Mesothelioma, the Silent Killer
Emily Walsh

Mesothelioma, the Silent Killer

How the 21st Century Cures Act might help fight a rare lung cancer caused by asbestos

It seems peculiar that something we’ve suspected as dangerous for nearly 100 years, and known as fact for nearly 80, still isn’t well known. When we hear “asbestos,” we know it’s a harmful substance, but most of us don’t know why.

Asbestos inhalation causes mesothelioma, a rare cancer affecting the lining of the lung, heart, or abdomen. When asbestos fibers are inhaled, they lodge themselves in the tissue causing inflammation that paves the way for cancerous tumors to grow. With the introduction of the Toxic Substances Control Act in 1976, asbestos importation became regulated, along with the method in which it was removed from public buildings like schools and courthouses. But asbestos is still found in consumer products, such as adhesive bonding cement used in construction and even some brands of crayons, causing unnecessary damage to the health of United States citizens.

One of those health problems is mesothelioma. Exposure to asbestos is the only known cause of mesothelioma. This very rare form of cancer, affecting approximately 3,000 Americans annually, can affect the lining of the lung, heart, or abdomen. Noticeable symptoms can take anywhere from 10 to 50 years to present and due to its long latency period, mesothelioma is often misdiagnosed until the disease’s later stages.

Current mesothelioma treatments involve combination therapy, including surgery to remove the tumors and affected tissue, as well as chemotherapy and radiation. Depending on the location of the cancer there are a number surgeries available. For example, a patient with pleural mesothelioma could have a pleurectomy, which removes the lining of the lungs, or a pneumonectomy, which is a complete removal of one lung.

The link between asbestos and mesothelioma is now well known, so asbestos use in the United States is on the decline and mesothelioma cases are expected to decrease as well. But better treatments and a cure are still desperately needed for those who were exposed to asbestos and diagnosed with the disease.

The 21st Century Cures Act, which promotes research and patient access to new drugs, offers some hope. The legislation passed late last year establishes US$4.8 billion in new funding for biomedical research, including high-risk, high-reward research conducted by early stage investigators. The funds will also be used to develop and implement a strategic plan for biomedical research and carry out specified provisions of the Act.

How might this help mesothelioma patients? Two very important factions of mesothelioma treatment and research fall under this umbrella. Immunotherapy, which is currently considered experimental, has shown promise for mesothelioma patients and further funding will allow scientists to provide the continued insight necessary. The “high-risk, high reward” portion of the Act allows for further research to be performed on rare diseases, including mesothelioma.

Under the 21st Century Cures Act, expanded access (also known as compassionate use) will allow for more patients to have access to drug treatment options otherwise not available to them. Clinical trials will still be performed, and the drugs being administered will continue being thoroughly tested, but those who have no other options and are not eligible for ongoing trials will be allowed to receive the study drugs. For patients whose cancer has been previously deemed untreatable, this can mean the difference of having potentially life-saving treatments available to them.

Let’s hope that the 21st Century Cures Act, which received rare bipartisan support last year from both the US House and Senate, can survive the regulatory and budgetary changes now occurring at the federal level. With the changing tides of the current government and leaders beginning the allocation of federal funding, it’s important now, more than ever, to preserve funding for this initiative.