Mesothelioma, a terminal cancer caused by asbestos exposure, is an incredibly aggressive disease that almost always has a poor prognosis. The disease has what’s referred to as a high latency, that is, a considerable stretch of time between exposure to the responsible agent (asbestos in this case), and the progression of the disease to a point of symptom recognition and diagnosis. Often it can take years, decades or even a half of a century between exposure to asbestos and development of mesothelioma. Sadly, this latency frequently means that by the time the disease is detected, the victim can only expect to survive between six to eighteen more months. With such a short amount of time left, quality of life becomes a serious concern.
The conventional treatments used to retard mesothelioma are chemotherapy, radiotherapy and surgery. Unfortunately all three of these treatments are very hard on the patient, and, depending on the stage of the disease, could potentially either degrade the patients quality of life for their remaining months, or in some cases, even shorten their remaining time. Adding to these concerns is the fact that determining the effectiveness of conventional treatments can itself be a rather invasive procedure, often requiring the doctor to draw a sample of the cancerous tumor, view the malignant cells under a microscope, and determine whether the cancer has spread to the lymph nodes.
Fortunately, Dr Raphael Bueno, the Director of the Thoracic Surgery Residency Program at Brigham and Women’s Hospital in Boston, MA, has developed a non-invasive gene test that shows promise in determining a patient’s candidacy for surgery. Raphael and his team isolated four gene sets that they believe can show whether a patient is likely to recover quickly from invasive surgery.
In a recent study to determine the efficacy of the test, 120 patients that had opted for surgery first underwent Dr Bueno’s non-invasive gene test. The results of the test placed the patients in one of two groups: A “good outcome” group who were suspected to recover more readily from surgery, and a “poor outcome” group who were not expected to respond well to the surgery.
The results indicated that the gene test was very accurate. The members placed in the “poor outcome” group survived an average of 9.5 months after surgery while the members of the “good outcome” group survived a much longer 16.8 months. The study was presented to the May 6 edition of the Journal of the National Cancer Institute by Dr Bueno and his associates. It states:
“Patients whose gene ratio test results predict a good prognosis after surgery may more confidently select the treatment option that includes surgery. Patients assigned to the predicted poor outcome group…could be counseled to forgo surgery, which would not benefit them, and to seek best supportive care.”
The new gene test will help patients make a more educated decisions about their own health and their quality of life when faced with an array of mesothelioma treatment options.
Source: Gordon GJ, Dong L, Yeap BY, Richards WG, Glickman JN, Edenfield H, Mani M, Colquitt R, Maulik G, Van Oss B, Sugarbaker DJ, Bueno R. Four-gene expression ratio test for survival in patients undergoing surgery for mesothelioma. Journal of the National Cancer Institute. 2009;101:678-686.
