As the number of mesothelioma cases in our country continues to increase, the United States is striving to form a National Mesothelioma Virtual Bank (NMVB), which would collect samples of mesothelioma pleural, peritoneal and pericardial tissues, along with blood and DNA samples. Once the samples have been collected, they would then be cataloged and made available for study through an online interface. The interface would then take newer findings and coordinate them to work in conjunction with existing cancer research.

While there is already a great deal of research being done, the bank will enable researchers everywhere to take their theoretical work and convert it into more practical approaches that could help patients much sooner.

The NMVB currently has three participating institutions: University of Pittsburgh, University of Pennsylvania, and New York University. The other participants supporting the NMVB include the Mesothelioma Applied Research Foundation, University of Hawaii, University of Vermont, and Fox Chase Cancer Center.

If you would like to participate in the NMVB’s prospective study you must be 18 years old or older and be able to provide informed consent. This can usually be obtained at the doctor’s office, clinic visits or upon hospital admission.

People who are not eligible to participate in the study include people under the age of 18 and prisoner-patients, who are excluded due to federal limitations. Individuals will not be excluded due to race, ethnicity, gender, or HIV status.

If you would like more information on the NMVB click here.

Numerous surveys show few patients realize there are clinical trials going on for what ails them, and even those who are aware are often leery of taking part. As a result, testing of genuinely new treatments has fallen behind, one reason that approvals of new drugs has slowed. A shortage of patients also means the quality of testing has suffered. That's because researchers are forced to widen the criteria that must be met for patients to take part, which often means the data collected is less definitive about whether the new drug works or is superior to existing treatments.

A survey of 6,000 cancer patients done for the American Association for Cancer Research found that 85 percent were either unaware or unsure that taking part in an experimental treatment was an option for them. However, 75 percent said they would have been willing to sign up if they'd known it was possible. As a result of this shortage in patients, 80 percent of cancer clinical trials being delayed.

There are generally three phases/stages of clinical trials. First, the FDA requires that any treatment first be tested to prove that it's safe in humans. These tests typically involve only a small number of volunteers, who may or may not be ill. Then testing moves on to demonstrate that the treatment has a positive effect on preventing or treating an illness at a certain dose, and that the effect is as good or better than the current standard treatment, or no treatment at all. Usually, researchers try to get from tens to hundreds of patients in these trials. Most study guidelines require that neither patients nor the doctor caring for them know whether they're getting the new drug or not. The third phase of a drug or procedure trial pits the new against the best standard treatment in several thousand patients, unless the disease or condition is rare.

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A new study has found that up to 80 percent of cancer patients who undergo radiation treatment do not take medications to combat pain. According to the report, many of the patients cited fears of addiction as well as cost as their reasons for saying no to painkillers. However, the most common reason given was that their healthcare provider had not recommended medication. "To eliminate barriers to optimal pain management for cancer patients, healthcare providers should talk with their patients about pain symptoms and pain medications,” said Dr. Charles Simone, from the National Cancer Institute (NCI) in Bethesda, Maryland.

The findings come from an Internet-based questionnaire posted on OncoLink examining analgesic use and pain control in cancer patients getting radiation treatment. Data from 106 patients were included in the analysis. 46 percent of patients reported pain related to the cancer itself, and 58 percent of subjects had pain from their treatment, the report's author’s note in the International Journal of Radiation Oncology, Biology, and Physics. The only statistically significant factor linked to non-use of painkillers was educational level. Specifically, individuals with education beyond high school were less likely to use analgesics than those with lower educational levels (11 percent vs. 36%).

To improve pain control for cancer patients undergoing radiation, Dr. Simone said that his center, the Radiation Oncology Branch of the NCI, has established an electronic system that requires healthcare providers to assess pain levels and pain medication every time they see a patient.

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Researchers from MIT have found that cells from different people don't all react the same way when exposed to the same DNA-damaging agent. The research team from MIT's Center for Environmental Health Sciences (CEHS) and the Departments of Biological Engineering and Biology, identified a group of 48 genes that can predict how susceptible an individual is to the toxic compound, known as MNNG. This finding could help clinicians predict how patients will respond to chemotherapy.

MNNG, is a DNA-damaging compound similar to toxic chemicals found in tobacco smoke and in common chemotherapy agent. The chemical usually kills cells by inducing irreparable DNA damage. However, the researchers found a wide range of susceptibility among cells taken from healthy people. "A cell line from one person would be killed dramatically, while that from another person was resistant to exposure," said Rebecca Fry, former MIT research scientist and lead author of the paper. "It wasn't known that cell lines from different people could have such dramatic differences in responses."

"Even if everyone is exposed to exactly the same things, they would respond differently, because we're all genetically different," said Leona Samson, senior author of the paper, director of CEHS, and an American Cancer Society Research Professor. The team members found that after measuring the expression of every gene in each cell line, they could predict cell sensitivity to MNNG from the expression of just 48 specific genes, with 94 percent accuracy. Several of those 48 genes have already been linked to cancer, said Samson, but it was not known that their expression is already altered before exposure to the DNA damaging agent.

This study is specific to MNNG, but similar efforts are now underway in Samson's lab to predict individuals' responses to other toxic agents, including cisplatin, a common chemotherapy agent, and temozolomide, used to treat brain cancer.

According to a recent study, conducted by the University of Rochester Medical Center researcher, and published in the Archives of Internal Medicine, researchers found that physicians missed many opportunities to recognize and possibly ease the concerns of their patients and routinely provided little emotional support. The study was based on 20 recorded and transcribed consultations with patients with lung cancer. Physicians rarely responded empathically to the concerns of the patients about mortality, symptoms or treatment options.

"When patients are struggling and bring up important issues, doctors don't have to take a lot of time to address them, but they do need to respond. Showing that they understand and giving their patients more of what they need is not that difficult," said Diane Morse, M.D., assistant professor of psychiatry and of medicine at the Medical Center. The study sheds light on the types of situations and remarks that physicians should recognize as opportunities to express understanding and support, she said. The research also showed that empathic responses can be brief and do not make consultations longer.

Morse and her researchers examined 20 representative transcripts from recordings of 137 consultations between physicians at a Veterans Affairs hospital in the southern United States and patients with lung cancer or a pulmonary mass requiring surgical diagnosis. In the transcribed consultations, the researchers identified 384 moments or "empathic opportunities" when patients stated or alluded to concerns, emotions or stressors. These included statements about the impact of cancer, diagnosis, treatment or health care system barriers to care. They found that physicians responded empathically to 39, or just 10 percent of the opportunities.

Morse and her co-authors suggest that physicians who have patients with a life-threatening illness should consider providing empathy early in the encounter and throughout treatment to validate patient needs and explore ways to build understanding. The connection can begin with a simple phrase, such as: "It sounds like you are very concerned about that."