Oncology Central

Biomarkers – making the early detection of mesothelioma more likely



One of the biggest problems with treating mesothelioma, the aggressive cancer associated with asbestos exposure and that most commonly develops in the tissue lining chest cavity, is that it is difficult to diagnose and is often only discovered in patients in later stages. This makes an already difficult to treat cancer even more of a challenge. Several research teams are looking into biomarkers unique to the disease to help make early diagnosis a reality.

Mesothelioma and the difficulty of diagnosis

Mesothelioma is a cancer of the mesothelium. This is the thin, double layer of tissue that surrounds the lungs, digestive system organs and the heart. It is a difficult cancer for a number of reasons: it grows as numerous small growths instead of one or two large tumors; it grows quickly and spreads aggressively; and it is frustratingly difficult to diagnose.

The most common form of this cancer is pleural mesothelioma, the form that attacks the tissue of the chest cavity and that is associated with inhaling asbestos fibers. The symptoms it causes, mimic those of conditions that are much more common like pneumonia. Even when it has been determined to be malignant, mesothelioma is often misdiagnosed as lung cancer. The rarity and the difficulty of distinguishing it from other diseases leads to many people being diagnosed in the late stages and this obviously limits treatment options and worsens prognosis [1].

Utilizing biomarkers to detect mesothelioma

One solution that researchers are working on and making important strides in recently, is detecting compounds that are unique to mesothelioma. These biomarkers may be found in the blood, in the pleural fluid or even in exhaled breath. None has yet proven to be fool proof in diagnosing mesothelioma but researchers are making progress and are getting closer to a real diagnostic tool.

A tool in very early stages is breathomics, the idea that exhaled metabolites could actually diagnose mesothelioma. The benefits are obvious: a breath test would be fast and non-invasive. Research is currently planned to test large groups of individuals, including those who are healthy and have been exposed to asbestos, those who are known to have mesothelioma and to have been exposed to asbestos, as well as other groups including smokers and non-smokers. Studies like this will help determine if a simple breath test can accurately pinpoint the people who have mesothelioma [2].

Other studies are continuing to investigate biomarkers in blood to develop a diagnostic tool. In a study from Germany, researchers are investigating at calretinin, a protein over-expressed in patients with mesothelioma growths. They have developed an enzyme-linked immunosorbent assay that is sensitive enough to detect elevated levels of calretinin. Combined with the detection of mesothelin, this new assay could help make earlier diagnoses [3].

Another protein of interest is called high mobility group box protein-1, or HMGB-1 which is known to play a role in asbestos-triggered inflammation and malignant growths. A small, but promising study demonstrated that a very sensitive test for HMGB-1 as a biomarker could reliably distinguish between individuals exposed to asbestos but not sick, individuals with mesothelioma and healthy controls [4].

The need for better diagnostics for mesothelioma is clear. Outcomes for patients will drastically improve when this cancer can be reliably detected before it has advanced to later stages. Treatment options are more numerous and more likely to be beneficial when patients are in the early stages of mesothelioma. Biomarkers have long been a subject of study for detecting mesothelioma, but until recently, the right ones have been frustratingly elusive. A slew of novel studies are turning up important new biomarkers and the tools needed to detect them and this could make all the difference for patients living with this cancer.

[1] https://mesothelioma.net/mesothelioma/
[2] http://cebp.aacrjournals.org/content/23/6/898#sec-11
[3] https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-10-242
[4] http://www.jto.org/article/S1556-0864(16)31597-0/pdf


Virgil Amenderson was recently diagnosed with mesothelioma, which is a cancer caused by exposure to asbestos. Virgil’s exposure came from doing building renovations during high school.

When he was diagnosed with mesothelioma he needed immediate medical attention. He found a few websites on the internet that are supposed to help people with mesothelioma cancer but nobody got back to him.

He then came across Mesothelioma.net. Even though he contacted them on a Sunday one of their patient advocates gave him a call back within minutes. They gave him a great deal of helpful information on doctors and resources available to him. As a result of their website, he is now being treated at the national cancer institute. He has become extremely limited in his activities and I can no longer work but fortunately the patient advocates have even provided him with financial assistance so he could afford a place to live during his chemotherapy.

Today, Virgil feels blessed to be able to spend time with his family and share his story with other people living with mesothelioma. While he has been through a lot and is still challenged by physical pain and limitations after having a lung removed, he sees every day as a gift. He hopes his story brings resilience and positivity to people living with mesothelioma while informing them of all the different options for post-treatment therapy.





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