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Research and Treatments

Western Australia:
A centre of excellence in research, diagnosis and treatment of asbestos-related diseases

The numbers of mesothelioma and asbestos-related lung cancer's are alarmingly on the increase. Owing to the long latency period from the exposure to asbestos fibres and manifestation of asbestos disease (often up to 30 years or more), the epidemic of asbestos diseases is yet to peak in Australia (around 2023). It is believed that as many as 45,000 persons may die in Australia over the next two decades if effective medical treatments are not found. About 2500 persons are annually diagnosed with asbestos caused diseases, and the numbers are rising.

Research into asbestos-related diseases in Australia is virtually non-existent except in Western Australia at Sir Charles Gairdner Hospital (SCGH). Asbestos diseases research is more advanced at SCGH than anywhere in the world. WA medical scientists Professors Bill Musk, Bruce Robinson and their colleagues have an enormous amount of experience and have won a number of awards for their work in epidemiology, diagnosis, immunology and treatment of asbestos-caused diseases.

The research at SCGH into asbestos-related diseases, largely stems from investigating the exposure to asbestos of former Wittenoom blue asbestos miners. The researchers have acquired valuable expertise in the epidemiology, cytopathology, molecular biology and immunology of mesothelioma.

It is well known both nationally and internationally that SCGH scientists are leaders in areas of novel clinical mesothelioma treatment trials and have a unique cell bank of human and animal mesothelioma cell lines. Thus, they are in an ideal position to make a unique contribution to find effective treatments for asbestos caused diseases. The SCGH research may also lead to improved early diagnostic methods of asbestos caused diseases and an increase in understanding similar diseases.

Importantly, research into asbestos-related diseases such as mesothelioma and lung carcinoma may provide major insights into the mechanisms, diagnosis and therapy of such solid malignancies as lung cancer, breast cancer, bowel cancer and prostate cancer as well as fibrotic lung disorders. SCGH medical scientists can only seize this unique opportunity and advance their valuable work if the ongoing support for a Centre of Excellence can be established.

Regrettably, the Sir Charles Gairdner Hospital research program receives very little funding from the public purse, save for the Western Australian Government. The lack of financial support by the Federal Government condemns at least 2500 Australians per annum to a premature death (it is a national disgrace).

Any reader of this booklet is respectfully urged to write or to speak to his or her Federal member of Parliament and bring to their attention the appalling situation of many doomed Australians now dying by virtue of neglect due to the Federal Government's misguided priorities of medical research funding.
Additional information on the SCGH Clinic of Excellence and inadequacy of the Federal Government's research funding will be provided by ringing ADSA on our toll free number 1800 646 690.
Asbestos-related Treatment and Research Programmes at SCGH

1. Prevention
ReVital Program (former Vitamin A Program)
In Western Australia persons with significant exposure to asbestos have been offered participation in a program providing dietary supplements of Vitamin A (Beta-carotene or Retinol) because of the known increased risk of lung cancer and malignant mesothelioma.

A program dispensing Vitamin A commenced in 1990 primarily to reduce the risk of lung cancer and mesothelioma amongst former Wittenoom miners and residents. Subsequently the program has been renamed ReVital and persons other than Wittenoom have been added to the program including some Eastern States members of the ADSA.

The ReVital Program has been exclusively funded by the Western Australian Government Department of Health and that was and is greatly appreciated. In addition to former Wittenoom workers and residents, workers from other industries where exposure to asbestos occurred are also participating in the program.

Over the years, there have been several evaluations of the program; (a) comparing rates of mesothelioma among ex-Wittenoom workers and residents on the program with those not on the program; (b) comparing rates of mesothelioma for all groups of subjects according to the intervention administered; (c) comparing death rates between Wittenoom subjects on and off the program; (d) examining associations of level of plasma retinol and disease and lung function in all program participants; (e) reporting side effects, withdrawals, and abnormal liver function during the ReVital Program.

The policy of the ReVital Program is not to turn anyone away, however the number of persons participating in the program are subject to the availability of resources (funding).

The encouraging results over the years have clearly shown justification to fund the program. The latest evaluation of 18 November 2002 definitely shows the beneficial effect it has on the participants. For example, the participants of the program (i) continue to experience lower mortality and mesothelioma incidence than non-participants, (ii) the magnitude of the relative reduction in mesothelioma rate in participants observed in the previous study has not been maintained but is still sizeable, (iii) previous evaluations were unable to distinguish benefits from retinol administration from overall program benefits such as health promotion advice, or group social capital. However, the internal analyses appear to indicate that retinol administration results in increasing plasma levels of retinol, which in turn are associated with reduced mesothelioma incidence and lung function improvement.

Regrettably, lack of funds is preventing the expansion of the life-saving program and there are several hundred persons on the waiting list (the current funding will expire at the end of June 2003).


2. Treatment of asbestos-related diseases
Lung Cancer: Patients with lung cancer are provided with diagnostic investigations and appropriate conventional treatment for lung cancer. Initial studies have evaluated the susceptibility of lung cancer cell lines to a variety of cytotoxic drugs. The capacity of asbestos fibres to directly suppress anti-cancer immune surveillance mechanisms has also been studied. In addition, the utilisation of different methods of developing tumour-specific T-lymphocytes for improvement in adoptive immunotherapy are studied.
The research work ranges from highly technological laboratory studies through to clinical trials using new therapies in patients with mesothelioma.

Current laboratory studies are aimed in a number of areas, including the use of gene transfer techniques to augment the body's capacity to fight mesothelioma, the use of molecular cloning to identify proteins within mesothelioma cells which may be recognised by the body's immune system and hence may be useful in the early diagnosis of the disease and/or may be useful in vaccination to prevent mesothelioma.
The sophisticated immunological techniques are used to understand how it is that the mesothelioma cancer cells escape detection by the body's immune anti-cancer defences.

A number of treatment trials are being used in patients with mesothelioma.

For example, the latest gene therapy approaches to transfer genes directly into tumours of patients with mesothelioma in an attempt to boost the body's immune system to fight the cancer.

The new chemotherapy regime has proved very powerful in laboratory studies and early indications are that it may have some effect in shrinking mesothelioma in patients. The two drugs being used at the moment are gemcitabine and cisplatinum.

For information on the asbestos research programmes ring our toll free number: 1800 646 690.

3. Research into the epidemiology of asbestos-related diseases
Former Wittenoom workforce and members of families have been traced to determine the frequency of asbestos-related diseases and the relationships of those diseases to the degree of asbestos exposure, smoking and other factors to provide information vital for understanding the damaging impact of asbestos on health.

The effects of lower levels of exposure to blue asbestos experienced by former Wittenoom residents (not being the workers of CSR) have been studied and a relationship between amount of exposure (determined from the date and duration of known residence in Wittenoom) and risk of mesothelioma.

Other Research

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