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This is a guest post by Cameron Von St. James, husband of mesothelioma survivor Heather Von St. James:

My wife and I will never forget November 21, 2005. This was the day we learned that my wife was diagnosed with malignant pleural mesothelioma, and the day that I became her caregiver. I was unprepared for the responsibility, but I had to be there for my wife. Three months prior to my wife’s diagnosis, we had our first daughter, Lily. At a time when I thought we should be celebrating her first holiday in the world, we were talking with Heather’s family about cancer treatments.

There were three different options for Heather’s treatment, but she was so in shock that she couldn’t decide which was best for her. I knew that she needed help. I selected a specialist, Dr. David Sugarbaker, instead of a local university hospital and a regional hospital for treatment, as I thought it would give Heather the best chance to beat this terrible disease. It would be the first of many difficult decisions we’d be asked to make in the coming months.

After she was diagnosed, Heather could not work, and I could only work part time. We were living in a chaotic state, and I had so many responsibilities. I had to take care of my daughter, make a doctor’s appointments, and make travel arrangements. I was overwhelmed with responsibility and under an enormous amount of stress. My thoughts raced, and I wondered if my wife was going to die, and leave me a broke, widowed single father raising a daughter who would never really know her mother. Some days I sobbed like a baby, crumbling under the stress and pressure, but I always tried to remain strong in Heather’s presence. I knew that the last thing she needed was to see my fears.

Based on my experience, coping with cancer alone is not recommended. Support of friends, family, and strangers are needed. I received this type of help in the form of everything from comforting words to desperately needed financial assistance. We were grateful for any help we received, and we recommend that everyone accept any help offered to them by others. I had to learn this the hard way; it took me a while to let go of my pride and accept this help, but once I did a huge weight was lifted off of my shoulders. I can never thank everyone who reached out to us enough.

Being a caregiver is never easy. It’s not a job that you can quite or walk away from. I knew that I had to use my resources to cope with the situation and remain sane. If you are in a similar situation, take these lessons from me. Don’t be afraid to ask for help, there are always people to go to, whether you see them or not. Allow yourself to have bad days, these are inevitable and even necessary at times. Above all else, never, ever give up hope for a better tomorrow.

Heather underwent months of mesothelioma chemotherapy, radiation, and surgery. Against all odds, she beat this terrible disease and has been cancer-free for seven years. We now hope that by sharing our story of success, we can help inspire others currently going through a similar situation today.

 

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A short video by Thomas P. Sterry, MD, a plastic surgeon, describing scar revision of a facial scar followed by dermabrasion.

Biomedical engineers at Johns Hopkins have developed a new liquid material that in early experiments in rats and humans shows promise in restoring damaged soft tissue relatively safely and durably. The material, a composite of biological and synthetic molecules, is injected under the skin, then “set” using light to form a more solid structure, like using cold to set gelatin in a mold. The researchers say the product one day could be used to reconstruct soldiers’ faces marred by blast injuries.

The researchers created their composite material from hyaluronic acid (HA), a natural component in skin of young people that confers elasticity, and polyethylene glycol (PEG), a synthetic molecule used successfully as surgical glue in operations and known not to cause severe immune reactions.

Jennifer Elisseeff, Ph.D. said the team has especially high hopes for the composite’s use in people with facial deformities, who endure social and psychological trauma. When rebuilding soft tissue, recreating natural shape often requires multiple surgeries and can result in scarring. “Many of the skin fillers available on the market consisting of HA-like materials used for face lifts are only temporarily effective, and are limited in their ability to resculpt entire areas of the face. Our hope is to develop a more effective product for people, like our war veterans, who need extensive facial reconstruction.”

More information from Johns Hopkins.

An informative article on the subject of post-laser wound care was recently published on Plastic Surgery Practice web site.

The author, Joseph Niamtu III, DMD, FAACS, discusses recent trends in laser treatments and focuses on post-treatment care:

Inducing an intentional and controlled second-degree facial burn removes the entire epithelium and part of the dermis. This is obviously a giant insult to the normally intact integument. Patients who undergo fully ablative, high-fluence, high-density, multipass CO2 laser resurfacing have to understand in the preop period that this treatment will be their hobby for 4 to 6 weeks. I am very blunt with my patients who are considering this type of laser treatment, and I do not sugarcoat the recovery.

Read more of his discussion here.

Stratpharma AG, Swiss based specialty pharmaceutical company has developed Stratamed, the first silicone-based scar management product that may be applied to open wounds and compromised skin after procedures discussed in Dr Niamtu’s article, such as laser skin resurfacing. The new product helps with rapid epithelialization, reduces down-time, and is the only silicone gel treatment that improves the outcome of scarring by up to 78%.

Prescription placebos used in research and pra...

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Renovo, a UK company, announced on February 11 that Phase III trials of its lead scar reduction treatment, Juvista (human TGF-beta3) had failed on its primary endpoint (assessment of the scars by independent experts) and on its secondary endpoint (assessment by the patients themselves). The news was even worse as the company is now trying figure out why in some patients, the half of the scar treated with placebo seemed to heal better than the Juvista-treated half.

The REVISE Trial was a double blind, within patient, placebo controlled trial to assess the efficacy of two dose levels of Juvista (200ng and 500ng/100ul/linear cm of wound margin) given twice, following wound closure and 24 hours later, on the appearance of scars following scar revision surgery. Over 350 patients were recruited from 56 centres in UK France, Hungary, Germany, Italy, Poland, Spain, Denmark, Latvia and USA. The EMA agreed primary endpoint for efficacy was a photographic based assessment at 12 months following surgery by an independent panel of experts using the Global Scar Comparison Scale. Secondary endpoints included an assessment of the scars using the Global Scar Comparison Scale by the patients themselves and by the clinical trial investigator. None of the primary or secondary endpoints were met for either dose.

For some additional analysis visit IN VIVO blog.

Surgeon doing a surgical breast biopsy.

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PharmEcosse, a Scottish company, is starting clinical trials to explore the use of insulin (PE001) for the reduction or prevention of surgical scars in patients undergoing non-cancer bilateral breast surgery. The trial will commence in January 2011 and is expected to report in the first quarter of 2013.

Insulin was found to control the activity of the key cells involved in wound closure and subsequent scar formation which apparently slows down or stops the build up of scar tissue.

For more information about taking part in clinical trials, please go to pharmecosse.com

We occasionally receive questions by email or in the comments section. Let us know if you have any questions related to scars, scar treatment or scar prevention and we will try to answer them. You can ask the questions anonymously via the comments section below. And remember, the only stupid question is the one you don’t ask.

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