Need Gene Therapy

M at brown.edu M at brown.edu
Mon Oct 21 21:11:43 EST 1996


>>>Date: Tue, 15 Oct 1996 23:15:44 -0400
>>>From: Ashika Singh <asingh at husc.harvard.edu>
>>>
>>>        My mom, Gunisha Singh, was diagnosed about a month ago with
>>>cancer--she has malignant mesothelioma, which is cancer of the inner chest
>>>cavity. This is a rare and mostly incurable form of cancer. Standard
>>>treatment like chemotherapy and radiation therapy is not very effective
>>>against it, and by the time her particular cancer was diagnosed it was
>>>judged inoperable by Dr. M.S. Bains of the Memorial Sloane-Kettering Cancer
>>>Center in New York City.
>>>        As far as we know, the only treatment that can potentially cure her
>>>is gene-therapy. Gene-therapy is on the cutting edge of cancer treatment;
>>>basically what doctors do is take an ordinary virus like the cold virus,
>>>fill it with "suicide genes" that will cause the cancer cells to
>>>self-destruct, and then inject the virus into the chest cavity. So far this
>>>treatment has been very successful. My mom was waiting in New York to get
>>>into a gene-therapy treatment program at the University of Pennsylvania, 
but
>>>the FDA just shut down the program because the virus the doctors there were
>>>using was having adverse side-effects. Doctors at UPenn have restarted that
>>>program using another virus and are now testing on animals. They will not 
be
>>>ready to take human patients for some months.
>>>        Life expectancy for sufferers from mesothelioma usually ranges from
>>>12-18 months. Please help my family. We are looking for **other treatment
>>>options for MALIGNANT STAGE III MESOTHELIOMA,** including other 
gene-therapy
>>>programs anywhere in the world.
>>>
>>>*****PLEASE SEND THIS EMAIL TO AS MANY PEOPLE AS YOU KNOW************
>>>
>>>We are primarily looking for DOCTORS/SPECIALISTS/RESEARCHERS who could 
point
>>>us to alternative treatments or GOVT. OFFICIALS/connections with the FDA 
who
>>>could we could communicate with about restarting the gene-therapy program 
at
>>>UPenn. But please send this to ANYONE and EVERYONE--post it in newsgroups,
>>>send it email, etc--you never know who could be a key link in the chain to
>>>my mother's recovery.
>>>
>>>Thanks everyone :)
>>>=)ashika
>>>
>>>********************************************************************
>>>THE FOLLOWING IS A DETAILED CASE DESCRIPTION OF MY MOTHER'S CANCER,
>>>FOR THE BENEFIT OF ANYONE WHO IS A DOCTOR/HAS MEDICAL KNOWLEDGE
>>>If you have no medical knowledge the following probably won't make much
>>>sense to you, but you are welcome to read it anyway.
>>>DESCRIPTION WAS WRITTEN BY LARRY R. KAISER, M.D., one of the doctors in
>>>charge of the gene-therapy program at UPenn, recommending my mom as an 
ideal
>>>patient for gene-therapy.
>>>********************************************************************
>>>Sept 13, 1996
>>>
>>>Gunisha Singh is a 46 year old Indian female with no significant past
>>>medical history who presents for evaluation of a newly diagnosed 
right-sided
>>>pleural malignant mesothelioma.
>>>        Mrs. Singh was in her usual excellent state of health until
>>>approximately January 1996 when she noticed the onset of right neck, arm,
>>>and shoulder discomfort gradually increasing in intensity. This was often
>>>accompanied by a burning sensation in the distal arm and fingers on the
>>>right side. At that time she was living in Hong Kong and was evaluated by a
>>>neurosurgeon who felt that her symptoms were consistent with two herniated
>>>cervical discs. The patient then came to the U.S. for evaluation by a
>>>neurosurgeon at the University of California in San Francisco who felt that
>>>she had cervical spondylosis with herniated discs without evidence of frank
>>>neurological impairment. At this time, her primary intervention was
>>>manipulation of pain to control her symptoms.
>>>        While in California, the patient had an episode where she had 
severe
>>>chest pain and collapsed from the severity of her symptoms. She was brought
>>>to John Muir Medical Center in Walnut Creek, California where chest X-ray
>>>was performed which documented the presence of right-sided pleural
>>>thickening and masses. On the 22nd of August, the patient underwent
>>>right-sided video thoracoscopy for biopsy which revealed the presence of
>>>malignant mesothelioma. Pathology was reviewed and confirmed at the Mayo
>>>Clinic in Scottsdale, Arizona. Importantly, no pleurodesis was performed at
>>>the time of the video thoracoscopy. Review of CT scans of the chest and
>>>abdomen at the time revealed questionable lymph adenopathy in the
>>>pre-vascular space, right pleural disease predominantly at the apex and at
>>>the base with no evidence of asbestos pleural plaques. There was a question
>>>of extension of the mass at the base of the right lung through the right
>>>hermidiaphragm and into the liver. A follow-up MRI examination of the chest
>>>with carinal views was obtained which again questioned the resence of
>>>transdiaphragmatic extension of the mass through the right hemidiaphragm
>>>into the peritoneal cavity.
>>>        The patient was referred to Dr. M.S.Bains at the Memorial
>>>Sloane-Kettering Cancer Center who on 9/11/96 performed a video laparoscopy
>>>with documentation of tumor extending through the right hemi-diaphragm and
>>>onto the surface of the liver. He felt that she would not be a candidate 
for
>>>primary surgical resection and referred her to the University of
>>>Pennsylvania Center for Lung Cancer and Related Disorders for evalution of
>>>Phase I clinical trial using gene-therapy for mesothelioma.
>>>        The patient's past medical history is essentially unremarkable. Her
>>>past surgical history is significant only for a C section. Occupational
>>>history is negative for exposure to asbestos. She does have a possible
>>>exposure to asbestos from her childhood in India at which time she lived in
>>>buildings which may have had extensive asbestos in them. Social history is
>>>negative for any tobacco, alcohol, or drug use as she is a Sikh. Her 
husband
>>>is an executive for Chase Manhattan Bank and although they currently live 
in
>>>Hong Kong, he is stationed in Bombay and they own a home in New York.
>>>        Mrs. Singh is a 46 year old female with a Stage III mesothelioma of
>>>mized cellular type with a question of mediastinal involvement but with
>>>documented extension through the right hemidiaphragm into the peritoneal
>>>cavity. In addition, I feel that she has suggestion of compression of the
>>>right brachial plexus accounting for her right cervical and right upper
>>>extremity symptomatology. The fact that she has patent pleural space, is 
not
>>>a surgical candidate, and has had no other therapy to date, she would be an
>>>excellent candidate for our gene therapy clinical trial.




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