MALIGNANT MESOTHELIOMA

Imagine a disease that lays eggs inside your lungs. These eggs do not produce discomfort or coughing, they don't cause outbreaks or rashes or anything of the sort. In fact these eggs don't do anything except sit in your lungs and germinate for 30 to 40 years. After this time you begin to have a slight cough, a fever, maybe some cold sweats. You write it off as the flu and continue as usual until it goes away. Three weeks later the flu is back in this time you're coughing up blood. You visit your doctor and hope he can prescribe something to take away this crazy flu. Your doctor runs in few tests and sends you home. A week later you're brought into his office and he lays the devastating news on you... you have mesothelioma cancer of the lungs.

This is the reality for roughly 2000 men and women residing in United States every year. These are people who oftentimes never smoked and have led healthy lives. The primary cause of mesothelioma cancer is linked to exposure to asbestos fibers which are breathed into the lungs or swallowed.  Mesothelioma is a horrible cancer.  It is very painful. There is no cure. Doctors measure life expectancy in months after diagnosis.

Asbestos is a material that comes from rock. When left in the ground, asbestos is safe. When asbestos is removed from the ground and incorporated into products it becomes extremely dangerous. Asbestos was used heavily for many years and hundreds of products. It was primarily used due to the fact that it is strong, resists fire and corrosion, and has very effective properties for insulation. In modern day, asbestos has many uses such as thermal pipe and boiler insulation, floor coverings, ceiling tiles, spray-applied fireproofing and soundproofing, roofing materials and pipe and metal sheeting. Due to the fact that asbestos was used in heavy construction in the industrial and building trades during the mid-1900s, most carriers of mesothelioma cancer are men who were working around asbestos during that time.

Mesothelioma is a cancer which afflicts our nation's heroes, people who built our country and who embody ideals of patriotism, hard work, and family.  They were exposed to asbestos while serving our nation in Navy ships and shipyards, building our homes and cities, working hard in our factories and industries to provide for their families, or washing their loved one's clothes at the end of a long work-day.

Asbestos is so deadly that there is no known safe level of exposure.  Even a tiny bit of fiber can cause disease.  Those at risk include everyone from U.S. Navy Veterans, workers in shipyards or demolition, break mechanics, roofers and cement masons, to workers' families and homeowners doing renovations.  Exposure to asbestos can cause a variety of cancers, with Mesothelioma being the deadliest.

ASBESTOS AND MESOTHELIOMA

Asbestos describes any of a group of minerals that can be fibrous, many of which are metamorphic and are hydrousmagnesiumsilicates. The name is derived for its historical use in lamp wicks; the resistance of asbestos to fire has long been exploited for a variety of purposes. Asbestos was used in fabrics such as Egyptian burial cloths and Charlemagne's tablecloth (which according to legend, he threw in a fire to clean). Asbestos occurs naturally in many forms; it is mined from metamorphic rocks.

When asbestos is used for its resistance to fire or heat, the fibers are often mixed with cement or woven into fabric or mats. Asbestos is used in brake shoes and gaskets for its heat resistance, and in the past was used on electric oven and hotplate wiring for its electrical insulation at elevated temperature, and in buildings for its flame-retardant and insulating properties, tensile strength, flexibility, and resistance to chemicals. The inhalation of some kinds of asbestos fibers, however, can cause a number of serious illnesses, including cancer. Many uses of asbestos are banned in many countries.

In 1989 the United States Environmental Protection Agency (EPA) passed the Asbestos Ban and Phase Out Rule which was subsequently overturned in the case of Corrosion Proof Fittings v. U.S. Environmental Protection Agency, 1991. This ruling leaves many consumer products that can still legally contain trace amounts of asbestos. For a clarification of products which legally contain asbestos visit the EPA's clarification statement. Depending on the type of Asbestos, the cancer can be worse. It also depends on the amount inhaled. This is a welding occupational hazard.

Uses

Historic Usage

Items made of asbestos were held in so great an esteem as to be of equal value with gold; none but emperors and kings had napkins made of it. Supposedly, Charlemagne had a tablecloth made of asbestos. Cleaning an asbestos cloth was simple- it was simply thrown into a fire. Some antiquaries have believed that ancients made shrouds of asbestos, wherein they burnt the bodies of their kings, in order to preserve only their ashes, and prevent their being mixed with those of wood, or other combustible materials commonly used in building funeral pyres.

Others assert that the ancients used asbestos to make perpetual wicks for sepulchral lamps. In more recent centuries, asbestos was indeed used for this purpose. Although asbestos causes skin to itch upon contact, ancient literature indicates that it was prescribed for diseases of the skin, and particularly for the itch. It is possible that they used the term asbestos for alumen plumosum, because the two terms have often been confused throughout history.

As early as 1898 the Chief Inspector of Factories of the United Kingdom reported to Parliament in his Annual Report about the "evil effects of asbestos dust". He reported the "sharp, glass like nature of the particles" when allowed to remain in the air in any quantity, "have been found to be injurious, as might have been expected" (Report of the Select Committee 1994). In 1906 a British Parliamentary Commission confirmed the first cases of asbestos deaths in factories in Britain and recommended better ventilation and other safety measures. In 1918 a US insurance company produced a study showing premature deaths in the asbestos industry in the United States. In 1926 the Massachusetts Industrial Accidents Board processed the first successful compensation claim by a sick asbestos worker. Many American injuries from asbestos exposure came from shipbuilders working during World War II.

Modern Usage

Asbestos linings were once used in automobile brake pads and shoes. Since the mid-1990s, a majority of brake linings, new or replacement, have been manufactured with Kevlar linings (the same material used in bulletproof vests).

Kent, the first filtered cigarette on the market, used crocidolite asbestos in its "Micronite" filter from 1952 to 1956.

Chrysotile is the form of asbestos that has been used commercially.  In the United States, chrysotile has been the most commonly used type of asbestos. Chrysotile is often present in a wide variety of materials, including but not limited to

• sheetrock taping
• mud and texture coats
• vinyl floor tiles, sheeting, adhesives and ceiling tiles
• plasters and stuccos
• roofing tars, felts, siding, and shingles
• "transite" panels, siding, countertops, and pipes
• acoustical ceilings
• fireproofing
• putty
• caulk
• gaskets
• brakepads and shoes
• clutchplates
• stage curtains
• fire blankets
• interior fire doors
• fireproof clothing for firefighters

Amosite and crocidolite were used in many products until the early 1980s. The use of all types of asbestos in the amphibole group was banned in the mid-1980s. These products were mainly

• Low density insulation board and ceiling tiles
• asbestos-cementsheets and pipes for construction, casing for water and electrical/telecommunication services
• thermal and chemical insulation (i.e., fire rated doors, limpet spray, lagging and gaskets)

Asbestos-Related Diseases

Diseases caused by asbestos exposure include:

• Asbestosis -- A lung disease first found in naval shipyard workers, asbestosis is a scarring of the lung tissue from an acid produced by the body's attempt to dissolve the fibers. The scarring may eventually become so severe that the lungs can no longer function. The latency period (the time it takes for the disease to develop) is often 10-40 years.
• Mesothelioma -- A cancer of the mesothelial lining of the lungs and the chest cavity, the peritoneum (abdominal cavity) or the pericardium (a sac surrounding the heart). It is believed that mesothelioma is caused by generation of reactive oxygen species (ROS) by the asbestos fibers.  Asbestos exposure is linked to at least 50% of patients developing malignant mesothelioma. Malignant mesothelioma has a peak incidence 35-45 years after asbestos exposure. Median survival for patients with malignant mesothelioma is 11 months. Asbestos has a synergistic effect with tobacco smoking in the causation of pleural mesothelioma.
• Cancer -- Lung Cancer has been linked to asbestos. Asbestos exposure alone can cause lung cancer, but asbestos exposure and tobacco smoking have a synergistic effect, greatly increasing the chances of contracting lung cancer. Cancer of the larynx has been linked to asbestos. Some studies suggest that asbestos exposure is linked to a slightly increased risk of stomach, pharyngeal, and colorectal cancer.

EWG Action Fund estimates that in the United States, about 9,900 people die each year of asbestos-related diseases, such as mesothelioma, asbestosis, lung cancer, and gastrointestinal cancer.

Other asbestos-related diseases

• Pleural Plaques -- discrete fibrous or partially calcified thickened area which can be seen on X-rays of individuals exposed to asbestos. They do not become malignant or cause other lung impairment.
• Diffuse Pleural Thickening -- similar to above and can sometimes be associated with asbestosis. Usually no symptoms shown but if extensive can cause lung impairment.
• Pulmonary Fibrosis -- many jobs - particularly those that involve mining or that expose workers to asbestos or metal dusts -- can cause pulmonary fibrosis. Workers doing these kinds of jobs may inhale small particles (like asbestos fibers) that can damage the lungs, especially the small airways and air sacs, and cause scarring (fibrosis).

Mesothelioma Overview

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products.

Risk Factors Associated With Mesothelioma

Although mesothelioma is a relatively rare cancer, reported incidence rates have increased in the past 20 years. Almost all people who develop mesothelioma have worked on jobs where they inhaled asbestos particles. In fact, a history of asbestos exposure at work is reported in about 70-80% of all cases. Usually, the risk of mesothelioma will increase with heavier and longer exposure to asbestos. Even low exposures to asbestos can lead to the development of malignant mesothelioma.

It is not uncommon for someone to develop this cancer after only a few weeks of exposure at a summer job decades earlier or from washing clothing worn by a worker exposed to asbestos on the job. There are even cases come reported in medical literature, of mesothelioma developing in people who simply lived near a site were asbestos products were used or manufactured.

Mesothelioma occurs more often in men than in women, and risk increases with age. Yet, mesothelioma may appear in either men or women at any age.

Who Is At Risk from Asbestos Exposure?

Asbestos has been mined and used commercially since the late 1800s. 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 U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, 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 does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

Exposure to asbestos fibers has been recognized as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.

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 fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct 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.

Health hazards from asbestos dust have been recognized in workers exposed in shipbuilding trades, Navy serviceman (including World War II veterans up through serviceman leaving the Navy in the 1970s), asbestos mining and milling, manufacturing of asbestos textiles and other asbestos products, insulation work in construction and building trades, brake repair, demolition workers, drywall movers, firefighters and a variety of other trades including: bricklayers, carpenters, cement finishers, construction workers, electricians, engineers, insulators, machinists, mechanics, sheet metal workers, pipe fitters, plumbers, roofers, steamfitters, welders, and even dentists. Other occupations exposed to asbestos include: power plant personnel, pipe fitters and steamfitters, building maintenance workers and superintendents.

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all 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.

Asbestos becomes harmful when an asbestos containing product breaks, cracks, or is otherwise disturbed. When this happens, asbestos fibers are released into the air, making it possible for infection to develop once these fibers are breathed in.  The problem with asbestos arises when the fibers become airborne and are inhaled. Because of the size of the fibers, the lungs cannot expel them.

Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking current cigarettes does not appear to increase the risk of mesothelioma.

While persons who work with products containing asbestos over a long period of time run the highest risk of Mesothelioma and other asbestos-related illness, occasional contact with high concentrations of asbestos fibers without the proper safety precautions can significantly increase the risk of ingesting asbestos in concentrations sufficient to cause severe health problems many years later.  For most people, these occasional risks of intensive asbestos exposure can occur during home remodeling and renovation projects.

Maybe you remodeled a house or engaged in construction or demolition during a summer job years ago.  If so, you probably punched out walls, floors, or ceilings containing asbestos fibers. Drywall, sheetrock spackling, joint compounds, floor tiles, and acoustic plaster all contained asbestos as a matter of routine through the late 1970s. Any demolition activities that generated dust in the course of dismantling and disposing of these materials in a structure built before 1980 almost certainly released asbestos into the air you were working in. This in turn could lead to severe illness and a diagnosis of Mesothelioma at any time more than ten years after the work was performed.

Persons working today on building remodeling projects are expected to comply with EPA guidelines intended to minimize the risk of asbestos ingestion through the demolition, cutting, or sanding of ceilings, walls, and floors. Older linoleum tiles and sheets used in flooring are especially dangerous to work with, because asbestos likely is contained in both the linoleum and the adhesive that attaches it to the bare floor.

Because of the fire resistance, insulating properties, and durability of asbestos, the substance was commonly used in many applications where heat or friction was a consideration in a moving part or production system. Brake shoes and clutch pads contained asbestos to prevent wear, and any auto mechanic who needed to grind down old brakes or clutches released a considerable volume of asbestos fiber into the air before the risks were widely understood.

In electrical power plants, the voltage transformers, transmission wire casings, and steam pipes were all heavily insulated with asbestos compounds, and the maintenance, trimming, and replacement of these components were a major source of airborne asbestos. Industrial boilers and steam heat systems often had a heavy external layer of asbestos insulation that would dry and crumble into dust over years. Any job that involved the maintenance or replacement of these components would necessarily generate the dispersion of asbestos particles into the air, frequently in a confined space.

Any worker who handled brakes, pipes, or transformers containing asbestos at any time from the 1930s to the 1980s is at risk of Mesothelioma. Most of the people exposed to the risk of this rare form of cancer will not develop Mesothelioma, but those who do in most cases will die within one year of diagnosis.

Because of the extraordinary risk that fire can present at sea, as well as the high temperatures generated by propulsion and heating systems, asbestos has been used to insulate boilers, steampipes, and hot water pipes that run throughout the length of the vessel. Shipyard workers who cut, trimmed, fitted, and repaired or dismantled these insulated assemblies have proved in later years to have suffered serious consequences to their health as a result of this exposure.  At Goldberg Law Offices, our lawyers represent Mesothelioma victims throughout the nation whose asbestos exposure might have occurred at shipyards, dry-docks, and navy bases anywhere in the United States.

We also represent mesothelioma victims whose asbestos exposure took place over years of work in chemical plants, oil refineries, power plants, mines, and manufacturing facilities of all kinds. Our ability to respond and investigate promptly can give your claim for compensation a distinct advantage.

Widely used in many building materials from floor tiles to insulation through the 1970s, asbestos fibers represent a highly dangerous human carcinogen when swallowed or inhaled. Materials containing asbestos in buildings are not usually dangerous unless the fibers are released into the air through sanding, cutting, trimming, or the deterioration of tape and wraps over many years. Under normal conditions, the persons most at risk of exposure to asbestos were not those who lived or worked in a contaminated building, but the workers who installed sheetrock, floor tile, asbestos cement, or ceiling panels that contain asbestos, or who removed such materials during a period of renovation or demolition.

Mesothelioma, or cancer of the lining of the lungs, heart, or abdomen, does not develop until ten to forty years or more after a period of exposure to asbestos fibers in dust or water. As a result, anyone who worked in construction or demolition at any time since the 1960s, when asbestos was still commonly used in building materials of many kinds, is likely to have handled asbestos and to have ingested it in the dust generated by construction or demolition activities. The demolition and disposal of old sheetrock, insulation, and insulated pipes years ago has proved to be an especially dangerous activity for renovation workers, because of the high likelihood of asbestos contamination during the removal of debris.

In the 1980s, many older schools underwent asbestos remediation programs, and the workers involved in asbestos removal were often contaminated because of insufficient protection against exposure. Although EPA guidelines address safety requirements for asbestos removal operations in considerable detail, many unscrupulous contractors would save money by using untrained and unskilled workers without protective clothing and equipment.

Although most cases of Mesothelioma can be traced back to workplace asbestos contamination on the job, it is also possible to have ingested the asbestos fibers that can cause cancer at home or at school.

There are many ways to ingest asbestos in a residential environment--release of asbestos fibers into the air through removing old house siding, drywall, sheetrock, insulated pipes, textured ceilings, or floor tiles; asbestos contamination in the water supply; or increasingly, contact with a family member whose job involved working with asbestos materials on a regular basis. Many recent cases of Mesothelioma and other diseases characteristic of asbestos exposure can be traced to washing work clothes, which would often involve shaking the dust out of the clothing before putting them in the washing machine.

Children also ingested asbestos fibers simply by playing with their fathers shortly after arriving home from a workday at a mine, a shipyard, or a power plant. The asbestos particles in the worker's hair or clothing could be and often were released into the indoor air for the entire family to breathe.

There are also documented cases of asbestos exposure of children at contaminated schools. Congress passed a law in 1986 that required every school to test for asbestos in its building and plan for the repair, removal, or containment of damaged materials containing asbestos that could be released for ingestion. Some of the teachers and children exposed to asbestos prior to the effective date of this legislation are only now being diagnosed with Mesothelioma. Others ingested asbestos afterward as the consequence of unsafe or ineffective steps taken to deal with school asbestos contamination.

Examples of common products that currently contain or formerly incorporated asbestos are: Roofing, siding, flooring, and tiles, drywall, sheetrock, drywall tape, and joint compound, wall insulation, spackling, sealing, acoustic tile, ceiling tile, and textured wall applications, brake shoes, brake shoe linings, clutch pads, and gaskets, electrical voltage transformers and electric wire casings, boilers, furnaces, water heaters, steampipes, and hot water pipes,asbestos cement, acoustic plaster, and adhesives,turbines, generators, and seals for pumps and valves, fireproof fabric, clothing, and theater curtains.

In most cases, it is not the asbestos product itself that presentsthe danger to a person working or living with it. It is the release of asbestos particles into the air when mixing, cutting, sanding, fitting, or removing a product that constitutes dangerous exposure. There are no safe levels of exposure to asbestos in any ingestible form.

Signs and Symptoms of Mesothelioma

Symptoms of mesothelioma are usually non-specific and may not appear until 10 to 40 years after someone is exposed to asbestos. When symptoms do finally appear, they may include shortness of breath and pain in the chest due to an accumulation of fluid in the membrane that surrounds the lungs and lining of the wall of the chest cavity. In addition, symptoms may include weight loss and abdominal pain and swelling, due to a build-up of fluid in the abdomen. In some cases, symptoms may even include bowel obstruction, blood clotting abnormalities, fever, night sweats and anemia. Malignant mesothelioma is almost always fatal and treatment options are limited. Survival is usually limited to 12 to 18 months from the time of diagnosis, sometimes substantially less. There are some people, however, usually relatively young and in good health before being stricken with this disease, who have achieved long-term survival.

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.

Mesothelioma that affects the pleura can cause these signs and symptoms:

• chest wall pain
• pleural effusion, or fluid surrounding the lung
• shortness of breath
• wheezing, hoarseness, or cough

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.

Diagnosis

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 cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a 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).

If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of 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.

If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening 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.

Screening

There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that 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.

Staging

Once the diagnosis is confirmed, the doctor may need to assess the stage to help plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

Epidemiology

Incidence

Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence is approximately one per 1,000,000. 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, there has been a three-fold increase in the diagnosis of pleural mesothelioma in caucasian males. From 1980 to the late 1990s, the rate of deaths from mesothelioma increased from 2,000 to 3,000 a year.

OHIO MESOTHELIOMA

In 1999, the state of Ohio had 131 mesothelioma related deaths. Ohio ranks 5 in the nation for mesothelioma cases. The mortality rate from mesothelioma is 14.7 per million, giving Ohio a crude mortality rank of 12 in the country. If you are living with mesothelioma or with someone who has it, you are not alone in your struggle. A mesothelioma lawyer can help you with medical bills to pay for aggressive life-extending treatment and compensate you for your pain and suffering. An asbestos attorney can help you force asbestos manufacturers who made you sick to reimburse you and your family. While the statistics can be discouraging, there is hope for people undergoing mesothelioma treatment. To get started with a mesothelioma lawsuit, call us toll-free, 1-888-MESO-INFO or send an email to steven@smglegal.com. Your case will be reviewed for free, with no obligation.

Malignant Mesothelioma Statistics:

OHIO:  Number of deaths, mortality rates (per million population), U.S. residents age 15 and over, 1999

West Virginia:  Number of deaths, mortality rates (permillion population),  U.S. residents age 15 and over, 1999

Pennsylvania:  Number of deaths, mortality rates (per million population),  U.S. residents age 15 and over, 1999

Michigan:  Number of deaths, mortality rates (per million population),  U.S. residents age 15 and over, 1999

Source: www.cdc.gov

Treatment

Malignant mesothelioma is an aggressive tumor that responds poorly to all medical and surgical therapies.  Treatment of malignant mesothelioma using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after diagnosis. The 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.

Malignant pleural mesothelioma (MPM) is a solid, locally aggressive tumor, which has been closely linked to asbestos exposure. The survival rate without treatment ranges from 4 to 12 months. Response to chemotherapy and radiation is poor, and surgery is the most effective therapy. There are currently 2000-3000 new MPM cases per year in the United States, with the peak incidence in the United States and Europe expected to occur in the year 2020. The prognosis depends on the stage of the tumor at the time of diagnosis, its histological type, lymph node status, and resection margins. While the diagnosis is often delayed, earlier intervention may improve life expectancy. Single-modality therapy has not been effective in changing the natural history of MPM. As a result, multimodality regimens involving surgery with radiation, chemotherapy, or immunotherapy have been initiated. Multiple modality approach has demonstrated favorable outcome, particularly in patients with epithelial histology, negative resection margins and presence of no metastases to extrapleural lymph nodes. Cisplatin and mitomycin have demonstrated modest efficacy in management of distant tumor recurrence. Cisplatin and gemcitabine regimen as well as cisplatin/pemetrexed followed by adjuvant hemithorax radiation have been reported to improve the outcome.

Surgery

Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing with a 5 year survival rate of less than 10%. 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. It is not possible to remove the entire mesothelium without killing the patient.

Radiation

Although the tumor is highly resistant to radiotherapy, these regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel.

Radiotherapy is commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.

Chemotherapy

In February 2004, the Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.

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.

Heated Intraoperative Intraperitoneal Chemotherapy

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.

Latest Research

The most important progress this year is in meso research and treatment. Mesothelin, a protein expressed by mesothelioma, is an inspiring example. In early 2007, the first ever biomarker for meso, MesoMark – a blood test based on mesothelin – received humanitarian FDA approval. It is now being used to measure response to chemotherapy, and to monitor for recurrence in successfully treated patients.

Research hospitals in Europe have successfully tested a new anticancer drug, “Vinflunine” (pronounced VIN-floo-neen). The October 20, 2007 issue of Journal of Clinical Oncology featured the news that Vinflunine has been shown to improve response and survival rates in patients diagnosed with malignant pleural mesothelioma .

Vinflunine was recently tested in Phase II clinical trials at hospital research centers in England and France. Dr. Talbot, from the Churchill Hospital in Oxford, and medical colleagues at seven European hospital centers, assessed the response rates of 67 patients who had not received prior chemotherapy or radiotherapy to determine the effectiveness of first-line Vinflunine treatment.

Doctors concluded that Vinflunine, when administered approximately every 21 days in high doses, improved patients’ response rates by 13.8 percent, and demonstrated such positive results that the drug therapy warrants further evaluation. In 2004, the Food and Drug Administration approved the first drug for this condition, “Alimta,” which, when used in combination with cisplatin, has helped patients extend their lives by several months, according to the FDA.

Prevention & Expectations

What can be done to prevent the disease? Since the 1970s, the Environmental Protection Agency and the Occupational Safety and Health Administration have regulated the asbestos industry in the U.S. In the past, asbestos was used as a fire retardant and an insulator. Other products are now used in its place. The controversy involving exposure to different forms of asbestos continues.

There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.

Removal is taking place in schools and other public buildings throughout the U.S. The hope is that these measures will greatly reduce the occurrence of this cancer.

Substitutes for asbestos in construction: Many companies that produced asbestos-cement products that were reinforced with asbestos fibres have developed products incorporating organic fibres. One such product was known as Eternit and another Everite now use Nutec fibres which consist of organic fibres, portland cement and silica.

What are the long-term effects of the disease? A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted example.

What are the risks to others? Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.

Asbestos In The Home

CPSC Document #453

This booklet will help you understand asbestos: what it is, its health effects, where it is in your home, and what to do about it.

Even if asbestos is in your home, this is usually NOT a serious problem. The mere presence of asbestos in a home or a building is not hazardous. The danger is that asbestos materials may become damaged over time. Damaged asbestos may release asbestos fibers and become a health hazard.

THE BEST THING TO DO WITH ASBESTOS MATERIAL IN GOOD CONDITION IS TO LEAVE IT ALONE! Disturbing it may create a health hazard where none existed before. Read this booklet before you have any asbestos material inspected, removed, or repaired.

Where Asbestos Hazards May Be Found In The Home

1. Some roofing and siding shingles are made of asbestos cement.
2. Houses built between 1930 and 1950 may have asbestos as insulation.
3. Asbestos may be present in textured paint and in patching compounds used on wall and ceiling joints. Their use was banned in 1977.
4. Artificial ashes and embers sold for use in gas-fired fireplaces may contain asbestos.
5. Older products such as stove-top pads may have some asbestos compounds.
6. Walls and floors around wood burning stoves may be protected with asbestos paper, millboard, or cement sheets.
7. Asbestos is found in some vinyl floor tiles and the backing on vinyl sheet flooring and adhesives.
8. Hot water and steam pipes in older houses may be coated with an asbestos material or covered with an asbestos blanket or tape.
9. Oil and coal furnaces and door gaskets may have asbestos insulation.

Where Can I Find Asbestos And When Can It Be A Problem?

Most products made today do not contain asbestos. Those few products made which still contain asbestos that could be inhaled are required to be labeled as such. However, until the 1970s, many types of building products and insulation materials used in homes contained asbestos. Common products that might have contained asbestos in the past, and conditions which may release fibers, include:

• STEAM PIPES, BOILERS, and FURNACE DUCTS insulated with an asbestos blanket or asbestos paper tape. These materials may release asbestos fibers if damaged, repaired, or removed improperly.
• RESILIENT FLOOR TILES (vinyl asbestos, asphalt, and rubber), the backing on VINYL SHEET FLOORING, and ADHESIVES used for installing floor tile. Sanding tiles can release fibers. So may scraping or sanding the backing of sheet flooring during removal.
• CEMENT SHEET, MILLBOARD, and PAPER used as insulation around furnaces and wood burning stoves. Repairing or removing appliances may release asbestos fibers. So may cutting, tearing, sanding, drilling, or sawing insulation.
• DOOR GASKETS in furnaces, wood stoves, and coal stoves. Worn seals can release asbestos fibers during use.
• SOUNDPROOFING OR DECORATIVE MATERIAL sprayed on walls and ceilings. Loose, crumbly, or water-damaged material may release fibers. So will sanding, drilling, or scraping the material.
• PATCHING AND JOINT COMPOUNDS for walls and ceilings, and TEXTURED PAINTS. Sanding, scraping, or drilling these surfaces may release asbestos.
• ASBESTOS CEMENT ROOFING, SHINGLES, and SIDING. These products are not likely to release asbestos fibers unless sawed, dilled, or cut.
• ARTIFICIAL ASHES AND EMBERS sold for use in gas-fired fireplaces. Also, other older household products such as FIREPROOF GLOVES, STOVE-TOP PADS, IRONING BOARD COVERS, and certain HAIRDRYERS.
• AUTOMOBILE BRAKE PADS AND LININGS, CLUTCH FACINGS, and GASKETS.

What Should Be Done About Asbestos In The Home?

If you think asbestos may be in your home, don't panic! Usually the best thing is to LEAVE asbestos material that is in good condition ALONE.

Generally, material in good condition will not release asbestos fibers. THERE IS NO DANGER unless fibers are released and inhaled into the lungs.

Check material regularly if you suspect it may contain asbestos. Don't touch it, but look for signs of wear or damage such as tears, abrasions, or water damage. Damaged material may release asbestos fibers. This is particularly true if you often disturb it by hitting, rubbing, or handling it, or if it is exposed to extreme vibration or air flow.

Sometimes, the best way to deal with slightly damaged material is to limit access to the area and not touch or disturb it. Discard damaged or worn asbestos gloves, stove-top pads, or ironing board covers. Check with local health, environmental, or other appropriate officials to find out proper handling and disposal procedures.

If asbestos material is more than slightly damaged, or if you are going to make changes in your home that might disturb it, repair or removal by a professional is needed. Before you have your house remodeled, find out whether asbestos materials are present.

 

Notable People with Mesothelioma

Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works 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, an American architect known for his cubist building designs, died in 1997.

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 sought alternative treatments from clinics in Mexico[citation needed]. He died of a heart attack on November 7, 1980 in Juárez, Mexico following cancer surgery. His disease was generally attributed to his having worked in a shipyard during World War II. At that time, shipyards used asbestos extensively and with few precautions.

United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.

After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments 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.

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 "The Median Isn't the Message," [6] for Discover magazine in which he argued that statistics such as median survival are just useful abstractions, not destiny. Gould lived for another twenty years eventually succumbing to metastatic adenocarcinoma of the lung, not mesothelioma.

Author Paul Kraus was diagnosed in June 1997 with peritoneal mesothelioma. He declined surgery, chemotherapy, and radiation, and later wrote about the various lifestyle changes and alternative modalities he has used to sucessfully manage his cancer.

Legal issues

Litigation

Asbestos litigation is the longest, most expensive mass tort in U.S. history, involving more than 6,000 defendants and 600,000 claimants. Current trends indicate that the rate at which people are diagnosed with the disease will likely increase through the next decade. Analysts have estimated that the total costs of asbestos litigation in the USA alone will eventually reach $200 billion. Due to the prevalence of asbestos, it is normally part of the scope of a Phase I Environmental Site Assessment to inspect for potential asbestos in a building which is being sold.

Many buildings contain asbestos, which was used in spray-applied flame retardant, thermal system insulation, and in a variety of other materials. Asbestos was sometimes "flocked" above false ceilings, inside technical ducts, and in many other small spaces where firefighters would have difficulty gaining access. Structural components like asbestos panels were also used. In residences, asbestos was often a component of a type of flocked acoustic ceiling called "popcorn ceiling", until its production was banned in the U.S. in 1978. However, the ban allowed installers to use up remaining stocks, so houses built as late as 1986 could still have asbestos in their acoustic ceilings. The only way to be sure is to remove a sample and have it tested by a competent laboratory.

Depending on how and where asbestos was applied, it might not pose any risk to most users of the building. If the fibers cannot become dislodged, they cannot be inhaled, and thus the asbestos poses no risk.

However, some methods of applying asbestos, particularly flocking, allow asbestos fibers to gradually drop off into the air. Asbestos poses hazards to maintenance personnel who have to drill holes in walls for installation of cables or pipes.

Even if the workers are protected, such maintenance operation may release fibers into the air, which may be inhaled by others. Interventions in areas where asbestos is present often have to follow stringent procedures. If removal is to be performed when users are still present in the building, it is usually necessary to relocate some users temporarily. Typically, the part of the building from which asbestos is being removed has to be sealed off in order to prevent contamination of the other areas. If the building is closed to normal users, it may be necessary to seal it off from outside atmosphere so that no accessible air is contaminated. An asbestos-containing building that is to be torn down may have to be sealed, and to have its asbestos safely removed before ordinary demolition can be performed. The asbestos removal may take longer and cost more than the actual demolition.

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 link 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, and government attempts at resolution of existing and future cases.

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. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite 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. 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.

Compensation For Asbestos Exposure Injuries --There Still May Be Time To Make A Claim

Many people who have suffered injuries from asbestos did not know of the health risks at the time of exposure. As a result, some states have enacted laws allowing people to file lawsuits for certain amount of time after the date when their asbestos-related illness was detected, rather than from the date of the exposure.

Many effects of toxic asbestos exposure are permanent and irreversible. Although the law seeks to place an injured person in a position he or she was in before injury, this usually is not possible for those suffering from malignant mesothelioma. Instead, economic compensation thought to be equivalent to the victims damage may be awarded. A plaintiff who can prove that he or she was exposed to asbestos may be able to recover for both the economic and non-economic consequences of that exposure, including:

• Cost of past and future medical care;
• Cost of necessary rehabilitation;
• Lost past and future wages;
• Lost earning capacity;
• Lost enjoyment of life;
• Emotional distress; and
• Past and future pain and suffering.

No matter how long ago your exposure to asbestos occurred, we can help you.

The fact that Mesothelioma is a relatively rare form of cancer is little consolation for those who have it. At Goldberg Law Offices, we have over 18 years of experience in helping victims of asbestos related cancers.  We are not afraid to go up against any responsible party for payment to you -- no matter how large, wealthy or powerful they may appear to be.  We are the law firm of choice in Ohio for representation for malignant mesothelioma cancer.  We know the products, the worksite, and the medicine -- everything necessary to obtain a successful result. If you are the victim of Mesothelioma or lung cancer related to asbestos exposure, or if someone in your family has been affected, financial assistance can be vital on you cope with the devastating effects of the asbestos-related cancer.  Wherever you live in the United States, we offer no-charge consultation and will be happy to travel to your home within 48 hours to discuss your potential claim.

The Goldberg Law Offices are committed representing individuals that have been harmed by asbestos exposure. All clients are represented on a contingency fee basis, rather than an hourly fee, and clients are not responsible for out-of-pocket expenses unless there is a recovery.

Dependent on where the case arises, our firm may partner with a prominent national law firm. This arrangement will not increase the percentage or amount of fees paid by our clients.  Our goal is to ensure that clients receive the most effective legal representation.

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