The salaries of pharmacists down the economy? In any labor market, wages are based on the value you provide and market supply / demand. Because the economy has led to a pharmacist in the tight labor market is a reality that 1) companies are experiencing budget cuts, 2) pharmaceutical layoffs lead to a greater supply of pharmacists. These trends are noted in the pharmacist labor market:
Pharmacies may be less generous relocation bonus or sign. Pharmacist Salaries stabilizes and does not seem to be increasing as in previous years, and decreases significantly.
Some hospitals do not pay for pharmacists to get to the interview, because budgets are smaller than in the past. You should not expect much space you have to negotiate higher salaries than in previous years. The competition is tough out there, so someone realizes too qualified may be willing to work for wages that can be thought is not enough.
Pharmacist Salaries stabilizes and does not seem to be increasing as in previous years. Do not expect much space you have to negotiate higher salaries than in previous years. I know a hospital pharmacist who took a break from his job for almost a year and is eager to return to the hospital or home infusion. She had the opportunity to return but was out of touch with the way the pharmacist labor market has changed, and felt that the salary was not competitive enough. She is still out of a few months of work for this reason.
If you are a pharmacist emergency, you may have noticed that the need for temporary staffing in some areas have declined (in part because they are occupied by full-time pharmacists easier in this difficult market). Pharmaceutical Companies recruiting experienced a reduction in pharmacies are paying and I saw some bodies to reduce the amount paid by pharmacists, as no service charges and costs of doing business in a decrease agency not only because it a tight labor market.
Senin, 02 Januari 2012
Selasa, 12 Juli 2011
Institutions Of Mesothelioma And Lung Cancer
You probably already know a lot about the symptoms, treatment and perhaps a few things about mesothelioma (or one of the many other forms of asbestos-related cancers), but there are four secrets of asbestos and insurance companies to their suppliers do not want you t know.
Here are four important truths:
1 Mesothelioma is almost always caused by previous exposure to asbestos.
2 Smoking does not appear to increase the risk of mesothelioma.
Smoking increases the risk of other cancers. So if you have been exposed to asbestos, do not let asbestos companies to make you believe that just because you smoke (or have smoked in the past) that it caused lung cancer mesothelioma .
3. You do not have to be exposed to asbestos for long periods of time or have heavy exposure to develop asbestos-related diseases.
There is ample evidence that some people have developed mesothelioma after only a brief exposure to asbestos.
4 You have only a limited amount of time to file a complaint for redress of your mesothelioma.
Some states allow year after diagnosis of mesothelioma. Most states allow two years and some states allow three or more years. If you do not file your case within the time limit can not be prevented from continuing your claim.
You can see why asbestos is in the interest of companies to pull things before you run out of time to file a lawsuit.
If the asbestos companies (or companies that use asbestos products) can have one of these four secrets to you, could possibly full of having to compensate for what they have done for you.
There are many forms of mesothelioma and asbestos related cancer. Here are the most common:
When mesothelioma affects the lining of the lungs is called pleural mesothelioma.
When you touch the heart is called pericardial mesothelioma.
When you touch the abdomen is called peritoneal mesothelioma.
There are many other forms of mesothelioma and asbestos-related cancers, and if you have one of these forms of cancer, you may be eligible to receive a big paycheck. Be sure to check with your doctor and a lawyer with experience in cases of mesothelioma and asbestos before the statue of limitations runs out on you. This is a situation where delay could really harm both your health and wallet.
In summary:
Do your research by selecting both the best treatment center and the best lawyer to help you and your family with your unfortunate (and possibly preventable) mesothelioma.
Please note that goes with your local family lawyer could cost thousands (or millions) in the form of the colony may have received adequate legal assistance.
Like the fact that you need a doctor who specializes in the treatment of mesothelioma to achieve the best results, you also need a lawyer who specializes in mesothelioma and asbestos-related cancers in order to receive payment maximum and as soon as possible.
Permission is granted to reprint this article as a credit, including information and links below.
Jerry Minchey is an engineer, author and researcher. It passes through advertising and reveals the facts that reveal secrets that are easily understood by non-technical terms. He has written several books and DVD products as a result of its investigation. You can view information about recent changes in treatment methods for mesothelioma and get all the details at the Center for mesothelioma asbestos lung cancer.
At the site of mesothelioma law firm can find information about attorneys who specialize in cases of mesothelioma and asbestos and information on lawyers who obtain the largest and the colonies.
Here are four important truths:
1 Mesothelioma is almost always caused by previous exposure to asbestos.
2 Smoking does not appear to increase the risk of mesothelioma.
Smoking increases the risk of other cancers. So if you have been exposed to asbestos, do not let asbestos companies to make you believe that just because you smoke (or have smoked in the past) that it caused lung cancer mesothelioma .
3. You do not have to be exposed to asbestos for long periods of time or have heavy exposure to develop asbestos-related diseases.
There is ample evidence that some people have developed mesothelioma after only a brief exposure to asbestos.
4 You have only a limited amount of time to file a complaint for redress of your mesothelioma.
Some states allow year after diagnosis of mesothelioma. Most states allow two years and some states allow three or more years. If you do not file your case within the time limit can not be prevented from continuing your claim.
You can see why asbestos is in the interest of companies to pull things before you run out of time to file a lawsuit.
If the asbestos companies (or companies that use asbestos products) can have one of these four secrets to you, could possibly full of having to compensate for what they have done for you.
There are many forms of mesothelioma and asbestos related cancer. Here are the most common:
When mesothelioma affects the lining of the lungs is called pleural mesothelioma.
When you touch the heart is called pericardial mesothelioma.
When you touch the abdomen is called peritoneal mesothelioma.
There are many other forms of mesothelioma and asbestos-related cancers, and if you have one of these forms of cancer, you may be eligible to receive a big paycheck. Be sure to check with your doctor and a lawyer with experience in cases of mesothelioma and asbestos before the statue of limitations runs out on you. This is a situation where delay could really harm both your health and wallet.
In summary:
Do your research by selecting both the best treatment center and the best lawyer to help you and your family with your unfortunate (and possibly preventable) mesothelioma.
Please note that goes with your local family lawyer could cost thousands (or millions) in the form of the colony may have received adequate legal assistance.
Like the fact that you need a doctor who specializes in the treatment of mesothelioma to achieve the best results, you also need a lawyer who specializes in mesothelioma and asbestos-related cancers in order to receive payment maximum and as soon as possible.
Permission is granted to reprint this article as a credit, including information and links below.
Jerry Minchey is an engineer, author and researcher. It passes through advertising and reveals the facts that reveal secrets that are easily understood by non-technical terms. He has written several books and DVD products as a result of its investigation. You can view information about recent changes in treatment methods for mesothelioma and get all the details at the Center for mesothelioma asbestos lung cancer.
At the site of mesothelioma law firm can find information about attorneys who specialize in cases of mesothelioma and asbestos and information on lawyers who obtain the largest and the colonies.
.
Minggu, 10 Juli 2011
Mesothelioma Treatment Costs
As though totally anatomies of malignant cancers, the boilersuit price of mesothelioma treatment is really expensive. An mesothelioma patient's care possibly thousands of dollars per month. The major factors affecting mesothelioma treatment costs admit age, fallout of the treatment, the effects of the treatment on the total health and the chances of survival, besides as the stage and severity of disease and the body parts over which the affliction has spread.
Mesothelioma is a cancerous affliction, mainly of three kinds - pleural, peritoneal and pericardiac. A variety of treatment choices, including surgery, radiology, and chemotherapy, is needed to cure this malady. Radiotherapy uses high-energy rays to damage tumors and stop them from further arising and carving up. Surgical operation totally removes the afflicted organ or its part. Chemotherapy is a treatment used to kill the tumor cells by coming in medicines intravenously into the afflicted areas. The price of this therapies and follow-up treatments are very high. Occasionally, a combining of two or more treatment method gets essential to handle the disease.
Generally, mesothelioma treatment prices admit fees for the physician, significant periods of hospitalisation, chemotherapy, and radiation treatments. Uncertain occasions, the patient and family members must travel far lengths to reach a facility where the best mesothelioma treatment is allowed. These will find them the another expenses of airfare, lodging, and related travel disbursals.
Absolute majority of mesothelioma diseases are directly associated to asbestos exposure. They are usually due to the willful carelessness of an employer, who does not issue the essential warning before offering employment. Therefore the financial obligation of bearing mesothelioma treatment cost consists the employer. The affected role had better confer with an lawyer who's a beneficial idea of the cost of treatment. Mesothelioma treatment costs in such cases can be recovered easily from the employer.
Approximate shows that the medical costs associated with this type of treatment exceed $150,000. Mesothelioma treatment costs also differ dependent on wherever the treatment is allowed.
A lot of checkup insurance plans useable in the market cover mesothelioma treatment costs. Assure your health policy to see what kind of coverage you accept.
Mesothelioma is a cancerous affliction, mainly of three kinds - pleural, peritoneal and pericardiac. A variety of treatment choices, including surgery, radiology, and chemotherapy, is needed to cure this malady. Radiotherapy uses high-energy rays to damage tumors and stop them from further arising and carving up. Surgical operation totally removes the afflicted organ or its part. Chemotherapy is a treatment used to kill the tumor cells by coming in medicines intravenously into the afflicted areas. The price of this therapies and follow-up treatments are very high. Occasionally, a combining of two or more treatment method gets essential to handle the disease.
Generally, mesothelioma treatment prices admit fees for the physician, significant periods of hospitalisation, chemotherapy, and radiation treatments. Uncertain occasions, the patient and family members must travel far lengths to reach a facility where the best mesothelioma treatment is allowed. These will find them the another expenses of airfare, lodging, and related travel disbursals.
Absolute majority of mesothelioma diseases are directly associated to asbestos exposure. They are usually due to the willful carelessness of an employer, who does not issue the essential warning before offering employment. Therefore the financial obligation of bearing mesothelioma treatment cost consists the employer. The affected role had better confer with an lawyer who's a beneficial idea of the cost of treatment. Mesothelioma treatment costs in such cases can be recovered easily from the employer.
Approximate shows that the medical costs associated with this type of treatment exceed $150,000. Mesothelioma treatment costs also differ dependent on wherever the treatment is allowed.
A lot of checkup insurance plans useable in the market cover mesothelioma treatment costs. Assure your health policy to see what kind of coverage you accept.
.
Sabtu, 02 Juli 2011
Four possibilities, a good mystery pharmacist pharmacy in attracting
Pharmacy directors and hiring managers: Do not she wish that you will hire about being fully yourself and always could never get or the husband IF pharmacists worries COVER Make yourself Does it?
The candidate should be chosen in several to choose from is also available in this highly competitive market to work, but pharmacies report is dass own good time, um, to find the right candidate. The candidate is then sift more. Are sure, in fact, MANY pharmacies nun with cave and she want all pharmacists, pharmacist know that the IS is a good investment.
Secret # 1: Will pharmacists be discouraged by the lack of a fulfillment in work unfortunately came.
SOLUTION: The more you are able to deliver a good mix of clinical staff / the ability to non-routine work and to participate FEELING A contribution of dying over distribution, Nevertheless she Éinen easier time pulling good pharmacist.
She is a give and take interest, too, not only growth in the development of vocational and career pharmacists, bidding for the chance But personal. So um die ability to develop and manage your pharmacist and not for different situations in the dream spot for your drugs the patient. This can mean, teleseminar training, training, live events, books, CDs in areas outside the pharmacy.
YOU with your potential hires as his part is different and personal fulfillment for connections to growth promoting Unfortunately, it did work. Your connections dies alone makes Attractive ALS others.
Secret # 2: Are pharmacists thought more about the stability of our Days. In an interview with pharmacists, my observations IS meantime, was impressed with last years changed, careful research to know that pharmacists came Unfortunately, Sindh, WHEN IS A Company Or not financially healthy. Some are for work on the little connections (DH small, independent pharmacies) for the reason of stability concerns.
Solution: Make Éinen she at ease pharmacist stability of your dying on the company, if the Finance Area, which features YOU, increase came Unfortunately defined benefit plan long-term vision and leadership Or.
Secret # 3: Pharmacists most die complaints about flexible working hours. This IS die most common complaint I die On Horen RESPECT in job satisfaction. MANY have pharmacists in the rotation, flexible working hours, and not black, your schedule will probably end up in the morning.
Solution: The pharmacy has IF A comprehensive program for transfer of knowledge and complete your mark IN voraus, Siemens, no doubt, beneficial Éinen ALS die.
Secret # 4: Focus on YOU yourself pharmacist die knowledge.
It Is Easy, a pharmacist who worked at the pharmacy or pharmacy students to WIN BEFORE A woman resident. Did she have to die, the available competitive, adequacy Lived ability of the pharmacist and for the position.
Solution: The development of pharmacists recovery program, a residency program or an internship, if you have already buy non-A. She stay in contact with them'they to Becoming KONNEN future employees.
The candidate should be chosen in several to choose from is also available in this highly competitive market to work, but pharmacies report is dass own good time, um, to find the right candidate. The candidate is then sift more. Are sure, in fact, MANY pharmacies nun with cave and she want all pharmacists, pharmacist know that the IS is a good investment.
Secret # 1: Will pharmacists be discouraged by the lack of a fulfillment in work unfortunately came.
SOLUTION: The more you are able to deliver a good mix of clinical staff / the ability to non-routine work and to participate FEELING A contribution of dying over distribution, Nevertheless she Éinen easier time pulling good pharmacist.
She is a give and take interest, too, not only growth in the development of vocational and career pharmacists, bidding for the chance But personal. So um die ability to develop and manage your pharmacist and not for different situations in the dream spot for your drugs the patient. This can mean, teleseminar training, training, live events, books, CDs in areas outside the pharmacy.
YOU with your potential hires as his part is different and personal fulfillment for connections to growth promoting Unfortunately, it did work. Your connections dies alone makes Attractive ALS others.
Secret # 2: Are pharmacists thought more about the stability of our Days. In an interview with pharmacists, my observations IS meantime, was impressed with last years changed, careful research to know that pharmacists came Unfortunately, Sindh, WHEN IS A Company Or not financially healthy. Some are for work on the little connections (DH small, independent pharmacies) for the reason of stability concerns.
Solution: Make Éinen she at ease pharmacist stability of your dying on the company, if the Finance Area, which features YOU, increase came Unfortunately defined benefit plan long-term vision and leadership Or.
Secret # 3: Pharmacists most die complaints about flexible working hours. This IS die most common complaint I die On Horen RESPECT in job satisfaction. MANY have pharmacists in the rotation, flexible working hours, and not black, your schedule will probably end up in the morning.
Solution: The pharmacy has IF A comprehensive program for transfer of knowledge and complete your mark IN voraus, Siemens, no doubt, beneficial Éinen ALS die.
Secret # 4: Focus on YOU yourself pharmacist die knowledge.
It Is Easy, a pharmacist who worked at the pharmacy or pharmacy students to WIN BEFORE A woman resident. Did she have to die, the available competitive, adequacy Lived ability of the pharmacist and for the position.
Solution: The development of pharmacists recovery program, a residency program or an internship, if you have already buy non-A. She stay in contact with them'they to Becoming KONNEN future employees.
.
Rabu, 29 Juni 2011
Asbestos Lawsuit affords Cash Award
The households from two men of upstate New York City who died from cancer caused of asbestos exposure consent got monetary recompense from Goodyear Tire and Rubber and Goodyear Canada afterward the company was ascertained to all in blame as getting the asbestos exposure that conduced to both of their 1998 dyings.
Both Eugene “Mac” McCarthy and Walter Koczur spent significant portions of their careers on the 1960s and 1970s doing work in professions that asked each day exposure to sheet gasket stuffs that was manufactured by The Goodyear Tire and Rubber Company and Goodyear Canada during the same time period.
Although McCarthy worked since an heavy equipment engine mechanic during the late 1960s and early 1970s where he regular dealt with Goodyear-produced gaskets that contained asbestos, Koczur used the gaskets while doing work as a steamfitter from 1969-1973.
When McCarthy and Koczur never worked together, their lives became intertwined following their diagnosis and dyings from lung cancer in 1998 that was thought to accept comprised caused by asbestos exposure. Their families joined forces in a lawsuit against Goodyear, averring that the companies products caused made them sick.
Abiding by a five week trial, the jury agreed. Both Goodyear companies comprised found to be at least partly responsible causing the illnesses that killed McCarthy and Koczur. McCarthy’s family won $8.5 million in a cash award from the jury, although the Koczur family was awarded $11.6 million.
Since those getting mesothelioma treatment who have antecedently worked in a profession where you were on a regular basis exposed to high amounts of asbestos, there may be reason to speak with a mesothelioma lawyer concerning a potential lawsuit.
Both Eugene “Mac” McCarthy and Walter Koczur spent significant portions of their careers on the 1960s and 1970s doing work in professions that asked each day exposure to sheet gasket stuffs that was manufactured by The Goodyear Tire and Rubber Company and Goodyear Canada during the same time period.
Although McCarthy worked since an heavy equipment engine mechanic during the late 1960s and early 1970s where he regular dealt with Goodyear-produced gaskets that contained asbestos, Koczur used the gaskets while doing work as a steamfitter from 1969-1973.
When McCarthy and Koczur never worked together, their lives became intertwined following their diagnosis and dyings from lung cancer in 1998 that was thought to accept comprised caused by asbestos exposure. Their families joined forces in a lawsuit against Goodyear, averring that the companies products caused made them sick.
Abiding by a five week trial, the jury agreed. Both Goodyear companies comprised found to be at least partly responsible causing the illnesses that killed McCarthy and Koczur. McCarthy’s family won $8.5 million in a cash award from the jury, although the Koczur family was awarded $11.6 million.
Since those getting mesothelioma treatment who have antecedently worked in a profession where you were on a regular basis exposed to high amounts of asbestos, there may be reason to speak with a mesothelioma lawyer concerning a potential lawsuit.
.
Minggu, 19 Juni 2011
Therapy Shows Promise for Rare, Deadly Cancer Caused by Asbestos
Pleural Mesothelioma
Pleural mesothelioma patients who undergo lung-sparing surgery in combination with photodynamic therapy (PDT) show superior overall survival than patient treated using the conventional therapy of extrapleural pneumonectomy (EPP) (or en bloc removal of the lung and surrounding tissue) with PDT, indicates new research from the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania. The research is published in the June 2011 issue of the
"Unlike patients who receive traditional lung sacrificing surgery for mesothelioma, the patients in our study who underwent lung sparing surgery and photodynamic therapy, a light-based cancer treatment, have experienced unusually long overall survival rates. The median survival for those patients had not been reached at over two years when the results were analyzed. That's unusual in this field, especially when the majority of those patients are older and have advanced cancer," said Joseph Friedberg, MD, co-director of the Penn Mesothelioma and Pleural Program and the thoracic surgeon who performed the operations cited in the study. "In addition to the overall survival statistics, the difference between having and not having a lung, both with respect to the risk of surgery and the ability to enjoy a normal life after surgery, is crucial for these patients."
Mesothelioma is one of the most aggressive and deadliest forms of cancer and is usually caused by exposure to asbestos. Exposure to asbestos typically precedes development of the cancer by anywhere from 10 -- 50 years, but once it occurs, the average survival rate following diagnosis is often only 9-12 months.
Although mesothelioma can occur in other locations like the abdomen, pleural mesothelioma is the most common form of the disease and accounts for roughly 70 percent of cases. This form originates in the pleura -- the membrane surrounding the lung and lining the chest -- where it starts off as a microscopic sheet of malignant cells that coats the interior of the chest and can grow to be several inches thick. The coating and enveloping nature of the cancer makes it impossible to completely remove it with surgery alone. As a result, the conventional surgery-based approach to treatment involves radical surgery that includes removing the lung, in combination with chemotherapy and whole chest radiation. Even with this aggressive treatment, the disease will recur in almost all patients.
The current study had two goals. The first was to determine if using a new combination of PDT and surgery would allow a less extensive surgical procedure to be used in lieu of an EPP. The second was to determine if, based on previous research from Penn with PDT, the treatment would have any positive effect on survival for patients.
Unlike radiation, which passes through the body, the PDT therapy used in the current study penetrates only a short distance which allows the lung to be preserved. The PDT treatment aims to eradicate the remaining microscopic disease trigger a patient's own immune system to help fight cancer. Penn is one of only two centers in the world where PDT is used to treat pleural mesothelioma.
In the study, 28 patients (19 men, 9 women) underwent surgical resection plus PDT for pleural mesothelioma. Patients were aged from 27 to 81 years. All patients were seen in a multidisciplinary setting and educated about the spectrum of treatment options available, including surgical intervention and its currently investigational status. Of the study group, 14 patients were treated by modified extrapleural pneumonectomy (MEPP) and 14 by radical pleurectomy (RP) and intraoperative PDT. Twenty-two of the 28 patients also received chemotherapy.
Demographics in the MEPP and RP cohorts were similar in age, sex, stage, nodal status, histology, and adjuvant treatments. Stage III/IV disease was present in 12 of 14 patients (86 percent) in both groups. The median overall survival for the patients who received the MEPP treatment was 8.4 months. At a follow-up 2.1 years after the end of treatment, a median survival rate for the patients who received a radical pleurectomy had not yet been reached. The results yielded by the radical pleurectomy and adjuvant PDT were superior to other studies of surgical treatment plans with patients of similar demographics.
"Our primary motivation in attempting the lung sparing surgery was preservation of quality of life, and we were hoping the survival results would at least be similar to the more traditional pneumonectomy approach," said Friedberg. "Although our pneumonectomy results were in line with what is often reported for similar patients having surgery-based treatments, we were completely caught off guard when the analysis revealed a significantly longer survival for the patients who retained both lungs."
Although all patients in the current study received the PDT therapy in combination with a different surgical technique, the researchers further note that the use of intraoperative PDT is the evident difference between the multimodal protocol used in the current study and other standard treatment options presently in use, and it seems worth speculating on any potential direct contributions of the PDT to the overall survival rates.
"Why this is happening is unclear and has emerged as the focus of our continuing research," said Friedberg. The possibility exists that the residual PDT-treated microscopic disease induced an autologous tumor vaccine effect or potentially enhanced the effect of adjuvant treatments.
"This study has limitations, as many mesothelioma studies do, but these results are very encouraging. The findings from our study are particularly notable because many of the patients in this study would often be excluded from surgery-based therapy because of their advanced age or unfavorable oncologic characteristics such as the large bulk of their cancers or the spread to the lymph nodes," said Dr. Friedberg. "Based on these results this lung-sparing technique, combined with photodynamic therapy, has become the backbone of our surgery-based treatment protocols."
A larger study investigating the efficacy of this multimodal approach is currently underway at Penn.
The Penn Mesothelioma and Pleural Program is a unique program that consists of a multidisciplinary team of dedicated specialists with a passion and expertise for treating patients with these difficult cancers. The Penn Program offers a true multidisciplinary approach, presenting patients with essentially all treatment options offered world wide and a number of treatments offered only at Penn.
Pleural mesothelioma patients who undergo lung-sparing surgery in combination with photodynamic therapy (PDT) show superior overall survival than patient treated using the conventional therapy of extrapleural pneumonectomy (EPP) (or en bloc removal of the lung and surrounding tissue) with PDT, indicates new research from the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania. The research is published in the June 2011 issue of the
"Unlike patients who receive traditional lung sacrificing surgery for mesothelioma, the patients in our study who underwent lung sparing surgery and photodynamic therapy, a light-based cancer treatment, have experienced unusually long overall survival rates. The median survival for those patients had not been reached at over two years when the results were analyzed. That's unusual in this field, especially when the majority of those patients are older and have advanced cancer," said Joseph Friedberg, MD, co-director of the Penn Mesothelioma and Pleural Program and the thoracic surgeon who performed the operations cited in the study. "In addition to the overall survival statistics, the difference between having and not having a lung, both with respect to the risk of surgery and the ability to enjoy a normal life after surgery, is crucial for these patients."
Mesothelioma is one of the most aggressive and deadliest forms of cancer and is usually caused by exposure to asbestos. Exposure to asbestos typically precedes development of the cancer by anywhere from 10 -- 50 years, but once it occurs, the average survival rate following diagnosis is often only 9-12 months.
Although mesothelioma can occur in other locations like the abdomen, pleural mesothelioma is the most common form of the disease and accounts for roughly 70 percent of cases. This form originates in the pleura -- the membrane surrounding the lung and lining the chest -- where it starts off as a microscopic sheet of malignant cells that coats the interior of the chest and can grow to be several inches thick. The coating and enveloping nature of the cancer makes it impossible to completely remove it with surgery alone. As a result, the conventional surgery-based approach to treatment involves radical surgery that includes removing the lung, in combination with chemotherapy and whole chest radiation. Even with this aggressive treatment, the disease will recur in almost all patients.
The current study had two goals. The first was to determine if using a new combination of PDT and surgery would allow a less extensive surgical procedure to be used in lieu of an EPP. The second was to determine if, based on previous research from Penn with PDT, the treatment would have any positive effect on survival for patients.
Unlike radiation, which passes through the body, the PDT therapy used in the current study penetrates only a short distance which allows the lung to be preserved. The PDT treatment aims to eradicate the remaining microscopic disease trigger a patient's own immune system to help fight cancer. Penn is one of only two centers in the world where PDT is used to treat pleural mesothelioma.
In the study, 28 patients (19 men, 9 women) underwent surgical resection plus PDT for pleural mesothelioma. Patients were aged from 27 to 81 years. All patients were seen in a multidisciplinary setting and educated about the spectrum of treatment options available, including surgical intervention and its currently investigational status. Of the study group, 14 patients were treated by modified extrapleural pneumonectomy (MEPP) and 14 by radical pleurectomy (RP) and intraoperative PDT. Twenty-two of the 28 patients also received chemotherapy.
Demographics in the MEPP and RP cohorts were similar in age, sex, stage, nodal status, histology, and adjuvant treatments. Stage III/IV disease was present in 12 of 14 patients (86 percent) in both groups. The median overall survival for the patients who received the MEPP treatment was 8.4 months. At a follow-up 2.1 years after the end of treatment, a median survival rate for the patients who received a radical pleurectomy had not yet been reached. The results yielded by the radical pleurectomy and adjuvant PDT were superior to other studies of surgical treatment plans with patients of similar demographics.
"Our primary motivation in attempting the lung sparing surgery was preservation of quality of life, and we were hoping the survival results would at least be similar to the more traditional pneumonectomy approach," said Friedberg. "Although our pneumonectomy results were in line with what is often reported for similar patients having surgery-based treatments, we were completely caught off guard when the analysis revealed a significantly longer survival for the patients who retained both lungs."
Although all patients in the current study received the PDT therapy in combination with a different surgical technique, the researchers further note that the use of intraoperative PDT is the evident difference between the multimodal protocol used in the current study and other standard treatment options presently in use, and it seems worth speculating on any potential direct contributions of the PDT to the overall survival rates.
"Why this is happening is unclear and has emerged as the focus of our continuing research," said Friedberg. The possibility exists that the residual PDT-treated microscopic disease induced an autologous tumor vaccine effect or potentially enhanced the effect of adjuvant treatments.
"This study has limitations, as many mesothelioma studies do, but these results are very encouraging. The findings from our study are particularly notable because many of the patients in this study would often be excluded from surgery-based therapy because of their advanced age or unfavorable oncologic characteristics such as the large bulk of their cancers or the spread to the lymph nodes," said Dr. Friedberg. "Based on these results this lung-sparing technique, combined with photodynamic therapy, has become the backbone of our surgery-based treatment protocols."
A larger study investigating the efficacy of this multimodal approach is currently underway at Penn.
The Penn Mesothelioma and Pleural Program is a unique program that consists of a multidisciplinary team of dedicated specialists with a passion and expertise for treating patients with these difficult cancers. The Penn Program offers a true multidisciplinary approach, presenting patients with essentially all treatment options offered world wide and a number of treatments offered only at Penn.
.
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