Mesothelioma

Very Interesting...

2004-07-07T16:21:00.000-07:00

I thought this was pretty interesting when I found this out:
There is no law that says asbestos has to be removed. It is only when the material can no longer be maintained in good condition and/or the airborne concentrations of asbestos are measured to be too high, or when the building is to be demolished or renovated, that removal may become the only option.

Asbestos Hazards

2004-07-07T16:20:00.000-07:00

Asbestos is not always an immediate hazard. In fact, if asbestos can be maintained in good condition, it is recommended that it be left alone and periodic surveillance performed to monitor it’s condition. It’s only when asbestos containing materials are disturbed or the materials become damaged that it becomes a hazard. When the materials become damaged, the fibers separate and may then become airborne. In the asbestos industry, the term ‘friable’ is used to describe asbestos that can be reduced to dust by hand pressure. ‘Non-friable’ means asbestos that is too hard to be reduced to dust by hand. Non-friable materials, such as transite siding and floor tiles are not regulated by the State provided it does not become friable. Machine grinding, sanding and dry-buffing are ways of causing non-friable materials to become friable.

Radiation Therapy for Mesothelioma

2004-07-07T16:18:00.001-07:00

Radiation therapy utilizes x-rays to kill cancerous cells. External beam radiation therapy uses radiation delivered from outside the body that is focused on the cancer. These treatments are much like an extended diagnostic x-ray. Brachytherapy involves radioactive material being placed directly into the chest or the abdomen at the site of the mesothelioma. Radiation therapy is sometimes used as the main treatment of mesothelioma in some patients, especially those whose general health is too poor to undergo surgery. Adjuvant radiation therapy can be used in addition to surgery to kill small deposits of cancer that cannot be seen and removed during surgery. Palliative radiation therapy can also be used to ease symptoms of mesothelioma such as shortness of breath, pain, bleeding, and difficulty swallowing.

Radiation therapy can have the side affects of fatigue and mild skin suburn like effects. Often these are temporary. Radiation may worsen the side effects of chemotherapy. Chest radiation therapy may cause lung damage and lead to difficulty breathing and shortness of breath. In the abdominal area, radiation therapy may cause nausea, diarrhea, and vomiting . If you are having any of these side effects of radiation therapy, contact your doctor for ways to control these side affects.

Mesothelioma Surgery Option

2004-07-07T16:18:00.000-07:00

Surgery for mesothelioma may be performed for one of two reasons: for palliation (to relieve pain and discomfort caused by the tumor), or to cure. Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to completely remove, or in cases where the patient is too ill to tolerate a more extensive operation. Curative surgery is offered when the patient is in otherwise good health and the tumor is thought to be localized and can be completely removed. Unfortunately, microscopic spread of cancer cells into the chest wall and diaphragm are common even when such spread cannot be detected by routine tests. Therefore, given the extent of these operations and their very limited success, the exact role of surgery in treating mesothelioma is often debated.

Article: ABB Seeking End to Asbestos Settlement

2004-07-07T16:05:00.000-07:00

ABB Ltd., the world's biggest maker of factory robots, today will seek to resolve opposition to its proposed $1.3 billion settlement of asbestos claims that once threatened the Swiss company with bankruptcy.
Click Here for more information...

Asbestos information from OSHA's Website

2004-07-07T15:49:00.000-07:00

Visiting OSHA's website, I've come accross a lot of pertinent mesothelioma information and resources that I've found to be very useful. It's definitely worth the look.

Mesothelioma: Lung Cancer

2004-07-07T15:45:00.001-07:00

Lung cancer, or bronchial carcinoma, occurs in several forms. The most common causes of lung cancer are smoking and asbestos. This web site has focused on the most lethal of the lung cancers-mesothelioma. Not every asbestos-related lung cancer, however, is a mesothelioma. Other thoracic carcinomas, such as adenocarcinoma, are also caused by exposure to asbestos.

The connection between asbestos exposure and lung cancer was noted as early as 1925, and confirmed over the next 70 years by many epidemiologic studies of asbestos-exposed workers. The four main types of commercially used asbestos, chrysotile, amosite, anthophyllite, and mixtures containing crocidolite, have all been associated with an increased risk of lung cancer. About one in seven people who suffer from asbestosis, a lung disease resulting from high exposure to asbestos, eventually develop lung cancer.

There is a relationship between cigarette smoking and asbestos exposure in causing lung cancer, such is that asbestos workers who smoke face a much higher risk than asbestos workers who do not. According to the National Cancer Institute, evidence suggests that asbestos-exposed workers who quit smoking can reduce their risk of developing lung cancer by 50% within five years of quitting.

What is Asbestos?

2004-07-07T15:45:00.000-07:00

Asbestos is the common name for any variety of silicate materials that are fibrous in structure and are more resistant to acid and fire than other materials. It has two forms, serpentine and amphibole, and is made of impure magnesium silicate. Asbestos is used for thermal insulation, fire proofing, electrical insulation, building materials, brake linings and has been used in numerous industries.

Serpentine and amphibole asbestos both exhibit physical and chemical resistance to high temperatures and applied force. The raw ore of both forms is made up of fibrous strands. The strands then continue to split into smaller and thinner fibers as disturbance continues and increases. Asbestos' ore form will initially divide into visible strands, fiber bundles, and individual fibers. But then those visible strands, bundles, and fibers will continue to split into microscopic fibers, bundles, and strands. The splitting can continue on to minute levels of microscopic levels of detection. This process is unique to asbestos and is why airborne asbestos is such a problem. The fibers can become so small that they remain airborne longer and pass undetected by the respiratory dust defenses.

Physical characteristics differentiate the serpentine and amphibole forms. Serpentines divide into curly, wavy fibers that show little resistance to being bent or spiraled. Amphibole fibers are needlelike shards that show great resistance to being bent or curled. Serpentines are like man-made wool in appearance, where amphiboles are like man-made fiberglass.

In addition to the two forms, there are three main types of asbestos: chrysotile, amosite, and crocidolite. Chrysotile asbestos is serpentine and amosite and crocidolite are amphibole. Chrysotile is the chief commercial asbestos today. Amosite is used in insulating materials and crocidolite is used for making asbestos-cement products.

Canada is a chief producer of asbestos, which has some of the largest asbestos mine fields in the world. Other producers are Russia, Zimbabwe, the Republic of South Africa, Cyprus, and the United States of America.

Asbestos is a potent carcinogen, that is, a cancer-causing substance, and is a serious health hazard. It is the known cause of pleural plaques, asbestosis, mesothelioma, and causes cancers of the lung, esophagus, and colon. Diseases caused by asbestos have a long latency period, usually taking ten to forty years before showing any symptoms of the disease. This is especially apparent today, when people who worked with installing asbestos as insulation and other materials in the 1970s are just now coming to realize that they are developing cancer at alarming rates.

Mesothelioma Breakthrough

2004-07-07T15:43:00.000-07:00

By Kylie Walker, AAP medical writer
December 17, 2003

NEW hope is on the horizon for the growing number of Australians with the deadly asbestos-caused cancer, mesothelioma.

Caused by the inhalation of asbestos fibres, mesothelioma has been incurable and almost always leads to death.

However, a promising new compound appears to kill the cells of both mesothelioma and another notoriously difficult to treat cancer, melanoma.

Together the lung and skin cancers claim hundreds of Australian lives every year, and federal government health experts predict about 10,000 more mesothelioma cases will be identified in Australia by 2020.

Professor Michael Millward and his team at Perth's Sir Charles Gairdner Hospital hope their research will lead to a new drug that will beat those cancers and others.

They have recently begun human trials of the compound, derived from the herbal medicine known as Devil's Weed.

"Currently, there are two patients and two more are starting shortly," Prof Millward said.

"We will be looking to treat about 18 to 25 patients between now and the second quarter of next year."

Animal and laboratory tests have shown extremely heartening results.

"We're talking about a reduction in tumour size in animals and outright killing of cells in the laboratory," Prof Millward said.

Most existing chemotherapy drugs trigger a self destruct mechanism in cancer cells, but mesothelioma and melanoma cells are largely immune to this kind of therapy.

The new compound works by unlocking a receptor on the cancer cell, invading the cell, then killing it – much like planting an explosive inside the cell.

However, Prof Millward warned cancer patients should not get too excited about the possible new treatment.

"After this phase we will then evaluate all the results and look at if the drug is safe and whether it may be beneficial, and if that's the case we will then go to trials for specific cancers," he said.

"If the next set confirms this is a promising treatment, then it will take several more years of large trials to know if it's going to be a marketable treatment for cancer."

In other cancer news, human trials are expected to start soon for a new drug that was found in animal studies to kill late-stage human prostate cancer cells.

Melbourne-based drug development company Cytopia said its new molecule halted the normal growth cycle of prostate cancer cells, eventually leading to cell death.

The company hoped to start testing the therapy on humans by mid-2004.

Choosing a Mesothelioma Lawyer

2004-07-07T15:40:00.001-07:00

A Mesothelioma Lawyer qualified to handle your case should definetly be considered as these are complex medical cases.

Many times mesothlioma lawyers who specialize in
these cases will be able to refer you to top treatment facilities, specialists and recommendations to help you find the proper care.

Mesothelioma is a rare form of cancer of either the lining covering the lungs as in pleural mesothelioma or the lining of the abdomen as in peritoneal mesothelioma.

Mesothlioma is virtually connected with asbestos exposure it's a rare but dangerous condition.

Tip: When choosing a Mesothelioma lawyer we suggest contacting at least 3 different attorneys specializing in Mesothelioma cases to get a broader scope and opinion before deciding who to represent you.

Mesothelioma Comepensation

2004-07-07T15:40:00.000-07:00

You are entitled to different types of compensation for the injuries you have suffered from Mesothelioma. These damages include lost income and future lost income, current and future medical expenses, compensation for your and your family’s pain and suffering, and, in some cases, punitive damages against the asbestos companies because of their conduct.

The amount of compensation for your mesothelioma injuries will depend on a number of factors, such as the extent of your exposure, the products you were exposed to, the dates and locations of your asbestos exposure, and the experience and resources of your mesothelioma lawyers. Although this amount varies significantly, the average mesothelioma case settles in the range of $750,000 to $2.5 million. See Verdicts and Settlements.

Mesothelioma Rights

2004-07-07T15:39:00.000-07:00

Asbestos is the only known cause of mesothelioma. As far back as the 1950s, most of the manufacturers of asbestos-containing products knew that their products were harmful to workers, including the risk of developing mesothelioma. Despite this knowledge, however, these companies did not warn workers of these dangers or take action to protect them.

In almost all cases, a person who has been diagnosed with mesothelioma has the right to recover compensation. The spouse of the person diagnosed also has a claim for injuries.

If a person diagnosed with mesothelioma has died, his wife, children or designated person from the will have the right to file a mesothelioma case against the asbestos manufacturers.

Mesothelioma Legal Assistance

2004-07-07T15:34:00.000-07:00

Mesothelioma lawsuits are divided into two categories - one, where the person suffering from mesothelioma is living (a personal injury case) and the second, where the person with mesothelioma has died (wrongful death case), and the plaintiff is a spouse, relative and/or representative of the deceased person's estate.

When the person who would normally be the plaintiff is deceased, an alternate individual (usually the spouse or a close relative) stands in as the plaintiff, and the injuries claimed include the loss of life itself. The most important part of a wrongful death case is locating persons who worked with the plaintiff to provide testimony that the deceased individual would have provided regarding work history and asbestos exposure.

If you or someone you love has recently been diagnosed with Mesothelioma, call our office today for a free confidential consultation no matter where you live. We will gladly help you understand the critical medical and legal issues surrounding mesothelioma diagnosis, treatment and financial recovery.

Because of the aggressive nature of mesothelioma it is important that the patient and his or her family move quickly to document the facts and circumstances particular to the individual’s exposure to asbestos. This includes gathering information on work history, the types and brands of asbestos products encountered in ones past as well as the different work locations where exposure may have occurred and names of co-workers.

We are able to assist in this research by providing access to asbestos documents, catalogs and advertisements (dating from 1940 to 1970). These resources and images are often crucial in jogging the memory and aiding in the proper identification of products.

Because we are able to work with local mesothelioma attorneys in any state. There is never a need to travel or inconvenience the mesothelioma patient and his or her family in any way.

When a mesothelioma patient hires our firm, a complete investigative procedure is immediately initiated and this documentation will speed this process along so that we may quickly determine the appropriate course of legal action. With most of our mesothelioma patients, a lawsuit must be filed immediately in order to obtain sworn statements of work history, evidence of exposure and product identification, and the client’s physical and mental condition.

If the diagnosed client is unable to come to our offices, depositions (interviews) may be conducted at their home, hospital or any other location which is comfortable and convenient to the client. If a deposition is not possible due to the progressed stage of the disease, other methods of obtaining the required proof of exposure and resultant illness will be pursued with the assistance of the client’s closest relatives.

Mesothelioma Law Firms

2004-07-07T14:44:00.000-07:00

There are many law firms out there that are willing and able to fight for your mesothelioma case.

Mesothelioma Litigation

2004-07-07T14:40:00.000-07:00

Mesothelioma litigation has increased during the second half of the 20th century as asbestos-exposed workers begin to show the underlying symptomology associated with mesothelioma cancer. In order to properly allocate liability and legal-financial responsibility for the ongoing mesothelioma cancer mortalities linked to asbestos exposure, trial attorneys are organizing class action lawsuits in order to represent victims' rights and interests.

Mesothelioma litigation reflects a cause of action undertaken by contingency law firm specialists on behalf of a large population segment that has been linked to asbestos exposure during their workplace environment. Individually, in order for you or your family member to qualify for inclusion within a mesothelioma litigation cause of action suit, you'll need to produce verifiable records evidencing your employment by the firm which goes to trial as defendant. Judicial due process rules also require that mesothelioma litigation evidence scientifically that you and the other victims have been exposed to asbestos and that pathology tests verify the presence of malignant mesothelioma.

Legal standards in a mesothelioma litigation cause of action are set at a high threshold for both plaintiff (victims' side) and defendant (company). In essence, the Court rules that the mesothelioma litigation plaintiff argument prevails if direct causality can be shown, linking verifiable evidence of asbestos contamination during the specific period when plaintiff was employed. With the spate of mesothelioma litigation over the past twenty years, many defendant companies have filed for Chapter 11 bankruptcy protections, their financial condition and vanishing insurer support rendering them cash-less and judgment proof in regards to collecting against a court judgment. A further complicating factor over-hanging mesothelioma litigations in America is the political lobbying in Washington DC which has caused Congress to weigh in to "cap" asbestos related class actions. In effect, mesothelioma litigation "over kill" has killed the "goose", and now little money is left to satisfy the compensatory damage claims ordered by the courts.

The pathway into mesothelioma litigation necessitates that you or your family member produce evidence of asbestos exposure, which could be minimal yet could have occurred 45 years ago. Many current mesothelioma cancer cases can be linked back to the US naval shipbuilding yards in World War II where over 4 million American men and women contributed to the war effort. As mesothelioma litigation court motions now set forth, workers handling piping and drywall materials were continuously exposed to asbestos, which was a significant insulating and protective covering bonded to pipes, wells, and certain dry wall insulating materials. Other mesothelioma litigation court documents have identified victims who were actually engaged in the asbestos extraction fields, dealing almost exclusively with asbestos each day. One additional plaintiff group has emerged in mesothelioma litigation, which includes those family members or other factory sites which experienced asbestos contamination due to "second hand" exposure where fibrous asbestos either migrated on wind currents between factories, or was brought into the home by Mom or Dad on work clothing, shoes, caps, hair and so on.

A planning consideration when participating in mesothelioma litigation procedures is to have your estate and financial affairs completely sorted out, so that any future jury-ordered award passes uninterruptedly to your heirs and assigns, according to law.

Risk of Mesothelioma

2004-07-07T11:57:00.000-07:00

The only cause that is known to cause Mesothelioma is past exposure to Asbestos. Workers were often not told that they were working around Asbestos. If the manufacturers revealed this secret, they would lose huge profits. Generally, anyone who has inhaled asbestos fibers is at risk of Mesothelioma.

Even the friends/family of a person who has had asbestos exposure are at risk. This is because Asbestos can often be carried on clothings.

Mesothelioma: Shark Cartilage and Cancer

2004-07-07T11:51:00.000-07:00

According to I. William Lane, author of "Sharks Don't Get Cancer" and a leading proponent of shark cartilage as an effective cancer treatment, ingestion of shark cartilage inhibits angiogenesis. In lay terms, what this means is that cartilage apparently reduces the creation of a network of blood vessels around a tumor, and therefore prevents it from growing or spreading.
A number of websites (including those owned by William Lane and his son, Andrew Lane) and health food stores sell shark cartilage pills and claim that they are effective cancer (and/or arthritis) therapies.

Potential consumers, however, should be aware that the effectiveness of shark cartilage has not been demonstrated scientifically. They should also know that although I. William Lane is popularly known as "Dr. Lane", he has a Ph.D. in agricultural biochemistry rather than a M.D. Also, he was a vice-president at W.R. Grace, which is an important defendant in many asbestos cancer lawsuits.

Potential consumers should also be aware that, in December 1999, the U.S. Department of Justice filed a lawsuit against Lane Labs-USA and Andrew Lane (its president and the son of I. William Lane) in the U.S District Court for the District of New Jersey. The FDA sought to stop them from marketing shark cartilage with claims that it is an effective cancer therapy.

Cartilage is a type of tissue found in the skeleton. Interestingly, the skeletons of sharks are almost entirely cartiliginous and, as far as we know, the cancer rate in sharks for certain types of tumors appears to be low. Shark and bovine cartilage, and possibly other types, contain angiogenic inhibitors - compounds that halt the creation of blood vessels. This combination of facts means that shark and other types of cartilage are of considerable interest to medical researchers.

However there is, at this time, no clinical evidence that swallowing powdered shark cartilage is an effective cancer treatment or that it inhibits angiogenesis. The cartilage is digested by the body's gastric system, rather than absorbed (with its antiangiogenic inhibitors) into the bloodstream.

Although there are several antiangiogenesis clinical trials in progress they are all in very early stages of testing. These drugs are not administered orally.

Before anyone with mesothelioma takes shark cartilage he/she should discuss this matter with his/her treating physician. There are a number of reasons to do this, including the need to ensure that he/she obtains only clinical-grade cartilage and the possibility of side-effects.

Mesothelioma: Unconventional Treatments

2004-07-07T11:43:00.000-07:00

A number of mesothelioma treatments are outside the mainstream of both established and experimental therapies. As lawyers, not doctors, we are not qualified to judge the value of such unconventional or unproven treatments. In our experience, most doctors disapprove of these treatments, and there is no clear, non-anecdotal evidence of the success of any of these treatments. However, we believe you have the right to all the information available so that you can discuss all possibilities with your physician and make an informed decision about your options.

Antineoplastons:

Dr. Stanislaw Burzynski has been working on antineoplastons as a treatment for cancer since 1967. Antineoplastons are naturally occurring peptides which Dr. Burzynski claims can "reprogram" cancerous cells to behave like "normal" cells again. The success of antineoplaston treatments has been highly controversial, however. The American Cancer Society reports that they have no reliable evidence of the objective benefits of antineoplastons. Dr. Burzynski was also charged in 1995 with fraud and violation of Federal Drug Administration regulations. The Burzynski Research Institute is currently conducting clinical trials of antineoplastons.

Mesothelioma: Angiogenesis Therapies

2004-07-07T11:42:00.000-07:00

Cancer cells, like other cells in the human body, rely for their growth on a rich supply of blood. They must be surrounded by an effective network of capillaries and larger blood vessels that nourish the cells. The medical term for the process of developing this network is angiogenesis.
In fact, fast-growing cancers are highly efficient at promoting angiogenesis. They produce angiogenesis promoters that create capillaries and a network of blood vessels around the tumor. The tumor is nourished with an increasing supply of oxygen-rich blood, and it grows and spreads (or metastasizes).

Understanding that angiogenesis is fundamental to the process of how tumors grow and metastasize, medical researchers started to investigate how they could slow down, stop, or reduce angiogenesis. If they could do this, they reckoned, they could starve the tumor to death - or at least slow its growth significantly. The National Cancer Institute has created an illustrated teaching tool to better understand how angiogenesis works.

A number of antiangiogenesis drugs, also called angiogenesis inhibitors or angiogenic inhibitors, have been developed. When administered to laboratory animals with tumors, they have caused the tumors to shrink or even disappear. Endostatin, combrestatin, angiostatin, thrombospondin, and vascular endothelial growth inhibitor (VEGI) are among these experimental drugs.

A few of these drugs are now being tested on humans. One of them, combrestatin, destroys the lining of blood vessels around tumors. Another, endostatin, acts by impeding the growth of new blood vessels around the tumors. For endostatin there have recently been some promising developments. Harvard's Dana-Farber Cancer Institute released an updated report on Phase 1 trials of the angiogenic inhibitor and says it exhibits virtually no toxicity even at high doses, while shrinking tumors in two of 28 advanced cancer patients and slowing disease progression in four others for more than six months.

This area of cancer research holds promise for the treatment of mesothelioma tumors, but it is very much in the early and experimental stages.

Mesothelioma: Immunotherapy & Gene Therapy

2004-07-07T11:40:00.000-07:00

Immunotherapy, also referred to as biological therapy, is based on the theory that it is possible to mobilize the body's own immune defenses against cancerous cells. Another name often applies to this therapy, biological response modifiers (BRMs), and is described in this article.
There are several new experimental treatments that try to enhance the immune system's ability to combat malignant mesothelioma. These include gene therapy and the use of cytokine proteins such as interferons and interleukins. These treatments are also being tested in combination with chemotherapy and other treatments.

Gene Therapy:

This a new treatment which is currently in clinical trials. Using an adenovirus for delivery, a "suicide gene" is inserted directly into the tumor. This gene makes the cells sensitive to a normally ineffective drug, such as glanciclovir. Treatment with the drug then destroys those cells that are rapidly dividing - which are the cancer cells - leaving the healthy cells unharmed.

In theory, this approach allows treatment to target the tumor specifically, as opposed to treatments such as chemotherapy which also kill healthy cells.

Gene therapy for mesothelioma is being researched at the University of Pennsylvania, with Dr. Steven Albenda as the principal investigator. This treatment is not without risk, as became apparent in the death of Jesse Gelsinger, a University of Pennsylvania gene therapy trial participant. (Note that Mr. Gelsinger was not a participant in the mesothelioma trial.)

Cytokines - Interferons (IFN) and Interleukins (IL):

Cytokines are small proteins that occur naturally in the human body. They are similar to hormones and have specific effects on the behavior of other cells.

In 1976 Dr. Robert Gallo (later head of the National Cancer Institute, and famous for his work on HIV) isolated a cytokine protein molecule called interleukin-2 (IL2) which is capable of stimulating the growth of immune system cells called T-cells. T-cells are sometimes called "killer cells" because they search out malignant or virally infected cells and kill them. Using IL2 as a treatment for pleural mesothelioma is still in the experimental stages, but researchers hope that injecting IL2 intrapleurally will promote a significant anti-tumor response.

Mesothelioma: Photodynamic Therapy

2004-07-07T11:37:00.000-07:00

This treatment uses light to kill cancerous cells.

Initially, the patient receives a photosensitizer which collects in cancerous cells but not in healthy cells. (A photosensitizer is a drug which makes cells vulnerable (sensitive) to light of specific wavelengths.) After the cells have been sensitized, fiberoptic cables are placed in the body (usually through open-chest surgery) in order to focus light of just the right frequency on the tumor. This causes the photosensitizer to produce a toxic oxygen molecule which kills the cell.

Although this treatment is still in a very experimental stage for the treatment of mesothelioma, it has shown promising results in the treatment of other cancers.

Mesothelioma: Drug Therapy

2004-07-07T11:36:00.000-07:00

Traditional Chemotherapy:

This traditional approach uses special anti-cancer (cytotoxic) medicines and chemicals to try to kill the malignant cells. Often, it is offered as an additional therapy alongside radical surgery and/or in combination with radiation therapy or immunotherapy, particularly when the cancer has spread beyond an operable area. Many drugs have been tried; however all have met with only limited success against malignant mesothelioma.

The chemotherapeutic agents can be administered either systemically (in the blood stream) or intrapleurally (in the pleural cavity itself.) These cytotoxic drugs are very potent and can have many severe side effects which you should discuss with your doctor.

Mesothelioma: Radiation Therapy (Radiotherapy)

2004-07-07T11:34:00.000-07:00

This treatment involves the localized use of high-dose radiation (like x-rays) on malignant tumors. Usually, it is not a primary treatment but is used in conjunction with other therapies such as surgical resection and chemotherapy. It is generally used to reduce the size of the symptomatic tumor and help relieve symptoms like pain and shortness of breath.

Factors which can limit the application of this treatment include the volume of the tumor and how near it is to vital organs

Mesothelioma: Surgery

2004-07-07T11:30:00.000-07:00

There are two main types of surgical treatment for pleural mesothelioma: extra-pleural pneumonectomy (EPP) and pleurectomy/decortication.
EPP involves the removal of the pleura, diaphragm, pericardium, and the whole lung involved with the tumor. Pleurectomy/decortication involves the removal of the pleura without removing the entire lung.

Which treatment is recommended depends on many factors, including the stage of the tumor. (The NCI has a detailed description of mesothelioma stages.) However, it is unclear if EPP provides significantly greater benefits than pleurectomy/decortication, and indeed if either is significantly more effective than non-surgical options.

A recent study followed about 400 mesothelioma patients who, between 1983 and 1998, had pleurectomy/decortication, or extra-pleural pneumonectomy (EPP), or thoracotomy. The results indicate that no one type of surgery was more effective than another in extending the survival rate. Rather, other factors seemed to determine how long people survived. These factors included the stage and cell type of the tumor, the gender of the patient, and the type of treatment(s) given together with the surgery. Click here for the text of this study.

Surgery can provide symptomatic relief and sometimes the bulk of the tumor can be removed. Surgery is often used in combination with other treatments (known as multi-modal treatments), but its value is very limited if the tumor is near any vital organs.

Both EPP and pleurectomy/decortication are complex surgeries, not performed frequently by most surgeons. They require referral to centers dedicated to such treatments. Many of these centers also specialize in other forms of mesothelioma treatment, either alone or in combination (multi-modal therapy.) You should discuss referrals with your doctor.

Multimodal Treatment of Mesothelioma

2004-07-07T11:28:00.000-07:00

Doctors specializing in mesothelioma treatment frequently adopt a multimodal approach: they treat a patient with a combination of therapies. Due to the relative lack of effectiveness of single-modality treatment in affecting patient survival, the multimodal combination of treatments holds more promise for survival of malignant mesothelioma patients. For an over view of single-mode and multimodal treatment regimens, see the abstract of "Treatment of Malignant Mesothelioma" by M.T. Jaklitsch, S.C. Grondin, and D.J. Sugarbaker and published in the World Journal of Surgery in 2001.
The December 1999 issue of the medical journal, Chest, published a clinical case presentation that illustrates a fairly typical multimodal treatment. The patient was a 52-year-old man with an early diagnosis of Stage I pleural mesothelioma. Doctors performed a pleurectomy (i.e. surgery) and then delivered intrapleural doses of chemotherapy drugs. Then he received additional localized radiation and chemotherapy. Two years after the surgery he did not show evidence of the tumor.

Computed Tomagraphy / CT Scan

2004-07-07T11:23:00.000-07:00

Computed tomagraphy, or spiral CT scan, is a special radiographic technique that produces a clear cross-sectional image that allows a radiologist to see distinct aspects of the lung or pleura that are not readily apparent from the standard X-ray image. Recent studies (CHEST 2002;122:15-20 and MAYO CLIN PROC 2002;77:329-333) support the use of annual chest computed tomography (CT scans) exams as a valuable screening tool for people with a high risk of developing lung cancer, including mesothelioma cancer. There does appear to be conflicting assessment as to the cost-effectiveness of CT screening. A 2003 study by Johns Hopkins raises this concern about the cost-effectiveness of CT scans and states, "There is a downside to this, including high costs and possible harm to individuals who may unnecessarily get invasive procedures if the scan detects a benign lung nodule." A more recent study in Chest, 2003:124:614-621 comes to a different conclusion: "A baseline low-dose CT scan for lung cancer screening is potentially highly cost-effective and compares favorably to the cost-effectiveness ratios of other screening programs."

Screening Methods to Identify Asbestos-Related Disease

2004-07-07T11:20:00.000-07:00

After a preliminary physical examination, the doctor may need to look inside your chest cavity with a thorascope; during this thoracoscopy procedure, a cut will be made in your chest and a small piece of tissue (biopsy) may removed for examination. While you may feel some pressure, there is usually no pain.

Another special tool that may be used is the peritoneoscope, which allows for examination inside your abdomen. This instrument is inserted into an opening made in the abdomen, and a biopsy specimen may also be taken.

If the presence of fluid is indicated by either of these procedures, the doctor may drain it by inserting a needle into the affected areaa. Removal of chest fluid is called thoracentesis; removal of abdominal fluid is call paracentesis.

Other screening methods to detect asbestos-related disease include various imaging tests. In addition to X-rays, methods include magnetic resonance imaging (MRI) or positron emission tomography (PET). A more recent and promising screening method is the computed tomography (CT) scan.

Early Signs of Malignant Mesothelioma

2004-07-07T11:17:00.000-07:00

Early symptoms of malignant mesothelioma may include difficulty in breathing (dyspnea) and/or chest pains, fever, nausea or anemia; other signals are hoarseness, difficulty swallowing (dysphagia), or coughing up blood (hemoptysis). For many suffering from pleural mesothelioma, there may be pain in the chest or lower back. Those people with peritoneal mesothelioma may experience an expanding waist size or abdominal pain resulting from the growth of cancer cells in the abdomen. Since many of these symptoms are also caused by less serious illnesses, it can be difficult to recognize asbestos-related diseases in the early stages. Due to this difficulty of early detection of asbestos cancer and mesothelioma, the best way to determine your health risk is to consult a doctor for an initial examination, which may include a pulmonary function test (PFT) and x-rays.

Other Mesotheliomas

2004-07-07T11:14:00.000-07:00

While the great majority of mesotheliomas are in either the pleura or the peritoneum, malignant mesotheliomas sometimes occur in other parts of the body, including the testicles (a variety of peritoneal mesothelioma) and the heart (a variety of pleural mesothelioma.) These are also caused by exposure to asbestos fibers. Benign mesotheliomas occur less frequently than malignant mesotheliomas. They are generally thought to be unrelated to asbestos exposure. Two thirds of benign mesotheliomas occur in females. (Kittle: Mesothelioma Diagnosis and Management, Year Book Medical Publishers, 1987)

Unfortunately, cystic benign mesotheliomas have a high incidence of local recurrence. (Katsube: Cystic Mesothelioma of the Peritoneum; Cancer 1982, 50:1615; Moore: Benign Cystic Mesothelioma; Cancer 1980, 45:2395) A July 1998 article by G.S. Letterie in the journal "Gynecology and Obstetrics" describes therapy with anti-estrogen tamoxifen as a non-surgical option for cases of symptomatic recurrent cystic mesotheliomas.

Mesothelioma Treatment: What You Can Do

2004-07-07T11:01:00.000-07:00

If you or someone you know has been diagnosed with mesothelioma, remember that time matters. The faster you consult your doctor and get professional care the better your chances will be of dealing with this dangerous cancer. There are three traditional methods of fighting cancerous mesothelioma: surgery, chemotherapy drugs and radiation therapy. Please contact your doctor as soon as possible to get more information.

Pleural Mesothelioma

2004-07-07T00:34:00.000-07:00

Pleural mesothelioma is of two kinds: (1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous.)
Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, however, are very serious. Fortunately, they are rare - about two thousand people are diagnosed with mesothelioma in the U.S. each year.

The remainder of this section is about diffuse malignant pleural mesothelioma.

Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.

Mesothelioma is sometimes diagnosed by coincidence, before there are any symptoms. For instance, tumors have been discovered through routine chest x-rays. However, when symptoms occur, they may include shortness of breath, weakness, weight loss, loss of appetite, chest pains, lower back pains, persistent coughing, difficulty in swallowing, alone or in combination. An initial medical examination often shows a pleural effusion, which means an accumulation of fluid in the pleural space - the area between the lungs and the chest wall.

The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan. This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.

The actual diagnosis usually requires obtaining a piece of tissue through a biopsy. This could be a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope.) If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube. This is a hospital procedure that requires anesthesia, but is not usually painful. The tissue sample is tested by a pathologist.

Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and much experience in understanding them.

The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.

The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.

Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.

There is as yet no known cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The Firm has represented many clients who lived for five to ten years after diagnosis, most of them in good health for a majority of those years. Some mesothelioma victims succumb within a few months; the average survival time is about a year.

The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously. Many people are treated with a combination of therapies, sometimes known as multimodal therapy.

Specific types of treatment include:

Chemotherapy and other drug-based therapies
Radiation therapy
Surgery and
Intra-operative photodynamic therapy.
There are also experimental treatments like gene therapy and immunotherapy, angiogenesis inhibitors, and clinical trials for various new treatments and combinations of treatments.

Treatments that reduce pain and improve lung function, are becoming more successful (although they cannot cure mesothelioma.) Pain control medications have become easier to administer. Debulking is a surgical process of removing a substantial part of the tumor and reducing the pleural thickening; this can provide significant relief. X-ray therapy has also been successfully used to control the tumor and the pain associated with it for a while.

Peritoneal Mesothelioma

2004-07-07T00:33:00.000-07:00

Many of the organs in the abdomen are enveloped by a thin membrane of mesothelial cells, known as the peritoneum.
Peritoneal mesothelioma is a tumor of this membrane. Its only known cause in the U.S. is previous exposure to asbestos, but it can be many years after exposure before the disease appears. Peritoneal mesotheliomas account for about one-fifth of all mesotheliomas.

Like pleural mesothelioma, peritoneal mesothelioma can be either benign or malignant. This discussion is only about malignant peritoneal mesothelioma.

Mesothelioma is sometimes diagnosed by coincidence, before any symptoms have appeared. For example, the tumor is sometimes seen on a routine abdominal x-ray for a check-up or before surgery.

When the symptoms of peritoneal mesothelioma appear, they typically include abdominal pains, weakness, weight loss, loss of appetite, nausea, and abdominal swelling. Fluid often accumulates in the peritoneal space, a condition known as ascites. Over time the wasting symptoms can become more and more severe.

The growing tumor can exert increasing pressure on the organs in the abdomen, leading to bowel obstruction and distention. If the tumor presses upward, it can impair breathing capacity. If the tumor pushes against areas with many nerve fibers, and the bowel distends, the amount of pain can increase.

X-rays and CT scans are, typically, the first step towards detecting peritoneal mesothelioma. The actual diagnosis is typically achieved by obtaining a piece of tissue. The medical procedure of looking at the peritoneum is known as a peritoneoscopy. It is a hospital procedure and requires anesthesia. If an abnormality is seen, the doctor will attempt to obtain a tissue sample - this is known as a biopsy. The tissue sample will be examined by a pathologist who makes a diagnosis using microscopic analysis of specialized stains.

There are at least two explanations for how asbestos fibers can get into the peritoneum. The first is that fibers caught by the mucus of the trachea and bronchi end up being swallowed. Some of them lodge in the intestinal tract and from there they can move through the intestinal wall into the peritoneum. The second explanation is that fibers that lodge in the lungs can move into the lymphatic system and be transported to the peritoneum.

Medical science does not know exactly how or why, at a cellular level, a carcinogen like asbestos causes a cell to become malignant (cancerous.) Thus it is not known whether only one fiber can cause a tumor to develop or whether it takes many fibers, or what the exact conditions and predispositions are for this change to happen.

At this time there are treatments, but no known cure, for peritoneal mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, its extent, the cell type, and whether or not the tumor responds to treatment.

However, the options for relief and treatment of people with peritoneal mesothelioma have improved, especially for those whose cancer is diagnosed early and treated vigorously. Many people receive a combination of therapies, sometimes known as multimodal therapy. Specific types of treatment include:

Mesothelioma Causes

2004-07-06T22:44:00.000-07:00

Exposure to asbestos fibers causes mesothelioma cancer. Mesothelioma can result A potentially dangerous exposure can result from very small fibers or dust particles at low exposure levels. Most such exposure would likely have occurred prior to the 1980s, but the latency period can be up to 40 years for most lung cancer to develop.

Many people have come into contact with asbestos fibers via their jobs, or occupational exposure. There is also a risk to the family members of those working in at-risk occupations; this exposure is called paraoccupational exposure. Likewise, people who live near sites likely to have asbestos around the facility are also at risk: refineries, power plants, factories, shipyards, steel mills and building demolition are types of work sites that can release asbestos fibers into the environment and contaminate nearby residential neighborhoods.

At Risk Job Locations:

-Asbestos product manufacturing (insulation, roofing, building, materials)
-Automotive repair (brakes & clutches)
-Construction/contractors
-Maritime
-Miners
-Offshore rust removals
-Oil refineries
-Power plants
-Railroads
-Sand or abrasive manufacturers
-Shipyards / ships / ship builders
-Steel mills
-Tile cutters

At Risk Occupations:

-Auto Mechanics
-Boiler makers
-Bricklayers
-Building Inspectors
-Carpenters
-Drywallers
-Electricians
-Floor Coverings
-Furnace Workers
-Glazers
-Grinders
-Hod carriers
-Insulators
-Iron workers
-Laborers
-Longshoremen
-Maintenance workers
-Merchant marines
-Millwrights
-Operating Engineers
-Painters
-Plasterers
-Plumbers
-Roofers
-Sand blasters
-Sheet metal workers
-Steam fitters
-Tile setters
-Welders
-U.S. Navy veterans
-Welders

Many occupations have an increased risk for developing lung cancer. For example, asbestos insulation workers have 92 times the risk of developing of lung cancer, and smelter workers have 3-8 times the risk of developing lung cancer. The risk of lung cancer is also increased in people who work in the manufacturing of certain industrial gases, pharmaceuticals, soaps and detergents, paints, inorganic pigments, plastics, and synthetic rubber. The risk of developing lung cancer is related to the amount of exposure to the cancer-causing agent. For example, the risk of lung cancer in humans is proportional to the number of cigarettes smoked. The risk of developing lung cancer is 8-20 times greater in smokers compared to people who have never smoked. A smaller, but real risk exists for cigar and pipe smokers. Some cancer causing agents react together to significantly worsen the risk of developing cancer. The combined exposure to asbestos and tobacco smoke clearly multiplies the risk of developing lung cancer. The risk of lung cancer is greater for those living in urban areas. This risk is approximately 1.2 to 2.3 times that of people living in rural areas. There is also an increased risk of lung cancer in smokers whose close relatives have had lung cancer. Scarring in the lungs from previous infections or injury can be associated with and increased risk of cancer.

Mesothelioma Symptoms

2004-07-06T22:40:00.000-07:00

In its early stages, mesothelioma does not have many symptoms. When symptoms do develop, they are often caused by the cancer growing and pressing on a nerve or other body organ.

The symptoms of the 2 main types of mesothelioma are different.

Pleural Mesothelioma Symptoms are:

Pain in the lower back or the side of the chest
A persistent cough
Shortness of breath
A hoarse or husky voice
Losing more than 10% of your weight when not dieting
Sweating and fevers
Difficulty swallowing
Peritoneal Mesothelioma Symptoms are:

Pain in the abdomen (stomach)
Swelling in the abdomen
Feeling or being sick
Poor appetite
Losing more than 10% of your weight when not dieting
Diahrea or constipation
These symptoms are all more likely to be caused by some other illness, rather than by mesothelioma. But if you have these symptoms, see your doctor. This is particularly important if you have been exposed to asbestos in the past.

Mesothelioma

2004-07-06T13:03:00.000-07:00

Mesothelioma is a rare disease caused as a result of malignant cancerous cells lining the patient’s body cavities such as chest, abdominal region or the area surrounding the heart. It is typically associated with exposure to asbestos which has been documented in as many as 70-80% of all mesothelioma cases. This disease is very difficult to assess consistently due to the great variability in time before diagnosis and the rate of progression of malignant mesothelioma.

Even insignificant exposure to asbestos (commonly reported in such work environments as asbestos mills, mines, shipping yards, some older Navy ships or patients’ homes) is known to result in mesothelioma, which in many cases does not occur for decades after initial exposure to this cancer-causing substance. In the recent years as many as 2000-3000 cases of mesothelioma have been diagnosed per year. It is also known that family members of workers exposed to asbestos can contract this disease through exposure to the worker’s clothing. Smoking greatly increases the risk of contracting mesothelioma.

Some of the earliest symptoms of mesothelioma can often be mistaken for less serious illness and are commonly overlooked. Some patients do not show any signs of sickness in the early stages of development of the disease. Most commonly the symptoms include dyspnea, pleuritic pain, lasting cough, fatigue, and weight loss. However, these can not be easily attributed to mesothelioma unless the patient is examined by their health care provider and necessary tests are done, which may include CT scans, x-rays scans, or MRI. Surgery can be one of the treatment options; however, the recurrence rate of cancerous cells is high. It is very important that the disease is diagnosed and treated as early as possible.

This disease is not linked with patient’s race; however it is more common in men. Most cases of mesothelioma occur 30-45 years after initial exposure to asbestos. Once it develops, this cancer will continue to grow until it is treated.