Prasad, Anil | Surviving Mesothelioma

Prasad, Anil

The legacy left by sixty-nine-year-old James Rhio O’Connor on July 11, 2009 was a new beginning for the next generation of medicine.

James Rhio O’Connor was diagnosed in October 2001 with malignant pleural mesothelioma. Surgery and chemotherapy were not plausible options for him, because the tumor was located close to his spine and poignant drug therapies would decrease his quality of life. Thus, his prognosis was roughly another six months to live.

The mesothelium is a membrane that covers, protects, and reduces friction between moving organs of the body (4). Mesotheliomas are tumors that arise from cells of the mesothelium; approximately 80% of the cases arise in the pleura, the mesothelium of the chest cavity, and approximately 20% of cases arise in the peritoneum, the mesothelium of the abdominal cavity (3). Three-fourths of pleural mesotheliomas diffuse, and they occur more prominently in men. A cause of malignant pleural mesothelioma has been traced to exposure to asbestos, in which 60%-80% of patients have had a history of exposure. The latency between exposure is between 20 and 40 years. Symptoms include shortness of breath, chest pain, and weight loss. Treatments are limited to surgical pleurectomies, pneumectomies or decortications; radiotherapy; chemotherapy; or combinations of the methods; however, treatments are rarely successful. Where surgical resection is not possible, the treatment options currently available are palliative through through the administration of chemotherapies such as cisplatin or pemetrexed. In any case, mesothelioma patients survive an average of 4 to 16 months from the onset of symptoms (2). James O’Connor survived for 81 months from the time he was diagnosed, despite his unfortunate prognosis.

His survival was hardly a matter of fortune. In order to outsmart his cancer, O’Connor designed a personal regimen and changed his diet. He references hundred of articles in medical literature in order to optimize his treatment to best fight the cancer metastases.

Honestly speaking, if I faced the same challenges as Jame Rhio O’Connor, I would hope to have at least half of the willpower that he did. I am in a very different situation an all I can say it what I would hope to do: work with my doctors to find a treatment regimen for me. I would research treatments other than surgery, chemotherapy, or radiotherapy, such as gene therapies and intelligent cancer-targeting pharmaceuticals. But while I am not facing the same challenges, does that mean that I am “off the hook”; that I am not responsible? The inspiration is that while I do not have cancer, I’m not going to wait until I get it (after all, of the people that will live over the age of 60, more than 1 in 2 will have or will have had cancer); I’m going to start taking action now (1). To me, this means that I maintain a healthy diet, and exercise (I did six miles of running each week for the last month). I am also aspiring to be a member of the medical community, and to me that means that my scientific explorations will be aimed at improving and designing the treatments of mesothelioma and other cancers and diseases.

When I took Doctor Mossman’s course on cancer biology, it became clear to me that the answer to the question “what is cancer?” is still unknown. Cancer has properties: disorganized, excessive proliferation of cells (neoplasia). But these cancer traits bypass immune response, making it challenging to answer “what is cancer?” from the perspective of a biochemical engineer. I am keenly interested in cancer diagnosis and treatment because curing cancer is a major forefront in medicine that will bring about presymptomatic diagnoses and predictive medicine for all types of future diseases. This is a dream I share with the medical science community.

My research is aimed at the personalization of preventative medicine, especially my ability to confidently administer it in the future. The idea is that if the genome can be mapped, then the potentially weak points in the genome can be identified. The genome is becoming more accessible, and the general process for accomplishing preventative medicine is to observe the pathogenesis of existing diseases, determine the points and tactics of attack on the genome, and design the appropriate enhancements and protectors. I believe that my role is in the design, hence my current research in protein modification. The next generation of medicine will be most effective if treatments are tailored to individuals, which requires the ability to modulate the specificity to elicit the appropriate responses under a variety of conditions.

Actually, mesothelioma is relatively rare compared to other cancers, occurring at a frequency of approximately 2000 patients or less per year. Other than the cause, there is little known about its pathogenesis, and without knowing the pathogenesis it is difficult to treat chemically; in general, mesothelioma is difficult to treat merely due to its proximately to vital systems. There are researches and institutions that have been doing the legwork and seeking out the funds in order to facilitate the investigation for treating the underrepresented cancer. Often is it is said that people have to die for something to get fixed. In fact, this will be the number one issue facing the implementation of preventative medicine – the biggest question will be “if people are not dying, why do we need it?” The thing that I admire most about James O’Connor is that he valued life and he valued his love ones. He did not wait snuff him out, but instead he was proactive. And so if we want preventative and presymptomatic medicines, they need to be cheap, accessible, and easy to use. And we need to get into the mindset that it shouldn’t cost lives for us to be proactive. This is the meaning of O’Connor’s last stand.

Normally, inscribed on a tombstone is a person’s epitaph, the last thing that anyone will read about a person. But I hope that an ode – an ode to life, to personalized medicine, and faith that cancer will be obliterated – is written on James Rhio O’Connor’s tombstone. It would be more appropriate since cancer fighters and survivors will be inspired by his legacy well into the future.

References

1.    America Cancer Society [Internet]. Cancer facts & figures 2008. Atlanta (GA). American Cancer Society. 70 p.
2.    Cornett PA, Dea, TO. Current medical diagnosis & treatment [Internet]. 49th ed. Chapter 39. New York (NY). The McGraw-Hill Companies, Inc.; 2010. Cancer, Mesothelioma; [cited 5 January 2010]; 77p. Available from: STAT!Ref Online Electronic Medical Library. 
3.    Kleinsmith LJ. Principles of cancer biology. San Francisco: Pearson / Benjamin Cummings; 2006. 312 p.
4.    Surviving mesothelioma: A patient’s guide [Internet]. Raleigh (NC): Cancer Monthly; 2009. cited 26 February 2010]. Available from: https://survivingmesothelioma.com

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