Now, you can finding the right medical professional to guide your treatment plan and proactively manage your medical care is your strongest weapon in the fight against mesothelioma. Your doctor should be well experienced with the diagnosis of mesothelioma, available treatments, and current clinical trials. It never hurts to obtain a second opinion, and while you may be most comfortable with your primary care physician, forming a doctor-patient relationship with an experienced mesothelioma physician is of the utmost importance.

Doctors by State

California

Connecticut

Florida

Georgia

Massachusetts

New Jersey

New York

North Carolina

Pennsylvania

Washington, D.C.

Washington (WA)

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California

• Robert Cameron, M.D.
  P. O. Box 951741
  Los Angeles, California 90095–1741
  Phone: (310) 794–7333
  email: rcameron@mednet.ucla.edu

  Dr. Cameron is Assistant Professor of Surgery and the Director of Thoracic Oncology at UCLA Medical Center. He is board-certified in general surgery and cardiothoracic surgery. His research interests include lung cancer, esophageal cancer and mesothelioma.

• David Jablons, M.D.
  UCSF Comprehensive Cancer Center
  Box 0128, UCSF
  San Francisco, California 94143-0128
  Phone: (800) 888-8664 or (415) 885-7777
  

  Dr. Jablons is the Program Leader of the Thoracic Oncology Program at the University of California, San Francisco (UCSF) and a Program Member of the UCSF Comprehensive Cancer Center. Current research initiatives include the molecular biology of non-small cell lung cancer and mesothelioma with emphasis on gene discovery through differential display and subtraction hybridization techniques in primary tumors, metastases, and cell lines.

• Theirry Jahan, M.D.
  2356 Sutter, 7th Floor
  San Francisco, CA 94115
  (415) 567–5581

  Dr. Jahan is an Associate Clinical Professor of Medicine and the Director of Clinical Services for the Division of Hematology/Oncology at the UCSF Comprehensive Cancer Center at the Mount Zion campus of the Department of Medicine, University of California, San Francisco.

• Dr. Mark Lischner
  2 Medical Plaza, Suite 100
  Roseville, CA 95661
  (916) 786-7498

  Dr. Lischner is a physician with the Sutter Physician Alliance and is affiliated with the Sutter Roseville Medical Center in Roseville, CA. His professional interests include asthma, interstitial fibrosis, asbestosis, sarcoidosis and mesothelioma.

Connecticut

• Mark Cullen, M.D.
  Yale University School of Medicine
  Division of Internal Medicine
  135 College Street, Room 366
  New Haven, CT 06510-2283
  (203) 785-6434 or 203-785-4197(Clinical Appointments)
  

  Dr. Cullen is Professor of Medicine and the Public Health Director for Occupational and Environmental Medicine. His research interests include isocyanate asthma, chronic beryllium disease, asbestos and cancer and work organization and occupational injury and diseases.

• Jack A. Elias, M.D.
  Yale University School of Medicine
  Pulmonary and Critical Care Medicine, Division of Internal Medicine,
  300 Cedar Street
  TAC-441 South
  New Haven, CT 06510-8057
  (203) 785-4119
  

  Dr. Elias Chairman of Department of Internal Medicine. His research interests include cellular and molecular pathogenesis of Asthma and COPD; cellular and molecular mechanisms of lung injury, repair and remodeling; transgenic modeling of pulmonary diseases and disorders; effector mechanisms of IL-13, VEGF, and TGF-beta type cytokines in the lung; and effector mechanisms of Th2 and Th1 cytokines in the lung.

• Graeme L. Hammond, M.D., F.A.C.S.
  Yale University School of Medicine
  Department of Surgery
  330 Cedar Street
  FMB 102
  New Haven, CT 06510-8062
  (203) 785-2704
  

  Dr. Hammond is a professor with the Department of Surgery at the Yale University School of Medicine in New Haven, Connecticut. He is board-certified in surgery and thoracic surgery.

• Carrie A. Redlich, M.D., M.P.H.
  Yale University School of Medicine
  Occupational and Environmental Medicine Program
  135 College St, 3rd floor
  New Haven, CT 06510
  (203) 785-5885
  

  Dr. Redlich is an Associate Professor of Medicine at the Yale University School of Medicine. Her research includes occupational lung disease, biomarker / molecular epidemiology environmental health research integrating clinical research with cellular and molecular approaches, clinical immunologic studies on the pathogenesis of isocyanate asthma, the protective role of retinoids/vitamin A in the lung, occupational liver disease, solvent-induced liver injury and clinical occupational medicine.

Florida

• Larry A. Robinson, M.D.
  H. Lee Moffitt Cancer Center & Research Institute
  At The University of South Florida
  12902 Magnolia Dr.
  Tampa, FL 33612
  (813) 745-8412

  Dr. Robinson is the Director of the Division of Cardiovascular and Thoracic Surgery at the H. Lee Moffitt Cancer Center. He is a member of the multidisciplinary Thoracic Oncology group, which evaluates and treats all stages of mesothelioma. Clinical and research interests include aggressive surgical management of mesothelioma and advanced lung cancer.

Georgia

• Dong M. Shin, M.D.
  Winship Cancer Institute
  1365C Clifton Road
  Atlanta, Georgia 30322
  (404) 778-1900

  Dr. Shin is an award-winning physician with the Winship Cancer Institute at Emory University. He specializes in medicine related to aerodigestive biology, as well as the head, neck and lung.

Massachusetts

• Raphael Bueno, M.D.
  Brigham and Women’s Hospital
  Division of Thoracic Surgery
  75 Francis Street
  Boston, MA 02115
  (617) 732-6824
  

  Dr. Bueno is the Associate Chief of Division of Thoracic Surgery for Brigham and Women’s Hospital. He is board certified in Surgery and Surgical Critical Care. His clinical interests include tracheal surgery, lung cancer, mesothelioma, esophageal cancer, benign esophageal disorders, thymomas and minimally invasive surgery.

• Pasi A. Janne, M.D.
  Dana-Farber Cancer Institute
  44 Binney Street
  Dana 1234
  Boston, MA 02115
  (617) 632-6049
  

  Dr. Jänne received his M.D. and Ph.D. from the University of Pennsylvania in 1996. He completed postgraduate training in internal medicine at Brigham and Women’s Hospital and in medical oncology at Dana-Farber Cancer Institute in 2001. He currently works in the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute. His main research interests include the study of epidermal growth factor receptor mutations in non-small cell lung cancer and their impact on the efficacy of EGFR-targeted therapeutic agents.

• David J. Sugarbaker, M.D.
  Brigham and Women’s Hospital
  Division of Thoracic Surgery
  75 Francis Street
  Boston, MA 02115
  (617) 732-6824
  

  Dr. Sugarbaker is Chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. He is a pioneer in mesothelioma research and one of the most cited physicians in the literature describing the treatment of mesothelioma.

New Jersey

• Bruce G. Haffty, M.D.
  The Cancer Institute of New Jersey
  195 Little Albany Street
  New Brunswick, NJ 08903
  (732) 253-3939

  Dr. Haffty is the Chairman of the Department of Radiation Oncology at the UMDNJ-Robert Wood Johnson Medical School and the Cancer Institute of New Jersey.

New York

• Manjit Bains, M.D., F.A.C.S
  Memorial Sloan Kettering Cancer Center
  1275 York Avenue
  New York, NY 10021
  (212) 639-7450

  Dr. Bains is a thoracic surgeon at the Memorial Sloan-Kettering Cancer Center in New York City. His clinical expertise includes the following: thoracic surgical oncology, lung cancer, esophageal cancer, mediastinal tumors, mesothelioma, pulmonary metastases, video-assisted thoracic surgery, pulmonary and upper gastrointestinal endoscopy, including laser endoscopy, and tracheobronchial and esophageal stents.

• A. Philippe Chahanian, M.D.
  Mt. Sinai Hospital
  5 East 98 St.
  New York, NY 10029
  (212) 241–6368

  Dr. Chahinian specializes in internal medicine and medical oncology at Mount Sinai Hospital in New York City. His clinical expertise includes lung cancer, mesothelioma, thoracic oncology and thymoma.

• David Ilson, M.D.
  Memorial Sloan Kettering Cancer Center
  1275 York Avenue
  New York, NY 10021
  (212) 639-8306 or (646) 497-9053 (New Patients)

  Dr. Ilson specializes in gastrointestinal oncology at Memorial Sloan-Kettering Cancer Center in New York City. His clinical expertise includes colorectal, esophageal, pancreatic, gastric, and other gastrointestinal cancers, as well as mesothelioma.

• Lee M. Krug, M.D.
  Memorial Sloan Kettering Cancer Center
  1275 York Avenue
  New York, NY 10021
  (212) 639-8420

  Dr. Krug is a medical oncologist who specializes in the treatment of thoracic cancers. He is board-certified in internal medicine and medical oncology. His research is focused primarily on small cell lung cancer and mesothelioma.

• Stephen M. Levin, M.D.
  Mt. Sinai Hospital
  1200 Fifth Avenue, 1B
  New York, NY 10029
  212–241-9059

  Dr. Levin is an Associate Professor of Community and Preventive Medicine and The Mount Sinai School of Medicine. He is board-certified in occupational medicine. His clinical interests include asbestos-related diseases, occupational asthma, carpal tunnel syndrome, repetitive strain injuries and musculoskeletal disorders.

• Valerie Rusch, M.D., F.A.C.S
  Memorial Sloan–Kettering Cancer Center
  1275 York Avenue
  New York, NY 10021
  Phone: (212) 639–5873

  Dr. Rusch specializes in treating patients with cancers of the lung, esophagus, mediastinum, and chest wall, including those with mesothelioma. Her research interests include the genetics of lung cancer and mesothelioma and predicting how a patient will respond to a particular treatment. She is also involved in developing methods for early detection of thoracic cancers.

• Harvey I. Pass, M.D.
  New York University Medical center
  530 First Avenue
  New York, NY 10016

  Dr. Harvey Pass is the director of the New York University Medical Center Division of Thoracic Surgery and is Chief of Thoracic Oncology. He is one of the world’s leading authorities on mesothelioma.

• Roman Perez–Soler, M.D.
  NW York University Kaplan Cancer Center
  550 First Avenue
  New York, NY 10016

  Dr. Perez-Soler is the Associate Director of Clinical Oncology at New York University Kaplan Cancer Center in New York, NY. He specializes in medical oncology and is the principal investigator of the Phase II L-NDDP/Platar trial for pleural mesothelioma.

• Scott J. Swanson
  Mt. Sinai Hospital
  1190 Fifth Avenue
  New York, NY 10029
  (212) 659-6815

  Dr. Swanson is a surgeon at Mount Sinai Thoracic Surgery Center. He specializes in thoracic surgery and has a sub-specialty in cardiothoracic surgery. His clinical interests include lung cancer, esophageal surgery, video assisted thoracic surgery, lung transplantation and thoracic oncology.

• Robert N. Taub, M.D.
  Professor of Clinical Medicine, Program Director
  Columbia–Presbyterian Hospital
  Atchley Pavilion Room 907
  161 Fort Washington Ave.
  New York, NY
  (212) 659-6815

  Dr. Taub is the Professor of Clinical Medicine at Columbia University, College of Physicians and Surgeons and a medical oncologist who directs the Connective Tissue Oncology Program at the Herbert Irving Comprehensive Cancer Center, where there are several ongoing multimodality studies of patients with pleural and peritoneal mesothelioma.

North Carolina

• David H. Harpole, Jr., M.D.
  Duke University Health System
  DUMC 3627
  Durham, NC 27710
  (919) 668-8413

  Dr. Harpole is Vice Chair of Faculty Affairs and a member of the Division of Cardiovascular and Thoracic Surgery in the Department of Surgery of the Duke University Health System. His clinical interests include thoracic oncology, general thoracic surgery, benign and malignant disease of the lung, esophagus, and mediastinum, as well as advanced airway and thoracoscopic surgery, hyperhidrosis palmaris, mesothelioma and esophageal cancer.

Pennsylvania

• Larry Kaiser, M.D.
  Hospital of the University of Pennsylvania
  3400 Spruce Street
  4 Silverstein Pavilion
  Philadelphia, Pennsylvania 19104
  (215) 662-7538

  Dr. Kaiser is The John Rhea Barton Professor and Chairman of the Department of Surgery and the Surgeon-in-Chief for the University of Pennsylvania Health System. His area of interest and expertise is thoracic oncology, specifically lung cancer, malignant mesothelioma and mediastinal tumors.

• Daniel Sterman, M.D.
  University of Pennsylvania Medical Center
  Pulmonary, Allergy & Critical Care Division
  833 West Gates Building
  3400 Spruce Street
  Philadelphia, PA 19104-4283
  (215) 614-0984

  Dr. Sterman is currently Associate Professor of Medicine and Associate Professor of Medicine in Surgery, and the Director of the PENN Interventional Pulmonology Program and Clinical Director of the Thoracic Oncology Gene Therapy Program of the Center for Lung Cancer and Related Disorders of the University of Pennsylvania Medical Center.

Washington, D.C.

• Paul H. Sugarbaker, M.D.
  Washington Cancer Institute
  106 Irving St.
  N-3900
  Washington DC 20010
  (202) 877-DOCS (202-877-3627)

  Dr. Sugarbaker is Director of Surgical Oncology at the Washington Cancer Institute. His clinical interests include congenital chest wall deformities, esophageal cancer and motility disorders, as well as general thoracic surgery, lung and pleural cancer, volume reduction emphysema surgery and mesothelioma.

Washington State

• Eric Vallieres
  Swedish Medical Center
  1101 Madison St., Suite 850
  Seattle, WA 98104
  (206) 215-6800

  Dr. Vallieres is a thoracic surgeon with the Swedish Medical Center. He is board-certified in general surgery and in thoracic surgery. His areas of interest and expertise include esophageal Cancer, hyperhidrosis, lung cancer, lungs & esophagus, mediastinal pathology, mesothelioma and pleural diseases.
  

For more detail, you can visit the site on www.mesotheliomahelp.net

A judgment issued in a Texas asbestos case has been overturned this week by the Texas Supreme Court. The Supreme Court stated that the man involved could not prove that asbestos was completely at fault for his illnesses.

A Texas mechanic that had filed suit regarding asbestos exposure will not receive a $169,000 judgment that he had been awarded by an appeals court. The Texas Supreme Court ruled that the judgment, in the amount of $169,000 was not warranted since the victim could not prove that his respiratory illness was the result of asbestos exposure only. The mechanic had sued four brake pad manufacturers regarding his illness, called asbestosis, stating that working with the brake pads for 30 years was the cause of his disease. Three of the companies settled out of court, while one chose to contest it.

With asbestos lawsuits, including suits regarding asbestosis and mesothelioma, specific steps need to be taken to show that asbestos was the cause of the illness. The victim had also been a longtime smoker, which, though it will not cause asbestos-related diseases, can increase the chances of contracting one. Medical testing can reveal if asbestos was the only factor in mesothelioma and asbestosis, and the victim had not completed those tests.

Asbestos that was found as an old Michigan middle school was being prepared for demolition will not increase the timeline by about one year. The removal of the asbestos will also increase the proposed budget by as much as $2 million.

A middle school demolition that was to take place this summer has been postponed due to large amounts of asbestos found in the old building. The razing was supposed to use up the last $500,000 existing in a bond issued in 2003 for school repairs in a small Michigan town. Now, the asbestos removal will push the budget up by millions of dollars, soaking up funds that were allotted for other school projects in the area like replacing old boilers. Initial school documents said that there were only small amounts of asbestos present in the building.

Asbestos removal is a costly business, mostly due to the caution that needs to be in place during and after the procedure. Abatement, as asbestos removal is called, needs to be conducted by licensed professionals that can safely handle and dispose of the deadly material. Disturbed asbestos can break apart into tiny fiber; inhaling the fibers can lead to asbestosis, emphysema and mesothelioma, a type of lung cancer. Mesothelioma can take decades to manifest, and there is no known treatment for the disease.

Mesothelioma is an aggressive cancer caused by asbestos. For decades, asbestos was used heavily in construction, industry, the Navy, even household products and appliances. It is still present in many homes, schools, and office buildings. The disease can arise from small exposures, and even as much as 50 years later. As a result, each year 3,000 Americans and many thousands more worldwide develop mesothelioma, and millions of us are at risk.

The Meso Foundation is the non-profit collaboration of patients and families, physicians, advocates, and researchers dedicated to eradicating the life-ending and vicious effects of mesothelioma. We promote critically-needed research to develop more effective treatments and ultimately a cure! We have awarded over $4 million in grant funding, advancing meso science through promising studies around the world.

Through our Patient Advocacy program we also offer personalized help to patients and family members, educating them on the disease, helping them to obtain the most up-to-date information on treatment options, and connecting them with meso treatment specialists, and with other patients and families.

This site is another tool to give meso patients and their families the latest and most relevant information about the disease, offer hope and support, and unite the meso community. We encourage you to explore the various topics and search through our vast document archive. We invite you to join the Meso Community where you will be able to chat with other meso patients and their families and find valuable resources. Finally, we encourage you to contact our Patient Advocacy Director to get personalized assistance.

And now, Mesothelioma Applied Research Foundation (MARF) standing with us. Together creating hope for all mesothelioma patients, also hope for their families. You can get any information about MARF activity on www.marf.org

Tell this information to your friends, may be they need it.

Malignant mesothelioma is a rare form of cancer which occurs in the lining of the lung (the pleura) or in the abdomen (the peritoneum). In very rare cases, mesothelioma can occur in other areas of the body as well. The major known cause of mesothelioma is exposure to asbestos. Although science is not certain as to the exact mechanism which causes mesothelioma, it is thought that the asbestos fibers puncture the parenchyma, become lodged in the pleura, and by process of irritation create the change in the cells which causes the mesothelioma.

The chance of recovery for a person with mesothelioma depends on several factors, including:

• Size of the cancer


• Location of the cancer


• Spread of the cancer throughout the body


• Response to treatment


• Appearance of the cells under a microscope


• Age of the patient

Malignant mesothelioma is the most serious of all asbestos-related diseases. Virtually all cases of malignant mesothelioma are attributable to asbestos exposure.

These web pages contain useful mesothelioma information for the sufferers of malignant mesothelioma disease. Knowledge of available mesothelioma treatment options can be an essential weapon in the fight against the progression of this deadly disease.

Mesothelioma is a rare form of cancer that forms near the lungs or ribs. Well, if it's so rare, why do so many lawyers advertise that they help mesothelioma victims? That's like saying automobile accidents are rare but you can find an auto insurance agency on every street corner anyway. There is total disconnect between the advertising for mesothelioma legal options and the claim that this is a rare form of cancer.

According to one source, 2500 new cases of mesothelioma are reported each year. Okay, that makes it rare. But then, why do so many law firms advertise for mesothelioma patients? I think the reason is that the same source says 70-80% of mesothelioma sufferers have worked with asbestos.

You may not be suffering from mesothelioma, but if like me you have grown up in the United States, how could you not have heard about the huge expenses associated with asbestos? We used to use asbestos in everything because it is fire-resistant. We just didn't realize it is also poisonous. It's like the ancient Romans using lead in all their dining ware and drinking utensils and plumbing. They sealed everything with lead, and in doing so they poisoned themselves.

It takes a long time for mesothelioma to appear. According to one source, mesothelioma may not reveal itself 35-40 years. That is long time to wait. That same source also suggests that as many as 300,000 new cases of mesothelioma may be diagnosed by the year 2030. Suddenly, all the law firm interest in mesothelioma starts to make sense. A few cases each year can not only pay off well (attorneys often take 25-40% of your settlement in contingency fees), they help build a law firm's reputation for resolving such cases.

Your mesothelium is a two-layer membraneous sack that surrounds and protects your internal organs. It secrets fluid so that your organs can move freely inside you. According to Surviving Mesothelioma, when the cells become cancerous, they begind to divide and multiply rapidly and begin invading nearby organs and other parts of the body. In short, they forget what they are genetically programmed to do and just start consuming resources and replicating as fast as possible.

The sooner you identify mesothelioma, the sooner you can begin treatment for it. And the sooner you can start looking for an attorney, if you want to. The symptoms of mesothelioma include: coughing, shortness of breath, difficulty breathing, chest or abdominal pains, loss of appetite (and weight loss), and fluid accumulation in your chest or abdomen. You may not recognize these symptoms right away, especially if you have other conditions that may produce one or more of those symptons.

You may or may not know if you have worked in or near asbestos. If you are sure you once worked in an asbestos environment but have not yet developed cancer, you can (and, in my opinion, should) take at least one precautionary step. Get a cancer policy. You cannot get these kinds of policies once you have been diagnosed (in some cases, you may be able to take out a cancer policy if you have been cancer free for ten years or longer).

Many companies offer supplemental health insurance programs. If you have heard of AFLAC, Colonial Supplemental Insurance, TransAmerica, or AllState's Supplemental Hospitalization plan, you have heard of supplemental insurance policies. You can often keep these policies if you leave your job because you pay for them directly.

For more information about mesothelioma, check out The National Cancer Institute's Mesothelioma section.

Author: Lisa Ann Homic, M.Ed. D.C. As science is looking for ways to fight cancer, more is being revealed about the body’s ability to self-regulate. An ideal therapy reinforces the body’s self healing mechanisms rather than depletes it. While many traditional cancer therapies weaken the immune system in order to stop tumor growth, there is a high chance that new tumors will appear. It is similar to the old saying about the dump attracting rats. If you only kill the current rats, there is still something about the dump that attracts more rats! Over time our bodies have become the dump. We fill ourselves up with chemical and emotional toxins so our immune systems can’t manage anymore. This has lead researchers to look at what makes the body strong or how the body makes cancer strong. The immune system, under normal conditions, prevents illnesses from developing by neutralizing foreign substances that enter the body. The immune system also regulates the cells of the body by directing a cell to die if it is mutated. Helping the body maintain this high state of vigilance is a natural method to restoring health and preventing illness. One approach to natural immune system care is through nutrition such as fucoidan which has been heavily researched in the last decade. It is a polysaccharide from brown seaweed which is a dietary staple of Japanese natives. It has been shown to improve cellular communication so mutated cells are destroyed by the body. It is also seen as an anti-aging nutrient that supports cell regeneration by mobilizing stem cells. Other benefits are seen in healthy joints, circulation, dietary cholesterol, gastrointestinal tract, respiratory system, kidneys, and anti-oxidant support. Known for its health preserving properties for centuries or longer, it has been studied since the 1970’s and marketed in supplements in Japan since 1997. For those interested in transforming their bodies from a dump to an oasis, adding fucoidan to their nutritional protocol is great approach. Another new development is the availability of gelceuticals. They are gel based nutritional supplements from whole foods, such as fucoidan in brown seaweed, that have exceptional bio-availability in the digestive tract. This is a recent advancement for people who want an alternative to pills and liquids. Pills have the least absorption rates and liquids need to be refrigerated and measured. Once harvested and processed into a gelceutical, the nutrients are retained as close to its natural state as possible, especially fucoidan which is already a gel-like substance. A sensible approach to cancer is to practice prevention or, with a diagnosis, allow the body its best opportunity to maintain a strong and proactive immune system. Harnessing the benefits of fucoidan in gelceutical form is one way to provide nutritional support.

About Author

Dr. Lisa Ann Homic is a chiropractor and wellness coach in Auburn, NY. She developed the Numbers Don’t Lie Diet Program. Visit http://www.CreatePurpose.com . She also dabbles with the website: http://www.ShopaholicFun.com . Article Source: http://www.1888articles.com/author-lisa-ann-homic-m.ed.-d.c.-3190.html

One rare form of cancer is called Mesothelioma, a malignant tumor in the mesothelial tissues of the lungs and the abdomen, arising from the inhalation of asbestos. Its rarity is one of the reasons why a lot of people are not aware of this kind of fatal disease. In fact, many people die of Mesothelioma undiagnosed. Although there is now a growing awareness of the hazards of asbestos to health, still many have not heard of Mesothelioma and thus, have not understood its nature, cause, signs and treatment. Even some physicians find it hard to detect Mesothelioma because its symptoms are akin to other diseases like lung cancer and pneumonia. Furthermore, it takes decades for a patient who was exposed to asbestos to develop Mesothelioma — fifty years, at most. Being unaware of Mesothelioma poses higher risks since it deters diagnosis and treatment. A person undergoing treatment must know the different stages of the cancer or the extent of the disease. Chances of recovering from Mesothelioma and the kind of treatment depend on the stage of the illness. There are basically two staging systems used for Pleural Mesothelioma (lungs): TNM system and Brighan system. These staging systems are also used in other kinds of cancers; however, the first is commonly used. There is no established method in determining the stage of the Peritoneal Mesothelioma cancer (abdominal) so the TNM system is used. There are three variables in the TNM system: tumor, lymph nodes and metastasis. In the earliest stage of Mesothelioma, stage I, the malignant Mesothelioma cells start to grow and multiply only one layer of the pleura. The pleura is the membrane that encloses the lungs and lines the wall of the chest cavity. However, there are some instances wherein the pericardium (membrane that covers the heart) and diaphragm cover are already affected. In this case, the cancer patient is still in stage I Mesothelioma. In the second stage, the two layers of the pleura are already affected by Mesothelioma. Take note, however, that in this stage, only one side of the body is affected. Normally, the pleura produces only small amount of lubricating fluid that allows easy expanding and contracting of the lungs. The excess fluid is absorbed by the blood and the lymph vessels so there’s a balance between the amount of fluid produced and removed. During the second stage Mesothelioma, fluid starts to build up between the membrane of the lungs and the membrane of the chest wall, resulting to pleural effusion. The increase in the volume of fluid produced causes shortness of breath and chest pain. Other Mesothelioma cancer patients experience dry and persistent cough. Diagnosis of the pleural effusion is achieved through a chest x-ray. Stage III Mesothelioma means that the malignant cells have already spread to the chest wall, esophagus and the lymph nodes on one part of the chest. The patient may suffer severe pain near the parts affected. When not treated immediately or when the Mesothelioma patient doesn’t respond well to medication, the cancer may advance to the fourth stage. The fourth stage Mesothelioma is formidable since at this stage the Mesothelioma cells have penetrated into the bloodstream and other organs in the body like the liver, the bones and the brain. The lymph nodes on the other side of the chest may also be affected by Mesothelioma in stage IV. Brighan staging system, on the other hand, determines whether the Mesothelioma can be surgically removed or not and whether the lymph nodes are affected or not. In stage I Mesothelioma, the lymph nodes are not yet affected and the patient can still recover through surgery. In stage II, surgery can still be executed but some lymph nodes have already been infiltrated by the cancer cells. In stage III, the heart and chest wall are already affected; thus, surgery is no longer advisable. The lymph nodes in this stage, however, may or may not be affected. In the final stage, stage IV Mesothelioma, cancer cells have already gone to the bloodstream and other parts of the body like the heart, brain, bone and liver. In most cases, a patient who has reached stage IV Mesothelioma only has four to twenty-four months to live.

Article Source: http://www.1888articles.com/author-smith-chen-5297.html

Deciding to pursue legal recourse and selecting an attorney to represent you in a mesothelioma or asbestos lawsuit are important decisions that should be made carefully. Below are five tips to consider:

1) You Were Probably Exposed to Asbestos

Some mesothelioma patients know they worked around asbestos, but many do not know how they were exposed. In fact, many are not sure if they were ever near this carcinogen. Unfortunately, there have been thousands of products that contain asbestos - cigarette filters, hair dryers, brakes, basement and roof materials, pipes, boilers, insulation, and many other products found throughout the home and at work. Mesothelioma patients are often not aware that the products around them contained this carcinogen. Also, the latency period (the time from asbestos exposure to mesothelioma diagnosis) can be over 30 years. If you were diagnosed with mesothelioma it is more than likely that you were exposed to asbestos multiple times in your life and that this happened decades before your diagnosis. A skilled lawyer can help you identify the various ways you were exposed.

2) Don't Wait to Discover Your Legal Options

When you have been given the news about this terrible disease, you may not feel that you have the time to deal with the legal questions - should I file a claim? should I talk to a lawyer? However, you should not wait too long to learn about your legal rights for at least three reasons:

1. Statutes of Limitations - There are statute of limitations which means you only have a limited time to file your case after diagnosis. The statute of limitations time period is set by individual states and varies. If you wait past this time period you cannot file. The clock usually starts ticking on the day of diagnosis.
   
   
2. Financial Pressure - A diagnosis can bring financial stress, less income, more expenses, and treatments that are not covered by insurance. Knowing that money may be on the way from filing a claim can bring great financial relief, make more treatment options available, and remove at least one stress.
   
   
3. Lawyers can be Excellent Resources - The more experienced mesothelioma lawyers and law firms can often be excellent sources of information about various doctors and treatment options available for this disease.

3) Don't Pick an Attorney Based Solely on TV Ads

Many asbestos lawyers advertise on television, however, you should not use a TV commercial as the sole reason to hire an attorney. Actual credentials are what counts. For example, what type of accomplishments has the law firm achieved? How committed are they to cancer cases? How many other cases like yours have they handled?

4) Make Sure You Understand Fees

Contingency is the term that means that the lawyer gets paid only after they collect money for you. Nearly all asbestos related lawsuits are handled on a contingency basis. The amount of the contingency fee that your lawyer can charge varies by state. It is usually between 33% and 40% of the amount that is awarded to you after expenses are deducted. It is important to discuss fees openly, ask what services they cover, how they are calculated, and whether there will be any extra charges.

5) Ask Yourself if This is a "Trusted Partner"

For something as important as a mesothelioma lawsuit, your attorney should not only be experienced, skilled, and dedicated, but also a trusted partner who keeps you well informed. You have the right to know and understand every step of the legal process and to be included in key decisions about your case. You should ask a potential attorney to explain how they intend to include you in the decision-making.

Finally, here are three warning signs that an attorney may not be right for you:

1. The lawyer is hard to reach, does not return calls promptly, or your calls are returned by someone else.
2. The lawyer seems uninterested in your opinions.
3. The lawyer asks you questions that make you doubt their competence or experience.

Here are experienced mesothelioma law firms you can contact for more information:

California - Paul, Hanley & Harley
If you are a resident of California and were diagnosed with mesothelioma please call Jerry Neil Paul of Paul, Hanley & Harley. Paul, Hanley & Harley has garnered many of the most significant California verdicts and they are dedicated to helping victims of mesothelioma. Call: 1-800-281-9804.

Midwest - The Maune Raichle Law Firm
Would you like free information on mesothelioma or legal representation? If you or someone you know has mesothelioma and lived or worked in the Midwest, call The Maune Raichle Law Firm or visit our website. We handle only mesothelioma cases. Call us at 1-800-358-5922.

New York and New Jersey - Levy Phillips & Konigsberg LLP ("LPK")
If you or someone you know has mesothelioma and has ever lived (or performed any work) in NY or NJ, call LPK for a free consultation, 24 hours a day, 7 days a week (1-800-637-6529) or visit their website. LPK has over three decades of experience, including many top mesothelioma jury awards in NY and NJ.

In the past, many of us had never heard of the word. Tragically, due to the ever growing list of innocent people who have lost their lives due to it, we now know that mesothelioma is caused by the inhalation of asbestos dust and that many years may pass between inhalation and onset of disease.

With no known cure presently available, the shock of receiving a mesothelioma diagnosis is intensified by prognosis, fear of the unknown and pain associated with this disease. My husband had lived in the West Australian mining town of Wittenoom for seven short months as a child. Forty five years later, at the age of 52, he was diagnosed with pleural mesothelioma and given a prognosis of three to nine months.

Accepting that his disease was terminal was a catastrophic experience and my feelings of helplessness were overwhelming. I greatly feared for the pain he would suffer and determined that I would do everything within my power to ease his burden. I realized that I could not do this without knowledge and searched the internet for everything I could find regarding mesothelioma; the stages of the disease and the pain and symptoms my husband would experience as his disease progressed. I learned a lot and in this way, I came to realize, that although I could not stop my loved one from dying - I could help him to live.

One of the most important things I learned, was that in order to obtain the best possible pain control - medication must be taken at regular prescribed times, regardless of whether pain is or isn't present, effectively keeping in front of the pain. I learned that there are different types of pain and that not all pain responds to the same medication; and how to measure intensity of pain and encouraged Brian to communicate to me - the type of pain he was experiencing and its intensity. Brian soon realized the benefits of this - It was an immense relief for him - to know that I understood what he was experiencing and more importantly - that I could do something about it.

I also began keeping a daily journal in which I listed the various medications Brian relied on, the times they were to be taken and their dosage. In this journal, I also recorded any break through pain he experienced careful to describe its type and intensity - Any symptoms Brian experienced both due to the progression of his disease and the side effects of the medication were also recorded. I took my journal with me on every visit to the doctor, my records enabling him to easily assess how Brian was coping with his disease and provided the means by which to accurately determine the strength of medication needed, to bring Brian's pain and symptoms back into control. As my efforts resulted in his improved quality of life, I lost my sense of helplessness and gained strength.

Experience has taught me that knowledge is the key, to better quality of life, not only for the mesothelioma patient but for those who care for them. My understanding of the stages and symptoms of mesothelioma, allowed for me to be one step ahead of its progression and gave me the opportunity to have medication and later, physical aids such as oxygen, wheelchair etc - on hand before Brian needed them. This alleviated much of the fear, pain and discomfort he would otherwise have suffered.

Chronic untreated pain is debilitating, it dramatically affects a patient's ability to participate in daily routines and in some cases takes away their will to live. Through my experience and the knowledge I have acquired, I have come to realize that many people are suffering chronic pain unnecessarily. This is in part due to them not being made aware of the importance of pain management and being shown the simple tools necessary to achieve it: lack of knowledge regarding the benefits and side effects of available medication is also a factor.

Many patients associate morphine and methadone with drug addiction and are reluctant to take it due to their belief that it will cause them to become "high" or sedated, this and their attempts to brave out the pain results in their pain spiralling out of control. This could be prevented if they were informed that chronic pain effectively "uses up" medication and that these drugs, when taken for the relief of pain associated with cancer, can dramatically reduce both the occurrence and intensity of pain, without causing sedation.

Testament to this, despite the large amount of methadone Brian was taking, he remained active and alert, drove his car for eighteen months after diagnosis and was able to continue going fishing, which was the passion of his life. Keeping him out of pain became the reason for my existence and I was vigilant in giving him his medication at prescribed times. There were many occasions when caring but uninformed loved ones and friends, said to me: "Brian does not need for you to be giving him medication at this time - he is not in pain." And I would patiently explain to them, that the reason Brian was not in pain, was because the regular medication he was receiving effectively allowed for him to remain in front of it.

As Brian's disease progressed, there were times when his pain broke through his stable medication, however due to our good communication and the use of hydromorphone; we were able to bring it back into control within a short time.

I believe that all patients and their carers must be encouraged to talk to their doctors about the progressive symptoms of mesothelioma, so that informed choices can be made regarding available treatment and medications. It is important for health professionals to realize and support a family's need to maintain some control over their lives, this removes their sense of helplessness, gives them purpose and helps them to cope with the anticipatory grief associated with terminal diagnosis.

Brian was not bed bound until three short days prior to his death. As was our wish, he passed away at home surrounded and supported by all of his loved ones. Through this, I have found much peace...

• Mesothelioma is a cancer that arises from the cells lining the chest or abdominal cavities.
• Mesothelioma typically results from exposure to asbestos.
• When mesothelioma affects the chest the doctor may look inside the chest cavity with a special instrument called a thoracoscope.
• When mesothelioma affects the abdomen, the doctor may look inside the abdomen with a special tool called a peritoneoscope.
• Mesothelioma is diagnosed by a biopsy.
• The outlook for patients with mesothelioma depends on how early the disease is detected and how aggressively it is treated.

Research is being conducted at various cancer centers all over the United States.

A recent study involving L-NDDP (brand name: Platar) produced two cases of remission in mesothelioma patients. Another study found that a drug known as Lovastatin may hold promise for mesothelioma patients.

To learn more about mesothelioma clinical studies and journal medical journal articles visit the Mesothelioma Web http://www.mesotheliomaweb.org.

What kinds of resources are available for people with mesothelioma?

There are numerous cancer web sites, some specific to mesothelioma. Because they are often difficult to locate, we have listed some relevant medical web sites that have information about mesothelioma.

American Institute for Cancer Research
(http://www.aicr.org)

American Thoracic Society
(http://www.thoracic.org/)

Canadian Cancer Society
(http://www.bc.cancer.ca)

MesotheliomaWeb
(http://www.mesotheliomaweb.org)

The above content is supplied with kind permission from MesotheliomaWeb (www.mesotheliomaweb.org).

Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated.

Mesothelioma Treatment Options (Traditional & New Treatments Being Studied)

Treatment options are often determined by the stage of mesothelioma a patient is in. There are three staging systems currently in use and each one measures somewhat different variables.

The oldest staging system and the one most often used is the Butchart System which is based mainly on the extent of primary tumor mass and divides mesotheliomas into four stages.

The more recent TNM system considers variables of tumor in mass and spread, lymph node involvement, and metastasis.

The Brigham System is the latest system and stages mesothelioma according to resectability (the ability to surgically remove) and lymph node involvement.

Traditional care

There are three traditional kinds of treatment for patients with malignant mesothelioma:

• Surgery (taking out the cancer)
• Radiation Therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
• Chemotherapy (using drugs to fight the cancer)

NOTE: Often two or more of these are combined in the course of treatment.

New Approaches Being Studied

New approaches to treat malignant mesothelioma are currently being tested. They often combine traditional treatments or include something entirely new. They include:

• Promising drugs
  • L-NDDP or Platar. Intrapleural administration of this platinum product is designed to overcome the toxicity and drug resistance currently limiting the usefulness of platinum drugs like Cisplatin. NOTE: A recent trial produced remission in two patients.
  • Endostatin, shown to work with angiostatin in destroying a tumors' ability to grow blood vessels without harming normal cells.
  • Lovastatin is a cholesterol drug shown in a recent study to potentially inhibit mesothelioma cancer cell growth.
  • Intrapleural interferon gamma is the direct administration of the anti-cancer drug Interferon Gamma.
• Photodynamic therapy kills cancer cells using the energy of light
• Immunotherapy treats cancer by helping the immune system fight the disease.
• Gene therapy treats cancer by correcting the genetic deficits that allow tumors to develop. A September 1999 study found that Interferon interleukin prevented the growth of mesothelioma cells in mice.

Additional Information

Surgery: There are several types of surgery used in treating mesothelioma.

• A pleurectomy is the removal of part of the chest or abdomen lining and some of the tissue around it.
• Depending on how far the cancer has spread, a lung also may be removed in an operation called a pneumonectomy.
• In an extrapleural pneumonectomy, the lung is removed along with the lining and diaphragm (the muscle that helps you breathe) on the affected side. In this surgery, the lining around the heart is also removed.
• Sometimes a pleurectomy/decortication is performed. In this surgery, the lining of the lung is removed along with as much of the tumor as possible.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

If fluid has collected in the chest or abdomen, your doctor may drain the fluid out of your body by putting in a needle into the chest or abdomen and use gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed from the abdomen, this is called paracentesis. Your doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be administered by pill, or it may be put into the body by a needle in the vein or muscle.

Chemotherapeutic agents can be administered either systemically (through the blood stream) or intrapleurally (in the pleural cavity). When it is administered intrapleurally, the treatment is localized at the site of the tumor. These drugs are generally very toxic and you should discuss their use very carefully with your physician.

Butchart System extent of primary tumor mass

• Stage I: Mesothelioma is present in the right or left pleura and may also involve the diaphragm on the same side.
• Stage II: Mesothelioma invades the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
• Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may also be involved.
• Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.

TNM System -- variables of T (tumor), N (lymph nodes), M (metastasis)

• Stage I:Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.
• Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
• Stage III:Mesotheliomas is now in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side with or without spread to lymph nodes on the same side as the primary tumor.
• Stage IV:Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal al cavity or neck. Any distant metastases is included in this stage.

Brigham System: (variables of tumor resectability and nodal status)

• Stage I: Resectable mesothelioma and no lymph node involvement
• Stage II: Resectable mesothelioma but with lymph node involvement
• Stage III: Unresectable mesothelioma extending into chest wall, heart, or through diaphragm, peritoneum; with or without extrathoracic lymph node involvement
• Stage IV: Distant metastatic disease

Mesothelioma is diagnosed by pathological examination from a biopsy. Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up around the lungs (pleural effusions), shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an x-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

• Thoracoscopy

For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller.

If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.

• Peritoneoscopy

For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.

If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.

• Biopsy

If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.

When Guillermo Rivera was diagnosed with colorectal cancer, he "didn't know what to do or where to go," he said.

But an experimental program here helped guide him through the cancer-care maze, the 63-year-old retired machinist told attendees at the annual meeting of the American Society of Therapeutic Radiation and Oncology.

The program is aimed at helping the poor and members of minority groups overcome barriers to care, according to David Khan, M.D., of Centinela Freeman Medical Center in Inglewood, Calif., who presented details of the program.

"When you have few to no resources, the process of cancer care is daunting," Dr. Khan said. "It's daunting for everyone, but with no resources it's even more difficult."

So, with the support of the National Cancer Institute, Dr. Khan and colleagues enrolled and trained 68 volunteer "patient navigators" to help low-income and minority patients. Four years later, 26 of the original group remain with the program, he said.

"We think of patient navigators as shepherds to help guide people through the process," Dr. Khan said.

The patient population for his facility is 71% black and 13% latino, many with incomes below the poverty line, he said, and patients face barriers such as a lack of transportation and childcare.

Of 493 patients offered navigation, 297 accepted, Dr. Khan said.

The main barriers to care were transportation, psychosocial issues, financial issues, fear of cancer, childcare needs, and difficulty with English, Dr. Khan reported.

A key message of Dr. Khan's presentation is that training and practice are needed for the program to work effectively.

At the start, he said, it took 42 days on average to work through all the barriers facing a given patient. Now, he said, the mean time is one day. He gave credit for the improvement to a quality-control program.

The navigator program also improved the chances that patients would be enrolled in clinical trials -- something that's often frightening for low-income and minority patients, Dr. Khan said.

There's "a lot of fear and uncertainty involved" after a cancer diagnosis, said Matthew Katz, M.D., of Saints Medical Center in Lowell, Mass., and support is important for patients.

"Having something institutionalized -- from the standpoint of the health care provider -- to help get patients through the system can be extremely useful," said Dr. Katz, who was not part of the study.

He also noted the importance of access to clinical trials, a two-way street. People with low incomes or members of a minority group often do not have access to clinical trials, which may mean they don't get the latest improvements in care.

And the absence of some demographic groups may limit the generalizability of clinical trials, Dr. Katz said. Improving access is a win-win situation.

Dr. Katz added that -- although such programs appear valuable -- they may be out of the reach of many institutions. "For small community hospitals, like my own, the question is whether there are resources to implement such a program."

And retired machinist Rivera?

"I'm doing great," he said.

A DATE has been set for an appeal against the decision to fund on the NHS a life-prolonging cancer drug developed in Tyneside.

The National Institute for Clinical Excellence (Nice) is holding the hearing after two appeals were lodged against its draft guidance to make Alimta available for those in the advanced stages of asbestos -related lung cancer mesothelioma.

A date has been set for November 23 but a final decision on whether to make the drug available will not be made for up to six weeks after that date when the panel has considered the findings.

The delay has caused an outcry among patients and their families in the North-East who are waiting for the drug which could give them valuable time.

The campaign in the North-East to make Alimta available on the NHS was led by Arthur Tiffin, 53, of North Walbottle, who died from mesothelioma in summer.

His family have said the drug gave him a precious two years with them and should be made available in the NHS across the country.

Since 2005, Alimta has been available for patients in the region but that could change when Nice guidance is finally released.

Last year, Nice agreed to reconsider its decision that the drug should not be used across the NHS in England and Wales after an appeal by manufacturer Eli Lilly and charities and support groups.

Campaigners spoke of their joy when in July this year Nice issued draft guidance recommending Alimta for use by a certain category of patients.

But they are now baffled as to who has lodged the appeals and on what grounds. The names of the appellants will remain a mystery until the day of the appeal which is yet to be set by Nice.

The desire to extend Alimta to all patients diagnosed with mesothelioma could be possible grounds for appeal if evidence showed the drug could help them, according to Nice.

Cancer cells treated with carbon nanotubes can be destroyed by non-invasive radio waves that heat up the nanotubes while sparing untreated tissue, a research team led by researchers at The University of Texas M. D. Anderson Cancer Center and Rice University has shown in preclinical experiments. In a paper posted online ahead of December publication in the journal Cancer, scientists show that the technique completely destroyed liver cancer tumors in rabbits. There were no side effects noted. However, some healthy liver tissue within 2-5 millimeters of the tumors sustained heat damage due to nanotube leakage from the tumor

Nursing mothers did'nt need worry. A new study shows that breastfeeding does not increase breast sagging. University of Kentucky plastic surgeon Dr. Brian Rinker and colleagues conducted the study with patients at UK HealthCare Cosmetic Surgery Associates. The study observed that breastfeeding does not adversely affect breast shape

The next cancer drug might come straight from the grocery store, as per new research reported in the November 2007 issue of The FASEB Journal. In the study, French researchers describe how high and low doses of polyphenols have different effects. Most notably, they observed that very high doses of antioxidant polyphenols shut down and prevent malignant tumors by cutting off the formation of new blood vessels needed for tumor growth. Polyphenols are usually found in red wine, fruits, vegetables, and green tea

Many patients with the intersex syndrome of complete androgen insensitivity can safely delay gonadectomy and vaginal reconstruction at least until late adolescence, suggests a long-term study.

Of 27 patients who underwent gonadectomy, 20 had the procedure in late adolescence or early adulthood, and seven had surgery in childhood, Todd Purves, M.D., of Johns Hopkins reported at the American Academy of Pediatrics meeting here. None of the surgical specimens demonstrated evidence of malignancy.

Additionally, 11 patients have had vaginal reconstruction, 10 procedures performed after puberty. Seven of the 10 postpubertal patients who had vaginoplasty are sexually active, as are 12 of 15 who decided not to have the surgery.

"A woman who has a vaginal depth of two or four centimeters won't be able to have sexual intercourse, but that finding and that decision [about surgery] can be made at age 19," Dr. Purves said in an interview. "The decision can't be made at age two or three or four."

"One of the bottom-line findings of this study is that if a physician sees a two- or three-year-old child with this condition, it would be inaccurate, inappropriate, and wrong to tell the parents 'Your child is going to need vaginal surgery,'" he added. "That is incorrect. Not all of these patients need surgery."

Much of the debate about caring for patients with complete androgen insensitivity syndrome centers on the need for, and the timing, of gonadectomy and vaginal reconstruction or dilation, Dr. Purves noted. For patients who have surgery, the principal issue becomes timing: Should the surgery be done before or after puberty?

The testes are not necessary for development after puberty, but patients with the syndrome face a risk of malignant transformation of 2% to 5% per year after age 25. Additionally, some patients and parents are advised that surgery will be required for normal sexual functioning.

Complete androgen insensitivity syndrome occurs in two to five of every 100,000 live male births, according to the National Institutes of Health. Those with the condition have XY sex-determination chromosomes of males, but because their body does not respond to androgen, they may develop female characteristics, including sexual characteristics.

The syndrome typically is diagnosed in one of two ways. A female child may develop an inguinal hernia and testes are discovered during the examination. Or evaluation of primary amenorrhea during adolescence leads to the finding.

Dr. Purves reviewed the history of 29 patients followed at Johns Hopkins, including 14 described in an earlier study by Hopkins investigators (J Clin Endocrinol Metab 2000;85:2664-2669). All 29 patients have undergone orchiectomy, and the exact date of surgery is known in 27 cases.

Of the 11 patients who have undergone vaginal reconstruction, the preoperative vaginal depth was 2 to 4 cm. In contrast, vaginal depth averaged 6.6 cm in the 18 patients who have not had vaginoplasty. Of the 25 patients who are older than 18, a total of 19 are sexually active, and the proportion is similar among those with and without vaginal reconstruction.

In summarizing the findings, Dr. Purves said the argument for delayed gonadectomy has at least three lines of support. Delayed gonadectomy:

• Is associated with a low risk of malignancy before puberty (three cases in the literature).
• Delays hormone replacement therapy until late adolescence.
• May enhance breast development and bone mineralization better than does exogenous hormones

The argument for delaying vaginal reconstruction rests on several observations.

• Most affected patients elect not to have surgery.
• Sexual function does not always require surgery.
• Sexually functional genitalia are not required in childhood.
• Older, more mature patients are better prepared to face complications and psychological issues associated with surgery.
• 80% of patients in the earlier Hopkins study cited late adolescence or early adulthood as the optimal time for surgery.

"A delayed approach to gonadectomy and vaginal reconstruction prevents unnecessary surgery, respects patient autonomy, and allows for a more mature patient to handle the psychological and physiological trauma of surgery and rehabilitation," Dr. Purves concluded.

Failure to follow treatment guidelines for patients with acute myocardial infarctions and pneumonia in U.S. emergency departments may result in 22,000 needless deaths each year, investigators here said.

Patients admitted to the ED with acute myocardial infarction received aspirin therapy only 40% of the time, and beta-blockers only 17% of the time, reported Julius Cuong Pham, M.D., of Johns Hopkins, and colleagues.

Overall, only 10% of patients got both of the recommended therapies in the ED, the investigators wrote in the October issue of Academic Emergency Medicine.

Similar but less glaring deficiencies occurred in ED care of patients with pneumonia, the authors found, with patients receiving recommended antibiotics about two-thirds of the time, and having recommended pulse-oximetry measurements less than half the time.

The failure to meet treatment goals may result in an estimated 22,000 needless deaths a year nationwide, the authors said.

They also detected significant racial and socioeconomic disparities, with patients who were young, white, had private insurance, or were seen in a nonprofit hospital more likely to have received aspirin during an episode of acute MI.

Whites were also more likely to receive antibiotics or pulse-oximetry measurements for pneumonia than others, the investigators found.

"These data suggest that the burden of inappropriate care is borne more by minorities and the poor than by others," said Dr. Pham. "They also suggest that we still have much work to do to ensure that everyone receives equitable care."

He and his colleagues conducted a cross-sectional study of emergency department visits with a diagnosis of acute MI or pneumonia in 544 EDs in the United States from 1998 to 2004, using data from the National Hospital Ambulatory Medical Care Survey.

They measured the proportion of MI patients who received the recommended therapies of aspirin and beta-blockers, and pneumonia patients who received appropriate antibiotics and pulse oximetry.

The authors also estimated preventable harm by multiplying the proportion of patients who did not receive the recommended therapy by the estimated number of patients who were eligible, and preventable deaths by multiplying the absolute risk reduction of mortality of the particular therapy with the opportunity for improvement.

They found that of an estimated 753 million ED visits, 5.1 million (0.68%) had an MI diagnosis and 14.2 million (1.9%) had a diagnosis of pneumonia.

Overall, only 9.9% of acute MI patients received all appropriate therapies (95% confidence interval, 8.1% to 12.1%).

"There were an estimated one million annual opportunities to improve the care of patients with AMI. We estimate that deficiencies in the care of patients with AMI resulted in approximately 15,000 excess deaths per year," the investigators wrote.

In a multivariate analyses, they found that patients who were young, were white, had private insurance, or were seen in a nonprofit hospital were more likely to have received aspirin, and that patients who were male or seen in the Northeast were more likely to have received beta-blockers.

Patients with a diagnosis of pneumonia received appropriate antibiotics 69% of the time, and pulse oximetry measurements 46% of the time.

Although the proportion of patients receiving recommended care for pneumonia was higher than that of patients with AMI, only one third of patients with pneumonia (34%, 95% CI, 31% to 38%) received both therapies.

Among all patients treated for pneumonia in the 544 EDs studied, the authors estimated that there were 1.7 million annual opportunities to improve care, and 7,000 annual excess deaths.

In multivariate analyses, patients more likely to have received recommended antibiotics (macrolides, beta-lactams, fluoroquinolones, or tetracycline) were young, had private insurance, were seen in a nonprofit hospital, in a metropolitan area, or in the Northeast.

Patients more likely to have been put on pulse oximetry included those who were between the ages of 18 and 64, white, or treated in a metropolitan area hospital.

During the course of the study there were statistically significant increases in the proportions of patients receiving beta-blockers and appropriate antibiotics; the proportions of patients receiving the other therapies did not change significantly.

The authors offered several possible explanations for why emergency department personnel may not be using recommended therapies.

"Health care providers may not be aware of these recommended therapies," they wrote it. "The training and credentials of ED health care providers may be important in this aspect. On the other hand, health care providers may not agree with these recommended therapies. For example, emergency physicians may not believe that drawing blood cultures is an important aspect of ED quality of care."

In addition, overcrowding and a lack of standards in treatment pathways may also contribute to the failure to adhere to recommended treatments.

The authors noted that the study was limited by the validity of the quality indicators they chose, the potential for misclassification of treatment caused by gaps in medical records, and by possible misdiagnosis of MI and or pneumonia.

To know what is mesothelioma is one of important thing in our lifes. Why? because it can attack us every time.

Mesothelial cells normally line the body cavities, including the pleura, peritoneum, pericardium, and testis. Malignancies involving mesothelial cells in these body cavities are known as malignant mesothelioma, which may be localized or diffuse. Diagnosis is difficult because the results from fluid analysis of the effusion from the tumor are not usually diagnostic. Most, but not all, pleural malignant mesothelioma is associated with asbestos exposure. Of patients with pleural malignant mesothelioma, 77% have been exposed to asbestos in the past. Mesothelioma is more common in males than in females and it occurs in the fifth and seventh decade of life. Most of malignant mesothelioma occur in the pleura (90% of the time).

Pathophysiology: The 3 major histological types of mesothelioma are sarcomatous, epithelial, and mixed. Pleural mesothelioma usually begins as discrete plaques and nodules that coalesce to produce a sheetlike neoplasm. Tumor growth usually begins at the lower part of the chest. The tumor may invade the diaphragm and encase the surface of the lung and interlobar fissures.

The tumor may also grow along drainage and thoracotomy tracts. As the disease progresses, it often extends into the pulmonary parenchyma, chest wall, and mediastinum. Pleural mesothelioma may extend into the esophagus, ribs, vertebra, brachial plexus, and superior vena cava.

Asbestos is the principal carcinogen implicated in the pathogenesis. The industries associated with asbestos exposure include ship building, construction, ceramics, paper mill, auto parts, railroad and insulation.

Most malignant mesotheliomas have complex karyotypes, with extensive aneuploidy and rearrangement of many chromosomes. A loss of a single copy on chromosome 22 is the most common abnormality.

Frequency:

• In the US: Approximately 2500-3000 cases are diagnosed per year.

• Internationally: Frequency is 0.9 cases per 100,000 persons.

Mortality/Morbidity:

• Median survival for patients with malignant mesothelioma is 11 months. It is almost always fatal. Median survival based on histologic type is 9.4 months for sarcomatous, 12.5 months for epithelial, and 11 months for mixed. Approximately 15% of patients have an indolent course.

• Asbestos exposure is linked to at least 50% of patients developing malignant mesothelioma. Approximately 8 million people in the United States have been exposed to asbestos in the workplace. Family members are also exposed to asbestos embedded in the worker's clothing. The combination of tobacco and asbestos exposure greatly increases the risk of developing pleural mesothelioma.

Race:

• Mesothelioma has no racial predilection. Asbestos exposure is the most important factor. Race is not a factor.

Sex:

• Malignant mesothelioma is more common in men, with a male-to-female ratio of 3:1. It can also occur in children; however, these cases are not thought to be associated with asbestos exposure.

• With regard to women with mesothelioma, a 1996 case series by Ascoli et al showed 86% of tumors arising from the pleura, of which most were the epithelial type. Of the patients in this series, 75% had a history of exposure to asbestos and more than half developed the malignancy secondary to household contact with a worker exposed to asbestos.

• With regard to men with mesothelioma, the same case series demonstrated 45.5% with a history of exposure to asbestos and 53% with occupational exposure to asbestos. Most who were involved were construction workers, railroad workers, naval mechanics, bakers, explosive workers, and automobile mechanics.

Age:

• Malignant mesothelioma has a peak incidence 35-45 years after asbestos exposure. It commonly develops in the fifth to seventh decade of life.

Asbestos exposure is the main cause of mesothelioma. After these fibers are breathed in, they travel to the ends of small air passages and reach the pleura where they cause physical damage to mesothelial cells that may result in cancer. In addition, they also cause injury to lung cells that can result in lung cancer and/or asbestosis (replacement of lung tissue by scar tissue). If swallowed, these fibers can reach the abdominal cavity where they have a role in causing peritoneal mesothelioma.

Exposure to asbestos, though mostly occupational, can also be environmental, or familial by household contamination, through the work clothes of an asbestos worker for instance.

Beginning 15 years after the onset of exposure, about 6% of asbestos workers die of mesothelioma. In one study of asbestos insulation workers, the death rate from mesothelioma was 344 times higher than in the general population.

Mesothelioma injury can be classified into three main groups, Pleural(chest), Peritoneal (abdominal) and Pericardial(heart). All three types of Mesothelioma injury are mainly cause through exposure to an Asbestos related substance.

Mesothelioma injury arises when the Mesothelioma cells surrounding the lungs, heart, or abdominal organs become cancerous. The Mesothelioma cells change to form nodules, which can then clump together to form a tumor, or tumors around the organ.

In more extreme cases of Mesothelioma Cancer, the Mesothelioma tumor can break through the walls of the organs that it surrounds and cause internal damage to the organ. Also, in some cases the Cancer can travel through the blood stream and affect other organs, not directly surrounded by the original Mesothelioma Cancerous Cells.

The origins of Mesothelioma injury begin when a person is exposed to an asbestos related substance. The person either inhales the Asbestos fibers, or the fibers enter the skin. These fibers either lodge in the lungs, or travel through the body and affect the heart, or abdominal organs.

The bodies natural defense system will attempt to eradicate the fibers from the body, through attempts to expel the fibers. However, some fibers will become lodged in the Mesothelioma cell layers that provide a protective layer around the lungs, heart and abdominal area.

Over time, the Mesothelioma cells surrounding the fibers, can change consistency and become cancerous. It is at this stage that the Mesothelioma injury begins to occur, as it turns into Mesothelioma.

However, Mesothelioma injury also includes the conditional affects that occur as a result of having Mesothelioma Cancer. Some of these conditional affects include, immune deficiency, which can lead to a slow break down of the bodies defense system.

Once the bodies defense system begins to break down the body can become subject to colds and other such illnesses. The overall affects of having Mesothelioma Cancer can lead to an array of Mesothelioma injuries and has the potential to cause major organ failure.

In order to prevent the adverse affects of Mesothelioma injury, Mesothelioma doctors have been implementing various treatments that aim to prevent further damage. Some of these treatments include, surgery, chemotherapy, radiation therapy and immune augmentative therapy.

In regard to Mesothelioma Cancer, Surgery aims to remove the Cancerous Mesothelioma cells, while chemotherapy uses drugs to kill the Cancerous cells. Radiation therapy also aims to eliminate the Mesothelioma cells, while immune augmentative therapy aims to restore the body’s natural immune system to a level in which it can be effective in helping to fight the effects of Mesothelioma Cancer.

All of these treatment methods are aimed at preventing further Mesothelioma injury to the patient. If you, or someone you know, have been diagnosed with Mesothelioma Cancer, ensure that you seek immediate treatment to prevent the affects of Mesothelioma Cancer and to avoid further Mesothelioma injury.

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking