Automotive mechanics are specially trained technicians specializing in car / truck maintenance and repair. Because many of the mechanical components in a car create friction and/or heat, asbestos was a long favored product used in these parts due to its natural ability to resist heat. Asbestos is frequently found in brake parts, clutch facings, transmission parts, brake pads and linings and more.
Some automotive products that were made with asbestos are: brake linings, clutch facings, transmission components, disc brake pads, drum brake linings, brake blocks, gaskets and others.
Auto Mechanics are Frequently Exposed to Asbestos on the Job
Working in an Auto shop can pose significant occupational hazards for auto mechanics, even today. The environment in auto shops is often asbestos dust-filled. Prior to the 1970's asbestos was the main insulation material used in common replacement parts such as brakes, gaskets, transmission parts etc. for both cars and trucks. Since the 1970's asbestos usage in these parts is more regulated but still exists in older cars and trucks and people may not be aware of this. In fact, there are a lot of modern day mechanics that do not understand that they face the risk of exposure every day. Second hand exposure may also be a risk for other employees that do not work on cars or trucks. When the asbestos dust and fibers get into the air it is very difficult to not breathe it in.
The nature of auto mechanic work lends itself to creating asbestos dust. Unfortunately not all workers are educated in the occupational risks and hazards associated with working in an auto shop and believe that if they do not directly inhale dust that they will not be affected. Nothing could be further from the truth. Many auto shops, especially today do provide respirator gear but a lot of mechanics believe they "get in the way" or are unattractive. Family members were also put at risk because the mechanics would come home with the asbestos dust on their clothes, shoes and hair.
Brake and clutch replacement is a common job that auto mechanics perform. The process of installing new brakes requires that mechanics file, sand and drill the brake pads and linings to get them on the car and they create hazardous dust in the process. Brake and clutch maintenance service usually requires that they be "ground down" to rejuvenate the brake linings. This also results in spilling dangerous asbestos fibers into the air of the shop. Even if a wet rag is used to attempt to minimize dust, asbestos fibers are still present once the rag dries.
Asbestos fibers also collect in the brake drum during the driving process. Brakes shoes are applied to the drum which creates friction. This asbestos dust spills into the auto shop when brake replacement or maintenance work is scheduled on the vehicle.
There are a number of companies that manufactured asbestos-containing car and truck parts. They include Johns-Manville, Owens Corning, Bosch, Dana Corp, Raybestos, Cooper Industries and RPM Int'l.
Mesothelioma, Lung Cancer and Asbestosis are Common Diseases Found in Auto Mechanics
The dangers of asbestos exposure were becoming very obvious by the middle of the 1970's. There were more and more occurrences of workers developing pulmonary disease including lung cancer, asbestosis and the most severe form of asbestos cancer - mesothelioma. This was particularly evident in workers who had extended exposure to asbestos dust and fibers in an occupational setting. We will explore these illnesses in a little more detail:
Mesothelioma
Mesothelioma is a severe form of cancer. The only certain cause of mesothelioma is exposure to asbestos. It can attack one or more areas but is generally seen in the lungs, the area surrounding the heart or in the abdomen. The organs themselves are not affected; rather it is the lining surrounding them that is attacked. Pleural mesothelioma is most commonly seen and involves the lining inside the lung. Peritoneal mesothelioma affects the stomach lining and pericardial mesothelioma affects the lining around the area of the heart.
Asbestos Related Lung Cancer
Unlike mesothelioma, lung cancer can develop from exposure to a variety of substances. However, workers exposed to asbestos that also have a smoking history have a higher risk of developing lung cancer because the exposure can result in cancerous tumors that block the airways.
Asbestosis
Asbestosis is a disease also caused exclusively by asbestos exposure where the exposure causes scar tissue to build in the lungs making it difficult for a person to breathe.
It is very common for much time to elapse from the end of asbestos exposure to the onset of an asbestos related disease. Oftentimes lung cancer will not show up until ten years after a person was exposed to asbestos and there is an even longer latency period for asbestosis and mesothelioma cancer. In those cases it can be as long as 30 or 40 years! Mesothelioma symptoms are often dismissed as common ailments in the early stages but can include chest pain, difficulty breathing, and a dry cough that may show blood.
Mesothelioma, more precisely malignant mesothelioma, is a rare form of cancer that develops from the protective lining that covers many of the body's internal organs, the mesothelium. It is usually caused by exposure to asbestos.
Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the pericardium (a sac that surrounds the heart), or the tunica vaginalis (a sac that surrounds the testis).
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos and glass particles, or they have been exposed to asbestos dust and fiber in other ways. It has also been suggested that washing the clothes of a family member who worked with asbestos or glass can put a person at risk for developing mesothelioma. Unlike lung cancer, there is no association between mesothelioma and smoking, but smoking greatly increases the risk of other asbestos-induced cancers. Those who have been exposed to asbestos often utilize attorneys to collect damages for asbestos-related disease, including mesothelioma. Compensation via asbestos funds or lawsuits is an important issue in law practices regarding mesothelioma (see asbestos and the law).
The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Signs and symptoms
Symptoms or signs of mesothelioma may not appear until 20 to 50 years (or more) after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space (pleural effusion) are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). 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.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* Chest wall pain * Pleural effusion, or fluid surrounding the lung * Shortness of breath * Fatigue or anemia * Wheezing, hoarseness, or cough * Blood in the sputum (fluid) coughed up (hemoptysis)
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* Abdominal pain * Ascites, or an abnormal buildup of fluid in the abdomen * A mass in the abdomen * Problems with bowel function * Weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* Blood clots in the veins, which may cause thrombophlebitis * Disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs * Jaundice, or yellowing of the eyes and skin * Low blood sugar level * Pleural effusion * Pulmonary emboli, or blood clots in the arteries of the lungs * Severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
Cause
Working with asbestos is the major risk factor for mesothelioma. In the United States, asbestos is the major cause of malignant mesothelioma and has been considered "indisputably" associated with the development of mesothelioma. Indeed, the relationship between asbestos and mesothelioma is so strong that many consider mesothelioma a “signal” or “sentinel” tumor. A history of asbestos exposure exists in most cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite. Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.
Asbestos was known in antiquity, but it was not mined and widely used commercially until the late 19th century. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the official position of the U.S. Occupational Safety and Health Administration (OSHA) and the U.S. EPA is that protections and "permissible exposure limits" required by U.S. regulations, while adequate to prevent most asbestos-related non-malignant disease, they are not adequate to prevent or protect against asbestos-related cancers such as mesothelioma. Likewise, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE assumes that no such "safe" threshold exists. Others have noted as well that there is no evidence of a threshold level below which there is no risk of mesothelioma. There appears to be a linear, dose-response relationship, with increasing dose producing increasing disease. Nevertheless, mesothelioma may be related to brief, low level or indirect exposures to asbestos. The dose necessary for effect appears to be lower for asbestos-induced mesothelioma than for pulmonary asbestosis or lung cancer. Again, there is no known safe level of exposure to asbestos as it relates to increased risk of mesothelioma.
The duration of exposure to asbestos causing mesothelioma can be short. For example, cases of mesothelioma have been documented with only 1–3 months of exposure. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
Latency, the time from first exposure to manifestation of disease, is prolonged in the case of mesothelioma. It is virtually never less than fifteen years and peaks at 30–40 years. In a review of occupationally related mesothelioma cases, the median latency was 32 years. Based upon the data from Peto et al, the risk of mesothelioma appears to increase to the third or fourth power from first exposure. Environmental exposures
Incidence of mesothelioma had been found to be higher in populations living near naturally occurring asbestos. For example, in central Cappadocia, Turkey, mesothelioma was causing 50% of all deaths in three small villages — Tuzköy, Karain and Sarıhıdır. Initially, this was attributed to erionite, a zeolite mineral with similar properties to asbestos, however, recently, detailed epidemiological investigation showed that erionite causes mesothelioma mostly in families with a genetic predisposition. The documented presence of asbestos fibers in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibers.
Occupational
Exposure to asbestos fibers has been recognized as an occupational health hazard since the early 20th century. Numerous epidemiological studies have associated occupational exposure to asbestos with the development of pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumors, and diffuse malignant mesothelioma of the pleura and peritoneum. Asbestos has been widely used in many industrial products, including cement, brake linings, gaskets, roof shingles, flooring products, textiles, and insulation. Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Paraoccupational secondary exposure
Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
Asbestos in buildings
Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or DIY activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.
Diagnosis
CXR demonstrating a mesothelioma
CT scan of a patient with mesothelioma, coronal section (the section follows the plane that divides the body in a front and a back half). The mesothelioma is indicated by yellow arrows, the central pleural effusion (fluid collection) is marked with a yellow star. Red numbers: (1) right lung, (2) spine, (3) left lung, (4) ribs, (5) descending part of the aorta, (6) spleen, (7) left kidney, (8) right kidney, (9) liver.
Micrograph of a pleural fluid cytopathology specimen showing mesothelioma.
Micrographs showing mesothelioma in a core biopsy.
Image of Metastatic mesothelioma
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytopathology if this fluid is aspirated with a syringe. For pleural fluid, this is done by thoracentesis or tube thoracostomy (chest tube); for ascites, with paracentesis or ascitic drain; and for pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure). Unfortunately, the diagnosis of malignant mesothelioma by cytology alone is difficult, even with expert pathologists. Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. Alternatively, the chest surgeon might directly open the chest (thoracotomy). If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary. Immunohistochemical studies play an important role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. There are numerous tests and panels available. No single test is perfect for distinguishing mesothelioma from carcinoma or even benign versus malignant.
Typical immunohistochemistry results
Positive
Negative
EMA (epithelial membrane antigen) in a membranous distribution
CEA (carcinoembryonic antigen)
WT1 (Wilms' tumour 1)
B72.3
Calretinin
MOC-3 1
Mesothelin-1
CD15
Cytokeratin 5/6
Ber-EP4
HBME-1 (human mesothelial cell 1)
TTF-1 (thyroid transcription factor-1)
There are three histological types of malignant mesothelioma: (1) Epithelioid; (2) Sarcomatoid; and (3) Biphasic (Mixed). Epithelioid comprises about 50-60% of malignant mesothelioma cases and generally holds a better prognosis than the Sarcomatoid or Biphasic subtypes.
Staging
Staging of mesothelioma is based on the recommendation by the International Mesothelioma Interest Group. TNM classification of the primary tumor, lymph node involvement, and distant metastasis is performed. Mesothelioma is staged Ia–IV (one-A to four) based on the TNM status.
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. Screening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening. Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells.
Pathophysiology
Diffuse pleural mesothelioma with extensive involvement of the pericardium.
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibers in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fiber can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibers from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibers may be deposited in the gut after ingestion of sputum contaminated with asbestos fibers. Pleural contamination with asbestos or other mineral fibers has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers). However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings. Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibers. It has been suggested that in humans, transport of fibers to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localized lesions of accumulated asbestos fibers in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumor. Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibers remain unclear despite the demonstration of its oncogenic capabilities (see next-but-one paragraph). However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibers has not yet been achieved. In general, asbestos fibers are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages. Analysis of the interactions between asbestos fibers and DNA has shown that phagocytosed fibers are able to make contact with chromosomes, often adhering to the chromatin fibers or becoming entangled within the chromosome. This contact between the asbestos fiber and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms. Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
Neurofibromatosis type 2 at 22q12
P16INK4A
P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
Inactivation of tumor suppressor genes
Activation of oncogenes
Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
Activation of DNA repair enzymes, which may be prone to error
Activation of telomerase
Prevention of apoptosis
Asbestos fibers have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences. Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
Treatment
The prognosis for malignant mesothelioma remains disappointing, although there have been some modest improvements in prognosis from newer chemotherapies and multimodality treatments. Treatment of malignant mesothelioma at earlier stages has a better prognosis, but cures are exceedingly rare. Clinical behavior of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favors local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease. The histological subtype and the patient's age and health status also help predict prognosis. The epithelioid histology responds better to treatment and has a survival advantage over sarcomatoid histology.
Surgery
Surgery, by itself, has proved disappointing. In one large series, the median survival with surgery (including extrapleural pneumonectomy) was only 11.7 months. However, research indicates varied success when used in combination with radiation and chemotherapy (Duke, 2008). (For more information on multimodality therapy with surgery, see below). A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed.
[edit]Radiation
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall. Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy
Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery.This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the group of patients treated with cisplatin in the combination with pemetrexed and who also received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give. Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin. In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.
Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained. This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells. This technique is also used in patients with malignant pleural mesothelioma.
Multimodality Therapy
All of the standard approaches to treating solid tumors—radiation, chemotherapy, and surgery—have been investigated in patients with malignant pleural mesothelioma. Although surgery, by itself, is not very effective, surgery combined with adjuvant chemotherapy and radiation (trimodality therapy) has produced significant survival extension (3–14 years) among patients with favorable prognostic factors.However, other large series of examining multimodality treatment have only demonstrated modest improvement in survival (median survival 14.5 months and only 29.6% surviving 2 years).Reducing the bulk of the tumor with cytoreductive surgery is key to extending survival. Two surgeries have been developed: extrapleural pneumonectomy and pleurectomy/decortication. The indications for performing these operations are unique. The choice of operation depends on the size of the patient's tumor. This is an important consideration because tumor volume has been identified as a prognostic factor in mesothelioma. Pleurectomy/decortication spares the underlying lung and is performed in patients with early stage disease when the intention is to remove all gross visible tumor (macroscopic complete resection), not simply palliation. Extrapleural pneumonectomy is a more extensive operation that involves resection of the parietal and visceral pleurae, underlying lung, ipsilateral diaphragm, and ipsilateral pericardium. This operation is indicated for a subset of patients with more advanced tumors, who can tolerate a pneumonectomy.
Epidemiology
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate varies from one country to another, from a low rate of less than 1 per 1,000,000 in Tunisia and Morocco, to the highest rate in Britain, Australia and Belgium: 30 per 1,000,000 per year. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. 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. Approximately one fifth to one third of all mesotheliomas are peritoneal. Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States. Between 1973 and 1984, the incidence of pleural mesothelioma among Caucasian males increased 300%. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.Society and culture
Notable cases
Mesothelioma, though rare, has had a number of notable patients.
Malcolm McLaren, former manager of New York Dolls and Sex Pistols, died on 8 April 2010.
Billy Vaughn, American bandleader, died in 1991.
Hamilton Jordan, Chief of Staff for U.S. President Jimmy Carter and lifelong cancer activist, died in 2008.
Richard J. Herrnstein, psychologist and co-author of The Bell Curve, died in 1994.
Australian anti-racism activist Bob Bellear died in 2005.
British science fiction writer Michael G. Coney, responsible for nearly 100 works, also died in 2005.
American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006.
Mickie Most, an English record producer, died of mesothelioma in 2003.
Paul Rudolph, American architect, died in 1997.
Bernie Banton, an Australian workers' rights activist, fought a long battle for compensation from James Hardie after he contracted mesothelioma after working for that company. He claimed James Hardie knew of the dangers of asbestos before he began work with the substance making insulation for power stations. Mesothelioma eventually took his life along with his brothers and hundreds of James Hardie workers. James Hardie made an undisclosed settlement with Banton only when his mesothelioma had reached its final stages and he was expected to have no more than 48 hours to live. Australian Prime Minister Kevin Rudd mentioned Banton's extended struggle in his acceptance speech after winning the 2007 Australian federal election.
Actor Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen subsequently sought alternative treatments at clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the U.S. Marines as a young adult—asbestos was then commonly used to insulate ships' piping—or from its use as an insulating material in automobile racing suits (McQueen was an avid racing driver and fan).
United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder award is given yearly by his wife at the MARF Symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.
Rock and roll musician and songwriter Warren Zevon, after a long period of untreated illness and pain, was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments that he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind, including the song "Keep Me in Your Heart," which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.
Christie Hennessy, the influential Irish singer-songwriter, died of mesothelioma in 2007, and had stridently refused to accept the prognosis in the weeks before his death. Hennessy's mesothelioma has been attributed to his younger years spent working on building sites in London.
Bob Miner, one of the founders of Software Development Labs, the forerunner of Oracle Corporation, died of mesothelioma in 1994.
Scottish Labour MP John William MacDougall died of mesothelioma on August 13, 2008, after fighting the disease for two years.
Australian journalist and news presenter Peter Leonard of Canberra succumbed to the condition on September 23, 2008.
Terrence McCann, Olympic gold medalist and longtime Executive Director of Toastmasters, died of mesothelioma on June 7, 2006, at his home in Dana Point, California.
Merlin Olsen, Pro Football Hall of Famer and television actor, died on March 10, 2010, from mesothelioma that had been diagnosed in 2009.
Notable people who have lived for some time with mesothelioma
Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote "The Median Isn't the Message" for Discover magazine, in which he argued that statistics such as median survival are just useful abstractions, not destiny. Gould lived for another 20 years, eventually succumbing to metastatic adenocarcinoma of the lung, not mesothelioma. Author Paul Kraus was diagnosed with peritoneal mesothelioma in July 1997. He was given a prognosis of less than a year to live and used a variety of complementary modalities. He continues to outlive his prognosis and wrote a book about his experience "Surviving Mesothelioma and Other Cancers: A Patient's Guide" in which he presented his philosophy about healing and the decision making that led him to use integrative medicine.
Legal issues
Main article: Asbestos and the law
The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars. The amounts and method of allocating compensation have been the source of many court cases, reaching up to the United States Supreme Court, and government attempts at resolution of existing and future cases. However, to date, the US Congress has not stepped in and there are no federal laws governing asbestos compensation.
History
The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. In 1960, an article published by Wagner et al. was seminal in establishing mesothelioma as a disease arising from exposure to asbestos.The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. Prior to the use of advanced microscopy techniques, malignant mesothelioma was often diagnosed as a variant form of lung cancer. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker. The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950. In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma. Despite proof that the dust associated with asbestos mining and milling causes asbestos-related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information. By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims. In Leeds, England the Armley asbestos disaster involved several court cases against Turner & Newall where local residents who contracted mesothelioma claimed compensation because of the asbestos pollution from the company's factory. One notable case was that of June Hancock, who contracted the disease in 1993 and died in 1997.
A recent wedding at Southern Oaks Plantation in New Orleans included a unique fashion worn by both wedding party members and wedding guests. The bride, Rebecca, of nearby Marrero, Louisiana, provided all 250 wedding attendants with mesothelioma awareness wrist bands, in honor of her mother Catherine Cook, who recently died from the deadly cancer at age 56. “We wanted everyone to be aware of what this terrible disease does, and how senseless it is,” Rebecca said.
Catherine was possibly exposed to mesothelioma’s cause, toxic asbestos, when her father and first husband worked at an insulation factory. Asbestos fibers may have been brought home on her husband’s clothes, which she washed every day.
Until her mesothelioma symptoms began appearing, Catherine was a healthy woman who enjoyed exercise and outdoor recreation. Her daughter Rebecca said, “At first when my mom was sick, people would say, ‘I didn’t’ know your mother smoked.’ But she didn’t smoke. She never smoked. She never drank. She lived a healthy life. She didn’t bring this upon herself. It’s really scary to think they still are producing products with asbestos when they knew long ago, it was killing people.”
Rebecca has taken it upon herself to raise awareness for mesothelioma, knowing how many people still do not understand the cause or development of the rare cancer. She said, “It still amazes me how little people know about mesothelioma. When people ask me about my wristband, I’m happy to explain. Some of my friends still wear their bands. Even my mom, when she knew she was dying, she’d say, `I wish I had gotten breast cancer instead. At least then, people would understand what I have.’ ”
“In a perfect world, I’d like to become this amazing scientist and find a cure for mesothelioma, or at least find a way to test people early, to stop it from reaching the stage where there is nothing you can do,” Rebecca said. She continued, “What I’d like someday is to have kids of my own and, start a non-profit organization to raise money for research to find a cure. I’d spend my whole life raising money for this cause if it could spare one family from having to go through what my mother went through. She was the best mother anyone could ask for, but near the end, she couldn’t walk five feet without needing oxygen. I just feel the need to do something about this disease. She would want me to help find a cure.”
After several misdiagnoses, Catherine was properly diagnosed with mesothelioma in March of 2009. She and her family traveled to Boston and Texas looking for experts that could help her fight mesothelioma successfully. Sadly, She died within a year.
“It’s such a terrible thing to watch someone go through this,” Rebecca said of her mother’s fight against mesothelioma. “I saw what my mom went through, and it was like watching someone drown, like she was slowly suffocating. It just seemed like compared to most diseases, the doctors didn’t have any real answers.
“My mother was like my best friend. We used to double date sometimes, her and my stepfather, me and my fiancé. I know she would have loved the wedding.”
On June 1, 2011 a lawsuit was filed by the estate of Milan Arthur Barackman by Michael Grant Mason. Mason filed the lawsuit thirty years after Barackman was exposed to asbestos on a United States Navy vessel. According to Mesothelioma.US, a news site for the disease, the lawsuit claims that Barackman was exposed to the material during the late 1960s and early 1970s and that he inhaled asbestos during these years, later resulting in his developing Mesothelioma. The estate of Barackman has filed a wrongful death suit against Foster Wheeler, Owens-Illinois Inc., General Electric Co., Uniroyal Inc., Riley Power Inc., Rapid American Corp. and Viacom Inc. with U.S. District Judge Jay C. Zainey presiding over Case No. 2:11-cv-01309. The suit claims that Barackman's diagnoses with Mesothelioma last year was a direct result of asbestos exposure.
Plaintiffs in the case argue that the listed defendants were allegedly manufacturing a dangerous product and yet gave no warning to Barackman or others of the dangers of being exposed to asbestos. This is not a single case. There are literally thousands of people suffering with this disease and more being diagnosed every day. Those who are diagnosed undergo Mesothelioma treatment which can be very expensive. Due to the fact that exposure to this dangerous product causes the disease, many seek compensation to pay for treatment of Mesothelioma as well as general pain and suffering.
Danziger & De Llano, LLP has been providing assistance to clients fighting Mesothelioma for a number of years. Those who have been exposed to asbestos and who are experiencing symptoms of Mesothelioma should contact the law firm for more information. Attorneys and staff can help clients to seek compensation for the treatment of Mesothelioma. Mesothelioma attorneys generally have more experience in representing clients against major companies. They can offer advice on the best route for the case as well as find information for clients about Mesothelioma clinical trials. The Law Offices of Danziger & De Llano, LLP offers experienced Mesothelioma lawyers who can help clients to seek compensation against companies that knowingly exposed them to hazardous products. When a case is accepted, a team of Mesothelioma lawyers as well as legal assistants and support staff is assigned to each client to help them to prepare for the legal process. Those who have Mesothelioma or have lost a loved one to this disease can contact the firm to speak with a qualified attorney or set up a consultation.
A recently released study shines light on the devastating effect of mesothelioma on veterans who served from World War II through the Vietnam era, New York asbestos exposure attorney Joseph W. Belluck said.
The study presented at the American Society of Clinical Oncology conference and published in the Journal of Clinical Oncology analyzed 928 veterans. Researchers found the average veteran had about seven months to live after diagnosis with malignant pleural mesothelioma.
“This confirms what we are seeing in the field,” said Belluck, a partner of the New York personal injury law firm of Belluck & Fox LLP and one of the nation’s leading advocates for mesothelioma victims.
“Many of our service members develop asbestos-related mesothelioma after years of it being in hiding,” Belluck said. “Their prognosis is grim when the disease takes hold.”
Although the study reported that malignant pleural mesothelioma “has a uniformly poor prognosis in all stages,” it did indicate that that the outlook is better for younger patients who catch their disease early and those who undergo therapy or have cancer with certain cell structures.
The median age of veterans with mesothelioma in the study was 71, while 87.6 percent were Caucasians, and 8.72 percent were African-Americans. Other races made up the remaining 3.66 percent.
Patients who had Stage I mesothelioma, the least developed type, lived an average of 9.6 months after diagnosis. Stage II patients lived an average of 10.26 months, while Stages III and IV lived an average of 6.7 months and 5.3 months, respectively.
Belluck, the New York mesothelioma lawyer, said the results underscore how crucial it is for veterans to contact a doctor if they believe they have mesothelioma.
Veterans diagnosed with asbestos-related disease should also consult a lawyer for help with pursuing a claim with the U.S. Department of Veterans Affairs to get compensation for their medical treatment and other damages, he said.
“This disease has such a long latency period that many veterans are just now discovering that they have mesothelioma decades after they were exposed to asbestos while serving in the Army, Air Force, Navy, Marines or Coast Guard,” Belluck said.
Belluck said statistics show that about 30 percent of all mesothelioma victims served in the military. That’s because many service members were exposed to asbestos between the 1940s and 1970s, when all military branches used the toxic substance, he said.
Even the spouses and families of veterans were frequently exposed to asbestos in housing or from second-hand contact with the substance on the service member’s clothes or body.
“Veterans suffering the effects of asbestos exposure and their families deserve just compensation,” Belluck said. “It’s highly advisable to contact an experienced mesothelioma lawyer to make sure your case is handled properly.”
In 2003, the U.S. Human Genome Project, an endeavor coordinated by Washington, D.C.’s U.S. Department of Energy and the National Institutes of Health, completed its mapping of human DNA, identifying a total of nearly 25,000 genes. Understanding the human genome has since allowed modern science to complete more accurate risk assessments, increase the precision of disease diagnosis, characterize genetic damage and repair processes and develop precision pharmaceuticals.
Having a roadmap of human DNA has also affected the diagnosis and treatment of mesothelioma, a rare cancer of the protective lining of the body’s major organs and cavities that is caused exclusively by prolonged asbestos exposure. The genetic biomarkers of this asbestos cancer have been indentified and can be used to determine the aggressiveness of the mesothelioma as well as diagnose epithelioid-type pleural mesothelioma, a tumor that specifically affects the lining of the lungs.
Mesothelioma is a particularly difficult cancer to detect because it takes between 20 and 50 years to develop and doesn’t become symptomatic until it reaches stage three or four. Even once symptoms become evident, diagnosis may still be challenging because the symptoms, such as shortness of breath and chest pain, can be indicative of any number of diseases. Being able to test for genetic markers specific to malignant mesothelioma can lead to quicker diagnoses, which in turn can lead to more timely treatment.
Genetic markers that provide more information about the type of mesothelioma may also contribute to more precise treatment. As this cancer is terminal, more precise treatment likely won’t be curative but it may extend a patient’s life expectancy anywhere from several months to a few years.
The University of Hawai’i Cancer Center has received $3.58 million from an anonymous donor to aid its important mesothelioma research work under its director, Dr. Michele Carbone, and her colleagues.
“Mesothelioma is a serious public health problem,” said Dr. Virginia Hinshaw, Chancellor of UH Mānoa. “We’re proud that Dr. Carbone’s team is leading the world in this area of discovery. This gift validates their efforts and will help them remain at the forefront of thoracic oncology research.”
The $3.58 million gift is the second largest one ever given to the UH Cancer Center. Among the work that has recently been completed by Dr. Carbone and researchers at the center were recently released findings relating to the presence of erionite – a material that causes mesothelioma – in rock materials that are used to pave roads in North Dakota.
The center has also conducted studies in Capadoccia, Turkey – a region where nearly 50 percent of the residents die of mesothelioma – and there are currently plans for Dr. Carbone and collaborators to conduct a clinical trial co-sponsored by the Early Detection Research Network of the U.S. National Cancer Institute and the Turkish Ministry of Health. The trial will seek to validate serum biomarkers that were discovered during previous research that may help improve early detection of mesothelioma.
For those receiving mesothelioma treatment who have previously worked in a profession where you were regularly exposed to high amounts of asbestos, there may be reason to speak with a Hawaii mesothelioma attorney regarding a possible lawsuit. Contact us for a free consultation to see if a Hawaii mesothelioma law firm can help to get you a monetary asbestos settlement from a former employer who may be at fault for an asbestos-related illness.
They are typically thought of as a cause of illness, but viruses may also be an important key to fighting the asbestos-linked cancer, mesothelioma. Medical researchers in Japan are using viruses to deliver information directly into mesothelioma cells in mice that can help the cells respond better to cancer-fighting medication.
The researchers first tested their approach to gene therapy in test tubes, delivering genetic information to mesothelioma cells using modified viruses called retroviruses. In the past, scientists primarily used retroviruses that were unable to replicate themselves, to ensure that the replication process did not get out of control. But for their recent experiments, the Japanese team used replicable viruses – called replication-competent (RCR) viruses – instead.
While it is considered a riskier approach, using replication-competent viruses is also thought to be more effective because they can help get the key genes into more cells. This was the case in the Japanese study. The team reports that the marker gene “successfully infected and efficiently replicated” in human malignant mesothelioma cell lines in vitro without affecting non-malignant mesothelial cells.
Next, the researchers tried the same experiment in live subjects. When the replication-competent retrovirus was injected into the tumors of mesothelioma-infected mice, it showed “robust spread” and “efficient transmission” of the prodrug activator gene throughout entire tumor masses. The infected tumors were then treated with an anti-fungal drug called 5-fluorocytosine, which interferes with the building of certain essential proteins.
In a recent report of their findings in the journal Cancer Gene Therapy, the researchers say the process resulted in “significant inhibition” of tumor growth and “significantly prolonged survival” in mice with peritoneal mesothelioma. They write, “These data indicate the potential utility of RCR vector-mediated prodrug activator therapy in the treatment of malignant mesothelioma.”
Gene therapy is a promising new area of research for mesothelioma, a rare but incurable disease that is caused by exposure to the mineral asbestos. Its fast growth, drug resistance, and irregular tumor shape tend to make mesothelioma difficult to treat with conventional therapies.
Sources:
Kawasaki, Y et al, “Replication-competent retrovius vector-mediated prodrug activator gene therapy in experimental models of human malignant mesothelioma”, June 10, 2011, Cancer Gene Therapy, Epub ahead of print. Hiraoka, K, “Therapeutic efficacy of replicaion-competent retrovirus vctor-mediated suicide gene therapy in a multifocal colorectal cancer metastasis model”, June 1, 2007, Cancer Research, pp. 5345-53.
Catherine Cook wasn’t there two months ago to see the loveliest wedding ever hosted at the Southern Oaks Plantation in New Orleans.
She wasn’t there to see her oldest daughter glowing, to see her walk down the aisle in that beautiful dress, to hear the heart-felt wedding vows. She wasn’t there to help Rebecca prepare for the big day like mothers do.
No, she missed all that. Catherine Cook wasn’t there for what would have been the happiest day in both of their lives.
Yet she was very much there – in spirit.
Catherine died in 2010 at age 56, poisoned by deadly asbestos fibers, becoming yet another innocent victim of mesothelioma, the cancer that shouldn’t be.
Rebecca, though, made sure her mother’s memory was present on her wedding day.
Every member of the wedding party – even the cute little ring bearer – and every guest in attendance was wearing a Mesothelioma Awareness wristband. There were 250 people in attendance. And 250 wristbands.
“My mother was like my best friend. We used to double date sometimes, her and my stepfather, me and my fiancé. I know she would have loved the wedding,” Rebecca said recently from her home in nearby Marrero, Louisiana. “We wanted everyone to be aware of what this terrible disease does, and how senseless it is.”
Raising Awareness for Mesothelioma
Rebecca has made it her goal to raise awareness and understanding of mesothelioma, a disease she knew nothing about before Catherine was diagnosed. As her mother battled mesothelioma, Rebecca scrambled for answers she never could find.
“It still amazes me how little people know about mesothelioma. When people ask me about my wristband, I’m happy to explain. Some of my friends still wear their bands,” she said. “Even my mom, when she knew she was dying, she’d say, `I wish I had gotten breast cancer instead. At least then, people would understand what I have.’ ”
Catherine was the picture of health not long before she was first diagnosed. She was active. She worked out regularly. She was on vacation, hiking with her husband on the trails of the Smoky Mountains in Tennessee when she suddenly was stopped by a shortness of breath. She was exhausted and puzzled.
After being misdiagnosed at least twice, she was told she had mesothelioma in March of 2009. It was attacking her lungs, and it had already spread.
The family didn’t wait, taking her to the country’s best doctors and hospitals looking for help and for hope, traveling first to Texas, then to Boston, but to no avail. Catherine died in less than a year.
“It’s such a terrible thing to watch someone go through this. I saw what my mom went through, and it was like watching someone drown, like she was slowly suffocating,” Rebecca said. “It just seemed like compared to most diseases, the doctors didn’t have any real answers.”
Second-hand Asbestos Exposure
Every year U.S. doctors diagnose 2,000 to 3,000 people with mesothelioma. Few doctors specialize in treating it. Finding one of them is imperative, as is catching the disease in an early stage.
Mesothelioma is almost always caused by an exposure to asbestos, a natural mineral that is used in a myriad of products. The havoc it causes within the body can sit dormant for 30 to 50 years.
Catherine Cook’s exposure to asbestos likely came decades ago and from a place she rarely went – a factory that produced insulation materials not far from where she lived. She never worked there, but her father once did and her first husband did, too. She would wash her husband’s clothes every day, unknowingly inhaling the deadly fibers.
“At first when my mom was sick, people would say, ‘I didn’t’ know your mother smoked.’ But she didn’t smoke. She never smoked. She never drank. She lived a healthy life. She didn’t bring this upon herself,” Rebecca said. “It’s really scary to think they still are producing products with asbestos when they knew long ago, it was killing people.”
Daily Reminders of Mesothelioma
Rebecca now drives to work every day in New Orleans to an older office building that likely has asbestos in its walls, floors and ceiling. She passes a least one billboard that mentions mesothelioma as a killer. There are other families in the area that have been rocked by the same diagnosis. She doesn’t need the reminder. She still feels a need to help others cope.
“In a perfect world, I’d like to become this amazing scientist and find a cure for mesothelioma, or at least find a way to test people early, to stop it from reaching the stage where there is nothing you can do,” Rebecca said. “What I’d like someday is to have kids of my own and, start a non-profit organization to raise money for research to find a cure.”
Before her wedding, Rebecca and her husband-to-be asked guests that instead of gifts for the new couple, to find a charity that helps fund mesothelioma research. What they found, though, were very few that used the money exclusively for this particular cancer, which is considered rare by comparison to others.
“I’d spend my whole life raising money for this cause if it could spare one family from having to go through what my mother went through,” Rebecca said. “She was the best mother anyone could ask for, but near the end, she couldn’t walk five feet without needing oxygen. I just feel the need to do something about this disease. She would want me to help find a cure.”
Asbestos causes cancer. That was again the official word from a congressionally mandated study of cancer-causing substances released this month, New York mesothelioma attorney Joseph W. Belluck said today.
The 12th edition of the U.S. Department of Health and Human Services’ Report on Carcinogens found “asbestos and all commercial forms of asbestos are known to be human carcinogens based on sufficient evidence of carcinogenicity from studies in humans.”
“Asbestos has been listed as cancer-causing in every Report on Carcinogens since the first report was released in 1980,” said Belluck, the New York asbestos lawsuits attorney. “Although it’s been clear for more than 30 years that asbestos causes mesothelioma and other cancers, many victims are just now finding out that they have asbestos-related cancer because the disease can hide for decades.”
The 12th Report on Carcinogens said that studies have found that asbestos causes both pleural (lung) and peritoneal (abdomen) mesothelioma, as well as cancer in the respiratory tract and other tissues. Exposure to asbestos can also increase the risk of lung cancer, studies show.
“These findings have been repeatedly peer-reviewed by medical scientists since the first Report on Carcinogens was issued three decades ago, and they have consistently reaffirmed that asbestos causes cancer,” said Belluck, a partner in the New York asbestos exposure law firm of Belluck & Fox, LLP.
Some of the people most susceptible to asbestos exposure include those who work or worked in construction, shipyards, building demolition and automotive brake repair. Second-hand exposure is also a problem for the families of workers who could bring asbestos fibers home on their clothes and bodies. Veterans are another category of concern because the U.S. military used asbestos heavily from the 1940s until the 1970s.
Symptoms of mesothelioma — also called “asbestos cancer” — include:
A persistent cough, which could be dry or could include mucous or blood
Shortness of breath
Problems swallowing
Fatigue
Weight loss
Profuse sweating
Painful breathing or pain the chest or ribs.
Belluck urged people to seek medical treatment promptly if they believe they have signs of mesothelioma. He also stressed that symptoms usually do not appear for 10 to 50 years after exposure to asbestos.
“It’s also important for victims of asbestos-related diseases like mesothelioma to know that they have legal rights and can pursue an asbestos exposure lawsuit against the company or agency that exposed them to this toxic substance,” Belluck said.
He advised victims of mesothelioma and other asbestos-related diseases to seek out a qualified asbestos exposure lawyer who has experience handling asbestos claims.
About Belluck & Fox, LLP
Belluck & Fox, LLP is a nationally recognized law firm that represents individuals with asbestos and mesothelioma claims as well as victims of crime, medical malpractice, motorcycle crashes, exposure to lead paint and other serious injuries. The firm provides personalized and professional representation and has won nearly $350 million in compensation for clients and their families.
Partner Joseph W. Belluck is AV-rated by Martindale-Hubbell and is listed in New York Magazine's Best Lawyers in the New York Area and in Super Lawyers. Belluck has won numerous cases involving injuries from asbestos defective medical products tobacco and lead paint, including a recent asbestos case that settled for more than $12 million.
Partner Jordan Fox is a well-known asbestos and mesothelioma attorney who has been named to the Best Lawyers in America, New York Magazine's Best Lawyers in the New York Area and to Super Lawyers. On two separate occasions his verdicts were featured as the National Law Journal' s Largest Verdict of the Year.
In September, Belluck & Fox, LLP won a coveted spot on a list of America's best law firms, which was published jointly by U.S News World Report and Best Lawyers magazine. The listing showcased 8,782 different law firms ranked in one or more of 81 major practice areas.
At the Annual American Society of Clinical Oncology meeting, held from June 4– 8 in Chicago, Illinois, Pfizer prevented its primary results from a clinical trial of their new, oral cancer drug crizotinib. Used as treatment for non-small cell lung cancer (NSCLC), crizotinib is doubling the survival rate of other drugs. The treatment only targets tumors with the anaplastic lymphoma kinase (ALK) genetic marker, which makes up only 3% to 5% of NSCLC cases. However, there may be a chance that the ALK marker could be found in pleural mesothelioma tumors.
Mesothelioma is a rare cancer that affects the lining of the body’s major organs and cavities, with the most common type, pleural, affecting specifically the lungs. It is caused almost exclusively by prolonged asbestos exposure and there is no known cure. The difference between lung cancer and malignant mesothelioma is that lung cancer consists of individual tumors with clear boundaries, while mesothelioma is a diffuse malignancy that blurs the boundaries between malignant and healthy tissue.
The recently revealed crizotinib results report that 74% of patients with advanced NSCLC treated with the drug were still alive after one year and 54% after two years. Typically, less than 20% of NSCLC patients survive past two years. The numbers decrease with mesothelioma, as the average life expectancy is between six and 18 months with treatment.
The fact that crizotinib is an ALK-inhibitor and showing successful results is contributing to the belief that focusing on personalized treatment targeted to a patient’s characteristics optimizes the potential for effective treatment and survival.
A new Mesothelioma website has been launched to help mesothelioma patients know if they can file a mesothelioma lawsuit. By visiting this website, victims will be able to learn more about their legal rights and get their mesothelioma case reviewed by legal experts.
People who have been diagnosed with Mesothelioma can find legal help through a Mesothelioma lawyer.Mesothelioma is a type of cancer commonly provoked by exposure to asbestos. As this disease is quite rare, it’s not that easy to find useful information about it. What patients should know is that the doctors consider Mesothelioma as being one of the most life threatening and painful cancer types.
As the number of patients increases every year, Jay Fleischman, the creator of Mesothelioma Lawyer News, http://mesotheliomalawyernews.com, decided to help people who suffer from this terrible condition to receive the compensation they deserve. “This compensation can actually help people to treat themselves. The treatments are quite expensive for this type of cancer and the right compensation can actually help them to cover for all the medical expenses and support their family”, says the website’s owner.
The first thing you will notice about this website is that it provides the possibility of finding out if one is entitled to receive any compensation. By simply filling out an online form, patients can find out if they are eligible for compensation. Once the form is submitted, the patient’s case is evaluated within 24 hours by legal experts. If the patient meets the eligibility criteria, a Mesothelioma lawyer will contact him to stabilize the details of the lawsuit. This way, victims are able to prepare themselves to file a Mesothelioma lawsuit with the help of a knowledgeable lawyer. A mesothelioma lawyer can provide precise information about the limitations over the condition. As well, he or she knows how to use exposure to toxic asbestos to obtain Mesothelioma compensation.
MesotheliomaLawyerNews.com proudly offers mesothelioma patients the opportunity to get their case evaluated by knowledgeable Mesothelioma lawyers.Finding a good lawyer is really important for this kind of cases since you can be sure that the ones responsible for the exposure to toxic asbestos will do all they can to give the smallest compensation or any at all. Moreover, victims should also keep in mind that if they want to get compensated, then they need to file as soon as possible because of the statutes of limitations.
Hiring a Mesothelioma lawyer is maybe the best thing victims can do. However, before hoping for the best, they need to make sure that they are eligible for compensation. They can use MesotheliomaLawyerNews.com to find out about this. It is true that no amount can compensate one’s health. However, compensation might help victims cover for all the medical expenses, secure the future of their family, and highlight the devastating effects of asbestos poisoning.
Mesothelioma is a rare, aggressive cancer in the lining of the lung and abdomen.
asbestos
Asbestos was often used at the Pearl Harbor Naval Shipyard
KAKAAKO (HawaiiNewsNow) - Some of the world's leading research on mesothelioma cancer is happening right here at the University of Hawaii Cancer Center. The center recently received the second largest donation ever - specifically dedicated to finding ways to prevent and treat the disease.
UH researchers have made a series of scientific breakthroughs in mesothelioma, and now, they're getting a bigger shot in the arm - a gift of three and a half million dollars from an anonymous, mainland donor. The center is becoming one of the leading facilities for mesothelioma studies.
"Hawaii is in the center of the world because it's the bridge between Asia and the United States, so it's the perfect place if you want to run a big research team that involves research from different parts of the world," says Dr. Michele Carbone, the cancer center's director.
Mesothelioma is a rare, aggressive cancer in the lining of the lung and abdomen. Most of the time, it's caused by asbestos - a mineral fiber - that we inhale. Dr. Carbone says Hawaii has some of the higher rates of asbestos in the country, in large part because of materials once used at the Pearl Harbor shipyard. The disease develops after prolonged exposure and inhalation, but it's a longshot.
"Among people who are very heavily exposed, like asbestos miners, 4.6% of those who work in an asbestos mine for many years will develop mesothelioma," explains Carbone.
Because it takes decades to develop, doctors usually discover the disease in older patients between ages 60 and 80. The median survival time after diagnosis is 12 months.
Some in Hawaii who've developed the disease have sued. We've all seen those TV commercials saying, "If you or a loved one has been diagnosed with mesothelioma, you may be entitled to financial compensation. It's become a big moneymaker, according to Carbone. "Billions of dollars exchange hands every year around mesothelioma litigation."
Researchers hope continued discoveries - and generous donors - can help prevent and treat the disease before the cases ever have to head to court.
Copyright 2011 Hawaii News Now. All rights reserved.
Attorneys for Merlin Olsen's widow dropped NBC as a defendant in a lawsuit stemming from the former Los Angeles Ram great's death of asbestos-related cancer, court papers show.
A year-long investigation revealed that the network, which employed Olsen, was not responsible for exposing him to asbestos, said Denyse Clancy, Susan Olsen's attorney.
The Hall of Fame football legend, sports commentator and actor was diagnosed with mesothelioma, a cancer caused by exposure to asbestos. He sued NBC and numerous other defendants in Los Angeles Superior Court in December 2009, and his wife became the lead plaintiff after his death in March 2010 at age 69.
Olsen's cancer was caused from a significant cumulative lifetime exposure to many asbestos products, including heavy equipment parts, construction materials used on Hollywood television sets and numerous other consumer and construction products, his widow's lawyers allege.
"`Merlin's instructions were simple: make a difference for other asbestos victims with this lawsuit," said another of Susan Olsen's lawyers, John Langdoc.
"Unlike our findings regarding NBC, we've uncovered that a number of companies -- many of which are household names -- were directly responsible for exposing Merlin and others to asbestos; and even worse, it is becoming clear that many of the companies knew some people would get cancer, and just did nothing to stop exposing people by putting asbestos in their consumer products," he said.
Olsen was selected to the NFL Pro Bowl an unprecedented 14 times and was voted into both the College and Pro Football Halls of Fame.
The Mesothelioma Victims Center says, “Having gone through mesothelioma with a close family member, who was a US Navy Veteran, we understand how devastating a mesothelioma diagnosis can be; we were devastated, too. We had to start from scratch, not knowing anything about mesothelioma. As we have built our mesothelioma victims advocacy initiative over the years, we have dramatically expanded the number of free services we offer a victim or a family dealing with a mesothelioma diagnosis. If you call us, we will provide free services or advice no one else does. No one ever has to start from scratch again, when it comes to mesothelioma.” The group says, “We think our most unique service right now is a mesothelioma cancer treatment options report. This report starts with local mesothelioma treatment options, starting with the best local doctors, hospitals in the specific area of a mesothelioma victim, and then it expands to include the best instate mesothelioma treatment options, regional mesothelioma treatment options, and then nationally. Each report includes all of the doctors’ names, their specific contacts, or any additional information we think the family needs to know. No other group in the nation has ever offered anything close to this. In addition we also will provide an individual diagnosed with mesothelioma the names of the most skilled, and passionate mesothelioma lawyers in the nation, along with their specific contacts. No other group does this either.” Individuals, US Navy Veterans, or family members dealing with a mesothelioma diagnosis can always call the Mesothelioma Victims Center anytime at 866-714-6466. http://MesotheliomaVictimsCenter.Com
Aside from US Navy Veterans, other high risk groups for mesothelioma cancer include shipyard, power plant, or oil refinery workers, plumbers, electricians, county, or city municipal water district workers, miners, demolition construction contractors, railroad workers, or auto brake technicians. The Mesothelioma Victims Center says, “We are becoming increasingly worried about retired electricians, plumbers and especially city or county water works employees, and mesothelioma. If these individuals were working in the 1950′s, 1960′s, or 1970′s, they were probably exposed to enormous levels of asbestos on their job sites. City or county water works employees could have been exposed to asbestos pipes up until the early 1990′s.” They say, “One thing we really want families to understand is mesothelioma cancer does not typically show up until the Navy Veteran or US citizen is in their 60′s, and more often than not their 70′s, or 80′s. Frequently mesothelioma is diagnosed three, four, or even five decades after the exposure to asbestos.” http://MesotheliomaVictimsCenter.Com
In the ongoing worldwide quest for an easier and more accurate way to diagnose malignant mesothelioma, one of the nation’s top mesothelioma research teams claims to have found a ‘promising’ new method.
The blood test, developed by SomaLogic, Inc. and tested at New York’s Lagone Medical Center, detects the presence and quantity of 19 different proteins (biomarkers) that can be secreted by tumor cells in the early stages of mesothelioma.
In National Cancer Institute-funded studies on the new test, researchers used 90 blood samples from patients who had been diagnosed with mesothelioma, and 80 samples from people who had been exposed to asbestos but did not have a mesothelioma diagnosis. The SomaLogic test accurately detected 15 out of 19 cases of stage one or two malignant pleural mesothelioma among the samples. The test was found to pick up the disease with 80 percent accuracy and produced no false positive results.
Lead researcher Harvey Pass, director of the Division of Thoracic Surgery at Lagone, says the test’s level of early stage accuracy is significant because “the only patients that seem to benefit from therapy in mesothelioma are those that are found in stage 1, and this is only 10 to 15 percent of patients.”
Mesothelioma is a malignancy of the mesothelial tissue surrounding internal organs. It spreads quickly and is caused by past exposure to asbestos – sometimes as long as 50 earlier. A multimodality treatment approach, with surgery as its basis, has been found to offer the best outcomes for the 2,000-3,000 people who are diagnosed with mesothelioma each year. Dr. Pass says earlier detection may make it possible for patients to have less radical surgery to control the cancer, giving them more treatment options even if the disease returns later.
The results of the testing on SomaLogic’s technique were presented at the 102nd Annual Meeting of the American Association for Cancer Research in Orlando.
Sources:
Pass, Harvey et al, “Detection of mesothelioma in asbestos exposed individuals with aptamer proteomic technology”, April 4, 2011, Presentation abstract, American Association for Cancer Research website, “NYU Cancer Institute experts present at the AACR 102nd Annual Meeting 2011”, April 6, 2011, e!Science News website.