Malignant Mesothelioma Treatment (PDQ®)

General Information Malignant Mesothelioma Treatment (PDQ®)

Prognosis in this disease is difficult to assess consistently because there is great variability in the time before diagnosis and the rate of disease progression. In large retrospective series of pleural mesothelioma patients, important prognostic factors were found to be stage, age, performance status, and histology.[1,2] Various surgical procedures may be possible in selected patients, and they provide long-term survival without cure. For patients treated with aggressive surgical approaches, factors associated with improved long-term survival include epithelial histology, negative lymph nodes, and negative surgical margins.[3,4] For those patients treated with aggressive surgical approaches, nodal status is an important prognostic factor.[3] Median survival has been reported as 16 months for patients with malignant pleural disease and 5 months for patients with extensive disease. In some instances the tumor grows through the diaphragm making the site of origin difficult to assess. Cautious interpretation of treatment results with this disease is imperative because of the selection differences among series. Effusions, both pleural and peritoneal, represent major symptomatic problems for at least 66% of the patients. (Refer to the PDQ summary on Cardiopulmonary Syndromes for more information.) A history of asbestos exposure is reported in about 70% to 80% of all cases of mesothelioma.

References

1. Ruffie P, Feld R, Minkin S, et al.: Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients. J Clin Oncol 7 (8): 1157-68, 1989.

2. Tammilehto L, Maasilta P, Kostiainen S, et al.: Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients. Respiration 59 (3): 129-35, 1992.

3. Sugarbaker DJ, Strauss GM, Lynch TJ, et al.: Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. J Clin Oncol 11 (6): 1172-8, 1993.

4. Sugarbaker D, Harpole D, Healey E, et al.: Multimodality treatment of malignant pleural mesothelioma (MPM): results in 94 consecutive patients. [Abstract] Proceedings of the American Society of Clinical Oncology 14: A-1083, 356, 1995.

5. Chailleux E, Dabouis G, Pioche D, et al.: Prognostic factors in diffuse malignant pleural mesothelioma. A study of 167 patients. Chest 93 (1): 159-62, 1988. [PUBMED Abstract]

6. Adams VI, Unni KK, Muhm JR, et al.: Diffuse malignant mesothelioma of pleura. Diagnosis and survival in 92 cases. Cancer 58 (7): 1540-51, 1986.

Malignant Mesothelioma Treatment Option (PDQ®)

Treatment Option Overview

Standard treatment for all but localized mesothelioma is generally not curative. Although some patients will experience long-term survival with aggressive treatment approaches, it remains unclear if overall survival has been significantly altered by the different treatment modalities or by combinations of modalities. Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown.[1] Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is less than 2%,[2] while mortality from extrapleural pneumonectomy has ranged from 6% to 30%.[1,3] The addition of radiation therapy and/or chemotherapy following surgical intervention has not demonstrated improved survival.[2] The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived.[4,5] Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied.[6] Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms.[6,7]. Recurrent pleural effusions may be treated with pleural sclerosing procedures; however, failure rates are usually secondary to the bulk of the tumor, which precludes pleural adhesion due to the inability of the lung to fully expand.

References

1. Rusch VW, Piantadosi S, Holmes EC: The role of extrapleural pneumonectomy in malignant pleural mesothelioma. A Lung Cancer Study Group trial. J Thorac Cardiovasc Surg 102 (1): 1-9, 1991.

2. Rusch V, Saltz L, Venkatraman E, et al.: A phase II trial of pleurectomy/decortication followed by intrapleural and systemic chemotherapy for malignant pleural mesothelioma. J Clin Oncol 12 (6): 1156-63, 1994.

3. Sugarbaker DJ, Mentzer SJ, DeCamp M, et al.: Extrapleural pneumonectomy in the setting of a multimodality approach to malignant mesothelioma. Chest 103 (4 Suppl): 377S-381S, 1993.

4. Bissett D, Macbeth FR, Cram I: The role of palliative radiotherapy in malignant mesothelioma. Clin Oncol (R Coll Radiol) 3 (6): 315-7, 1991.

5. Ball DL, Cruickshank DG: The treatment of malignant mesothelioma of the pleura: review of a 5-year experience, with special reference to radiotherapy. Am J Clin Oncol 13 (1): 4-9, 1990.

6. Weissmann LB, Antman KH: Incidence, presentation and promising new treatments for malignant mesothelioma. Oncology (Huntingt) 3 (1): 67-72; discussion 73-4, 77, 1989.

7. Ong ST, Vogelzang NJ: Chemotherapy in malignant pleural mesothelioma. A review. J Clin Oncol 14 (3): 1007-17, 1996.

How to Increase Your Adsense Revenue

How to Increase Your Adsense Revenue


If you're a webmaster, you've probably heard about Google's Adsense. Perhaps you're even earning from it already. This article will show you a method to increase your Adsense revenue dramatically.

Google's Adsense allows webmasters to place links from Google's Adwords advertisers on their webpages by inserting a special code. When a visitor clicked on a link, the webmaster gets a cut of the profit Google made from the advertiser. The unique feature about Adsense is that the links it generates on your webpage are relevant to your page content. Thus, your keywords and topics become very important determinant for the type of links that will appear on your webpage.

There are only two factors that determine how much a webmaster can make from Adsense. The first factor is the number of visitors who click on the links. The more people who clicked on the links, the more you make. Naturally, this means that the more targetted traffic to the website, the more you'll make. This is where most webmasters focus their efforts on.

The second factor is the value of the links they clicked on. Here's where you can make a great difference to your earnings from Adsense and is our focus in this article.

Suppose you have 1000 visitors to your website and you get 2% conversion, that is 20 people clicked on your Adsense links. Let's assume that your Adsense links pay you only 50 cents per click. So you earn $10 dollars.

Now let's see how much this same traffic will make for you if your Adsense links pay you $5 per click. For the same number of clicks, you make $100 dollars. That's a ten-fold increased in revenue!

Well, that makes sense, you said, but how am going to determine what type of links appear on my webpages?

Good questions!

Here's where you'll need to do a little research and here's a tool to help you do just that.

Go over to http://www.pixelfast.com/overture/ and you'll get a tool that shows you how much each keyword is worth. While this tool is for Overture's keywords, we can safely assume that this reflects the keyword values for Googles Adwords as well. Once you've found the keywords with high monetary values, you can optimize your webpages for them. This will increase your chances of having these high value keyword links appearing on your webpages.

Some people have actually made extensive researches on Google's top paying keywords and found that one or two keywords are worth almost $100! However, generally most keywords are valued at between 50 cents and $5 dollars. Some keywords like "internet marketing" may fetch up to $7 dollars and "mortgage" pays up to $10 dollars.

These values may change from time to time but they generally hover around these levels. Naturally, this information is priceless and you'll have to pay to get it. I feel it is worth every cent you paid for it. You can check it out at http://theselfimprovementsite.com/links/top-paying-keywords.html.

And there you have it! A single factor that can radically increase your Adsense revenue!

Need More Information?? Search Here

Adsense Features

Adsense Features

The important AdSense features are listed below.

Context Sensitivity

Google ads are based on your website content. The keyword rich content decides your ads.

Google says :

"We go beyond simple keyword matching to understand the context and content of web pages. Based on an algorithm that includes such factors as keyword analysis, word frequency, font size, and the overall link structure of the web, we know what a page is about, and can precisely match Google ads to each page."

Occasionally Google gets it wrong. It places great importance on the file name. So be sure to use important keywords in the file name of each page, such as "contextual-advertising.html" for an article on contextual advertising.

Ad Types

Google adsense allows you to display either textual ads or image ads or both.

Example Adsense Ad Formats

Multiple Ad Units

Google adsense allows upto 3 ad units per webpage. These ad units can be of same kind or different type.

* leaderboard (728x90)
* banner (468x60)
* skyscraper (120x600)
* medium rectangle (300x250)

Multiple Search Units

Google's Search is also available to adsense users in the name of adsense for web search. Google adsense allows 2 search units per web page. Adsense for search can be both as web search and site search.

Relevant Ads Only

Google adsense is backed by google's unique keyword matching algorithm. Thus the ads coming on your site is based on the keywords in your sites content.

Live Statistics

From your adsense control panel you can view the live statistics of the clicks, impressions , CPM ( Earnings per 1000 impressions), CTR ( Click Through Rate ), each day's earnings. These statistics are almost real time now. You will get the data with in seconds.

URL Filter

You can add up to 200 sites to your filter list. The URLs you enter into your filter list can be the actual URL of the website or the URL that is displayed on the ad for that website.

Channels

Channels provide you with a way to view detailed reporting about the performance of your pages. By pasting channel-specific ad code into any combination of pages, you can track a variety of metrics across your sites. Track your leaderboard performance versus the performance of your towers, or compare your motorcycle pages to your automobile pages, by assigning each group of pages to a specific channel and comparing results in your custom channel reports. You can even assign a channel to each of your separate domains, to see where your clicks are coming from.

With up to 50 AdSense channels, plus 50 AdSense for search channels available for each publisher, you can use channels to gain the insight you need to optimize your site's performance. It's easy to add, deactivate, or rename your channels, and customized reports are simple to generate.

Alternate Ads

Alternate ads allow you to utilize your ad space in the event that Google is unable to serve targeted ads to your page. By specifying an image, HTML page, or ad server of your choice, you can make sure that your advertising space is always being used effectively, either by targeted Google ads, or by your own choice of content. You can also select a solid color or collapsing ad unit script as your alternate ad, if you prefer not to display other advertisements or content when targeted Google ads are unavailable. Alternate ads count as page impressions like any other ad. Google does not keep track of clicks on alternate ads and you will not receive revenue for them. Alternate ads, if specified, will be shown when there are no targeted ads available for your page.

Collapsing Ad Unit

Collapsing ad units are an optional advanced feature of alternate ads – the collapsing ad unit code will 'collapse' your ad unit so that it takes up no page space if there are no targeted ads available. This allows you to minimize any blank space that would otherwise occur through the use of alternate colors.You will need to host a small HTML file on your domain. Your alternate ad URL will reference this file, which will be called if there are no ads available for that particular ad unit.

Click here to download the script.

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Are You Horny?

Are You Horny?
by bcamer ©

"Are you horny?" If not, I have a fantasy to share with you, that hopefully will make you horny, and have a great orgasm at the same time.

Are you ready???

Please put on a tight pair of jeans with black panties, and a nice tight top, braless of course, (like the gray shirt you got for Christmas). Find a comfortable spot, slip on the headphone, pop this tape in, hit play and ENJOY.....

Close your eyes.. Clear you mind... Are you horny?

Do you remember the first time we made love?? It was September 25, 1992. Picture that Friday afternoon in your mind. It was rainy. I arrived before you at our clandestine location, picking up strawberries and Champagne for this special occasion. It was special because for the first time I was going to make love to you. Anticipation had been building for weeks. Teasing, touching, letters, notes... Remember!!!!

Excitement, nervousness, and passion filled the air. Take a deep breath. Can you smell it?? You finally arrive. As I open the door to let you in to our sex chamber, I notice your beauty immediately. Your sexual energy fills the room. Can you feel it??

You are ready to take your man in ways he could not imagine. All the while surprising yourself in the process. As the champagne brings euphoria, so does the smell of sex that now envelopes the room. Can you smell it? Our bodies start to tingle. Be free with your body!! Your lips are inviting. As I slowly, softly start to kiss you, the euphoric feeling brought on by the champagne, intensifies the sexual energy that fills the air. Neither of us can remember discarding our unwanted clothing. Caressing, licking, sucking, fucking.. I can feel my cock start to harden, as I remember how hot and beautiful you looked. Upon reaching our first of many orgasms, our minds could no longer hold what needed to be said. "I LOVE YOU"...

"ARE YOU HORNY YET??"

"What I want to do is to have us masturbate each other. More accurately, I want to get you off using your hands instead of my own. When I say I'm doing something, I want you to do it for me. Like, right now I want to caress your neck, so I need you to rub your neck, caress it for me..." (If the experience will be better for you, you can respond to me using your voice as if I was there) "Your neck feels wonderful to my fingertips. I like stroking them over it, feeling the softness of your skin as I run my hand over it. The touch of your hair on the back of my hand as I look into your eyes, enjoying the passion I see reflected in them. I move my hand down the front of your shirt, lightly, outlining the curves of your breasts, without touching them firmly enough to enjoy their mass. I move my hand down to your belly, and rest it there, massaging for a moment before I move to your hip and caress there. Your body feels so soft, so warm and so alive under me that I want to tear your clothes off. My cock gets stiffer just thinking about it.

"I'm rubbing your belly, your shirt between my hand and your fine skin. I can't wait to see your naked body... I move my hand down to your silky shorts and rub there for a little while, caressing around your hip bones, enjoying the feel of your body beneath the silk. I want to feel that body, so I move my hand back up, under your silky shirt, to your belly. I can feel it quivering under my hand. I rub the skin, back and forth, tracing your navel. I like the way your skin feels to my questing fingers. I move them down to the top of your shorts, working them underneath. "If I stretch far enough, I can feel pubic hairs. My cock throbs at the touch of your pubes. I can't see all the way to your beautiful pussy yet... All I can see of you is a little of your belly, and your silky shorts. The pubic hair feels soft and silky as I caress the top of your mound.

"I can't wait to touch your pussy, but I have to feel your tits first. I move my hands from your pubic hairs up to feel your breasts through the material of your shirt. I like their mass, the way they feel under my hand. I can feel your nipples getting hard as I caress your breasts. It feels marvelous.

I'm stroking my cock, just thinking about it.

I want to see those wondrous mounds of yours. I slowly pull your shirt off.

As soon as it's off, I use both hands to play with your nipples, rubbing each of them between my thumb and forefinger, tugging gently, feeling the way they move as each finger comes into contact with them; caressing them with the palms of my hands. I love your nipples poking into the palms of my hands. MMMMMMmmmmm they feel good. I like stroking and looking at my rock-hard cock as I think about rubbing those marvelous tits of yours.

"Are your nipples hard??

Is your pussy feeling warm??

ARE YOU HORNY YET??

I look back at your breasts, taking my eyes of my cock. They look wonderful to me, round and _very_ hard nipples, poking up from on top. I take my hands and cup your breasts, running my thumbs over your nipples while I knead the soft undersides, running my hand back and forth against the skin of your belly." "Are you moaning?? I can hear your mouth watering with anticipation. "My cock is starting to drip with pre-cum. You look so good, and your moans just make me want you more. I keep one hand on your breasts, moving back and forth between the two, caressing the nipples, stroking the round sides, and enjoying the soft undersides. The other hand moves down your belly, to your silky shorts and starts caressing the top of your mound. I slowly find the top of your clit, running my finger over the top of your shorts. You can't cum just yet..

ARE YOU HORNY YET??

I move my hand to the skin just above your shorts. I trace the outline of the top of your shorts, around the outside, down the inside of your thighs, building the anticipation of the heat and wetness underneath them. I like the heat I feel coming off of them. This all feels so good, I have to stop touching myself, or I'll cum right here! "Does it feel good, having me touch you? Your skin is so soft to my hands that my head is spinning and my cock is drooling. I can't wait to blow my wad - it's going to be awesome.

"I take my hand off of your breast. It's time to take your silky shorts off. I reach down with both hands... Slowly I take them off, and smell them. The smell of your wet pussy races around my brain, and my hard cock is pulsating... "Do you smell good??" "Does you clit want to be touched" "It's going to have to wait a little bit, I want to touch you all over first. I like running my hands up and down the outsides of your thighs, reaching around to cup your ass. I love your tight ass. Just looking at it always makes me want to fuck you. I squeeze it for a moment before I move my hands back to your thighs. As soon as my hands start to move to the inside of your thighs, you spread your legs. Even moving your hips in the direction of my hand so that I'll touch your pussy. I'm not going to do that quite yet.

On the inside of your thigh, I move my hand down to the bottom, and work my way up until I'm tickling the pubic hairs around your hot pussy. "I move my hand to your pussy, cupping it in my hands, and not moving for a minute. After what seems an eternity, I slowly move my left hand to your tits, as my right hand starts its magic on your waiting clit. My fingers move in circles around your swollen member. I stop occasionally to gentle flick it, building anticipation for your orgasm. Each time I flick it, your breathing staggers and your moaning intensifies. I stop circling and flicking to feel the wetness building. "I've got my palm on the top of your pubic mound, above the hood to your clit. My middle finger is resting between pussy lips; a favorite position for it to be, with your pussy lips on either side of it. I start moving my hand up and down, allowing my middle finger to feel the wetness coming from inside you. Each time my hand moves up, it bumps against your clitoris... You are so wet.

Are you horny yet?

Do you want to cum??

"I touch your clit again, making you gasp... It almost makes me come right then and there to hear that kind of passion in your voice.

"Slowly, I start to apply pressure with my middle finger as I move my hand up and down. My left hand is expertly squeezing and pinching your nipples, which now are reaching their height of sensitivity. My right hand begins circling around your hole, slipping it in every so often, before moving back to your clit. I tease you. Circling your clit, stopping short of ecstasy, and moving my middle finger into your wet pussy. Each time I put it into you a little deeper, until my hand almost stops moving. My middle finger moves in and out of your wet pussy, slowly at first, but then faster and faster. "Do you feel it?? It feels so good, feeling your pussy grabbing at my finger, I want so badly to cum... You are so wet, and you're so beautiful. I can hear you gasping with pleasure.

GOD, I want to stroke my cock, but I know that I'm going to cum the moment I touch it - your passion has gotten me so horny, I can't stand it!" "I can tell that you're ready... I move my middle finger out of your wetness and find your clit. The slipperiness of your pussy intensifies the circling on your clit.

Your left hand has found its way to join you right for a moment. It spreads your hairy pussy lips, to give your right hand the perfect motion for orgasm.

I'm starting to stroke my cock, now. I can hear your ragged breathing telling me that you're getting close to orgasm. It feels so good to stroke my cock while I watch you enjoying your body. I love that look on your face. It is so filled with passion...

"Your left hand has found it's way back to your nipples, while your other rubs at your clit both at the same time looks so sexy! I'm drooling about it. My cock is, too. I can feel my own orgasm growing." I can hear you starting to gasp as an orgasm builds within you. It fires my cock all the more. I know you're close. I can hear it in your voice. "Mmmmmmmmm your orgasm is feeling so good building on my fingers.

I'm getting close. I can't hold on any longer. I'm cumming... Cum with me!!! "Ohhh - Ohhh- yes, yes that's good. MMMMM" my cum explodes all over my stomach. I wish I was shooting into you. Did you come yet?" Did You?? Yes you did, Your pussy feels so wet. I love the taste of your wetness. I put my finger back into your wet pussy, and then to mouth, absorbing the nectar you left on my finger... I hope you enjoyed this as much as I did...

"I Love you"