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Chemotherapy Does Not Improve Treatment For Mesothelioma


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For mesothelioma patients, the addition of chemotherapy to the usual active symptom control (ASC) does not appear to improve survival or quality of life, according to an article released on May 16, 2008 in The Lancet.

Malignant pleural mesothelioma (MPM) is cancer of the mesothelium, the protective layer that covers the lungs. Generally associated with exposure to asbestos, it is almost always fatal.

http://www.medicalnewstoday.com/articles/107633.php

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A study published in the European Respiratory Journal last April, revealed that talc stimulates healthy cells to produce endostatin, a hormone considered the magic bullet for treating metastatic lung cancer. The University of Florida researchers say talc is an exciting new therapeutic agent for cancers largely considered incurable.

They found that talc causes tumor growth to slow down and actually decreases the tumor bulk. Talc is able to prevent the formation of blood vessels, thereby killing the tumor and choking off its growth. The tumors appeared to grow much slower and in some cases completely disappeared.

Scientists have only recently discovered that talcum powder stunts tumor growth, though the mineral has been used for almost 70 years to treat the respiratory problems that accompany metastatic lung cancer. About half of all patients accumulate fluid around the surface of the lungs, a condition known as malignant pleural effusion. That fluid can press down upon the lung, impair the breathing of the patient and cause the patient to feel very short of breath.

Pleural effusions indicate that the cancer, which might have started in the breast, lung or gastrointestinal tract, has spread throughout the body. The prognosis for the roughly 200,000 patients afflicted with this condition is poor: Many die within six months.

To make life more bearable for these patients, doctors close the extra space between the lung and the chest wall, where the troublesome fluid collects. The trick is gluing the two surfaces together. Talc is blown into the patients' chest cavity to irritate the tissue and create tiny abrasions. When the lung tissue heals, it becomes permanently adhered to the chest wall without impairing the patients' breathing. The effects of the procedure, called medical thoracoscopy with talc pleurodesis, are immediate and last a lifetime.

The Food and Drug Administration approved talc for use in medical thoracoscopy in 2003. Doctors have noticed that patients who undergo medical thoracoscopy with talcum powder live up to 18 months longer than expected.

Talc has added benefits besides causing scarring and taking away the fluid that surrounds the lung. The cells that cover the lining of the lung are stimulated by the presence of talc to produce a factor that inhibits the growth of blood vessels and kills the tumor cells themselves.

Less than one day after treatment with talc, patients began producing 10-fold higher levels of endostatin, a hormone released by healthy lung cells. Endostatin prevents new blood vessels from forming, slows cell growth and movement, and even induces nearby tumor cells to commit suicide. All of these make it hard for tumors to grow and spread into healthy lung tissue.

What is being done is the normal pleural mesothelial cells continue to produce endostatin. Talc doesn't go away. Talc stays in the chest cavity, constantly causing the normal cells to produce this factor that inhibits the growth of the tumor. And the antitumor effects of talc appear to be long-lasting.

This work will undoubtedly have a significant influence on future clinical trials dealing with the treatment of pleural malignancies, including lung cancer, mesothelioma and metastatic adenocarcinoma involving the pleural surfaces.

Source: University of Florida

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  • 3 months later...

Talc Induces Apoptosis in Human Malignant Mesothelioma Cells In Vitro

Am. J. Respir. Crit. Care Med., Volume 161, Number 2, February 2000, 595-600

NAJMUNNISA NASREEN, KAMAL A. MOHAMMED, PATRICK A. DOWLING, MELISSA J. WARD, GABRIELLA GALFFY, and VEENA B. ANTONY

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Veterans' Affairs Medical Center, Indiana University School of Medicine, Indianapolis, Indiana

Pleurodesis with talc is an accepted method for the treatment of symptomatic pleural effusions secondary to mesotheliomas. Patients with mesothelioma who have talc-induced pleurodesis have a lower morbidity than do those who do not have pleurodesis. The mechanisms whereby talc mediated these effects were considered to be secondary to a decrease or absence of a pleural effusion. The possibility that talc may directly affect malignant cells was not considered. The present study was designed to evaluate if talc directly effects cell death of malignant mesothelioma cells (MMC) or normal pleural mesothelial cells (PMC). Three confluent MMC and PMC were exposed to talc for 24, 48, and 72 h. In parallel experiments, glass beads similar in size to talc were included as control. Apoptosis was determined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and DNA electrophoresis. Our results demonstrated that talc at a therapeutically achievable concentration (6 µg/cm2) induces significant apoptosis in MMC. Talc-induced maximum apoptosis in MMC (39.50 ± 2.55%, 31.87 ± 4.69%, and 15.10 ± 3.93% in CRL-2081, CRL-5820, and CRL-5915, respectively) at 48 h, which was significantly (p < 0.05) greater than that in control cells. Electrophoresis of DNA isolated from talc-exposed MMC demonstrated the typical ladder pattern of internucleosomal DNA cleavage. Talc did not induce apoptosis in PMC, and glass beads did not cause significant apoptosis in either MMC or PMC. The present study has demonstrated that talc induces apoptosis in MMC without affecting normal mesothelial cells of the pleura. Nasreen N, Mohammed KA, Dowling PA, Ward MJ, Galffy G, Antony VB. Talc induces apoptosis in human malignant mesothelioma cells in vitro.

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