Surgeons performing surgery Researchers “Freeze” Mesothelioma with Cryotherapy

 Surgeons performing surgery Researchers “Freeze” Mesothelioma with Cryotherapy

Surgeons performing surgery Researchers “Freeze” Mesothelioma with Cryotherapy

The Mayo Clinic has started a new clinical trial to test freezing mesothelioma tumors. In the trial, doctors use liquid nitrogen to freeze tumors before removing them from the patient’s body. This clinical trial is currently recruiting patients with malignant pleural mesothelioma.
This innovative approach has shown promise when used against other types of cancer. Now, the Mayo Clinic wants to bring that hope to mesothelioma patients.

The Cryotherapy Procedure

The experimental cryotherapy treatment in this clinical trial will involve 2 to 3 applications of cryospray on the affected area. Cryospray is made of liquid nitrogen. It is sprayed onto tumors to freeze them.
This clinical trial is testing the ability of these cryospray treatments to trigger an immune response from the patient’s body. The hope is that the immune system will continue to fight off mesothelioma after the frozen tumors are removed.
The procedure consists of several applications of cryospray. The doctor will use the spray to freeze the mesothelioma-affected area in small sections at a time.
Here’s a summary of the process used for the trial:
  • 1
    The doctor freezes over a minimum of 2 cm² for 15 to 20 seconds.
  • 2
    About 60 seconds is allotted for the space to thaw.
  • 3
    The doctor repeats the procedure in the same area up to 2 times.
  • 4
    The first 3 steps are repeated on more small areas, adding up to at least 6 cm².

Trial Details and Process

The trial has two arms: an experimental arm and a control arm. This is an open label study, so patients and their doctors will know which treatment they are going to receive.
Participants in both arms will have their blood drawn and then undergo a pleuroscopy to collect pleural fluid and biopsies. The patients in the experimental arm will also receive cryotherapy treatment during their pleuroscopy.
All patients will receive standard surgical treatment about 14 days after their pleuroscopy. They will also have their blood drawn and pleural fluid and biopsies collected again. Hopefully, by this point, the body’s immune system will have been triggered by the cryotherapy to fight the patient’s mesothelioma.
“It also is less toxic and requires less aggressive surgery afterwards,” said Dr. Tobias Peikert, Mayo Clinic pulmonologist.

Raising Mesothelioma Awareness on World Cancer Day

Raising Mesothelioma Awareness on World Cancer Day
Raising Mesothelioma Awareness on World Cancer Day
February 4th is World Cancer Day, a day dedicated to raising awareness about how everyone can do their part to prevent and fight cancer.
People and organizations representing all types of cancer, including mesothelioma, are encouraged to speak out on World Cancer Day about how they can make a difference. From 2016-2018 the theme of World Cancer Day is “We can. I can.” According to the World Cancer Day website:
“World Cancer Day 2016-2018 will explore how everyone – as a collective or as individuals – can do their part to reduce the global burden of cancer.”
World Cancer Day is organized by the Union for International Cancer Control (IUCC). According to IUCC, 8.2 million people die from cancer worldwide every year and the World Health Organization (WHO) estimates that up to 43,000 people die of mesothelioma every year.

How the Mesothelioma Community Can Get Involved

There are events planned all over the world for World Cancer Day. In New York City, the Empire State Building will be lit up in blue and orange, the IUCC’s colors. Mesothelioma patients and their families can show their support by finding local events in which to participate. However, the easiest way to get involved, is to use social media.
The official hashtags for the day are #WorldCancerDay and #WeCanICan. IUCC has launched the “Talking Hands” campaign as a way for people around the world to share their own stories and how they can make an impact in the fight against cancer. Individuals can write on their hands “I can” followed by how they fight cancer, and groups of people can use a collection of hands to do the same with “We Can.”
World Cancer Day I Can We Can Social Media
Mesothelioma patients make up a somewhat small percentage of cancer cases in the world, but even small groups can make a large impact. World Cancer Day is a great opportunity for advocates to raise awareness about mesothelioma, the dangers of asbestos exposure, and laws that could hurt or help mesothelioma patients.

Mesothelioma and Cancer Prevention

February also happens to be National Cancer Prevention Month here in the United States. There are many factors that go into whether or not a person will develop cancer, but there are some easy ways that people can help lower their risk.
The American Institute for Cancer Research offers these three tips for lowering cancer risk:
  • 1
    Eat mostly plant foods, limit red meat, and avoid processed meat.
  • 2
    Exercise in any way for 30 minutes a day
  • 3
    Maintain a healthy weight
All three of those tips apply to mesothelioma, however, a fourth tip is also necessary: avoid asbestos and materials made with it. For mesothelioma patients, survivors, and their families, World Cancer Day and National Cancer Prevention Month can be viewed as opportunities to spread awareness about the risks of asbestos exposure and how to avoid it.

Veterans with Mesothelioma Get the Facts about your Benefits

Veterans with Mesothelioma Get the Facts about your Benefits

Veterans with Mesothelioma: Get the Facts about your Benefits

Many veterans with mesothelioma don’t even think about the VA and what kinds of benefits they may be entitled to. Some think that “VA Benefits” means VA Health Care, which they either already have, or don’t want. But, allow me to provide a brief explanation of the two main benefits for which you may be entitled: VA Disability Compensation and VA Pension.
These are two financial benefits that could be extremely helpful as you deal with the financial burden of fighting this mesothelioma.

VA Disability Compensation (VADC)

VADC is a monthly benefit paid to any veteran who is suffering from a “service-related” disability. Usually, this means you were injured in some way while in the military, and you still have lingering effects of it after leaving the service. However, disabilities can also be “service-related” if they were caused by an “event” in service.
Therefore, veterans with mesothelioma (or any asbestos illness for that matter) are eligible for VADC if the primary reason they developed mesothelioma is because of their exposure to asbestos in the military. Notice I highlighted the word primary, and I did that because this is the crux of any asbestos claim.
Convincing the VA that the primary reason you developed mesothelioma comes down to convincing the VA that at least 50%, or more, of your total occupational exposure occurred during your military service.

So, how does the VA determine that?

  • 1
    Service Record – First, they will go through your service record. The problem is, if you were not in a job in the military normally associated with asbestos (such as a boilerman), there isn’t going to be any valuable information in your service record that explains to the VA how you were exposed to asbestos. That is why it is essential that you write a detailed exposure summary.
  • 2
    Exposure Summary – The exposure summary fills in the blanks about your asbestos exposure for the VA by describing where you came into contact with asbestos while in the military. The summary must also explain to the VA what you did in your civilian jobs, both before and after the military and if there was any exposure in those jobs, why you believe it was less significant than your military exposure.
Many vets struggle when trying to write these summaries, but that is where I come in. I have helped over 1,200 veterans write their exposure summaries and I also have many examples that I can send you to assist you in writing yours.
Note: The VA never asks veterans to provide any information about any personal exposures, such as changing the brakes on your own car, or remodeling your home. They only ever ask veterans to provide information about their military exposures, and their civilian jobs before and after their military service. So, keep your comments focused only on your occupations.
If approved, the asbestos section of the VA manual states that the VA must award you a 100% disability rating (unless you are cured or in remission and no longer receiving treatment), which equates to $2,906 per month…tax free.
You will receive additional compensation if you are married, have any dependent children, or are housebound or in need of the regular Aid & Attendance (A&A) of another person to perform basic daily tasks.

VA Pension

VA pension is a monthly benefit paid to wartime veterans who are either totally disabled (mesothelioma counts) or over the age of 65, and whose income is below the VA’s income threshold.
Your mesothelioma does NOT need to be service related in order to be eligible for VA pension – in fact, if it is service related, I would advise you to file for VADC, not pension.
However, pension is a means tested benefit. This is how it’s calculated:
  • The amount you receive varies depending on your income and your out of pocket medical expenses (the VA will also deduct other expenses from your income, please contact me if you need more detailed information).
  • Once the VA calculates your income for pension purposes, it will subtract that from the limit, and pay you the difference in 12 equal monthly installments throughout the year.
  • If you are married, have dependent children, are housebound, or in the need of the regular A&A of another person, then the income limits are higher.
So, it is possible that your income may be too high to receive Pension now, but if, in the future, you became housebound or needed A&A, you could then qualify if your income is below that higher limit.
Note: There is a common misconception out there among vets who believe that Aid & Attendance is a stand-alone benefit. It is not. You cannot apply for Aid & Attendance by itself. You must be eligible for Pension (or VADC) and simply file a pension claim under the higher income threshold for veterans in need of Aid & Attendance.
LCDR Jewett 8x10If you have mesothelioma and would like my assistance in filing for VADC or Pension, please fill out a VA request form on our website here, or you can always call me directly at 844-VET-MESO (838-6376).
And thanks for your service to our great nation.

The Nurse’s Corner: Covering the Cost of your Mesothelioma Treatment

The Nurse’s Corner Covering the Cost of your Mesothelioma Treatment


The Nurse’s Corner: Covering the Cost of your Mesothelioma Treatment

How you are going to pay for treatment is not your first thought after being diagnosed with cancer. However, having health insurance or financial assistance gives you peace of mind. Not to mention, it is one less thing to worry about when you should be focusing on treatment and prolonging your prognosis. Your health comes first.
The cost of treatment should not affect the quality of treatment you receive.
Duke University conducted a study in 2011 that stated the average amount of out-of-pocket expenses for a cancer patient with health insurance was $712 a month. That is $8,544 a year.
Even if you have health insurance, you may find out down the road that not all services were covered.
Make sure to ask your doctor what he expects to be covered. This way you can try to plan ahead. There may be travel expenses if you are traveling for treatment. It takes time and energy managing monthly bills and sometimes affording care can become an issue. Do not fret; there is hope.
Hopefully the following information and resources helps you to afford the care you need.

Government Resources

The health care law signed by President Obama in 2010, called the Affordable Care Act (ACA), put health insurance reforms into place that have improved access, affordability, and quality in health care for U.S. citizens. Part of the plan requires health insurance companies to cover people with pre-existing conditions like mesothelioma.
  • If you are under the age of 65 and cannot receive health insurance through your employer, I highly advise you to see if you qualify for an open enrollment period or a special enrollment period with the healthcare marketplace. Visit for more information.
  • If you are 65 or older, look into Medicare. Medicare is a federal health insurance program that also includes people under 65 with a disability who have been receiving Social Security benefits for 24 months. To qualify you must be a U.S. citizen or qualified legal immigrant and meet certain criteria. Visit for more information
There are 4 parts to Medicare coverage. I suggest looking into Part D – Medicare Prescription Drug Plan, which is optional, to help pay for prescription drugs. Most cancer drugs, like IV infused drugs given by your doctor at a hospital or clinic, will be covered by Part B. However, there are some oral cancer drugs that are only covered by Part D. Be sure to communicate with your doctor to find out if the drugs you are taking are covered.
Medicaid is a state and federal health insurance program for those with income below a certain level. These levels vary by state and please be aware that many physicians do not accept Medicaid. When diagnosed with a cancer such as mesothelioma, you may be entitled for Emergency Medicaid. Visit to see if you qualify. I also suggest contacting your hospital’s social worker to help answer your questions.

4 Supplemental Resources

  • 1

    Social Security Disability

    For those diagnosed with malignant mesothelioma under the age of 65 who have contributed to Social Security, you may be eligible for disability benefits. The Social Security Administration should expedite an application for malignant mesothelioma as it is found on their Compassionate Allowance list.
  • 2

    Create a Donation Fund

    Consider joining or having a family member create a page on a fundraising website. One example is This gives a platform for families and friends to support you financially and emotionally. Most sites are able to be updated daily with news about your condition and allows your support team to leave encouraging messages. People want to help; let them.
  • 3

    Veteran’s Assistance

    More than 30 percent of all mesothelioma patients are U.S. Military veterans. Consider enrolling in the VA Healthcare System. Copays and deductibles, as well as some prescription drugs tend to be lower than Medicare.
    Two of the top mesothelioma surgeons are in the VA health care system. Veterans who develop mesothelioma as a result of their service in the military may be entitled to benefits like VA Disability Compensation. I can get you in touch with our VA Accredited Claims Agent to see what may be available to you.
  • 4

    Asbestos Trust Funds

    Consider looking into the legal side of this diagnosis for supplemental income. There are trust funds set up by judges to help compensate mesothelioma patients who were exposed to asbestos. These trusts have been created by companies who have knowingly exposed individuals to asbestos products.
    This is money that has been set aside for mesothelioma patients to cover the cost of treatment, travel, pain and suffering. You may not be a litigious person but the legal judgement will protect you and your family in the future from unexpected medical bills.
Applying for any of these resources can be tedious. My goal is to reduce frustration and stress during this already difficult cancer journey.
Photograph of Jenna for nurses corner
Please do not hesitate to contact me to help walk you through the process or to provide additional information in any of the areas mentioned above.
Contact me by phone at 888-385-2024 x102 or email me at

How the Mesothelioma Staging System Could Be Improved

How the Mesothelioma Staging System Could Be Improved

How the Mesothelioma Staging System Could Be Improved

A new study explains how the staging system for malignant pleural mesothelioma could be improved.
By taking tumor volume and weight into consideration, doctors may be able to diagnose their mesothelioma patients more accurately. More accurate scoring would help doctors create more accurate treatment plans for patients.

Using Tumor Volume to Stage Mesothelioma

The most commonly used scoring system takes into account if the tumor has spread to other parts of the body and the size of the tumor. This new study, written by Dr. Wickii Vigneswaran, argues that the weight and volume of tumors may be important factors to consider in staging mesothelioma.
Dr. Wickii Vigneswaran
Dr. Wickii Vigneswaran is the division director of Thoracic Surgery at Loyola University Medical Center and a professor at Loyola University Chicago Stritch School of Medicine. He is highly experienced in treating mesothelioma patients and has performed nearly 200 mesothelioma surgeries.
The title of the study is, “Specimen weight and volume: important predictors of survival in malignant pleural mesothelioma” and it was sponsored by the Mesothelioma Heroes Foundation of Chicago. The researchers wanted to test if tumor volume could be a good predictor of survival in pleural mesothelioma patients.
Over 6 years, researchers examined 116 patients who were receiving extended pleurectomy and decortication (EPD) surgery for pleural mesothelioma. Instead of using CT scans to estimate the volume of the patients’ tumors, the researchers measured the actual tumors after they were surgically removed.
The study showed that tumors with a higher volume were associated with shorter survival times. This information could help develop a new, more detailed staging system.
To measure tumor volume, the researchers used the fluid displacement method. This method involves putting a solid object into a measured liquid and seeing how much the volume rises.

Current Staging Systems for Mesothelioma

There are currently three staging systems used for mesothelioma. All of these systems classify mesothelioma into 4 stages and none of them take volume or weight into account.
  • The Butchart System – The Butchart System focuses on the location of the main tumor instead of the size or the number and spread of cancer cells. Dr. Eric Butchart developed this system in 1976 making it the first mesothelioma staging system.
  • The Brigham System – This system focuses on the location, size, and spread of the cancer. This system was developed by Dr. David Sugarbaker while he was at Brigham and Women’s Hospital.
  • TNM Staging System – The TNM system focuses on evaluating the tumor (T), the spread to the lymph nodes (N), and metastasis (M). This system was developed by the American Joint Committee on Cancer (AJCC).

TNM Staging

The tumor/node/metastasis or TNM system is now the most commonly used system to stage cancer, including mesothelioma. The diagnosis of stage 1 through 4 is decided based on 3 categories represented by T, N, and M.
The categories are rated by the extent of cancer with X or a number 0 through 4. X means that category couldn’t be evaluated properly. Then 0-4 represent the severity of the cancer, 0 being the least cancer and 4 being the most.
  • Tumor: This category evaluates the main tumor and how much it has grown and spread. TX means that the tumor can’t be assessed. Then the range of tumor growth can be measured from T0, meaning that there is no evidence of a main tumor, to T4, meaning the tumor has grown too far to be surgically removed.
  • Node: This category evaluates whether the cancer has spread to the nearby lymph nodes and how much. NX means the lymph nodes cannot be assessed. N0 means there has been no spread to nearby lymph nodes. N3 is the highest rating which means that the cancer has spread to lymph nodes on the opposite side of the body from the main tumor.
  • Metastasis: This category evaluates whether the cancer has spread to other organs. Metastasis is only evaluated as 0 or 1. M0 means that there has been no spread to distant organs or areas. M1 means the cancer has spread to distant organs or areas.
While the TNM staging system has proven effective enough to become the most popular staging system for cancer, it may not be precise enough when it comes to mesothelioma. Mesothelioma is unique in that it spreads itself out unevenly around an organ and is similar in density to the healthy tissues around it.

Pericardial Mesothelioma

Pericardial mesothelioma affects the lining surrounding the heart (pericardium). It is a rare form of mesothelioma and only accounts for 1 percent of all diagnoses.

What is Pericardial Mesothelioma?

Pericardial mesothelioma is a cancer that affects the pericardium. It is currently unknown how the asbestos fibers get into the pericardium, and this type of mesothelioma is extremely hard to detect. Men are two times more likely to be diagnosed with pericardial mesothelioma than women. There have been cases of pericardial mesothelioma metastasizing to the lung or abdomen.

How Is Pericardial Mesothelioma Treated?

  • Peritoneal Mesothelioma Icon


    This surgery is rarely used in pericardial mesothelioma patients because the diagnosis is so rare that it is hard to catch early. If patients are eligible, doctors remove the affected part of the pericardium and any surrounding tumors.
  • Mesothelioma Chemotherapy Treatment Icon


    This is the most common treatment option for pericardial mesothelioma patients. There are various chemotherapy methods that can be used to improve a patient’s prognosis. Chemotherapy is most effective when used in conjunction with another treatment like radiation.
  • Mesothelioma Radiation Treatment Icon


    This is the least invasive treatment option for pericardial patients. Radiation is used for both palliative and curative purposes. Radiation works by shrinking the tumor, reducing the invasion on the heart.


Patients may experience chest pain or other symptoms of pericardial mesothelioma. One of the most common reasons pericardial mesothelioma goes undetected is because it is highly uncommon for mesothelioma to originate in the pericardium. Patients have also reported symptoms that cause it to be mistaken for other heart ailments.
  • Chest Pain
  • Shortness of breath
  • Swelling of face or arms
  • Fatigue
  • Cough
  • Pericardial effusion
  • Irregular heartbeat
  • Murmurs


Physicians have a difficult time diagnosing pericardial mesothelioma because of the extreme rarity of the disease.
Pericardial mesothelioma has also been confused with constrictive pericarditis, cardiac tamponade (pressure from fluid buildup) and cardiac failure.
Pericardial mesothelioma can be diagnosed through fluid and tissue biopsies. Patients with pericardial mesothelioma commonly complain about chest pain. When mesothelioma is suspected, cardiac surgeons extract fluid or tissue and test the sample for mesothelioma.
Doctors use tests like the echocardiogram and CT scan to gather images that may tell if a patient has pericardial mesothelioma. An echocardiogram uses sound waves to diagnose or monitor heart ailments, including atrial fibrillation, heart disease and pericardial mesothelioma.
The echo allows a doctor to hear how a patient’s heart is beating and pumping blood. Many patients with pericardial mesothelioma experience chest pain because their heart is unable to pump blood at maximum capacity. Echocardiograms are also essential to determine the extent to which the heart has been affected by the mesothelioma.
Pericardial Mesothelioma Body
Pericardial Mesothelioma Heart
Pericardial Mesothelioma


Treatment options for pericardial mesothelioma are limited because of the proximity of the tumors to the heart itself. Unlike pleural or peritoneal mesothelioma, where the lung or abdominal lining can be removed, the pericardium presents further risks and can be difficult to remove.

Pericardiectomy Surgery

Mesothelioma Pericardiectomy SurgeryA pericardiectomy is the removal of some or all of the pericardium. If patients are deemed eligible, they may be able to have tumors surgically removed from the lining of their heart.
This procedure is often done to relieve the heart from constriction. It is a risky surgery because of the heart being so close and the risk of damage in the process. It’s also a very rare procedure in the case of mesothelioma because many diagnoses have already metastasized.
It is also seldom performed because only 1% of all diagnosed mesothelioma originates in the pericardium.


Many cases of pericardial mesothelioma are discovered post mortem. Due to its rarity, much is unknown about this type of cancer. However, as scientific advances are made, more is being discovered about the causes of pericardial mesothelioma and possible chemotherapy options.
One of the only effective chemotherapy treatments for patients with pericardial mesothelioma is the drug gemcitabine. Gemcitabine can shrink tumors and slow the progression of mesothelioma. More research is being done to find more treatment options for this rare type of mesothelioma.


The prognosis for patients with pericardial mesothelioma is poorer than for pleural and peritoneal mesothelioma. The rarity of pericardial mesothelioma means it isn’t able to be studied as much as other types of mesothelioma, contributing to the poor prognosis.
There is also less information available about how the asbestos fibers lodge into the pericardium and which treatments are most effective. However, some patients show a positive outlook.
One patient who underwent a pericardiectomy survived five years after his initial surgery date. There has been research conducted through Johns Hopkins Hospital that shows pericardiectomies are performed with lower mortality rates as time goes on. Taking part in clinical trials also offers unique treatments and is one way many patients improve their prognosis.

Peritoneal Mesothelioma

Peritoneal mesothelioma is a form of cancer that affects the lining of the abdomen (the peritoneum). It is caused by the ingestion of asbestos fibers.

What is Peritoneal Mesothelioma?

Peritoneal mesothelioma accounts for 20 to 25 percent of all mesothelioma cases. It is the most common diagnosis after pleural mesothelioma. Peritoneal patients have longer life expectancies than those with other types of mesothelioma. Some studies report patients living upwards of 5 years after cytoreductive surgery.

How Is Peritoneal Mesothelioma Treated?

  • Peritoneal Mesothelioma Icon

    Cytoreductive Surgery

    This is the only surgical option available to those with a peritoneal diagnosis. This surgery has high success rates when it is combined with chemotherapy.
  • Mesothelioma Chemotherapy Treatment Icon


    This is the most common treatment for peritoneal mesothelioma. It is sometimes administered directly to the abdomen during surgery.
  • Mesothelioma Radiation Treatment Icon


    This is the least invasive treatment option for peritoneal mesothelioma patients. Radiation may be delivered during surgery as well.