M. D. Anderson patient shares experience and advice

Mark Stratmann has always enjoyed the outdoors, riding motorcycles and traveling, but as a two-year survivor of a rare cancer called mesothelioma, these hobbies are now more important than ever. They remind him to enjoy life and encourage other patients to seek treatment at a cancer center with a team of specialists dedicated to this disease.

Stratmann, a resident of Jacksonville, Fla., was admitted to The University of Texas M. D. Anderson Cancer Center for treatment of Stage III malignant pleural mesothelioma in December 2007. He had begun his journey three months earlier after experiencing trembles that did not respond to antibiotics. X-rays showed an abnormality around Stratmann’s left lung. Over the following weeks, four liters of fluid were drained from the organ. He received his diagnosis in November 2007, after surgeons in Florida removed a tumor in the lung’s lining.

According to the National Cancer Institute, mesothelioma is usually found decades after exposure to asbestos. Over time, cells in the mesothelium, the membrane that covers most internal organs, can become cancerous; the disease can develop in the lungs, heart or abdominal cavity.

“I researched the disease on the Internet and learned it was an asbestos-related cancer with a low survival rate,” said Stratmann. “I knew my best option was to seek care at an institution committed to fighting this disease with innovative treatment.”

At M. D. Anderson, Stratmann’s care is closely monitored by Anne Tsao, M.D., director of the Mesothelioma Program and assistant professor in the Department of Thoracic Head and Neck Medical Oncology.

“This disease is difficult to treat and leaves patients with little hope for survival,” Tsao said. “It’s seen in only 3,000 people each year. There has been little advancement in treatment, so it’s really important to investigate and provide options.”

The standard of care includes a combination of surgery, adjuvant radiation and/or chemotherapy. Survival rates rarely surpass 17 months for any of the regimens.

M. D. Anderson’s Mesothelioma Program uses a team approach to recommend the best treatments and provide a compassionate environment for each patient and his or her loved ones. More than 30 experts are committed to developing better therapies, discovering new agents and improving survival for those diagnosed with this disease. As one of the largest referral centers in the United States, the program sees 150 new mesothelioma patients each year.

Researchers at M. D. Anderson are investigating nine drug combinations as potential therapies. Some are explored as novel treatments and are not tested at other institutions.

Dasatinib, also known as Sprycel®, is one of the agents under study. In the lab, this agent had an anti-tumor effect on mesothelioma cells with the protein Src Tyr419, Tsao said. Similar results were found when study participants responded after just four weeks of this therapy. Tsao hopes this biomarker- based trial will establish an innovative structure for similar studies and help identify patients who would benefit from this treatment.

M. D. Anderson is building one of the largest and most comprehensive tissue banks for mesothelioma. Investigators are studying these repositories for additional biomarkers in hopes of developing tests to detect the disease earlier and determine the most effective agent for each patient.

“For a long-term solution, we must offer more than just the standard treatment for this rare cancer,” Tsao said. “Only about 20 percent of our patients are candidates to potentially receive the combination of surgery, radiation and chemotherapy, so we must find better agents. The Mesothelioma Program at M. D. Anderson is dedicated to discovering better therapies and treating this disease.” After discussing options with Tsao, Stratmann selected radiation and chemotherapy and participated in a clinical trial that studied Gleevec®, also known as imatinib mesylate, as a targeted therapy. Already approved for chronic myelogenous leukemia, researchers are studying the impact this agent has on an abnormal protein that causes tumor cells, like those found in mesothelioma, to grow and divide.

Stratmann’s cancer was stabilized in August 2008. He returned to M. D. Anderson every three months for follow-up until Tsao noticed a small growth during a recent appointment. He undergoes chemotherapy every 21 days to treat the cancer.

Although news of this recurrence was difficult to hear, Stratmann plans to stay positive, enjoy his favorite pastimes and spread a message of hope to other patients.

“Dr. Tsao has never steered me wrong, so I will continue to trust her expertise and leave it all in her hands,” said Stratmann. “When I was diagnosed, I wanted someone who knew how to treat this disease. I encourage others to stay positive and get treated at a cancer center with a team dedicated to mesothelioma.