Posts Tagged ‘mesothelioma clinical trial’

What causes lung cancer — a dreadful disease that seems to have no mercy on the lives of those affected? Research shows that a lung cancer prognosis in many patients doesn’t exceed five years. This is disheartening at best. Being given a diagnosis such as this leaves the patient thinking what causes lung cancer?

What causes any type of cancer is really still a mystery. However there are suspicions about what causes lung cancer and there are suggested risks. Whenever lung cancer is discussed, the great risk factor focused on is smoking. Nowadays not only is tobacco use considered a risk for lung cancer but second-hand smoke or environmental tobacco smoke is also considered to be a risk. Other suspected causes of lung cancer are exposure to materials such as radon, asbestos and industrial substances such as arsenic. Some organic chemical are considered to be a risk for lung cancer. Radiation exposure, air pollution and tuberculosis are also suspected regarding what causes lung cancer.

It the cause or lung cancer was known with certainty, perhaps a cure could be found for this awful disease. Patients would be able to look to the future without the fear of premature death. What causes lung cancer? Many things are considered to be causes and for this reason these risks should be avoided. Staying away from these risk factors should definitely decrease a person’s chances of being diagnosed with lung cancer. Research has shown that men who smoke increase their chances of dying from lung cancer at a rate of more than twenty-two time of men who don’t smoke. Research also shows that women who smoke increase their risk of death from lung cancer by a rate of more than twelve times of women who don’t smoke. Research has also shown that women who don’t smoke are more likely to be diagnosed with lung cancer than men who are non-smokers. These are all facts and figures discovered through research. What causes lung cancer? It could be one of these risk factors and for that reason people should follow the advice offered regarding lung cancer prevention.

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Due asbestos exposure Asbestosis and Malignant Mesothelioma are caused. The condition also leads to lung cancer if not treated in time. Mesothelioma life expectancy reduces greatly in those patients who do not receive treatment on time.

Lethal exposure to Asbestos:

Asbestos appears in a naturally fibrous form and is basically recognized as a class of minerals. It is used in the manufacturing industry and has many other uses due to its properties of chemical resistance, heat resistance and flexibility. It is extensively used in ship building material, roofing material and building material. When a person is constantly subjected to the inhalation of the asbestos fibers for a long period of time, the asbestos exposure endangers the person’s health.

The fibers are not visible to the naked eye. They are microscopic, and get lodged firmly in the lungs when they are constantly inhaled. The first manifestation can take up to 40 years to surface, with the least time span being about 15 years since the initial exposure. Health takes a beating with asbestos inhalation in the form of malignant mesothelioma, lung cancer and asbestosis.

Other cancers:

There are other cancers caused due to asbestos exposure too. Cancer of the kidney, oral cavity, colon, stomach and larynx are included. Cancer of the intestines, stomach and esophagus is caused due to constant exposure to asbestos fiber in the drinking water. Smoking and prolonged asbestos exposure are hazardous and result in lung cancer.

If smoking is quit as soon as possible, then the risk of developing lung cancer gets reduced greatly. Once asbestosis is diagnosed, mesothelioma life expectancy decreases in the presence of a cigarette smoking addiction. Those who smoke and have had prior exposure to the asbestos fiber should immediately quit smoking. Even those who have been subjected to low levels of asbestos inhalation over a long period of time can develop malignant mesothelioma. It is one of the most painful cancers of all.

After long term exposure to asbestos, the fibers get lodged into the lungs firmly causing asbestosis. This disease can be contained with early diagnosis and proper treatment. However, if it is ignored and/or it is worsened with further inhalation of asbestos fibers and/or smoking, it leads to lung cancer and subsequently decreased Mesothelioma Life Expectancy.

Prevention:

However small the job might be, when you get an old construction razed or renovated never attempt doing it yourself. Professionals are aware of the risks involved and they ensure that neither they nor you get exposed to the asbestos fiber or the diseases associated with it. Those at risk are those directly involved in servicing of brake and auto clutch assemblies, building renovators, ship breakers, ship and house building etc.

It was way back in the 1920s that the connection between lung cancer and asbestos inhalation was detected. When different variants of asbestos like crocidotile, amosite, chrysostile, and anthophyllite are inhaled, lung cancer is the lethal outcome. Those suffering from asbestosis develop lung cancer. The condition is now also being addressed by the keepers of the law with compensations that make the fiscal demands bearable.

Malignant Mesothelioma and Mesothelioma Life Expectancy many other related diseases like Asbestosis are cause due to asbestos exposure. This recognized human carcinogen is primarily responsible for causing lung cancer too.

Robart Alex

About Mesothelioma

Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.

What is the mesothelium?

The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.

How common is mesothelioma?

Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.

Mesothelioma Symptoms

Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis.

The early symptoms of mesothelioma are often ignored, because they may be caused by a variety of ailments. These symptoms include:

pain in the lower back or at the side of the chest

shortness of breath

difficulty swallowing

cough

fever

fatigue

abdominal pain, weight loss, and nausea and vomiting (symptoms of peritoneal mesothelioma)

Causes of Mesothelioma -

The primary risk factor for developing mesothelioma is asbestos exposure. In the past, asbestos was used as a very effective type of insulation. The use of this material, however, has been declining since the link between asbestos and mesothelioma has become known. It is thought that when the fibers of asbestos are inhaled, some of them reach the ends of the small airways and penetrate into the pleural lining. There the fibers may directly harm mesothelial cells and eventually cause mesothelioma. If the fibers are swallowed, they can reach the abdominal cavity, where they can contribute to the formation of peritoneal mesothelioma. Exposure to certain types of radiation as well as to a chemical related to asbestos known as zeolite has also been related to incidences of mesothelioma.

Mesothelioma Treatment -

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient’s age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

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Clinical trials, phases I through III, are experimental treatments that have not yet been proven to be effective enough to be accepted as standard treatment. In fact, they are done for the purpose of determining whether they are or are not effective, and of determining to what degree they are effective. Results from clinical trials are compared with other forms of treatment to determine the most effective treatments under varying conditions. Clinical trials types include:

• Prevention trials

• Screening trials

• Diagnostic trials

• Treatment trials

• Quality-of-life, or Supportive care trials

• Genetics studies

What Kinds of Clinical Trials are Available for Mesothelioma Patients?

Clinical trials for treatment of mesothelioma might be designed to find a new treatment, or to improve a standard one. They test new drugs, radiation therapy, vaccines, new methods of surgery, or new treatment combinations.

Quality-of-life, also called supportive care trials work to improve cancer patients’ and survivors’ quality of life, comfort, or reduce the side effects of treatment or the cancer, itself.

How to Enroll in a Clinical Trial.

If your physician is unable to offer you a treatment or surgical option that he believes will cure, or improve, your condition, you may be eligible to enroll in a clinical trial. Your physician will be able to tell you which clinical trials are appropriate for you, and how to enroll.

Who Pays for Clinical Trials?

Clinical trials are not free. As with any medical treatment, you are responsible to pay for payment. If you have health insurance, you will need to find out whether or not they cover the particular clinical trial you intend to undergo. If your policy states that it considers clinical trials to be experimental or investigative, it may not cover any or your expenses for this treatment.

Increasingly, states are passing laws that require coverage for at least the routine care you would get during a clinical trial. These include doctor visits, hospital stays, lab work and x-rays and other costs common to any covered treatment that you might receive. In most cases the group sponsoring the trial will cover some of the costs of the clinical trials. These would include the costs that are related to tests that are done solely for research purposes.

The National Cancer Institute (NCI) is one of those research groups. NCI is working with major health insurance companies and managed care groups, and Medicare covers patient care clinical trial costs. NCI offers links to articles about clinical trials that may answer many of your questions. Other links to valuable information are at NCI Publications.

What Happens During a Clinical Trial?

There are four phases of treatment clinical trials:

Phase I: First step in testing a new treatment in humans

• Evaluates effective dose, route of delivery, and frequency of treatment

• Evaluates harmful side effects

• Involves only a small number of human subjects

Phase II:

• Studies safety and effectiveness of this treatment

• Evaluates effect on human body

• Limits to a specific type of cancer

• Involves fewer than 100 patients

Phase III: Compares this treatment to the current standard treatment

• Patients are randomly assigned to either the standard treatment or the one under study

• Treatments at phase III have shown promise based upon results from phases I and II

• Involves large numbers of people from many different places in the country

Phase IV:

• Evaluate the long-term safety and outcomes of this treatment

• Usually done after treatment is approved as a standard treatment

• Involves hundreds to thousands of people to ensure consistency in results

A 2002 study at phase III showed that a new chemotherapy drug regimen was effective in extending the lives of mesothelioma patients while reducing pain and discomfort.

About the Author

If you have received a diagnosis of mesothelioma or asbestosis, you may be entitled to compensation. Please visit the website of Parker, Dumler & Kiely, LLP, the experienced mesothelioma lawyers in Baltimore, Maryland and Washington, D.C.

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Article Source: http://www.articlesbase.com/ – Mesothelioma Clinical Trials

Mesothelioma is an insidious form of cancer because of the fact it is often discovered so late that treatment options are simply non-existent. For many people, the only option is to consider clinical trials. The question is whether this is a good option.

What are clinical trials? They are testing periods for new drugs or procedures that may eventually prove effective and be approved by the FDA as a treatment for something. Put another way, they are the process of testing whether a drug or procedure does what it is intended to do. Sometimes they do. Sometimes they don’t.

Mesothelioma is a brutally difficult cancer to deal with for a unique reason. The problematic characteristic is it is very hard to find until it is too late for the patient. A person can have the cancer for 10, 20 or 30 years during which it can be treated, but still die of it because it went undetected. Given this problem, there are many different clinical trials going on all the time devoted to Mesothelioma treatments. For example, one related to the Mesomark, which is a promising new blood test that can lead to early detection.

Is it safe to take part in clinical trials? Generally, the answer is that it is safe to do so. A drug company does not just produce a drug and then start testing it on people. It must undergo testing and vetting processes before that happens. Still, clinical trials are undisputedly a form of experiment. The researchers think the drug or procedure being tested will work, but aren’t sure. This is, after all, why they have not been approved as of yet. The downside is usually just ineffectiveness, but side effects and rarely even death can occur.

Should you submit to clinical trials if you have Mesothelioma? The decision is entirely up to you. A late stage diagnosis of Mesothelioma is very often fatal, so there may be little choice.

About the Author

Thomas Ajava is with MesotheliomaandAsbestosInformation.com – your online resource for Mesothelioma and asbestos information.

(ArticlesBase SC #1307917)

Article Source: http://www.articlesbase.com/ – Mesothelioma Clinical Trials – A Good Option?

If you are a cancer sufferer and you are not sure whether to take part in a clinical trial or not; it can be a very difficult and frustrating decision.

Basically clinical trials are studies based around people and how they react to certain medical treatments. The doctors will be making sure that any new mesothelioma treatment is totally safe for human use and is actually effective. These mesothelioma trials are vitally important to determining whether or not a treatment or a procedure can actually help sufferers or maybe even cure.

It can be difficult to determine whether or not to actually take part in any clinical trial as you nor the doctors know what is going to happen and how it’s going to turn out; this is the whole point to the trials. If you already knew what was going to happen there would be no need for trials and the treatment would just be administered.

Many people do not bother paying any attention to clinical trials until the day they are diagnosed with something that is included in trials. There are instances where trials do go wrong and people suffer more; this is rare; the media do not report on good clinical trials only the negative ones. Of course this is par for course in certain clinical trials as that is what they are designed for; no one knows the outcome of the trials.

Thousands upon thousands of people are helped every year through mesothelioma clinical trials however, and millions more benefit from the successful outcomes to any clinical trial not just the mesothelioma clinical trials. That is why it is important that people do get involved in the medical trials, as without them there would not be any advances in science and in treatment. However, it is an extremely personal choice to make, and you should never feel pressured at any time to undertake a trial.

The decision is an extremely personal decision when it comes to clinical trials; talk it over with your friends and families and see if you can gain any support and help from them as well. You will need to think about your choices and always make sure you are 100% in whatever your decision may be! Your family and your friends will be a good point of comfort and care when you undertake the mesothelioma cancer treatment trials, so always keep them close and fully informed.

If you are considering taking part in a mesothelioma clinical trial then get as much information as you can about what it will entail, what may happen, any known dangers or side effects and the such like.

You need to speak to your doctor before embarking on any clinical trial. Find out as much as you can before starting any trial. You need to have all the information at your fingertips; that way you can be sure when you are making your decision

About the Author

If you have been exposed to asbestos and would like to know more about mesothelioma or treatment for asbestos cancer . Also feel free to contact us if you are looking for a mesothelioma lawyer

(ArticlesBase SC #407424)

Article Source: http://www.articlesbase.com/ – Are Mesothelioma Clinical Trials Safe?

Mesothelioma and asbestosis patients may have heard about clinical trials, but don’t know where to start or what to expect. Clinical trials for asbestos related cancer and diseases have saved lives and defied statistics. A clinical trial might be the answer to improve the quality of life and prognosis for you or your loved one.

Asbestosis from asbestos exposure and the threat or diagnosis of mesothelioma are not only difficult to diagnose, they are difficult to treat. A general physician typically has little experience treating asbestosis or mesothelioma, and since the diseases are rare, tests for these diseases will typically be down the ladder in a long line of tests until the physician is aware of asbestos exposure.

The treatment options suggested typically start with chemotherapy, radiation and lung removal. But chemotherapy and radiation have had little success and can produce significant pain. Lung removal is dangerous, but often necessary. It is frequently met with short success until the cancer cells grow and spread. Participating in a clinical trial could be the answer to a longer life, or at least a better life. If the asbestosis or mesothelioma are in the later stages and standard treatment hasn’t worked, there isn’t much to lose and your participation will help future patients battle the odds for survival. In fact, clinical trial surveys show that most participants participate to help themselves and to help others.

Doctors often have enough medical news to deal with, and may only be aware of a few clinical trials available for treating asbestosis or mesothelioma. Asking your doctor and many other doctors in related fields what clinical trials are available is often the first step to finding a clinical trial to join. The next biggest and most time-consuming step is to use the Internet. Those who have been resisting the computer must learn that research on the Internet has the potential to lead the cancer patient to a better, longer and healthier life. Family, friends and volunteers can help research clinical trial options for asbestos-related diseases. These clinical trials can be sponsored by hospitals, pharmaceutical companies and other research organizations, universities, and are held all over the world. Keep in mind that transportation to these trials may be a burden, however there are organizations for support, and many people have been successful with fundraisers.

The first factor to evaluate is what qualifications are needed to participate. Once you find a list of clinical trials, you will have to examine what ages they are accepting, what stages of the disease they are accepting, and what prior treatment or non-treatment may be accepted. There are often many tests that need to be performed before the trial; however, it is also likely many of these tests have already been performed. Clinical trials do not arise quickly, and often there are months to wait – which is frightening for someone who has months to live. Persistent research and persistent phone inquiries on cancellations or alternatives can speed up the treatment.

Asbestosis and mesothelioma clinical trials have been promising. The trials may include a mix of drugs, a new kind of therapy based on injections, laser surgery, or even gene therapy. There are hundreds of clinical trials available but they do take a great deal of research to find. Getting the assistance from a volunteer will make shuffling through the tests and medical terminology easier. Clinical trials might be the answer to overcoming your asbestosis or mesothelioma. Start researching, ask for help, and be persistent. Your life isn’t ready to wait, and it’s best to start now.

About the Author

Asbestosis-Mesothelioma website provides Asbestosis, Mesothelioma and

asbestos treatments news, care tips and many other useful information.

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Article Source: http://www.articlesbase.com/ – Asbestosis and Mesothelioma Clinical Trial Basics

Clinical trials for new mesothelioma treatments give hope for the discovery of a possible cure for the deadly cancer. Mesothelioma is an aggressive form of asbestos related cancer with a very high mortality rate, most victims die within 1-2 years after the diagnosis. The patients currently involved in mesothelioma clinical trials will hopefully lead to the discovery of better and more efficient ways of treating the disease. Consulting with a physician about various available clinical trials should be considered at the initial diagnosis.

A clinical trial is a process that new treatment options and medications pass through before they are approved for use by the general population. Many patients with terminal diseases are advised to participate in clinical trials as a last hope for a cure. Many drugs and therapies that become the standard therapy of care for many diseases have gone through an extensive period of testing with clinical trials before they were approved for general use.

Factors to Consider Before Taking Part in a Clinical Trial There are a variety of factors to take into consideration when considering participation in a clinical trial.

1- The distance to the trial center and the financial implications of taking part in the clinical trial

Clinical trials most times take place in large metropolitan hospitals located in the major cities, some of the patients however live in smaller towns far from these major cities. It is important to know how often participants will need to see the physicians coordinating the trials and how long each visit will take, and how much the hotel and travel expenses will likely cost.

2- Selection criteria for the trial

Not everyone qualifies for a clinical trial ,the criteria for selection for a particular drug trial varies. Some clinical trials will want patients that have tried using some other medication which did not work, while other clinical trials require that the participating patients have not started any treatment for their disease.

3- The risk factor

Another factor when considering a clinical trial is the loss of control over medical treatment. In some clinical trials, referred to as randomized studies, patients receive the traditional treatment while others receive the experimental treatment. The patient does not choose which treatment they receive, nor do they likely know what treatment is being administered. There is no guarantee that a participant will receive the experimental treatment. There is always a risk involved in using experimental drugs and treatments, they might have unknown side effects that will only show up when they are used by human beings.

4- General state of health of the patient

A patient’s general health is also a major consideration when preparing to participate in a clinical trial. Patients with other pre-existing medical disease will not be allowed to participate in most clinical trials as well as patients on other major medications. The presence of other medical diseases might affect the accuracy and reliability of the results of the clinical trials. Some of those other major medications might also interact negatively with the actions of the drugs that are on trial.

About the Author

Bello kamorudeen.For complete information on mesothelioma visit http://www.mesotheliomacorner.blogspot.com

(ArticlesBase SC #1197567)

Article Source: http://www.articlesbase.com/ – 4 Major Factors to Consider When You Want to Participate in a Mesothelioma Clinical Trial

Arming yourself with knowledge and a detailed plan will exponentially increase your chances at being successful when trying to quit smoking. Did you know that only about 10% of your addition to cigarettes is physical? That leaves the other 90% to be entirely in your mind! Physically, you can easily quit smoking because the worst of the storm passes, on average, in under three days. So the hard part is getting control of your brain.

To start your planning, you should develop a simple chart. Grab a piece of paper and a pen and find yourself a few minutes to really sit down and think long and hard about this. You’ll have two categories to fill: 1. Why did I start smoking to begin with? and 2. Why do I want to quit smoking now? When you thoroughly analyze your reasoning behind these actions, you can better overcome them. You’d be surprised at some of the reasons people pick up smoking to begin with – and you’ll most likely find that none of those reasons even apply today.

So, what makes you want to quit? Don’t write down simple reasons like, “It’s bad for my health.” Get down to work and be as specific as possible! Find reasons that really touch you and inspire you to continue on this endeavor. Never ever list things that might not happen, such as becoming a victim of cancer, because later down the road when you become weary in your struggle your mind will use the fact that that may not happen against you.

Let’s take a look at a few examples of reasons that are specific and not maybes. Do you ever find yourself tired or exhausted when trying to do any sort of physical activity? Maybe you’re getting cold quite easily. Did you know that cigarettes can increase your blood pressure and weaken the circulation of blood throughout your body?

Maybe you’ll need reasons that don’t apply to your health! Think about all the disgusting physical effects that smoking causes. Your skin becomes drier faster when you’re smoking and it results in a faster aging process. Have you ever taken a look at your fingernails and teeth? Yep, they’re probably discolored from cigarettes as well!

With today’s economy, you’ll probably also want to examine any possible financial reasons as well. Imagine the money that you could save if you quit smoking – maybe you would be able to do some home improvements, pay off your debts, make some charitable donations, or even just relax and go on a vacation far away.

Finally, a whole category of miscellaneous reasons exist as well. For example, did you ever consider that maybe your family gets worried knowing about all of the negative effects of smoking? What if tomorrow your children picked up the habit because they’ve seen you doing it? And what about how unsanitary smoking is… the walls in the home of a smoker typically lose their color and turn to a shade of yellow much faster than anywhere else. Plus, the smell of cigarette smoke lingers on everything.

I guarantee that something listed above does apply to you – and I know that there are many other reasons that you can probably think of for your own list. If you sit down and truly examine your life and how smoking effects it, you will be able to quit much more easily. Good luck!

Bholanath Has Expertised in Content Writing.
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The cancerous disease mesothelioma can remain undetected and symptomless in a person for decades. Regrettably this means the disease is often diagnosed late, when it has progressed to a more dangerous stage, and treatment can become difficult. The disease is caused by coming into contact with asbestos, which unfortunately was not recognised as a dangerous material until the 1970’s, eventually become banned in 1999. Prevention of the disease is possible through conducting asbestos surveys of work areas and the responsible asbestos management of buildings and other spaces. It is best to call upon reliable asbestos consultants to carry out this task safely.

The early symptoms of mesothelioma are generally non-specific, for example they can sometimes resemble viral pneumonia. Pleural mesothelioma patients may experience shortness of breath, chest pain and/or persistent cough; but some patients show no symptoms at all. Symptoms of peritoneal mesothelioma can include pain or swelling in the abdomen due to a build-up of fluid, the patient may also experience nausea, weight loss, anemia or swelling of the feet.

Clear communication and openness between doctor and patient is vital when treating a disease as serious as mesothelioma. Treatment is determined by what stage of mesothelioma the patient is in, most staging systems take into account the size and location of the primary tumour, the number of tumours, lymph node involvement, cell type and metastasis (if the cancer has spread to another part of the body). Treatment options can include surgery, chemotherapy, and clinical trials as well; new approaches such as photodynamic therapy, immunotherapy, and gene therapy may be offered. Palliative care can be an option depending on the advance of the disease, the patient’s age, and any additional health problems. As this option treats the symptoms but not the disease, it is vital the patient thoroughly discusses the options with their doctor.

Can psychological treatment have a positive effect upon the patient while they are undergoing the treatment of physical symptoms? Studies have suggested that 25% to 50% of cancer patients are suffering from psychological conditions related to their diagnosis.

A recent study conducted by the American Cancer Society examined the potential of social-cognitive therapy in mesothelioma pain management. In the study 265 patients living with mesothelioma, who were experiencing at least moderate pain or pain related to impairment, were randomly assigned to receive either an education/coaching (TEC) program specifically designed for them or receive educationally-enhanced usual care (EUC). TEC is based on social-cognitive therapy, and is comprised of six components— assess, correct, teach, prepare, rehearse and portray. Both programs were provided to the patient for an estimated 30 minutes before they had their oncology visits, as an intervention treatment.

Researchers are determining outcomes related to anxiety, pain severity and impairment, patient-physician communication, self-efficacy for pain control, and well-being. If the outcome proves that pain management plays as big a role as researchers are anticipating, the treatment may be rolled out across the US.

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