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1 Mesothelioma is a devastating form of cancer that is relatively rare when compared to the incidence rates of other cancers. The word mesothelioma is derived from the English word mesothelium, which is a specific type of simple squamous epithelial tissue that lines the organs facing the body s internal cavities, including the heart (pericardiac cavity) and lungs (pleural cavity), as well as the Latin root oma, which means tumor. Therefore, mesothelioma is a tumor of the mesothelium. Although these tumors can develop anywhere in the mesothelium, by far the most common location is in the pleural cavity. This is largely due to the fact that carcinogenic substances, when inhaled, can disturb the normal DNA synthesis pattern of the mesothelium, and form a tumor. Because many pleural mesotheliomas are caused this way, they are almost always classified as malignant tumors which are cancerous growths that have the potential to spread, as opposed to benign tumors that are simply noncancerous hyperplasias. One of the most notorious carcinogenic agents is asbestos, a salicate-derived, naturally-occurring, fibrous material that was popular in manufacturing and materials design until it was discovered that it was a potent carcinogen. In the mid-1940s, efforts were begun to reduce asbestos exposure, and they were drastically increased in the 1970s. In most developed countries, asbestos and any by-products are no longer used for materials or projects in which humans would have any exposure to possible carcinogenic harm. One of the many individuals who were diagnosed with, and eventually succumbed to mesothelioma was James Rhio O Connor. However, Rhio did not let his mesothelioma take over his life and diminish his daily experiences. Originally, Rhio was diagnosed with malignant mesothelioma due to exposure to asbestos earlier in life. His doctors gave him a prognosis of less than one year to live before the cancer would kill him. At this time, in October of 2001, Rhio was 61 years old. However, Rhio was determined to outlast this prognosis and did so by an incredible

2 amount of time. Rhio passed away on July 11, 2009, nearly eight years after his original diagnosis. Surgery, chemotherapy, and radiation were not options for Rhio due to the high risk of further complications, and there were no other treatment options available. Rather than simply accept his prognosis and his physicians suggestions to finish out his life peacefully and with the realization that nothing could be done, Rhio chose to fight back. Rhio decided to undertake massive amounts of research on the subject of cancer and the physiology behind the disease, and worked with a dietician and clinical specialist in oncology to come up with a plan of supplements and a healthier diet to help Rhio improve his health and be smarter than his mesothelioma. These supplements included vitamins and herbal products, and his diet consisted of little meat and various vegetable and whole grain options. Additionally, Rhio may have been able to outlive his prognosis by so long due to his incredible optimism and the spiritual aspect of his care. Rhio began to practice a form of mind-body medicine, and always held the belief that he could overcome his mesothelioma. This form of medicine which involves focusing on the pulse of energy throughout the body, may give the patient the necessary mindset to produce the appropriate chemicals and neurotransmitters which may aid the body in its battle against the cancerous tissue. Certainly, there is no harm that can come from this practice, and if it proves beneficial to some patients then they should take advantage of it. Even if mind-body medicine provides no medical benefit, it may still provide psychological condolence to the patient and make the process of living with the cancer less burdensome. To help others in their walk with cancer, Rhio wrote and published a book entitled They Said Months, I Chose Years: A Mesothelioma Survivor s Story. He discusses his difficult journey he had with mesothelioma and the choices he faced in developing his diet and supplement regimen, as well as the aspects of practicing mind-body medicine with the intention of providing

3 advice for others who have been diagnosed with an incurable cancer, or one for which treatment is otherwise not possible. I believe that Rhio s choice of writing this book was a good decision on his part because many other cancer patients may not have been aware of the alternative medicine therapies that Rhio chose to prolong his life. Countless others may have received the benefit of the therapies with which he chose to experiment, not knowing if they would have a single advantage against his cancer. Large pharmaceutical companies are reticent to invest money to conduct clinical trials on alternative therapies due to the current lack of evidence of efficacy surrounding these treatment regimens, as well as the fact that even if these treatments do offer clinical benefit, they may still be unprofitable because the supplements are often herbal products that are found in nature, and therefore cannot be patented. Additionally, his decision to write his book may spur others with cancer and cancer survivors to share their own stories of the difficult treatments they faced, and what worked best for them, as well as any unique supplemental regimens they may have taken. If faced with a similar situation as Rhio, where surgery, chemotherapy, and radiation were all impossible options due to the specific circumstances surrounding my cancer, I would also reject the physicians ideas that nothing could be done in terms of treatment, and that the only thing possible was to let the cancer take its natural course. I would seek a second opinion from a skilled oncologist to see if they believed any options existed for treatment. If they thought other options existed, I would pursue plans for that treatment. However, if the second oncologist agreed with the first, I would seek out ways to prolong my life and delay the action of the cancer against my body. As a student in pharmacy school, I would utilize the extensive database of drug information resources available through my school, to see if there were any suitable chemical alternatives to doing nothing. I already know that certain drugs such as methotrexate that

4 function as inhibitors of dihydrofolate reductase, one of the cyclin dependent kinase enzymes that promotes the replication of DNA and cell division, are used in patients with rheumatoid arthritis as well as cancer patients, and that drug could be appropriate. Other drugs such as cyclophosphamide directly bind to DNA to stop any replication. These mechanisms of action would help stop cancer cell metastasis. Unfortunately, as with all drugs, these would also have side effects, particularly immunosuppressive effects where I could experience a blood dyscrasia. I would also have to convince an oncologist that these therapies were appropriate for me, using data from the medical literature. In fact, reviewing various medical and scientific academic journals would be another priority on my list. I would check for research in new or alternative cancer treatment therapies of which the oncologists may be unaware. I would check regularly with cancer research institutions and journals. I would also consult with my student peers, my professors at school, and the staff at the hospital at which I work to gather their thoughts and opinions and hear what they know about certain drugs or treatment regimens. Additionally, I would seek research on herbal and dietary supplements to see if any are produced that would be beneficial. Certainly, any supplement that can function as an antioxidant would be beneficial as the molecules can scavenge any free radicals in the body that could potentially cause cellular and DNA damage, which could result in new or further carcinomas. Additionally, I would seek to change my diet and lifestyle. I would eat healthier foods and not foods that are overly high in fats and triglycerides, sugar, and cholesterol. I would seek to gain enough vitamins and minerals from my natural diet in order to provide my body and my immune system with the nutrients it needs to deal with and attack the cancer cells. I would also try to adjust other factors so that my CHEM-7 and other laboratory values are closer to normal range, or even exceed medical recommendations. I haven t had

5 trouble with my blood pressure in the past, but I do need to watch my cholesterol, especially my LDL. Perhaps asking my physician about prescribing a statin or other relevant medication may be useful in trying to help keep the body in top condition while it prepares for a very aggressive fight against the cancer. I would try to consume less red meat and more vegetables, more whole grains, and fewer sweets and salty snacks. I would also work on getting more exercise, particularly walking more and moving my limbs around instead of leaving them sedentary. If I am lucky enough, I can live many years like Rhio and write a book about my experiences to share with others as they have the battle of a lifetime against cancer.

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