Paul Kraus-Mesothelioma Survivors and the Immune System

Paul Kraus

Paul Kraus – Ten Year Mesothelioma Survivor

In 1997, Paul Kraus was diagnosed with widely disseminated mesothelioma.  The prognosis was poor – a few months at best.  Not ready to give up, he consulted with various physicians and conducted his own research.  From this information he created his own path to healing which involved boosting his immune system with integrative therapies, alternative treatments, dietary changes, and mind-body approaches.  As he maintained his health and quality of life from weeks to months and then from months to years, many were interested in what he did. 

Mesothelioma, the asbestos related cancer, is a particularly insidious disease.  Unlike other cancers that have a typical survival measured in years, the median survival with mesothelioma is often measured in months. 

As a result of his miraculous survival, Mr. Kraus wrote a book called “Surviving Mesothelioma and Other Cancers: A Patient’s Guide.”  After reviewing the book, Dr. Bernie Siegel remarked that, “Paul Kraus' book has all the information a cancer patient needs to have in order to learn what survival behavior is about…”

But, Mr. Kraus is not alone.  There are other long-term mesothelioma survivors.  A cursory review of the medical-scientific literature identified various survivors who lived decades after they were diagnosed.  Of course the bigger question is Why?

Other Long Term Mesothelioma Survivors

In 1994, a 58 year old man was diagnosed with malignant pleural mesothelioma.  He had a left thoracotomy, multiple pleural biopsies, and chest wall resection.  As of 2007, he is still alive.1  In 1986, a 65 year-old women was diagnosed in mesothelioma and lived for 14 years with no treatment other than radiation at the end.2  In 1970, a 53 year-old man who had worked at a plant adjacent to the Brooklyn Navy Yard, where asbestos was used, was diagnosed with mesothelioma.  Other than thoracotomy, no treatment was provided.  A medical article was published about him in 1978 and he was reported as still doing well.3  These are just three examples.  There are others.

The Role of the Immune System – What Do Long-Term Survivors Have in Common?

What is striking is that some of the scientific reports allude to the fact that the patient’s immune system may have played a role in their recovery.  In writing about the 58 year-old man, doctors suggested that the “spontaneous regression may be an immune-mediated phenomenon.”  And in the article about the individual who had worked at a plant adjacent to the Brooklyn Navy Yard, physicians wrote, “Our findings are consistent with the concept that normal immunological function may effectively impede dissemination of the disease (malignant pleural mesothelioma).”

Scientists and clinicians are currently testing a variety of immunotherapies for the treatment of mesothelioma.  These treatments are designed to artificially improve the performance of a patient's immune system using various proteins.  Some of these therapies have already demonstrated promise compared to the conventional approaches of surgery, chemotherapy, and radiation.

For example in a clinical trial involving immunotherapy and chemotherapy, the median survival was reported at 29.2 months4 and in another immunotherapy trial the median survival was 15 months.5  This may not sound like a lot, but keep in mind that median survival with the best conventional therapies is about 9-12 months.

Mesothelioma and the Immune System

This raises the question - does the immune system play a role in controlling malignant mesothelioma? Paul Kraus' experience and those of other long-term mesothelioma survivors suggests that such a role may be possible.  If proven true, this may also address other intriguing questions.  For example, why does mesothelioma evolve from asbestos many decades after exposure – did the patient’s immune system help keep it in check until a certain time?  And why are only a few people who are exposed to asbestos ultimately diagnosed with mesothelioma – was their immune system able to protect them from the disease throughout their life?

The treatment approaches used by long-term mesothelioma survivors like Paul Kraus may ultimately help answer these critical questions.

Listen to Mesothelioma Survivor

For more information about attending the Paul Kraus Teleconference on April 26 at 5 PM (PT) 8 PM (ET) call 1-619-261-7922 or go to http://www.survivingmesothelioma.com/index.cfm  for more information.

Endnotes

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

(2) 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.

(3) Fischbein, A,. et al., “Unexpected Longevity of a Patient with Malignant Pleural Mesothelioma.” Cancer 1978; 42:1999-2004.

(4) Monnet I, et al., “Intrapleural infusion of activated macrophages and gamma-interferon in malignant pleural mesothelioma: a phase II study.” Chest. 2002 Jun;121(6):1921-7.

(5) Castagneto B, et al., “Palliative and therapeutic activity of IL-2 immunotherapy in unresectable malignant pleural mesothelioma with pleural effusion: Results of a phase II study on 31 consecutive patients.” Lung Cancer. 2001 Feb-Mar;31(2-3):303-10.

Pleural mesothelioma and its treatment options

Mesothelioma is a critical and fatal cancer. It is caused by direct exposure to asbestos. Mesothelioma cancer is categorized into three categories: pleural mesothelioma, peritoneal mesothelioma and pericardial mesothelioma. This destructive cancer damages the mesothelium which is a membrane that forms the lining of several body cavities like the pleural (thoracal cavity), peritoneum (abdominal cavity) and pericardium (heart sac).

Pleural mesothelioma
Pleural mesothelioma is one of the most common forms of mesothelioma. More than 75% of victims fall in this category. This cancer affects the outer lining of the lungs and the chest cavity and makes it thicket. Symptoms of pleural mesothelioma are very common like difficulty in breathing, pain in the chest, fatigue, swelling of the face and neck, trouble when swallowing, cough and weight loss. These symptoms are shown by other diseases also and hence it becomes difficult to diagnose this cancer. Lining of the lungs are made up of two layers, parietal which covers the chest wall and visceral which covers the lungs. Mesothelium cells grow and produce a tumor which enlarges the space, causing it to fill with fluid. This extra thickness in layers is known as pleural effusion which leads to discomfort and pain in the chest. The pain may also be felt in the arms and the shoulders.

After the diagnosis of pleural mesothelioma you can opt for several mesothelioma treatment options. The factors like the patient’s age and history, location of the tumor, and stage of the cancer are to be noted while treating the patient. The different treatments available for the pleural mesothelioma are radiation, chemotherapy, pneumonectomy, and palliative therapies. Pneumonectomy means removing the cancerous lung or parts of the diaphragm where the disease has spread. In this treatment parts of chest and surrounding tissue which may be affected by the cancerous cells are also removed. This treatment can be carried out depending on the patients overall health, the amount of asbestos inhaled and the spread of the disease.

The next form of treatment is radiation. In this treatment the area affected by the cancer is exposed to the radioactive source. These radiations destroy the cancerous cells. Radiation therapy do not cause any harm to the healthy cells. Chemotherapy is one of the common treatments for pleural mesothelioma. In this treatment high power drugs are given to the patients either by injecting it or in the forms of pills. These drugs may cause some side effects such as vomiting, hair loss, nausea, weight loss and fatigue. The disadvantage in this treatment is that the drugs administered have to make their way to the cancerous cells, unlike radiation therapy where the radiation is directly targeted to the affected area. This may cause harm to the healthy cells as well.

Palliative therapies involve extracting extra fluid by needle and suction from the affected areas. In order to keep fluid accumulation under control, drugs are used. Researches are being performed to find new ways to treat this deadly cancer and so you should always keep yourself updated with these treatments and researches.

Pleural Mesothelioma

Mesothelioma is an aggressive form of cancer of mesothelial cells along the pleura, the membrane that creates the lung lining and chest cavity. About 75% of all diagnosed with pleural mesothelioma. Pleural Mesothelioma is usually unilateral (one side of the chest), and occurs most frequently in men aged 60 to 80 with a history of asbestos, often decades before the diagnosis.

If pleural mesothelioma begins, it appears as a series of small white nodules, to the diffusion, or an area on the surface of the pleura. Gradually began to thicken and grow together the nodes that form a "skin" that the injured lung and extends into the gap or groove of the pleura and diaphragm. Tumor spreads by direct invasion of surrounding tissue in the liver by pressure on the lungs, chest wall and ribs, and external attacks.
Mesothelioma Symptoms

The first symptoms of pleural mesothelioma is usually not accurate enough to trigger an alarm, and in most cases associated with age or too much work. Therefore, probably several months from the onset of symptoms occurred before the first symptoms of the common acute pleural effusion. At this time, progressive shortness of breath caused by an effusion and chest pain caused by the invasion of the chest wall can be identified. The most common symptoms are dry cough, fatigue, night sweats and weight loss.

Mesothelioma Diagnosis

At the initial examination by a physician, 80% to 95% of patients showed pleural effusion on X-rays showed the other little or no fluid. First, free-flowing liquid, and is similar in appearance as in other benign causes or congestive heart failure, and therefore see, this is another opportunity to be first must be excluded in the diagnostic process. Then the effusion "partitioned," or included in the pleural cavity where the fluid is not moving.

CT is final and can not just shedding, but the presence of pleural masses and lymph nodes of a certain size to show is that MRI is more sensitive in determining the invasion of the chest wall and spread of disease through the membrane, PET in the Staging of pleural mesothelioma in the surgical resection help rule out possible expansion in the lungs (opposed) to the opposite side or the other far away places.

The analysis confirmed the diagnosis of pleural fluid in a relatively small percentage of patients made little needle biopsy provides better results. Currently, the method of choice (value-added video thoracoscopic surgery) procedure, which results in the diagnosis of> 95%, and allows the pleural biopsy, drainage of the fluid and pleurodesis. Tong also ensure that adequate tissue samples to facilitate a definitive diagnosis.

Mesothelioma staging

As with any type of cancer staging plays a role in the choice of treatment in patients with pleural mesothelioma qualify. Several classification systems are used, however, is the most complete and widely used, the TNM system of mesothelioma associated with the group international attention.

Mesothelioma Treatment

Based on a number of factors, some treatment options available are surgery, chemotherapy, radiation therapy (or a combination of the three, known as trimodal therapy). Choice of treatment plan depends on the stage of cancer. Phase I of mesothelioma, no problem, be treated by surgery to remove cancerous tissue, unless the patient is too weak to undergo surgery. Sometimes treatment can not be done on short notice. Of course, the two patients who were operated on and those who are not closely monitored for the future growth of cancer. The prognosis for people with mesothelioma, so that phase I may very optimistic. Unfortunately, some patients who are diagnosed early have. Learn about the systemic treatment of pleural mesothelioma.

Stage IV and metastatic mesothelioma patients have the worst. Surgery is rarely in these patients - chemotherapy as palliative treatment alone.

These patients in phase II and III are most often combined with a multimodal treatment with surgery chemotherapy or radiation. Ill patients are evaluated for surgery. You are not feasible for the rigors of surgery (due to age or illness) who were treated with chemotherapy - some services and a different system, if necessary. Those who qualify for surgery and chemotherapy are often evaluated. May decide cancer, surgical debulking with adjuvant chemotherapy and radiotherapy or chemotherapy are early (usually a combination of Alimta and cisplatin) and then perform surgical exploration followed. If the operating system are not observed points for the tumor, may be withdrawn in some networks, but the patients are treated with chemotherapy. If the efficient removal of judges, surgeons can be done, a new surgical procedure is planned, in which it is performed pleurectomy / decortication to extrapleural pneumonectomy. Adjuvant radiotherapy after pneumonectomy.

Physicians with little experience with this disease can only treat the symptoms of pleural effusion with drainage and talc treatments. Specialists in major cancer centers were more likely to suggest a trimodal therapy. Second-line treatment of pleural mesothelioma usually with chemotherapy. Individual treatment is disappointing, as often proposed multimodality treatments. Although pleural mesothelioma continues to be difficult cancer to treat more awareness of the disease, new diagnostic and treatment options to better and more effective contribution to improving the prognosis.