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Factoren die een aanwijzing kunnen geven over de levensverwachting van mesothelioompatiënten zijn: het soort mesothelioom, de locatie van de tumor in het lichaam, sekse, rookgedrag en de conditie en symptomen van de patiënt. Een Behandeling met een combinatie van chemo-, radiotherapie en operatieve verwijdering van de tumor lijkt het best te werken, hoewel meer onderzoek nodig is. Dit concluderen Amerikaanse onderzoekers na analyse van medische gegevens van 945 patiënten die tussen 1990 en 2005 in een New Yorks ziekenhuis voor mesothelioom waren behandeld. Flores, R.M. et al., (2007). Prognostic Factors in the Treatment of Malignant Pleural Mesothelioma at a Large Tertiary Referral Center. Journal of Thoracic Oncology, 2, oct. 2007, p. 957-965.

Flores, R.M. et al., (2007). Prognostic Factors in the Treatment of Malignant Pleural Mesothelioma at a Large Tertiary Referral Center. Journal of Thoracic Oncology, 2, oct. 2007, p. 957-965.
Abstract:
Introduction: Most studies describing the natural history and prognostic factors for malignant pleural mesothelioma antedate accurate pathologic diagnosis, staging by computed tomography, and a universal staging system. We conducted a large single-institution analysis to identify prognostic factors and assess the association of resection with outcome in a contemporary patient population.
Methods: Patients with biopsy-proven malignant pleural mesothelioma at our institution were identified and clinical data were obtained from an institutional database. Survival and prognostic factors were analyzed by the Kaplan-Meier method, log-rank test, and Cox proportional hazards analysis. A p value &lt. 0.05 was considered statistically significant.
Results: From 1990 to 2005, 945 patients were identified: 755 men, 190 women. median age, 66 years (range, 26&ndash.93). Extrapleural pneumonectomy was performed in 208 (22%), pleurectomy/decortication in 176 (19%). Operative mortality was 4% (16/384). Multimodality therapy including surgery was associated with a median survival of 20.1 months. Significant predictors of overall survival included histology, gender, smoking, asbestos exposure, laterality, surgical resection by extrapleural pneumonectomy or pleurectomy/decortication, American Joint Committee on Cancer stage, and symptoms. A Cox model demonstrated a hazard ratio of 1.4 without surgical resection when controlling for histology, stage, gender, asbestos exposure, smoking history, symptoms, and laterality (p = 0.003).
Conclusions: In addition to tumor histology and pathologic stage,
predictors of survival include gender, asbestos exposure, smoking,
symptoms, laterality, and clinical stage. Surgical resection in a
multimodality setting was associated with improved survival.

52 amerikaanse wetenschappers hebben verklaard dat chrysotiel asbest in remvoeringen mesothelioom kan veroorzaken. Zij stellen dat ook kortdurende en lage niveaus van asbestblootstelling mesothelioom kunnen veroorzaken. In de wetenschappelijke literatuur komen honderden gevallen van mesothelioom onder automonteurs voor. De verklaring is een reactie op de verdediging die de Amerikaanse auto-industrie voert bij het Hooggerechtshof van Michigan. Men probeert daar aan te tonen dat het aangevoerde bewijs voor mesothelioom door chrysotiel asbest in remvoeringen wetenschappelijk ondeugdelijk is (“junk science”. Bron: Welch, L.S. et al., (2007). Asbestos Exposure Causes Mesothelioma, But Not This Asbestos Exposure: An Amicus Brief to the Michigan Supreme Court. International Journal of Occupational Environmental Health.13:318-327.

Welch, L.S. et al., (2007). Asbestos Exposure Causes Mesothelioma, But Not This Asbestos Exposure: An Amicus Brief to the Michigan Supreme Court. International Journal of Occupational Environmental Health.13:318-327.
Abstract
Manufacturers of asbestos brakes, supported by many manufacturing and insurance industry amicus curie, requested the Michigan Supreme Court to dismiss testimony of an expert regarding the ability of asbestos dust from brakes to cause mesothelioma as “junk science” Scientists are concerned with the sweeping and unequivocal claims that any conclusion that asbestos from brakes caused a signature asbestos-related disease in a particular person must be “junk science.” The manufacturers” sweeping pronouncements are what veer
from accepted, reliable mainstream scientific methods and conclusions. This article outlines the evidence supporting the conclusion that asbestos from brakes can and does cause mesothelioma, and describes the defendants” attempts to fabricate doubt about this conclusion.

Franse huisartsen zien bij rokende longkankerpatiënten nogal eens over het hoofd dat asbestblootstelling een rol kan hebben gespeeld bij het ontstaan van de ziekte. Franse longartsen zijn daar echter wel alert op. Bron: Verger, P. et al. (2007). Inequities in reporting asbestos-related lung cancer: influence of smoking stigma and physician’s, specialty, workload, and role perception. OEM online, 10 okt 2007, doi:10.1136/oem.2007.035808.

Verger, P. et al. (2007). Inequities in reporting asbestos-related lung cancer: influence of smoking stigma and physician’s, specialty, workload, and role perception. OEM online, 10 okt 2007, doi:10.1136/oem.2007.035808.
Abstract:
Objectives: To study physician barriers to workers&rsquo. compensation claims for asbestos-related cancers, focusing on smokers&rsquo. stigma and physicians&rsquo. speciality and role perception.
Methods: Cross-sectional telephone study of 486 randomly-selected physicians: general practitioners (GPs) and pulmonologists in southeastern France. Standardised questionnaires explored their behaviour, attitudes and practices in the field of occupational health and their responses to a case-vignette about a lung cancer patient with long-term occupational asbestos exposure. Randomised subgroups of GPs and pulmonologists heard alternative versions
varying only in the worker&rsquo.s smoking status. We studied factors associated with the recommendation that the case-vignette patient file a compensation claim with simple and multiple logistic regressions.
Results: The response rate was 64.4% among GPs and 62.5% among pulmonologists. Recommending the filing of an occupational disease claim was significantly associated in multiple logistic regressions with speciality (OR=4.46. 95%CI=2.38-8.37, for pulmonologists versus GPs), patient&rsquo.s smoking status (OR=3.15. 95%CI=2.11-4.70, for non-smokers versus smokers), physician&rsquo.s workload (OR=1.83. 95%CI= 1.17-2.88, for &le.25 consultations per day versus &gt.25), and role perception (OR=2.00. 95%CI=1.22-3.27, for those who considered completing occupational disease medical certificates to be part of their role versus those who did not).
Conclusions: The results of this French study appear applicable to various countries and contexts. To make physicians and especially GPs more aware of occupational health and smoking stigma, officials and educators must give these topics higher priority during initial training and continuing medical education. Tools and equipment that take time constraints into account.

Biochemicus Peter Duesburg stelt dat schade aan chromosomen de directe oorzaak is van het ontstaan van kanker en niet een bij-effect van de versnelde celdeling. Dat geldt vooral voor kankersoorten die door gevaarlijke stoffen als asbest ontstaan. De menselijke cel bevat 40.000 genen die in 23 verschillende groepen zijn verdeeld, genaamd chromosomen. Bron: The Irish Times, 16 augustus 2007.

Finse onderzoekers constateerden dat aan asbest blootgestelde bouwvakkers die in herfst of winter geboren zijn relatief vaker fibrose aan de longen hebben dan degenen die in lente of zomer geboren zijn. Een mogelijke verklaring is dat herfst- en winterkinderen vlak na de geboorte vaker infecties aan de luchtwegen hebben die hen gevoeliger maken voor de effecten van asbestvezels later in hun leven. Bron: Hannu, T. et al., (2007). Season of birth and lung fibrosis among workers exposed to asbestos. Chronobiology Intenational 24(3):539-552.
Hannu, T. et al., (2007). Season of birth and lung fibrosis among workers exposed to asbestos. Chronobiology Intenational 24(3):539-552.
The season of birth has been suggested to influence the development of some diseases, but its role in lung fibrosis seems to not have been studied previously. The aim of this study was to investigate the relation between the season of birth and fibrotic abnormalities as detected radiologically in high-resolution computed tomography (HRCT) among workers exposed to asbestos. The HRCT examination was performed on 528 study subjects. Multiple ordinal regression analysis adjusting for covariates was used to study the relations between birth month or season and radiological fibrosis signs. Subjects born in autumn or winter had more extensive fibrotic changes than those born in spring or summer. This applied to all fibrotic changes, apart from subpleural nodules, but only the overall fibrosis score, septal lines, and honeycombing showed statistically significantly higher values in comparison to spring births. The highest scores were detected among those born in autumn and winter months (September-February). These results suggest that there are differences in fibrotic radiological abnormalities according to the season of birth in adults exposed to asbestos. Several hypotheses could explain the observed findings, including the effects of early respiratory infections, cold temperature, and differences in air pollution levels, as well as some metabolic and hormonal effects.

Een artikel in het Britse blad Nursing Standard beschrijft de specifieke uitdagingen voor verpleegkundigen bij de zorg van mesothelioompatiënten, een groep waarmee zij steeds meer in aanraking komen omdat het aantal patiënten nog steeds toeneemt. Maligne mesothelioom vereist een speciale aanpak omdat de ziekte zowel medische als juridische gevolgen heeft. In het Verenigd Koninkrijk moet de ziekte bijvoorbeeld gemeld worden bij de politie. Er bestaan geen nationale richtlijnen voor de behandeling. Nursing Standard, 21, nr. 42, juni 2007, pag. 24-25.

Slechts de helft van de Australische asbestslachtoffers met mesothelioom krijgt behandeling met het medicijn Alimta vergoed. Het hangt af van het gebied waarin men woont. Bron: The Advertiser, 29 augustus 2007

In een Italiaans onderzoek werden bij 32 van 169 mesothelioompatiënten (19%) andere primaire tumoren gevonden. Bij al deze pati&euml.nten was asbestblootstelling aanwijsbaar. De onderzoekers adviseren nader onderzoek naar gemeenschappelijke oorzaken van maligne mesothelioom en bepaalde andere tumoren. Bron: Bianchi, C & T. , (2007). Malignant mesothelioma of the pleura and other malignancies in the same patient. Tumori, 93, 19-22.

Bianchi, C &amp. T. , (2007). Malignant mesothelioma of the pleura and other malignancies in the same patient. Tumori, 93, 19-22.

Aims and background: The co-existence of mesothelioma, mostly asbestos-related, and other primary malignancies has repeatedly been reported. The present study evaluated the frequency of such an occurrence. Methods: In the period October 1979-June 2002, 215 cases of malignant pleural mesothelioma were diagnosed at the Hospital of Monfalcone, Italy. All the cases of the above series, examined at necropsy (169), were included in the study. Occupational histories had been obtained from the patients or from their relatives by personal or telephone interviews. In 132 cases, asbestos bodies were isolated after chemical digestion of lung samples. The thoracic cavities were examined for pleural plaques. Results: Additional malignancies were observed in 32 cases (18.9%). Multiple tumors were synchronous in 22 cases, metachronous in 8 cases, and synchronous and metachronous in 2. Four different tumors were found in 2 cases, 3 malignancies were detected in 6 patients, and 2 malignancies in the remaining 24. The most frequent additional malignancies were prostate adenocarcinoma (7 cases), non-Hodgkin lymphoma or chronic lymphocytic leukaemia (5 cases), bladder carcinoma (4 cases), kidney carcinoma (4 cases), large bowel carcinoma (4 cases), and liver cell carcinoma (4 cases). All the patients had histories of exposure to asbestos, mostly in shipbuilding. Lung asbestos body burdens ranged between 60 and 230,000 per gram of dried tissue. Pleural plaques were found in 26 cases. Conclusions: In contrast with other series of the literature, in the present cases the co-existence of mesothelioma and other malignancies appeared as a relatively frequent event. The lack of a control group does not allow definite conclusions about the meaning of the occurrence. However, the co-existence of certain tumors with asbestos-related mesothelioma suggests that mesothelioma and associated malignancies might share some etiologic factors (asbestos and others)

De Britse gezondheidsautoriteit NICE is teruggekomen op een eerdere uitspraak dat het medicijn Alimta niet door de National Health Service (NHS) vergoed zou moeten worden. Een jaar geleden oordeelde NICE dat er niet genoeg bewijs was dat behandeling met dit medicijn beter werkt dan voordeliger behandelingen. Artsen, patiëntengroepen en farmaceut Ei Lily gingen tegen deze uitspraak in beroep. Nu wordt in een richtlijn vermeld dat chemotherapeutische behandeling met een combinatie van Alimta en Cisplatine aanbevolen is en door de NHS moet worden vergoed. Bron: The Times, 9 juli 2007.

Een Schotse gezondheidsdienst heeft verzuimd een mesothelioompatiënt te informeren over de mogelijkheden van schadevergoeding en aan welke voorwaarden daarvoor moet worden voldaan. Het slachtoffer overleed drie maanden na diagnose zonder dat aan de voorwaarde van een biopsie ter herbeoordeling van de diagnose was voldaan. Pas na zijn dood hoorde zijn vrouw over de mogelijkheden om in aanmerking te komen voor een schadevergoeding. De Schotse ombudsman Publieke Diensten oordeelt dat de Gezondheidsdienst excuses moet aanbieden aan de weduwe. Bron: The Herald, 21 juni 2007.