Eugene Dumoulin awoke one night with a slight warm sensation between his ribs.Three months later, doctors found a grapefruit-sized tumour in his lung.Mr. Dumoulin, 58, who was a high-school science teacher in Timmins, Ont., for 31 years, has malignant pleural mesothelioma, a form of cancer associated with exposure to asbestos.
Patients with similar diagnoses normally live only six to eight months. But Mr. Dumoulin has been placed on a new drug called Alimta, the first of its kind to be specifically approved to treat mesothelioma. Although it can't cure him, it may extend his life.
For four months, Mr. Dumoulin underwent chemotherapy at a Sudbury hospital. He received six courses of Alimta, which is normally taken with cisplatin, a standard chemotherapy agent.
Although he was nervous before starting the treatment, he said it hasn't been as difficult as he expected. "During all these sessions, I hardly had any negative side effects," he said. "For example: No nausea, no fatigue, my blood kept up its normal state."
He did experience a slight drop in his magnesium levels, and his hair thinned a bit, but it never fell out in clumps like in the movies, he said. "I've never had a day that I felt sick."
According to Dr. Frances Shepherd, chair in lung cancer research at the University of Toronto, malignant pleural mesothelioma is one of the most devastating kinds of cancer.
In a press release from Eli Lilly Canada Inc., the company that developed Alimta, Dr. Shepherd said the severe symptoms of chest pain and shortness of breath can be incapacitating, and until recently, there were few treatment options.
Trials of Alimta have shown very positive results, according to Barbara Melosky of the B.C. Cancer Agency.
"They did a large trial [with mesothelioma patients]that showed a survival advantage, and that's a huge thing because there's never been a survival advantage in these patients," she said. "We knew that chemotherapy may help their symptoms but we had no proof that it actually made them live longer."
The trials show those treated with Alimta live an average of three months longer than those on conventional chemotherapy agents. The figures include patients who didn't respond to the treatment.
"Certainly, if you respond, and there's an over 40-per-cent chance of responding, your benefit will likely be a lot longer than three months," she said.
"Our experience is that people who do respond to this regimen are alive and well over a year [later] One of my patients is back at work."
Dr. Melosky said the drug is also so well-tolerated by patients that she has even prescribed it for a 77-year-old.
"Some chemotherapy regimens are really difficult. Patients lose their hair, or their nausea is extreme, or they have to be admitted to hospital, whereas this one is an outpatient [procedure]" she said.
Alimta is an expensive drug. Its price hasn't been set in Canada yet, but the average price of one cycle in the United States is $3,900 (U.S.), and the average patient undergoes four treatment cycles. Dr. Gurmit Singh of the Juravinski Cancer Centre in Hamilton said although Alimta is expensive, it's an example of a drug that offers hope for better, more affordable treatment down the road.
The incidence of malignant pleural mesothelioma is expected to peak in the next 15 to 20 years, as the population exposed to asbestos in the 1950s and 1960s grows older. About 500 Canadians are expected to be diagnosed with the disease this year, and it can appear anywhere from 20 to 40 years after an asbestos fibre gets lodged in the lungs.
Mr. Dumoulin thinks it may have been the three or four summers he spent working construction with his father and hauling asbestos shingles that led to his mesothelioma.
He said he continues to enjoy a good quality of life following his treatment. His tumour has shrunk and he's back at home enjoying the outdoors.
He's been fishing 12 times this summer, he said, and even caught a 70-centimetre walleye recently. He's been out gardening, planting trees, and trying to live every day to the fullest.
"I watch myself, but I do everything," he said.
Joe Friesen