MAGAING MESOTHELIOMA MEDICARE

The volume of paperwork involved in managing insurance claim forms, co-pays, benefits statements, etc., can be overwhelming for a MESOTHELIOMA patient who is trying to concentrate on their health care, but by keeping organized, accurate records, you can eliminate unnecessary stress.
Perhaps the simplest way of keeping information to be referred to when filing an insurance claim, is to use a paper calendar to make note of all doctor's appointments, lab tests, procedures and treatments, as well as prescription drugs purchased. If this information is recorded on the day it occurs, you will have a complete chronological record when you need it. Other records you should organize in an expandable folder or binder include:
• Bills from all health care providers.
• Bills or receipts for prescription drugs.
• Receipts from co-pays or other health care related costs.
• Insurance claims filed.
• Reimbursements received.
Keeping medical expenses entered on a basic computer spreadsheet is another option, or, there is specialized software available for those who prefer a better display of information and the ability to search for and sort information. One of these programs is the "Medical Expense Manager" offered by Quicken. This program will allow you to track and organize medical expenses, tax deductions, medical and prescription history for multiple individuals, insurance payments and deductibles and billing or claims disputes.
Another alternative is to hire someone to manage your claims for you, and if you feel you need professional help, there are health insurance claims assistance services available in many areas. These professionals can file and track claims, contact health care providers and insurance companies to resolve claim issues, review medical bills for accuracy and appeal rejected claims. Fees for services rendered can vary significantly according to provider.
For those with Medicare coverage, a health insurance assistance program is available in every state. Counselors can help Medicare recipients understand their benefits, and can make suggestions on establishing a record keeping system.

MESOTHELIOMA TEST DIOGNATEST

ince introducing mi RIview meso in December 2008, Rosetta Genomics has already begun distributing the breakthrough test in Israel el and Turkey.

miRview™ meso is a microRNA-based molecular diagnostic test that differentiates malignant pleural mesothelioma from other carcinomas in the lung. Malignant mesothelioma is a rare form of cancer that is almost exclusively caused by asbestos exposure. Those who are typically at risk of contracting the disease have either worked in the shipyard, construction, electrical, or automotive industry.

The test uses up-to-date molecular technologies for the processing and measuring of microRNAs. MicroRNAs, which are a newly-discovered family of genes in protein complexes, have been shown to be very specific to different types of tissues and tumors.

During the test, two separate scores are calculated to indicate the amount of mesothelioma and non-mesothelioma microRNAs in the sample. The scores are then analyzed to determine whether or not the sample is a mesothelioma or non-mesothelioma sample.

Although miRview meso is only being distributed to the public in Israel and Turkey, Rosetta Genomics has made the test commercially available to the United States through its Philadelphia-based CLIA-certified lab.

The test, which can only be ordered by a physician, simply requires a formalin-fixed, paraffin embedded (FFPE) tumor tissue sample to be shipped to Rosetta Genomics’ Philadelphia-based lab. Once the sample is received, results can be available within 10 business days.

This test is a critical breakthrough for diagnosing mesothelioma. Currently, there is no single marker that is entirely conclusive for either malignant mesothelioma or metastatic tumor, which often makes it difficult for physicians to make a complete diagnosis. However, Rosetta Genomics’ miRview meso test applies microRNA biomarkers and molecular technology to address this clinical need. High confidence cases have already shown 100 percent accuracy in determining the presence of mesothelioma.NEW

ABOUT MESOTHELIOMA

The National Cancer Institute states that: "Malignant mesothelioma, a rare form of cancer, is a disease in which cancer (malignant) cells are found in the sac lining the chest (the pleura), the lining of the abdominal cavity (the peritoneum) or the lining around the heart (the pericardium)."

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart,[1] the pericardium (a sac that surrounds the heart) or tunica vaginalis.

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing mesothelioma.[2] Unlike lung cancer, there is no association between mesothelioma and smoking.[3] Compensation via asbestos funds or lawsuits is an important issue in mesothelioma (see asbestos and the law).

The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.

CHEMOTHERAPY SEDHULE

Chemotherapy Schedules

How often you will receive chemotherapy will be determined by your doctor, taking into consideration factors such as the stage of your cancer, the types of drugs you receive, the anticipated toxicities of the drugs and the time necessary for your body to recover from these toxicities. The doctor may also consider whether the goal of the chemotherapy is to control the growth of the cancer, or to ease symptoms associated with the disease.

In general, chemotherapy treatment is administered in "cycles" — a "cycle" being defined as a period of treatment followed by a period of rest. This cycle allows the cancer cells to be attacked by the drugs, and then allows the body's normal cells time to recover. The combination of drugs used, the length of time to administer the drugs, how often they should be repeated and the number of cycles recommended have been analyzed throughly in clinical trials. For mesothelioma patients, the "standard" treatment is a combination of Alimta and cisplatin, administered IV, with a 10 minute infusion of Alimta followed by two hours of cisplatin, given in 21 day cycles. Modifications to this schedule may be made according to what your doctor feels is appropriate in your particular case.

The number of treatment cycles, or the length of time between the beginning and end of chemotherapy may vary, however in general, 3 to 4 cycles of treatment are given before response is evaluated; 2 to 3 cycles are considered a minimum to assess for effectiveness. After response to the treatment has been determined, the following criteria will be used to decide whether chemotherapy should continue:

• If there is shrinkage of the tumor, or the disease is kept stable, chemotherapy may be continued for as long as it can be tolerated and there is no disease progression.

• If there is continued disease progression, chemotherapy will be stopped, and the patient will be given alternative options.

The goal of setting a chemotherapy schedule is to make treatment as effective, timely and trouble-free as possible, but while the drugs are working to kill cancer cells, they may also affect healthy cells causing side effects. One of the most common side effects, and one your doctor will monitor carefully, is a chemotherapy-induced low white blood cell count (neutropenia) which means your immune system is weakened, therefore leaving you more prone to infection. While this side effect is anticipated when someone is undergoing chemotherapy, it can cause delays in your treatment schedule, or changes in the dosage of the drugs you will receive. Click here for more on understanding your blood counts.

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Note to Patients:

Chemotherapy treatment should be a cooperative effort between you and your doctor. The interaction that takes place is important to your health. It will not only help you feel better, but will also address any potential problems with miscommunication.

1. It is necessary for your doctor to be aware of any side effects which may result from your chemotherapy treatment.

These may include:

o Fever of, or greater than 101 degrees

o Nausea or vomiting

o Diarrhea or constipation

o Fatigue

o Tingling or numbness in the fingers or toes

o Ringing in the ears

o Bruises or rashes

o Sores in the mouth or throat

2. Taking other medication of any kind can alter the effects of chemotherapy or cause undesirable interactions.

Be sure you report all over-the-counter and prescribed medicines to your doctor. Don’t take aspirin unless it has been approved by your doctor. Ask your pharmacist if aspirin is contained in any drugs you plan to purchase.

3. Take extra care with your daily health.

Try to maintain a stable weight by eating a healthy diet and drinking plenty of fluids. If your stomach is upset, ask your doctor for helpful hints or work with a nutritionist who can tailor a program to your needs. Brush your teeth after every meal, or if you can’t brush, rinse your mouth thoroughly with water.

Stay away from people who have colds or the flu. Chemotherapy can compromise your immune system and lower your resistance to germs. Make sure you keep appointments for blood work – these tests help your doctor monitor your health.

4. Be open about your feelings regarding your treatment.

It is normal to feel sad, angry or afraid, however, letting these emotions get out of control can be detrimental to your overall well-being. Seek out the help of family, friends, your doctor, a counselor or a support group

CHEMOTHERAPY

CHEMOTHERAPY

Chemotherapy is defined as the treatment of cancer using chemical substances. When cancer occurs, abnormal cells continue to divide uncontrolled. Anticancer, or chemotherapy drugs, work to destroy cancer cells by preventing them from multiplying. Read more on types of chemotherapy medicines.

Purposes of Chemotherapy

Chemotherapy may be used to achieve different goals, depending on the stage of the cancer at the time of diagnosis and the age and health of the patient. Since chemotherapy for mesothelioma is not considered "curative", the goal is:

• To control the cancer by stopping its spread or slowing its growth.

• To shrink tumors prior to other treatments, such as surgery. This is called neoadjuvant chemotherapy.

• To destroy microscopic disease which may remain after surgery. This is called adjuvant chemotherapy.

• To relieve symptoms, such as pain. This is called palliative chemotherapy, and is given in cases when a drastic reduction in the tumor is not expected.

The most common use for chemotherapy in mesothelioma patients, is as an option for those who are not surgical candidates, however, various cancer centers are now conducting trials using the neoadjuvant approach. Alimta (pemetrexed) is a drug approved by the Food and Drug Administration (FDA) for use with Cisplatin in the treatment of patients with malignant pleural mesothelioma whose disease is either unresectable or who are not candidates for curative surgery. Alimta is the first drug approval specific to mesothelioma.

The Alimta/Cisplatin chemotherapy regimen is the first Food and Drug Administration (FDA) approved treatment specifically for malignant pleural mesothelioma. This is currently considered the most effective first-line treatment for mesothelioma patients who are not surgical candidates. A multi-targeted antifolate drug, Alimta works by blocking the enzymes necessary for DNA copying and cell division. During the clinical trial process, Alimta/Cisplatin improved median survival for pleural mesothelioma patients by approximately three months over treatment with Cisplatin as a single agent. Eli Lilly's information on treatment with Alimta.

As with any medical treatment, it is important to discuss the use of Alimta with your doctor. This conversation should include all pertinent information regarding effectiveness, administration and possible side effects of the drug combination. It is also important to begin vitamin supplementation of B12 by injection during the week prior to treatment (to be repeated every 9 weeks), and folic acid by mouth daily (to be continued until 21 days after the last cycle of Alimta). Additionally, you will be given an oral steroid medication to minimize the risk of skin rash or other possible side effects. Your doctor will have information on the correct dosages of each medication. Be sure to tell your doctor of any other medications you are taking (including non-prescription drugs) so he may be aware of any adverse interactions.

Alimta/Cisplatin is administered to patients on an outpatient basis every 21 days. This cycle of treatment involves a 10-minute IV infusion of Alimta followed by a 2 hour infusion of Cisplatin. How many cycles of treatment you receive will be dependent on your response rate to the drug (regression of the tumor or halt to progression of the disease) and the side effects you might experience.

Side effects of Alimta/Cisplatin are mild to moderate for most mesothelioma patients, i.e., nausea, vomiting and fatigue, and can usually be managed by your doctor. For some patients, however, side effects may be debilitating, and may require a decrease in dosage or removal from the program. All potential side effects should be mentioned to your doctor. Never assume any complaint is minor.

Administration of Chemotherapy

The most common way to administer chemotherapy is intravenously, or through a vein. A thin needle is inserted into a vein in the hand or in the lower arm. Intravenous administration of drugs allows for rapid entry into the blood stream. Drugs may also be delivered via catheters and/or ports.

• Catheters are soft, thin, flexible tubes placed into a large vein in the body. They remain in place for as long as they are needed.

• The catheter may sometimes be attached to a port, a small round plastic or metal disc placed under the skin on the chest. Ports also remain in place for as long as necessary.

Intraperitoneal chemotherapy may also be delivered through a catheter or a port. The catheter is inserted through the abdominal wall. Chemotherapy drugs can then be infused directly into the abdominal cavity. Ports may also be placed under the skin of the abdominal wall and the catheter tunneled between the skin and muscle into the peritoneum.

Side Effects of Chemotherapy

Cancer cells grow and divide more rapidly than normal cells, but some normal cells also multiply quickly, particularly those in the digestive tract, reproduction system, and hair follicles. It is the damage done to normal cells that causes side effects. The type of side effects you might experience and how severe they are, depend on the type of chemotherapy you are receiving, the dosage given and how your own body reacts. Before beginning any chemotherapy treatment, you will be asked to sign a consent form. Before signing the form, be sure your doctor informs you of all the facts regarding the treatment he/she will be administering, including information about the particular drug or combination of drugs to be used, the possible risks or side effects (including nausea and vomiting and peripheral neuropathy), the number of treatments you will receive and how often, and whether it will be given during a hospital stay or on an outpatient basis. More on vomiting and nausea from chemotherapy. More on peripheral neuropathy. More on anti-nausea treatment for chemotherapy patients.

Click here if you are interested in learning more about chemotherapy for mesothelioma and the types of questions you should ask your doctor.

TREATMENT FOR MESOTHELIOMA

Mesothelioma is a rare and severe type of cancer. The treatments available are not effective in treating the disease. This also arises partly from the fact that the disease is not well known. New methods and procedures need to be developed in order to improve the effectiveness of the treatment. Clinical trials are studies directed for the purpose to develop new treatments and to evaluate the effectiveness and safety of these new treatments.

There are basically four phases in a clinical trial and each phase has its goals. The phases are as follows:

Phase 1: This phase studies the safety and side effects of a new drug. It tries to determine the best way that this new drug is administered and tries to determine the appropriate dosage. It is important to state that not only new drugs are studied in a clinical trial but treatments such as surgery, radiation therapy and other treatments may also be studied. Before any treatment is tested on humans it has been already tested in the laboratory, usually on animals, but its side effects on humans will not accurately be determined until it is actually tested on them.

Phase 2: In this phase the treatment's effectiveness to fight mesothelioma will be studied and the treatment's safety will further be evaluated.

Phase 3: the new treatment is compared to existing treatments in order to study side effects and confirm its effectiveness.

Phase 4: Information is gathered in order to determine how an already approved treatment can be used to treat other diseases.

To be eligible for a clinical trial the patient should have certain characteristics. Eligibility depends on the stage of the disease, the age of the individual and many other factors. There are different types of clinical trials and eligibility is not the same for all. There is no guarantee that a clinical trial will produce the desired results. Further more the patient is obviously exposed to certain risks. Therefore it is very important that the patient talks with his physician and is well informed about the advantages and risks involved and the adequacy of clinical trial in his or her particular situation.

For more info go to Mesothelioma Cancer