Mesothelioma survivors and the immune system

From Cancer Monthly, April 2007

Is there a connection between survival and immunity?

Paul Kraus – Ten Year Mesothelioma Survivor

In 1997, Paul Kraus was diagnosed with widely disseminated mesothelioma.  The prognosis was poor – a few months at best.  Not ready to give up, he consulted with various physicians and conducted his own research.  From this information he created his own path to healing which involved boosting his immune system with integrative therapies, alternative treatments, dietary changes, and mind-body approaches.  As he maintained his health and quality of life from weeks to months and then from months to years, many were interested in what he did.

Mesothelioma, the asbestos related cancer, is a particularly insidious disease.  Unlike other cancers that have a typical survival measured in years, the median survival with mesothelioma is often measured in months.

As a result of his miraculous survival, Mr. Kraus wrote a book called “Surviving Mesothelioma and Other Cancers: A Patient’s Guide.”  After reviewing the book, Dr. Bernie Siegel remarked that, “Paul Kraus’ book has all the information a cancer patient needs to have in order to learn what survival behavior is about…”

But, Mr. Kraus is not alone.  There are other long-term mesothelioma survivors.  A cursory review of the medical-scientific literature identified various survivors who lived decades after they were diagnosed.  Of course the bigger question is Why?

Other Long Term Mesothelioma Survivors

In 1994, a 58 year old man was diagnosed with malignant pleural mesothelioma.  He had a left thoracotomy, multiple pleural biopsies, and chest wall resection.  As of 2007, he is still alive.1  In 1986, a 65 year-old women was diagnosed in mesothelioma and lived for 14 years with no treatment other than radiation at the end.2  In 1970, a 53 year-old man who had worked at a plant adjacent to the Brooklyn Navy Yard, where asbestos was used, was diagnosed with mesothelioma.  Other than thoracotomy, no treatment was provided.  A medical article was published about him in 1978 and he was reported as still doing well.3  These are just three examples.  There are others.

The Role of the Immune System – What Do Long-Term Survivors Have in Common?

What is striking is that some of the scientific reports allude to the fact that the patient’s immune system may have played a role in their recovery.  In writing about the 58 year-old man, doctors suggested that the “spontaneous regression may be an immune-mediated phenomenon.”  And in the article about the individual who had worked at a plant adjacent to the Brooklyn Navy Yard, physicians wrote, “Our findings are consistent with the concept that normal immunological function may effectively impede dissemination of the disease (malignant pleural mesothelioma).”

Scientists and clinicians are currently testing a variety of immunotherapies for the treatment of mesothelioma.  These treatments are designed to artificially improve the performance of a patient’s immune system using various proteins.  Some of these therapies have already demonstrated promise compared to the conventional approaches of surgery, chemotherapy, and radiation.

For example in a clinical trial involving immunotherapy and chemotherapy, the median survival was reported at 29.2 months4 and in another immunotherapy trial the median survival was 15 months.5  This may not sound like a lot, but keep in mind that median survival with the best conventional therapies is about 9-12 months.

Mesothelioma and the Immune System

This raises the question – does the immune system play a role in controlling malignant mesothelioma? Paul Kraus’ experience and those of other long-term mesothelioma survivors suggests that such a role may be possible.  If proven true, this may also address other intriguing questions.  For example, why does mesothelioma evolve from asbestos many decades after exposure – did the patient’s immune system help keep it in check until a certain time?  And why are only a few people who are exposed to asbestos ultimately diagnosed with mesothelioma – was their immune system able to protect them from the disease throughout their life?

The treatment approaches used by long-term mesothelioma survivors like Paul Kraus may ultimately help answer these critical questions.

Listen to Mesothelioma Survivor

For more information about attending the Paul Kraus Teleconference on April 26 at 5 PM (PT) 8 PM (ET) call 1-619-261-7922 or go to http://www.survivingmesothelioma.com/index.cfm  for more information.

Endnotes

(1) Pilling, J.E., et al., “Prolonged Survival Due to Spontaneous Regression and Surgical Excision of Malignant Mesothelioma.” Ann Thorac Surg, 2007; 83: 314-5.

(2) Wong, C.F., et al., “A Case of Malignant Pleural Mesothelioma with Unexpectantly Long Survival without Active Treatment.” Respiration March/April 2002; 69, 2: 166-168.

(3) Fischbein, A,. et al., “Unexpected Longevity of a Patient with Malignant Pleural Mesothelioma.” Cancer 1978; 42:1999-2004.

(4) Monnet I, et al., “Intrapleural infusion of activated macrophages and gamma-interferon in malignant pleural mesothelioma: a phase II study.” Chest. 2002 Jun;121(6):1921-7.

(5) Castagneto B, et al., “Palliative and therapeutic activity of IL-2 immunotherapy in unresectable malignant pleural mesothelioma with pleural effusion: Results of a phase II study on 31 consecutive patients.” Lung Cancer. 2001 Feb-Mar;31(2-3):303-10.

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