February 2, 2007 Volume 108 Number 3

L.A. lab works to improve odds against asbestos cancer

When Olympic Gold medalist Terry McCann began having chest pains, he knew something was wrong. He never drank or smoked. He worked out daily in the gym and was a member of the San Clemente morning surf “dawn patrol” in California.

The chest pain went away, but mesothelioma, the deadly cancer within his chest wall, did not. Before Terry passed away last year at age 72 — more than two years after his symptoms had surfaced — he had already beaten the odds. Ten years ago, men and women with mesothelioma faced a certain and swift death. The cancer, which kills 2,000 to 4,000 men and women a year, oftentimes misdiagnosed as pneumonia or as an inflamed lining of the lungs, would quickly surround the victim’s lungs and heart sac with a concrete-like sheath, and crush the patient to death.

People with mesothelioma still face a tremendous struggle, but in Los Angeles cutting-edge research and treatment to detect and manage the illness is is being conducted at the non-profit Pacific Heart, Lung & Blood Institute and its Punch Worthington Research Laboratory (PWR), in collaboration with the David Geffen School of Medicine at UCLA.

Dr. Robert Cameron, a surgeon and scientist who directs the PWR Lab, has put together an aggressive agenda to tackle mesothelioma head-on. The lab’s Risk Reduction Program is focusing on prevention of mesothelioma in workers exposed to asbestos and early detection through breath and blood tests. The Lab’s Mesothelioma and Asbestosis Treatment Program is seeking to improve therapies for people with already existing disease.

Mesothelioma is caused by inhalation of asbestos fibers. It has a long latency period (the time between first exposure to asbestos and the diagnosis of the disease). In rare cases the latency period has been as short as 10 to 15 years. Typically, however, mesothelioma occurs 20, 30, 40 or more years after the first exposure.

Workers in the construction trades are particularly vulnerable to exposure, but the illness itself doesn’t discriminate based on the color of the collar. “This disease affects Olympic athletes, drywallers, congressmen, pipefitters, admirals in the Navy, Hollywood icons, insulators, young women college students, painters, interior decorators, boilermakers and everyone in between,” said Roger Worthington, an attorney and board member of the Pacific Heart, Lung & Blood Institute. The Punch Worthington Laboratory was named in the memory of Roger’s father, David “Punch” Worthington of Salem, a union organizer and Ph.D. in genetics who died last year from asbestos-related cancer.

The Portland area is considered a hotspot for mesothelioma due to its historic shipbuilding and paper mill industries, yet the closest treatment centers with doctors who specialize in mesothelioma are in Seattle (at the Swedish Cancer Institute) and Los Angeles, Worthington said.

“It’s too bad the local doctors haven’t responded to the asbestos epidemic here in Oregon,” said Greg Deblock, a retired business manager of Portland-based Steamfitters Local 235, which later merged to become the United Association of Plumbers and Steamfitters Local 290. In November, Deblock was diagnosed with malignant mesothelioma. He is struggling to find specialized care in Portland.

Worthington says too many doctors are resigned to “doomsday” with asbestos cancers. “They assume that mesothelioma cannot be cured,” he continued, “ but the sad truth is neither industry nor the government has invested in finding cures for this orphan cancer. How do we know it’s ‘incurable’ if we don’t try to cure it?”

To date, there isn’t a reliable test to detect mesothelioma at an early stage. Imaging tests, such as X-rays and CT scans, are not satisfactory. Screening tests exist for breast cancer, colon cancer, prostate cancer and lung cancer, and have resulted in better diagnosis of early disease and improved cure rates. Early detection for mesothelioma could lead to similar benefits.

One promising test under study at the PWR Lab involves identifying evidence of mesothelioma and even asbestos exposure through markers in a person’s exhaled breath or blood.

The Institute is recruiting volunteers — particularly workers and their families residing on the West Coast — for the early detection breath and blood screenings, although the start date has not been finalized, the Lab is taking names and will contact volunteers once the trials begin.

Since asbestos inflames the lining of the chest (pleura), the lab’s prevention program also is testing agents that inhibit inflammation as a means of preventing the disease. Doctors believe that interrupting the long cycle of inflammation could break the progression of changes that lead to cancer. Indomethacin, celecoxib, aspirin and other agents may hold the key.

The PWR Lab is testing celecoxib right now. This trial is for people who have been exposed to asbestos and who have a history of smoking. (The testing is free, but participants will have to go to Los Angeles to participate.)

 

For more information about the celecoxib test, call Jessica Like, executive director of the Pacific Heart, Lung & Blood Institute, at 310-622-4960. For more information about the early detection program, or for information about meso treatment options, contact Dr. Cameron at 310-622-4960.


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