Detailed study of mesothelioma is important not only in its own right but for a number of other reasons.
Firstly, it is an example of an occupational lung disease which has frightening rather than nuisance consequences. In that regard the social and medico-legal aspects of the disease are important to discuss. For every patient who develops mesothelioma, thousands of patients live in fear that the ‘sword of Damocles’ will fall upon them; i.e. the morbidity extends beyond those individuals who get the disease. In fact some patients suffer profound anxiety and depression knowing that they have been exposed to asbestos and may develop malignancy at some time in the future. In Australia we have been fortunate to have a dedicated group of individuals who have formed a society which not only supports the individuals who are at risk of the disease or who have developed the disease but also act as advo- cates for these individuals medically and legally.
Secondly, malignant mesothelioma has a number of features which make it an ideal ‘model’ for learning about cancer in general. Because most at-risk individuals can be clearly identified, preventative studies, e.g. using vitamin A, can be undertaken. Also, it is possible to study these individuals to determine if there are any early markers of disease, e.g. serological markers. The fact that mesothelioma is largely untreatable by any of the standard therapeutic modalities (surgery, radiotherapy and chemotherapy) means that a number of centres have been compelled to try novel experimental treatments. In this regard mesothelioma has been an excellent target for immunotherapy protocols, with some success, and has been one of the first tumours treated by gene therapy, either suicide gene therapy or immunological gene therapy.
When we began our research into mesothelioma in the mid-1980s there were very few laboratories studying this disease, few cell lines available, few animal models available and little was known about the basic cell biology underlying the disease. The situation has changed dramatically and there are currently a number of groups studying mesothelioma. An impressive degree of international co-operation exists between these scientists who have met together as the International Mesothelioma Interest Group every two years for the past decade to share scientific and clinical information.
Firstly, it is an example of an occupational lung disease which has frightening rather than nuisance consequences. In that regard the social and medico-legal aspects of the disease are important to discuss. For every patient who develops mesothelioma, thousands of patients live in fear that the ‘sword of Damocles’ will fall upon them; i.e. the morbidity extends beyond those individuals who get the disease. In fact some patients suffer profound anxiety and depression knowing that they have been exposed to asbestos and may develop malignancy at some time in the future. In Australia we have been fortunate to have a dedicated group of individuals who have formed a society which not only supports the individuals who are at risk of the disease or who have developed the disease but also act as advo- cates for these individuals medically and legally.
Secondly, malignant mesothelioma has a number of features which make it an ideal ‘model’ for learning about cancer in general. Because most at-risk individuals can be clearly identified, preventative studies, e.g. using vitamin A, can be undertaken. Also, it is possible to study these individuals to determine if there are any early markers of disease, e.g. serological markers. The fact that mesothelioma is largely untreatable by any of the standard therapeutic modalities (surgery, radiotherapy and chemotherapy) means that a number of centres have been compelled to try novel experimental treatments. In this regard mesothelioma has been an excellent target for immunotherapy protocols, with some success, and has been one of the first tumours treated by gene therapy, either suicide gene therapy or immunological gene therapy.
When we began our research into mesothelioma in the mid-1980s there were very few laboratories studying this disease, few cell lines available, few animal models available and little was known about the basic cell biology underlying the disease. The situation has changed dramatically and there are currently a number of groups studying mesothelioma. An impressive degree of international co-operation exists between these scientists who have met together as the International Mesothelioma Interest Group every two years for the past decade to share scientific and clinical information.
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