in your home, and what you should do about it if you find it.

When Was Your Home Built?

Asbestos is most commonly present in homes built before 1974, when asbestos-containing materials were banned for construction uses. In the interests of caution, some experts suggest checking for asbestos in any home built before 1979. It’s important to remember that just the presence of asbestos in your home isn’t a cause for panic. It only becomes dangerous when the material is damaged, releasing asbestos fibers into the air where they can be inhaled. That’s why renovations and repairs in homes built before 1980 can be hazardous to your family’s health. In most cases, experts recommend leaving the materials in place and covering them to prevent accidentally disturbing them.

Where to Look for Asbestos in Your Home

Asbestos was used in many different products for home construction and repair, including floor and ceiling tiles, roof shingles, siding, pipe cement, joint compound, sheetrock and all types of insulation, including insulation around ducts, fireplaces, boilers and sheeting. It was used in attic insulation and wall insulation, as well as in some types of paint. Generally, if you’re planning to do any major renovation in an older home, you should expect that you might encounter asbestos.

If you’re starting to think that finding asbestos in your older home may be difficult, you’re right. You can’t tell that something contains asbestos just by looking at it. In most cases, the presence of asbestos can only be definitely determined by microscopic examination and expert testing. However, these are some of the most common places where you might find asbestos in an older home and what you can do about them.

Floors

  • Floor tiles installed before 1980, particularly those that measure 9″x9″, 12″x12″, or 18″x18″. In most cases, it’s better to leave these tiles in place rather than remove them. You can reduce the risk by encasing or covering the floor – pouring cement over it, for example. If you must remove the tiles, most states have regulations about how the work must be carried out. It’s often safest to hire an expert to do the job.
  • Vinyl flooring containing asbestos was also commonly used until the 1980s, and flooring adhesive used to lay flooring also frequently contained asbestos. As with the floor tiles, most experts agree that it’s safer to encase the floor than it is to try to remove it.

Ceilings

  • Popcorn ceilings were very popular in homes in the 1960s and 1970s. The textured paint treatment often contained asbestos, a well-known fire retardant. If you want to remove a popcorn ceiling, it’s best to test the paint for asbestos. If asbestos is found, consider having the work done by an experienced asbestos removal contractor.
  • Acoustic ceiling tiles and drop ceilings installed before 1980 are likely to contain asbestos. These ceilings are prone to damage which might release asbestos into the air. If you’re planning to remove drop ceilings in an older home, check with your state’s environmental agency for any regulations concerning removal. Many state agencies maintain lists of experts you can consult to determine whether the tiles contain asbestos.

Walls

  • Drywall and paneling in homes built between 1930 and 1980 may contain asbestos. Plain drywall most often used in single family homes most often did not, but the heavier sheetrock panels used between units in multi-family dwellings often did. In single-family homes, decorative paneling, such as faux-brick panels, often contained asbestos.
  • Mud and joint compound used to cover seams between panels, however, almost always contained asbestos. Even if the drywall panels are asbestos-free, removing or destroying old walls and paneling carries the risk of releasing asbestos into the air. As with floors and ceilings, it’s recommended that you treat the materials as if they do contain asbestos unless you determine that they definitively don’t.

Insulation

  • Foam insulation around plumbing, pipes and boilers often contains asbestos. More often than not, experts recommend encasing the asbestos to prevent it being disturbed.
  • Sheet insulation and insulating tape around pipes often contained asbestos.
  • Vermiculite attic insulation, particularly loose vermiculite insulation, was commonly used in the 1950s and 1960s.

If your home was built before 1989, the year that the EPA finally banned all forms of insulation with asbestos, you should always suspect that older insulation contains asbestos. Your state environmental agency maintains a list of labs and experts qualified to determine whether or not asbestos is present in the materials, and who can recommend the best way to deal with them.

Home Exteriors

Asbestos is commonly found in siding, tiles and roofs of homes built or renovated between 1900 and 1980. Because any work done on the exterior of a home will potentially release asbestos fibers into the neighborhood, many states strictly regulate who can do the work and how it must be done. There are experts who can evaluate roofing tiles, house siding and other materials on older houses to determine if they contain asbestos.

Types of Asbestos

What is asbestos, exactly? Unlike many chemicals and substances that have been found to be harmful, asbestos is not a specific mineral or substance, and has no defined chemical structure. The word itself doesn’t refer to a specific mineral. Instead, it’s a commercial term for a group of minerals that form strong, flexible, durable fibers rather than the crystalline structure we usually associate with minerals. The Toxic Substances Control Act of 1976 defines six types of asbestos, based on the mineral from which they are manufactured. The six minerals are chrysotile, amosite, crocidolite, tremolite, anthophyllite and actinolite. These minerals are not themselves “asbestos.” Rather, they are minerals that can form into fibers which can then be woven into asbestos for commercial use. Each of them has been used in various ways throughout history, and some are more toxic than others.

Serpentine Form

Asbestos is further classified as falling under two types – serpentine and amphibole. The only one of the six regulated forms of asbestos to form serpentine fibers is chrysotile asbestos, which accounts for most of the asbestos used commercially in the U.S. and throughout the world.

Chrysotile – White Asbestos

Chrysotile asbestos is the most widely used type of asbestos, accounting for nearly 95% of asbestos used commercially throughout the world. It was incorporated into paint, wall boards, roofing tiles and floor tiles as an element of fireproofing, and is still found in many residential and commercial buildings. Chrysotile asbestos is also found in pipe insulation, automobile brake linings and in seals for boilers and gaskets. Because of its wide use, even countries that ban other types of asbestos often allow the use of chrysotile asbestos under certain conditions. That doesn’t mean it’s safer than other types of asbestos – it’s a known carcinogen, as has been proven by multiple studies. The reason that it’s exempted from most bans is that the asbestos industry has a long history of lobbying for its use.

Form: Serpentine

Of all known types of asbestos, chrysotile is the only one in the serpentine family. It forms long, curly fibers that are finer than amphibole asbestos, and is more suitable for most applications than other types of asbestos.  It is also commonly known as white asbestos.

Chrysotile Asbestos – Toxicity

Exposure to chrysolite asbestos has been linked to lung cancer, mesothelioma, ovarian cancer and laryngeal cancer. It is often contaminated with trace amounts of tremolite, which is considered more toxic, but some reports show that exposure to chrysotile alone can be just as toxic as exposure to amphibole asbestos. The National Institute for Occupational Safety and Health has stated that chrysolite asbestos should be treated with the same concern and caution as amphibole asbestos.

Chrysotile Asbestos Uses

Chrysotile asbestos has been used (and in some cases continues to be used) in:

  • Insulation
  • Brake pads
  • Brake linings
  • Gaskets
  • Cement
  • Roofing materials
  • Joint compound

Amphibole Asbestos

The remaining five types of asbestos used commercially all fall under the amphibole classification. Amphibole fibers are more brittle, and can break off with sharp edges. Traditionally, amphibole forms are considered more toxic than chrysotile.

Amosite – Brown Asbestos

Amosite is a commercial name for asbestos that was mined in Africa. In fact, its name comes from the acronym Asbestos Mines of South Africa, the company that mined most of the amosite in use. It is commonly known as brown asbestos, and was most frequently used in cement sheet and pipe insulation. The Environmental Protection Agency names amosite as the second most commonly used type of asbestos in the United States.

Amosite – Toxicity

Numerous studies have found that amosite, like most amphibole asbestos, is more dangerous than chrysolite, and requires far less exposure to cause harm than other forms. The American Cancer Society says that exposure to amosite carries a higher risk of cancer than exposure to other types. It has been associated with lung cancer, mesothelioma and asbestosis.

Amosite – Uses

Amosite was used in:

  • Thermal, plumbing and chemical insulation
  • Insulation boards
  • Cement sheets
  • Electrical insulation
  • Roofing tiles, ceiling tiles, floor tiles
  • Roofing products
  • Gaskets
  • Fire protection

Crocidolite – Blue Asbestos

Crocidolite, also known as blue asbestos, is also found in South Africa, as well as in Bolivia and Australia. It is widely considered to be the most deadly form of asbestos, with some reports estimating that up to 18% of crocidolite miners died of mesothelioma, and some studies suggest that people living near crocidolite mines have a higher risk of asbestos-related illnesses.

Crocidolite – Toxicity

Crocidolite forms fibers about the diameter of a strand of hair. Because of their fineness, the fibers can be inhaled and lodge in the linings of the lungs more easily than other types of asbestos. Many studies suggest that because of this, exposure to crocidolite may be more deadly than other exposures. Crocidolite has been associated with mesothelioma, lung cancer and asbestosis.

Crocidolite – Uses

Crocidolite is less heat resistant than other types of asbestos, which limited its industrial uses, but it still made its way into many products used in construction.

  • Spray-on insulation
  • Ceiling tiles
  • Chemical insulation
  • Insulation boards
  • Water encasement
  • Cement sheets
  • Millboards
  • Electrical wires

Tremolite

Tremolite is not mined on its own, but can be found in other minerals, including vermiculite and talc. The amphibole fibers are strong and heat-resistant, and can be woven into cloth. It was extensively used in household and industrial products through the 1970s.

Tremolite – Toxicity

Like other amphibole forms, tremolite is considered to be more hazardous than chrysolite. Exposure to tremolite increases the risk of lung cancer, mesothelioma, asbestosis, laryngeal cancer and ovarian cancer. Tremolite is often found in minerals like vermiculite and talc. One of the most notorious asbestos-related cases in U.S. history occurred at the vermiculite mines in Libby, Montana, where dozens of miners and local residents were exposed to tremolite over a period of decades.

Tremolite – Uses

Tremolite was widely used in heat-proof and insulating products, including:

  • Paints
  • Insulation
  • Sealants
  • Roofing materials
  • Plumbing materials

Non-commercial Asbestos – Anthophyllite, Actinolite

The remaining types of asbestos have never been mined or used commercially, but exist as contaminants in commercial asbestos where they can contribute to the exposure risk.

Anthophyllite

Anthophyllite occurs largely as a contaminant in other minerals, such as talc or vermiculite. Studies have shown that it can cause lung cancer and other asbestos-related diseases. A study of miners in Finland suggested that exposure to anthophyllite increases the risk of lung cancer more than it does of mesothelioma.

Actinolite

Actinolite is usually used alongside other materials, such as talc and vermiculite. When used together with vermiculite, for example, it makes a lightweight, effective insulation material, and was frequently used that way until the early 1970s. Because of its widespread use for insulation and fireproofing, actinolite can still be found in many residences and commercial buildings in the United States.

Have you or a loved one been diagnosed with Mesothelioma and would like help with health and legal services? Call us at (855) 970-9988 for help today.

Life after Mesithelioma dianose

Life After a Mesothelioma Diagnosis

When you’re diagnosed with mesothelioma, your life changes forever. For at least the early months, your time and energy will probably revolve around all the medical appointments required for diagnosis and treatments. Even after that early whirlwind of activity, though, living with mesothelioma will require some adjustments and added support. These are some of tactics and resources to help you understand what to expect, and what you can do to make your life easier as you go through this difficult and challenging time.

Physical Challenges

Mesothelioma symptoms causes pain, discomfort and restrict your ability to move and go about your daily life. Unfortunately, chemotherapy, radiation, and surgery, most often used to treat mesothelioma, may make you feel even sicker, at least temporarily. Understanding and recognizing this can help you prepare to deal with it in advance. Building a strong support network, either of your friends or through support groups, can make all the difference in the world to help you get through the day.

  • There will be days when you are too exhausted to do or deal with anything. Cancel plans, cut visits short, and ask friends for help with things that must be done.
  • If you live alone, arrange to have someone stay with you or check in on you regularly to help you with physical things you can’t manage.
  • Take full advantage of medical resources, such as visiting nurses, home health aides like mesothelioma hospice care, and home care workers. Not only will they help you with daily activities, they can reduce the strain on your partner and other family members.
  • Maintain communication with your doctor and mesothelioma treatment team, and be open and honest with them. Your treatment team will work with you to adjust medications for nausea and pain relief, and may offer referrals to alternative therapies that other patients have found useful.

Emotional Challenges

Feeling sick all the time takes a toll on your emotional and mental health as well as your physical health. In addition to the day-to-day realities, you may also be facing existential questions and questions about the future. Nothing can relieve all of your anxieties and fears – many of them are based on reality, after all – but there are things you can do to help you face them and deal with them.

  • Take advantage of mesothelioma support groups for both you and your caregivers. No one understands what you’re going through better than someone who is also dealing with the same challenges and experiences. Who else can tell you where to find the medical supplies you need at half the price, or laugh with you at something ludicrous that you’d never share with someone who wouldn’t understand?
  • Communicate with your family and friends as openly as you comfortably can. If your significant other’s optimistic, cheerful attitude makes you fear disappointing them, let them know that. Talking about your feelings and your thoughts can help you work through things and ease stresses that make living with a mesothelioma diagnosis so stressful.
  • Consider a mind-body therapy to help with emotional balance. Many mesothelioma patients and survivors find that yoga, tai chi, music therapy and other alternative medical treatments help them restore balance – and may also provide physical benefits.
  • Exercise if your doctor permits it. Maintaining some level of physical activity not only benefits you physically, it can also help you with stress reduction.
  • Shut people out. There will be days when you don’t want to deal with anyone or anything. Don’t be afraid to let your friends and family know that this isn’t a good day for you and you need your rest.
  • Accept that people want to help. It’s so easy to feel like you’re suddenly a burden on people around you, and they’re doing you favors when they help you. In reality, many of them are feeling helpless in the face of a devastating disease. Allowing them to help you in practical ways is, very honestly, a gift to them.

Financial Resources for Mesothelioma

Among the most difficult challenges of dealing with mesothelioma is the financial cost of treatments. Luckily, there are resources that can help you and your family access the treatments and other things you need. In addition to your own insurance, you may be able to access trust funds set aside specifically for people with mesothelioma. There are advocates who can help you find those funds and apply for them, as well as lawyers who specialize in helping you get payments for the treatments you need. In addition, there are special resources set aside for U.S. veterans, who make up a disproportionate number of those diagnosed with mesothelioma. Finally, many cancer treatment centers have financial offices that can help you find organizations that can help you pay for treatment and other things you need to get adequate health care and after care for mesothelioma.

Have you or a loved one been diagnosed with Mesothelioma and would like help with health and legal services? Call us at (855) 970-9988 for help today.

Mesothelioma Treatment question for Doctor

What to Ask Your Doctor After Being Diagnosed with Mesothelioma

Asking the right questions after a mesothelioma diagnosis can help prepare you to deal with the future, and provide you with information you need to be an informed partner in deciding on the best path for mesothelioma treatments. When you first meet with your doctor after getting your diagnosis, though, it may be hard to remember all the questions you want to ask. This list of questions can help you get all the information you need, and may include questions you wouldn’t have thought to ask.

Questions About Your Mesothelioma Diagnosis

  • What kind of mesothelioma is it?
    • There are three types of mesothelioma based on the location of the cancer — pleural, peritoneal and pericardial. Each of these have different prognoses, and suggest different types of treatment. They also present with different symptoms. Knowing which type of mesothelioma you’re dealing allows you to start preparing yourself for treatment.
  • What stage is my mesothelioma?
    • The Mesothelioma stage defines how far the cancer has progressed. The stages are numbered one through four, with stage one mesothelioma offering the most hopeful prognosis and the most treatment options. Ask your doctor which stage of cancer you’re dealing with, and exactly what that means to your prognosis and possible treatment options.
  • Has my cancer metastasized?
    • If the mesothelioma has spread beyond the original site of the tumor, it can be harder to treat. Your doctor can explain if and how far the cancer has spread, and how that will affect your treatment options and your prognosis.
  • Is my cancer resectable?
    • resectable cancer is one that can be removed by surgery. Your doctors can’t know for certain until they actually perform the surgery, but they can make an educated guess at how likely it is that a surgeon can remove all the cancerous cells with surgery.
  • Do you need to do other tests before we decide on a treatment?
  • Are there other types of doctors I should see?

Questions About Your Doctor

  • Have you treated this type of cancer before?
    • A doctor experienced in treating mesothelioma is more likely to be aware of the wide range of treatment options, as well as of clinical trials for which you may qualify. Mesothelioma specialists, in particular, are likely to know and understand the specific challenges of this devastating cancer, and can steer you to support services and other services that can be immensely useful to you during and after your treatment.
  • Should I get a second opinion?
    • The answer to this question should always be yes. An experienced cancer doctor will generally be happy to recommend another doctor for a second opinion.

Questions About Mesothelioma Treatment

  • What are my treatment options?
    • Your options will depend on a number of factors, including the type and stage of mesothelioma, your age and general health, and the doctor’s experience with different treatments.
  • What is the goal of treatment?
    • There is currently no cure for mesothelioma, but there are a number of encouraging new treatments that can help extend your life after a diagnosis, as well as many treatments that can stop the spread of the cancer, or relieve the symptoms and make your life more comfortable. Understanding the goal of a specific treatment will help you understand what to expect.
    • In conjunction with this question, ask what treatment your doctor recommends, and why he feels it’s the best course of action for you.
  • Do I need to decide on treatment right now?
    • Mesothelioma is an aggressive, fast-moving cancer. It’s understandable for most patients to feel overwhelmed by treatment options and unable to decide right away. It’s important to know the time frame you have to make a decision so that you can begin treatment as soon as possible.
  • What are the risks and side effects of each treatment you’re suggesting?
    • All cancer treatments carry risks and side effects, including some that will make you feel even sicker during treatment. You have the right to be fully informed about all the risks and side effects of each of the treatments your doctor recommends to help you make a decision on which treatment path to follow.
  • Tell me about the treatment. What will it entail?
    • Treating mesothelioma is complex and may involve several different therapies. Your doctor or treatment team should be able to give you a “road map,” explaining where each treatment will be administered, how long it will take and what you should expect before, during and after each treatment they recommend.
  • How should I prepare for my treatment?
    • In most cases, the Mesothelioma cancer centers or your treatment team will give you printed materials that include specific recommendations and requirements leading up to your appointment. If you’re uncertain about any of the recommendations, ask your doctor to clarify them.

Questions About Living with Mesothelioma and Follow Up

  • How will this treatment affect my daily activities?
  • What sort of arrangements can we make to help me deal with chores, tasks and other daily activities while I’m undergoing treatment and after treatment?
  • What kind of follow up and aftercare will I need after treatment?
  • What if the treatment doesn’t work? Are there other options?
  • Are there any clinical trials for which I might qualify?

One of the most proactive things you can do is to ask a patient advocate to accompany you to your appointment. They may be specially trained advocates, or just someone you know with a medical background. They’ll often have questions for the doctor that someone without a medical background may not think to ask.

Have you or a loved one been diagnosed with Mesothelioma and would like help with health and legal services? Call us at (855) 970-9988 for help today.