Mesothelioma

Mesothelioma is a benign (noncancerous) or malignant (cancerous) tumor affecting the lining of the chest or abdomen. Exposure to asbestos particles in the air increases the risk of developing malignant mesothelioma.

The Paul Calabresi Award (K12) is a multi- and transdisciplinary institutional training award supporting the research career development of clinicians only or clinicians and Ph.D. basic scientists to: 1) perform clinical oncology therapeutic research that develops and tests scientific hypotheses based on fundamental and clinical research findings; 2) design and test hypothesis-based, clinical therapeutic protocols and adjunct biological analyses and for clinician candidates to administer all phases (i.e., pilot/Phase I, Phase II, and Phase III) of cancer therapeutic clinical trials; and (3) conduct cancer therapeutic research in team research settings in which basic and clinical scientists collaborate and interact to expedite the translation of basic research discoveries into patient-oriented therapeutic cancer research. Awards (renewable) for up to $750,000 annually in direct costs (clinician programs) or up to $1,050,000 annually (programs combining clinicians and Ph.D.'s) are made to institutions for up to five years.

The Award requires that at least 2 oncology disciplines are represented in the appointments to a K12 Program and the participating K12 Program faculty, didactic and research core requirements in basic science and clinical research for each appointee; and a basic science mentor and a clinical mentor for each appointee. All clinician candidates or trainees must currently be physicians holding the M.D. or D.O. degrees, or be nurses with a Ph.D. degree; and must have completed the necessary clinical training (i.e., completed residency and are board eligible) to engage in clinical oncology research. All basic science candidates must have doctoral-level degrees (e.g., Ph.D., D.V.M.) or the equivalent, a minimum of 2 years of postdoctoral research training, and a total basic research experience that is clearly preparatory (e.g., experience with animal models or preclinical research) for devoting a career to human therapeutic cancer research.

All candidates must be committed to a minimum of 75 percent full-time professional effort conducting research and engaging in activities directly related to research career development, which includes all relevant didactic activities during the period of the award. They must be citizens or non-citizen nationals of the United States, or must have been lawfully admitted to the United States for permanent residence (i.e., in possession of a currently valid Alien Registration Receipt Card I-551, or other legal verification of such status). Non-citizen nationals are generally persons born in outlying possessions of the United States (i.e., American Samoa and Swains Island). Individuals on temporary visas are not eligible.

Candidates may be former or current principal investigators on NIH Small Grants (R03) or Development and Innovation Grants (R21) or non-NIH equivalents to these grants/awards.

Candidates may not be current or former principal investigators on NCI K01 grants (Temin Award), NCI K07 grants or NIH K08 grants, NIH Research Project Grants (R01, R29) or subproject leaders on Program Project Grants (P01) and Center Grants (P50), or non-NIH equivalents to these grants/awards. Candidates also may not be current or former principal investigators on NIH K23 grants, NCI K22 grants, or non-NIH equivalent grants/awards. However, clinician candidates appointed to K12 grants are encouraged to apply for these grants/awards.

The most important diagnostic tool remains the medical history: the character of the complaints and any specific symptoms (fatigue, weight loss, unexplained anemia, paraneoplastic phenomena and other signs). Often a physical examination will reveal the location of a malignancy.

Diagnostic methods include:

* Biopsy, either incisional or excisional;
* Endoscopy, either upper or lower gastrointestinal, bronchoscopy, or nasendoscopy;
* X-rays, CT scanning, MRI scanning, ultrasound and other radiological techniques;
* Scintigraphy, Positron emission tomography and other methods of nuclear medicine;
* Blood tests, including Tumor markers, which can increase the suspicion of certain types of tumors or even be pathognomonic of a particular disease.

Apart from in diagnosis, these modalities (especially imaging by CT scanning) are often used to determine operability, i.e. whether it is surgically possible to remove a tumor in its entirety.

Generally, a "tissue diagnosis" (from a biopsy) is considered essential for the proper identification of cancer. When this is not possible, empirical therapy (without an exact diagnosis) may be given, based on the available evidence (e.g. history, x-rays and scans.)

Occasionally, a metastatic lump or pathological lymph node is found (typically in the neck) for which a primary tumor cannot be found. This situation is referred to as " carcinoma of unknown primary", and again, treatment is empirical, based on past experience of the most likely origin.