CA Jury Rules Plaintiff’s Mesothelioma Caused by J&J Talcum powder
March 20, 2019 - A California woman who says Johnson’s Baby Powder and other similar talc-containing products caused her to develop mesothelioma was recently awarded $29 million by a jury in Oakland. J&J says it will appeal the judgment. The 12 jurors found that J&J and onetime talc supplier Cyprus Mines Corp. were both at fault and responsible for plaintiff’s injuries.
The jury determined that Plaintiff Teresa E. Leavitt’s development of mesothelioma was in large part the result of her use of Johnson’s Baby Powder and other similar talc-containing cosmetic products. The 12 jurors found that J&J and onetime talc supplier Cyprus Mines Corp. were both at fault and responsible for plaintiff’s injuries.
J&J was deemed to be 78% liable for Leavitt’s injuries, J&J Consumer Inc. 20% liable, and Cyprus Mines 2%.
The award included:
- $291,000 to Leavitt for past medical expenses
- $1 million for future medical
- $1.2 million for loss of earnings
- $7 million for past physical pain and mental suffering
- $15 million for future physical pain and mental suffering
- $2 million to her partner, Dean McElroy, for past loss of love and companionship
- $3 million for future loss of love and companionship.
Wednesday's verdict is another win for the plaintiffs’ bar in the wave of suits against J&J over its talcum powder, after the pharmaceutical and consumer products giant had recently racked up several favorable results.
Last October and November, J&J convinced juries in New Jersey and California that it wasn’t to blame for 2 women’s mesothelioma.
The case is: Leavitt v. Johnson & Johnson, case number RG17882401, in the Superior Court of the State of California, County of Alameda.
J&J Forced to Pay $80 Million in Talc Mesothelioma Lawsuit
April 12, 2018 - A New Jersey jury on Wednesday ordered Johnson & Johnson and its talc supplier, Imerys S.A., to pay $80 million in punitive damages after ruling that the companies were negligent in selling asbestos-containing talcum powder that led to the plaintiff’s development of mesothelioma.
Less than 1 week after the same New Jersey jury slammed J&J and Imerys with a $37 million verdict in compensatory damages, they found that an additional $80 million in punitive damages were called for because the companies acted in reckless disregard of the rights of plaintiff Stephen Lanzo III and his wife.
The jury awarded $55 million in punitive damages against J&J and $25 million against Imerys, according to Law360. Lawyers for the plaintiff demanded jurors send a clear message that selling baby powder and other cosmetic products which contain asbestos is wrong and will not be tolerated.
The jury heard the message loud and clear, in what goes down as the first ever decision in favor of a plaintiff alleging cancer from a talcum powder product. Many feel the ruling will turn the tide in favor of more plaintiffs in these cases. J&J still faces approximately 5,500 lawsuits over its Johnson’s Baby Powder and Shower-to-Shower.
A Brief History of Mesothelioma
In this day and age, occupational health and safety standards are an essential component within any legitimate manufacturing environment, though this has not always been the case. The discovery and identification of mesothelioma as a distinct occupational hazard took over 60 years to be established.
Asbestos has been used for centuries in fireproofing, insulating, and other industries. Although malignant mesothelioma was not linked to asbestos exposure until the 1960s (and the information was not released to the general public until the 1970s), medical experts throughout the world began speculating about health concerns associated with asbestos exposure as early as the late 1800s and early 1900s.
In the early 1900's, workers at asbestos factories in Britain were experiencing an extremely high rate of lung disease. By the late 1920's, lung disease problems associated with asbestos mining and production were becoming well known, so much so that the British government commissioned a study in 1930. The study results showed that asbestosis was an occupational disease and was associated with asbestos exposure.
The link between mesothelioma and asbestos emerged slowly. As many asbestos workers were dying of lung cancer in the 1930's and 1940's, there was also high growth rate of tobacco use and a high occurrence of tuberculosis. Unless an autopsy was performed, it was difficult to determine the exact type of lung cancer that caused death. During this time period, it appears that the asbestos industry officials made hardly any effort to establish the link between asbestos and mesothelioma, even though a lot of evidence suggested this link.
To date, even with the intense scrutiny this form of cancer draws, no effective mesothelioma treatment has been discovered. With a near 100% fatality rate, victims of this deadly disease can only hope to prolong their life after their diagnosis.
Malignant Mesothelioma is a rare form of cancer that affects the thin cell wall lining of the body's internal organs and structures. It is known only to be caused by asbestos exposure.
Malignant mesothelioma affects the lining or membranes of certain large cavities in the body. These cavities, called the serous cavities, house certain major organs in the body including the heart, lungs, abdomen and others. The membranes that surround these cavities are called the serous membranes. They serve to protect these major organs from the friction and abrasion that occur as the organs move against each other during typical daily functioning, such as breathing and heart beating. The serous membranes derive from specialized cells called mesothelial cells. These cells form to create the mesothelium, which is the major tissue layer of the serous membranes. Cancer that occurs in the mesothelium tissue is called mesothelioma.
The most common cause of malignant mesothelioma is asbestos exposure. Workers in the steel, mining, plumbing, milling, insulation, and electric industries, among hundreds of others who handle or manufacture asbestos products, are at the highest risk of developing malignant mesothelioma.
While the risks of the disease increase depending on the frequency and intensity of asbestos exposure, there have been a number of malignant mesothelioma cases among people who have had only one or two months of exposure.
Symptoms of Malignant Mesothelioma
Some common mesothelioma symptoms of the malignant type include (but are not limited to):
- chest pains
- shortness of breath
- severe weight loss
Types of Malignant 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, this type of mesothelioma accounts for 75% of diagnosed cases.
- Peritoneal Mesothelioma - Rare form of asbestos cancer that is extremely difficult to diagnose and treat, and which in most cases, unfortunately leads to death.Malignant peritoneal mesothelioma is a rare type of cancer that occurs in the thin cell walls which surround the abdominal cavity, known as the peritoneum. This thin membrane acts a lubricant within the abdominal cavity so that surrounding organs and internal body structures may contract and expand within their normal body function.The second most common form of mesothelioma cancer is peritoneal mesothelioma. Peritoneal mesothelioma can spread to the lungs and when this occurs, it is considered secondary lung cancer. Peritoneal mesothelioma cancer is found in 10 percent to 20 percent of mesothelioma patients. The only known cause of mesothelioma is exposure to asbestos.
Peritoneal Mesothelioma Symptoms
Clinical symptoms of peritoneal mesothelioma at the time of presentation may include (but are not limited to):
- Abdominal pain
- Abdominal mass
- Increased abdominal girth
- Distention of the abdomen
- Ascites (fluid in the abdomen)
- Weight loss
- Digestive disturbances
- Pericardial Mesothelioma - Disease that affects the lining of the heart (pericardium). Over 2,000 new cases of mesothelioma are diagnosed each year, approximately 200 of which are pericardial mesothelioma.
Malignant pericardial mesothelioma is a type of cancer that originates in the mesothelium, a thin wall of cells that surround the body's organs and internal body structures. Other locales of the disease are malignant pleural mesothelioma, which occurs in the lining of the lungs and malignant peritoneal mesothelioma, which occurs in the abdomen wall. Pericardial mesothelioma is an asbestos cancer, meaning its only known cause is asbestos exposure.Pericardial mesothelioma is considered one of the rarest forms of mesothelioma. Those who have been diagnosed with this condition have developed cancerous tissues around the lining that surrounds the heart.The pericardium provides an important function to the body because it acts as a fluid-filled ‘sac’ that protects the heart. This lining is important because it keeps the heart contained in the chest cavity, as well as prevents the heart from over expanding when blood flow increases. The cavity that is in between the protective lining produces fluid to keep the area lubricated and lessens the friction between the membranes.When a person develops mesothelioma around the lining of the heart, it is mainly caused by the scar tissue that had been inhibited within the cavity for many years. The fibers that become lodged in the area cause the scar tissue, and it eventually leads to cancerous cells expanding in the cavity. In most cases, negative side effects include inflammation of the area around the heart, heart palpitations, and irregularities in heart function.
- Sarcomatoid Mesothelioma - Behind pericardial mesothelioma, this is the least common of the three cellular mesothelioma types. This form of mesothelioma accounts for approximately 7 to 20 percent of cases. When viewed under a microscope, malignant sarcomatoid mesothelioma cells appear as elongated spindle-shaped cells that are irregularly shaped and often overlap one another.
- Sub-types (or cell types) - of mesothelioma are epithelial (the most common, and considered the most amenable to treatment), sarcomatous (a much more aggressive form), and biphasic or mixed (a combination of both of the other cell types).
Unfortunately, many individuals with mesothelioma do not display any symptoms until 20-50 years after exposure to asbestos occurs. The symptoms often tend to resemble less serious conditions, which can make diagnosis difficult.
The early symptoms of mesothelioma are generally non-specific, and may lead to a delay in diagnosis. Sometimes resembling viral pneumonia, mesothelioma patients may experience shortness of breath, chest pain and / or shortness of breath. Less common symptoms include fever, night sweats, and weight loss.
One of the most common symptoms of mesothelioma is a pleural effusion, or an accumulation of fluid between the parietal pleura (the pleura covering the chest wall and diaphragm) and the visceral pleura (the pleura covering the lungs). Pleural effusion is broken down into two categories, transudates and exudates. A transudate is a clear fluid that forms not because the pleural surfaces are diseased, but because of an imbalance between the normal production and removal of the fluid. The most common cause of transudative fluid is congestive heart failure. An exudate, which is often cloudy and contains many cells and proteins, results from disease of the pleura itself, and is common to mesothelioma.
Symptoms vary depending on the type of mesothelioma a patient has. Peritoneal mesothelioma patients may display symptoms such as abdominal swelling, changes in bowel movement and development of lumps under the skin on the abdomen. Patients with pericardial mesothelioma may experience heart palpitations, chest pain, difficulty breathing and fever or night sweats. Testicular mesothelioma patients may notice testicular lumps.
Malignant mesothelioma is an unusual form of cancer in that it usually remains latent in the body for 20-50 years before it appears. However, benign or non-malignant mesothelioma can surface much sooner and is often an indication that the individual should be carefully watched for signs of more serious asbestos-related diseases in the future.
Appearing more in men than women, benign mesothelioma tumors usually start in the tissues under the mesothelium, which is known as the submesothelium. A similar tumor may grow in the peritoneum, the lining of the abdomen. Doctors have appropriately named that disease "solitary fibrous tumor of the peritoneum."
Benign mesotheliomas are actually very rare. They account for less than 10 percent of all mesothelioma cases worldwide. However, they do occur, usually presenting symptoms that are quite similar to those connected with malignant pleural mesothelioma. As a matter of fact, it is nearly impossible to differentiate between the two without extensive testing or surgical procedures.
Benign Mesothelioma Symptoms
When the doctor suspects that a benign mesothelioma tumor exists, he or she may initially perform a simple chest x-ray. Follow-up diagnostic techniques such as CT Scans, MRIs, and open lung biopsies are required to differentiate between malignant and benign mesothelioma.
The most common mesothelioma symptoms that may indicate the presence of a solitary fibrous tumor of the pleura are:
- Chest pain
- Shortness of breath
- Chronic cough
Cases of benign mesothelioma are easily treatable, unlike malignant mesothelioma. In most cases, mesothelioma surgery to remove the tumor is usually sufficient. The prognosis is usually excellent in these cases.
Mesothelioma patients are typically diagnosed within three to six months of their first visit to a doctor with complaints about breathing problems or chest / abdominal pain. The first step involved in a proper diagnosis is providing a full medical history to your doctor, including details about possible exposure to asbestos.
As with all diseases, a doctor begins the mesothelioma diagnosis by doing a complete physical exam and reviewing your medical history. Because mesothelioma is almost always caused by breathing in asbestos, you should tell your doctor about your exposure to asbestos if you suspect you may have mesothelioma. After performing the physical exam, a doctor should have x-rays of the chest performed and pulmonary function tests to determine if the symptoms are consistent with malignant mesothelioma.
Additionally, a doctor may order CT scans and / or MRI’s to aid in the diagnosis. These tools allow a doctor to assess the size, location, and extent of the tumor in the chest or abdomen.
If, after performing these tests, a doctor suspects mesothelioma, a biopsy should be taken to confirm the diagnosis. A biopsy is used for obtaining a tissue sample of the tumor. Although a biopsy is the most effective procedure for diagnosing mesothelioma, malignant mesothelioma cells can look like other types of cancer. Therefore, special laboratory tests are sometimes performed or electron microscopes are used to confirm a diagnosis of mesothelioma.
Abdominal mesothelioma, also known as peritoneal mesothelioma, is a cancer of the tissues in the abdominal cavity. Abdominal mesothelioma generally affects men ages 50-70, although women make up about one-fifth of all abdominal mesothelioma cases.
This type of mesothelioma spreads within the abdominal cavity, infiltrating the liver, the bowel or spleen. In this case, as well as with pleural mesothelioma, the most common complaint is pain. Moreover, the fluid gathering within the abdominal cavity causes enlargement of the abdomen.
Malignant peritoneal mesothelioma is a variation resembling pleural mesothelioma, except for the fact that it spreads in the abdomen. The expansion of the tumor generally leads to bowel obstruction and/or distention because of the pressure it creates. Normal breathing may be disturbed in case the tumor spreads upwards in the abdominal region. This kind of mesothelioma represents approximately one fifth of all mesothelioma cases.
Abdominal Mesothelioma Symptoms
Symptoms of abdominal mesothelioma may include (but are not limited to):
- abdominal pains
- abdominal weakness
- weight loss
- loss of appetite
- abdominal swelling
Patients exhibiting these symptoms are usually scheduled for further examinations to search for other abdominal mesothelioma signs. If an X-ray or CT scan indicates signs that the patient indeed may have abdominal mesothelioma, a biopsy is conducted, allowing the physician to determine the malignancy level.
Mesothelioma detection, like other cancers, can be accomplished with imaging equipment such as x-ray machines. But once detected, mesothelioma diagnosis is difficult because of the extended time period between the exposure to asbestos and the onset of the disease.
Mesothelioma diagnosis typically begins with a sufferer's visit to the doctor complaining of chronic chest pain. This pain is caused as a result of a buildup of fluid inside the pleural space; this is called pleural effusion and is the most common presenting symptom of malignant mesothelioma.
X-rays and other types of imaging technologies can be used to detect tumors or effusion (build up of fluid) in the body, including mesothelioma detection. A growth in the chest cavity will show up in an X-ray or MRI analysis. But these devices cannot directly determine the type of cancer or provide a mesothelioma diagnosis.
The only way to definitively verify a suspected case of malignant mesothelioma is through a biopsy. A biopsy is a relatively minor procedure (dependent on the location of the tumor) during which a small section of suspect tissue is removed. The removed section is examined by a histopathologist, an expert in the study of diseased tissue.
Due to this diagnostic confusion, much research is underway to find new methods for diagnosis. One method is to evaluate the types of compounds generated by the mesothelioma cancer cells. Immunochemistry is also being used to detect mesothelioma. This area of study evaluates the presence of antibodies in the body. Certain types of antibodies are known to be associated with certain types of cancer.
Those who may have been exposed to asbestos in the past are encouraged to disclose such information to their doctor. If possible, consulting with a physician who is experienced in detecting signs of asbestos exposure or dealing with mesothelioma is most beneficial.
A conclusive mesothelioma diagnosis usually requires a biopsy, or the removal of a sample of cells or tissue for examination under the microscope. This can be a frightening experience for an already-nervous patient. Understanding the reasons for taking a biopsy and what the procedure entails can help ease the patient's worries.
If tests and health history are consistent with mesothelioma, a surgical biopsy allows the doctor to make a conclusive diagnosis. The biopsy is an effective diagnostic tool, but it is not used first because the removal of a sample of cells or tissue is more invasive than a simple x-ray or blood draw.
Types of Mesothelioma Biopsies
Different procedures are used to collect cell or tissue samples, depending on the suspected location of the cancer. These include:
1- Incisional biopsy or a core biopsy
In this type of biopsy, only a small part of the tissue is removed. Incisional biopsies are used most commonly when the tumor is located in an area that is easily reached.
2- Excisional biopsy
In excisional biopsies, the whole tumor mass is removed by the surgeon. Excisional biopsies naturally come with greater risks. Surgery is more extensive and time consuming; however, it is always better to operate once very extensively than to make the patient undergo the same operation twice once the laboratory tests on the tissue samples confirm the cancer.
3- Fine needle aspiration biopsy
The third type of diagnostic biopsy is called needle aspiration biopsy. In many cases, this is the technique most preferred by surgeons because it is a safe, quick procedure. Although most often used for tumors that are close to the skin''s surface, needle aspiration biopsy (also called fine needle aspiration cytology or fine needle aspiration) can also be used to diagnose mesothelioma. Essentially, this technique uses a long, hollow needle to remove a sample of cells from the body to be tested and properly diagnosed.
Regular doctor appointments are crucial to ensure proper health, but exposure to asbestos presents added urgency to routine examinations. Asbestos-related diseases incubate for decades, and early detection is critical for proper treatment.
Individuals who have held jobs in the construction, shipbuilding, and manufacturing industry need to be screened for mesothelioma and other asbestos-related health conditions routinely. The following screening tests can be useful to diagnose mesothelioma:
Imaging - Imaging tests like a simple chest X-Ray, CT Scans, and Magnetic Resonance Imaging (MRI) are often very useful and they may show thick, nodular masses on the pleural surface.
Needle biopsy - A needle biopsy involves medical procedures wherein cell samples from the body are collected for laboratory testing. Core needle biopsy and fine-needle aspiration are the two most commonly used needle biopsy procedures.
Open biopsy - This is one of the most accurate methods to diagnose mesothelioma. A larger tissue sample is often obtained with an open biopsy. Open biopsies are usually performed under general anesthetic.
Cytology - This test analyzes cells in the pleural fluid and looks to identify malignant cancer cells. Cytology can be performed in conjunction with a biopsy.
Even with the best screening techniques, mesothelioma often evades diagnosis. Early and constant screenings are paramount for those who have suffered asbestos exposure. Medical science produces breakthroughs every day, and eventually a cure will be found. Until then, victims of mesothelioma should take action against those responsible.
Types of Asbestos Exposure
Working with asbestos has been proven to be the major risk factor for mesothelioma. The relationship between asbestos and mesothelioma is so strong that many consider mesothelioma a “signal” or “sentinel” tumor.
Incidence of mesothelioma have been found to be higher in populations near naturally occurring asbestos. The documented presence of asbestos fibers in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibers.
Numerous epidemiological studies have associated occupational exposure to asbestos with the development of pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumors, and diffuse malignant mesothelioma of the pleura and peritoneum. Asbestos has been widely used in many industrial products, including cement, brake linings, gaskets, roof shingles, flooring products, textiles, and insulation.
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 fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos.Those performing renovation works or DIY activities may expose themselves to asbestos dust. The use of Chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos was banned in the mid-eighties. Buildings built or renovated prior to these dates may contain asbestos materials.
Chrysotile is one of the most common forms of asbestos still in use today, and can increase the risk of mesothelioma if it is inhaled and absorbed in very large quantities.
Chrysotile asbestos accounts for about 90% of all serpentine asbestos found around the world. The most commonly used form of asbestos, the mining and export of chrysotile has prompted a continuous battle between health professionals and countries that mine chrysotile, such as Canada, Russia, and Italy. While these mining countries consider the mineral to be safe and eagerly export it to others, many organizations maintain that it presents a formidable health hazard.
About 90% of the world production of chrysotile is used in the manufacture of chrysotile-cement, in the form of pipes, sheets and shingles. According to the Canadians, some 60 industrialized and developing nations use these asbestos-containing products due in part to their cost-effectiveness and durability.
Other products that include chrysotile asbestos include those classified as "friction" products, such as brake shoes, disk pads, and clutches for automobiles as well as elevators brakes. Chrysotile may also be found in some textiles, plastics, rubber products, caulking, paper, roof sealants, and gaskets. Chrysotile fibers are also used in asphalt, and the roads in some countries - including parts of Canada - are paved with the material. Proponents of chrysotile claim that when mixed when asphalt, the material increases wear resistance without a loss of stability.
The fact remains that all forms of asbestos are carcinogenic, including chrysotile, and doctors and researchers have said again and again that no level of exposure is safe. Though the amphibole varieties of the mineral (such as amosite and crocidolite) are more likely to cause mesothelioma and other asbestos-diseases when inhaled, exposure to this serpentine variety carries the chance of developing cancer as well.
Asbestos Exposure at Dow Chemical Plant
In 2002, Dow Chemical's subsidiary, Union Carbide, was found liable by a West Virginia court for several thousand asbestos-related deaths. 2000 plaintiffs claimed to have been exposed in one of Union Carbide's plants in which asbestos insulation was frequently employed; others alleged exposure from one of the numerous asbestos products produced by the company up until 1985.
The Dow Chemical Company, with annual sales exceeding $30 billion, is the largest chemical manufacturing company in the world. Despite being one of the richest companies on the planet, Dow has done little to be a good steward of the environment. Dow's environmental track record includes the original manufacturing and distribution of now highly restricted or banned chemicals such as DDT, Agent Orange, Dursban (pesticide), and asbestos.
Unfortunately, many of Dow's past and present workers have experienced asbestos exposure. Much of the asbestos used in chemical plants was chrysotile asbestos, which many companies claimed was harmless. However, this is not true, and several studies have shown that chrysotile can cause cancer. Asbestos is especially dangerous while it ages, as it can crumble and become more friable. Once this occurs, the material is more likely to release airborne asbestos fibers that can be inhaled. Industrial facilities that were built prior to the 1980s are definite areas where asbestos was used.
The term 'pathology' refers to the study and diagnosis of disease through observation and testing of tissues, organs, and bodily fluids. Thus, mesothelioma pathology involves the diagnosis of malignant mesothelioma from a biopsy sample of cancerous tissue or fluid.
Malignant mesothelioma develops in the mesothelial cells that form the pleura, the peritoneum, and coverings of other organs. Most cases arise in the pleura, the thin membrane that covers the lungs and lines the chest wall; right-sided involvement is more common. In these cases, malignant mesotheliomas first look like multiple, tiny, round, gray, flat or slightly raised spots on the pleura. These spots fuse together over time, so that the pleural surface becomes progressively thicker and bumpy. The tumor spreads in all directions, forming a continuous thick, soft, 'rind' encasing the lung, and contracting it.
As the tumor advances, other nearby organs are invaded, including the lungs themselves, chest wall, the mediastinum and its structures, and ribs. There may be direct invasion through the diaphragm into the abdominal cavity, and so to the liver. In many cases, the tumor may also grow along wounds or tracts left by diagnostic or therapy procedures; this can be avoided by the use of radiation therapy at the time of the procedure.
The term 'histopathology' refers to the microscopic examination of cells to observe physical characteristics that denote the type of cancer a patient is facing.
In the laboratory, potentially cancerous cells are tested under the principles of histopathology in two primary ways. First, they are observed under a microscope to establish their general appearance. Second, they undergo testing for the presence of oncoproteins (proteins associated with cancer growth) and other molecules that are produced by specific types of cancer cells.
The classic histopathology of mesothelioma is a biphasic tumor with both an epithelioid and sarcomatoid or spindle cell component. From this description, it can be readily appreciated how the diagnosis may be very difficult to confirm. The task of the pathologist is to separate the mesothelioma from its many mimics including adenocarcinoma from the lung (in pleural cases) and soft tissue sarcomas such as malignant fibrous histiocytoma (in peritoneal cases). Immunoperoxidase studies and electron microscopy may aid in this distinction.
Under a microscope, mesothelioma cells can be distinguished from healthy cells by their shape and other differences in appearance. Further tests are needed to determine the exact histological nature of the cells. These tests evaluate the types of proteins that are present on the surface of the cells. Evaluating the surface proteins allows a pathologist to determine if the cells are malignant mesothelioma, another type of cancer, or healthy cells. The application of histopathology in the diagnosis of mesotheliomas is primarily to differentiate epithelial mesotheliomas from mucin-producing adenocarcinoma.
Mesothelioma Pathology Report
Diagnosis from tissue is considered the standard on which treatment for mesothelioma is based. Tissue removed for biopsy undergoes a formal process of testing by the pathology lab. Understanding your pathology report is important in order to help you make informed treatment decisions and be comfortable with what you decide. Obtaining a copy of this report from your doctor or the hospital medical records department can not only make you more knowledgeable about your mesothelioma, but can also help keep you in control of your treatment. A number of factors are covered in a pathology report and may include the following:
- Personal Information - Such as the patient's name, date of birth and the like.
- Clinical History - A history of the patient's medical history pertaining to the disease.
- Clinical Diagnosis - Description of the potential diagnosis from the doctor's initial examination.
- Gross Description - Description of the tissue that was sampled as well as the origin.
- Microscopic Description - Describes the tissue sample from microscopic evaluation, which can contain technical language to discuss with your doctor.
- Immunohistochemical Analysis - Depicts the chemical stains utilized to diagnosis the cancer and contains results that help determine the diagnosis.
- Diagnosis - This section describes the microscopic findings, stating if there is malignancy and gives the histologic type of the cancer.
Tumor markers are an oncological method of diagnosing cancer. These markers are most commonly found in body fluids such as blood and urine, and are typically helpful in assisting in diagnosis. While a biopsy is usually the best method to determine the presence of cancer, the possible presence of tumor markers in both malignant and benign tumors can enhance the effectiveness of a biopsy.
In addition to being used for the diagnosis of cancer, tumor markers can also be measured to determine how a patient is responding to treatment. Marker levels will often be measured before treatment begins to determine the correct course of action when addressing the cancer. Tumor marker levels can further be used to determine whether a patient has suffered a recurrence of their cancer.
Tumor markers are most often identified as proteins in the blood, urine or tissue. To identify them, antibodies to various proteins are introduced to the blood, urine or tissue, and any reaction is noted. Abnormal levels of particular proteins can be linked to certain kinds of cancers. There are over a dozen specific markers known to doctors, and continuing research is going into discovering new markers. Using DNA analysis, doctors are learning new gene patterns that can be found in tumor markers.
Mesothelioma cells come in several different forms. Once an individual is diagnosed with mesothelioma, doctors will try to identify the cell type so that they can better estimate the patient’s life expectancy as well as devise the best treatment plan.
There are several types of cells, depending on the type of mesothelioma and the part of the body where it develops:
- Epithelial cells – are the most common, comprising 50% to 70% of all malignant mesotheliomas diagnosed. Because it is the least aggressive of the cell types, it generally responds the best to treatment, and offers the best prognosis. Under the microscope, this cell type appears relatively uniform, and is described as having a tubular papillary structure. Each individual cell is cube-shaped and has an easily identifiable nucleus.
- Sarcomatoid cells – represents 7% to 20% of cases diagnosed, and is the most aggressive sub-type. It generally does not respond well to treatment, therefore, prognosis with this cell type is considered poor. The differential diagnosis of sarcomatoid mesothelioma versus other types of sarcoma is more challenging than in the epithelial variant, and chemical staining can be confusing. Microscopic analysis normally shows a spindle cell or storiform structure with elongated nuclei not as apparent as in the epithelial type.
- Biphasic cells (or mixed type) – is a combination of elements of both the epithelial and sarcomatoid sub-types, with components of each in the same tumor, or found in specific groupings throughout the tumor. Prognosis for biphasic mesothelioma is normally intermediate between the two types. This cell type makes up 20% to 35% of mesotheliomas.
Whether only one cell type is present or a combination of several, the methods of treatment are very similar. There are traditional methods such as chemotherapy, surgery and radiation, and recently there has been further research in to less traditional methods, with many suggesting these types of treatment will have more success.
By inhaling asbestos, the tiny fibers reach soft tissue in the chest or abdominal wall lining (pleura, peritoneum or pericardium). The tiny fibers act like needles, creating scar tissue and allowing for mesothelioma tumors (or carcinomas) to appear.
Mesothelioma, like many other cancers, tends to develop in a large mass of cells called a tumor. Being on the mesothelium, the layers of tissue which make up the pleural, peritoneal and pericardial internal organ cavities, a mesothelioma tumor tends to exert force on one of the body’s most vital organs, most commonly the lungs. The pressure resulting from the growing tumor most commonly begins to result in shortness of breath, painful breathing, or a pleural effusion, and eventually reduced dissolved oxygen in the blood. Reduced dissolved oxygen is most noticeable by the clubbing of the fingers and toes but also results in decreased organ function and fatigue.
The most dangerous aspect of a malignant mesothelioma tumor is the fact that it is a very aggressive form of cancer and can quickly spread. Mesothelioma can quickly progress from stage one to stage two as it spreads from one or two very localized tumors to a nearby organ; in the case of pleural mesothelium, the lungs. As the cancer spreads from one tumor and develops new tumors, it becomes increasingly difficult to treat and results in increased symptoms. It is important to diagnose mesothelioma early so tumors can be removed before they have a chance to spread. A mesothelioma tumor needs to be treated by the best possible chemotherapy and radiation treatments to prevent that tumor from spreading further or the development of a new tumor.
Tumors of any part of the mesothelium can be malignant (cancerous) or benign(non-cancerous). A major source of confusion is that malignant mesothelioma is sometimes called simply mesothelioma. However, many benign forms of tumors have traditionally also been called mesothelioma. Fortunately, doctors are now working together to make these terms less confusing.
A pleuroscopy is a surgical procedure that involves the insertion of a long, thin tube with a light and camera on the end (called a pleuroscope). Through the use of a pleuroscope, doctors can diagnose problems in the chest and get a clear picture of where a tumor is located.
With the evolution of minimally invasive technology, the evaluation of patients via pleuroscopy has been encouraged. This technique allows for better visualization of the tumor, which, in turn, improves the adequacy of tissue sample biopsies.
A pleuroscopy normally requires the use of sedative medications, but not necessarily a general anesthetic. In this case, the patient is awake and relaxed as the pleuroscopy proceeds but usually does not remember what happened during the procedure. Oxygen is normally administered during the procedure and vital signs are monitored.
Doctors typically perform the pleuroscopy with the patient lying on his or her side. An ultrasound is used to determine the correct place for the surgeon to cut and one or several small incisions are made. The pleuroscope is then inserted and the surgeon proceeds by exploring the chest area, removing fluid or tissue samples, and administers treatment for effusion if needed. The lung is then re-inflated and the incisions closed and bandaged. In some cases, a tube may remain to allow for drainage of air or fluid. It may be removed just a few hours after surgery or, if drainage is heavy or complications arise, it may be kept in place for a few days.
A patient’s release from the hospital after a pleuroscopy will depend on drainage and any post-operative complications, which are fairly uncommon after this procedure. Such complications may include infection, bleeding, loss of air in part of the lung, or in very rare cases, respiratory failure.
Rare Forms of Mesothelioma
Mesothelioma of the reproductive organs in men and women is extremely rare and is technically considered a cancer of the abdominal lining, as the lining itself extends into that region. This form of the disease has a poor prognosis, with treatments such as surgery to remove the affected organs followed by radiation therapy and chemotherapy often utilized. Even after these treatments, patients rarely survive more than 12 to 18 months with this condition. It is often identified from tumors and lumps found in the testicles and ovaries, but is usually diagnosed at a late stage of the cancer's development.
Another rare form of mesothelioma is cystic mesothelioma of the peritoneum - a layer of mesothelial cells covering many organs in the abdomen - which is usually found in young women. Its prognosis is benign with the majority having surgical resection. There have been reports of many cases of cyst recurrence, so hormonal therapy is typically used to try and control the size of cysts and alleviate some of the symptoms. Treatment includes extensive electron microscopy and immunohistochemical studies.
Pericardial mesothelioma is the rarest type of the disease. It is responsible for between 5 and 15 percent of asbestos-related cancer fatalities in the United States annually. It is the form of mesothelioma that is linked to very long term exposure to asbestos, with most of the individuals that have it spending the majority of their lives working in close proximity to the mineral. Patients with this form of cancer in its advanced stages are given between 6 weeks and a year to live.
Cystic mesothelioma is a form of mesothelioma that is rare and always benign. While it is not a form of cancer, it is still a serious illness that is hard to diagnose, requires long-term monitoring, and has symptoms that may be painful.
Cystic mesothelioma is a type of peritoneal mesothelioma that affects young females. When cystic mesothelioma occurs, cysts are lined with a layer of benign mesothelial cells. Since cystic mesothelioma is a benign form of mesothelioma, normal life expectancy occurs. In some instances, though, cystic mesothelioma will require some treatment depending on the pain or symptoms experienced.
Unfortunately, patients experience a high recurrence of cyst development. Although not cancer, this form of mesothelioma is a serious illness requiring long term monitoring and treatment. Electron microscopy and immunohistochemical studies must first occur before cystic mesothelioma is found. Partial excision or decompression can be used to relieve any pain or symptomatic problems associated to cystic mesothelioma.
Mesothelioma trials are currently being conducted to find a better and more effective means of treatment. Anyone interested in participating in a clinical trial should discuss the particular trial thoroughly with their doctor before a making a decision on whether it is right for them.
Clinical trials are research studies completed with the help of human volunteers allow doctors, researchers, and drug companies to test various treatments for specific ailments. When handled by a professional and competent staff, clinical trials are safe for participants and can allow volunteers access to new and novel treatments for their disease. For a rare and difficult-to-treat cancer like mesothelioma, clinical trials can provide an alternative treatment path to certain patients.
There are three stages of clinical trials. Phase I trials enroll a limited number of people. They normally center around the correct dosage and relative safety of a particular drug. Phase II trials enroll more people and are used to determine if the new drug actually works against a particular illness. Phase III trials are the final phase before a drug is approved for treating a disease. During Phase III, the new drug is compared against the existing treatment. The goal during Phase III is to prove the new drug is a more effective treatment.
There are a variety of resources on the Internet that list ongoing clinical trials for mesothelioma, which include the qualifications for each. Those interested in participating in a clinical trial should consult their doctor. Doctors have access to all upcoming and current clinical trials, and can also help determine if a patient qualifies for a particular trial.
Conventional Mesothelioma Treatments
Conventional treatments for mesothelioma typically consists of surgery, chemotherapy, and radiation therapy. Surgery can include any number of surgical procedures. Chemotherapy includes various drugs that are considered toxic because they work by killing both healthy and cancerous cells. Radiation therapy can be delivered internally by placing radioactive substances such as cesium, iridium, and iodine near or into cancerous cells within the body or administering radionuclides directly into the bloodstream.
Radiation is very useful against cancer of cells that divide quickly, like mesothelioma, because it kills cells that replicate fast. When patients undergo radiation therapy, they receive several successively higher doses of radiation, which shrink the tumor to a manageable size. Radiation relieves a great deal of pain, and victims of pleural mesothelioma suffer reduced instances of shortness of breath. Unfortunately, radiation cannot kill all of the cancerous cells without causing significant damage to the patient.
Radiation therapy can be used as treatment in different ways. Often is it used to try to cure mesothelioma, but sometimes it may be too far spread and no longer curable. In these cases, radiation therapy can still be used as palliative care. This means that it is used to help reduce the severity of mesothelioma symptoms a patient may be experiencing. Mesothelioma patients with an advanced stage of cancer may find this beneficial in reducing cancer pain and shortness of breath. In incurable cases, radiation therapy can also be used as life-extending therapy; although the cancer cannot be cured, the radiation treatment is used for the benefit of extending life as long as possible.
Radiation Therapy Symptoms
There are many symptoms you may experience during your treatment for mesothelioma that can at times become quite severe. Some of the most common symptoms include:
- skin damage and skin rashes
- hair loss
- difficulty swallowing
- loss of appetite
The number and severity of symptoms you will experience depends on the type and amount of radiation treatment used as well as the area of the body. Your doctor will talk with you about what you can most likely expect. However, remember that each individual undergoing radiation treatment experiences their symptoms differently, and they can vary quite widely from person to person.
In mesothelioma treatment, several options for chemotherapy are available. Most chemotherapy drugs have specific side effects such as nausea, vomiting, loss of appetite, hair loss, and increased vulnerability to infection. Any symptoms experienced while undergoing treatment with chemotherapeutic drugs should be reported to the doctor.
Chemotherapy may be used to achieve different goals, depending on the stage of the mesothelioma at the time of diagnosis and the age and health of the patient. Since chemotherapy for mesothelioma is not considered "curative," the goal is:
- To control the cancer by stopping its spread or slowing its growth.
- To shrink tumors prior to other treatments, such as surgery. This is called neoadjuvant chemotherapy.
- To destroy microscopic disease which may remain after surgery. This is called adjuvant chemotherapy.
- To relieve symptoms, such as pain. This is called palliative chemotherapy, and is given in cases when a drastic reduction in the tumor is not expected.
Mesothelioma is a very aggressive form of cancer, so doctors treat it as aggressively as possible. That includes the use of highly toxic chemo drugs that will, hopefully, help destroy cancer cells while also providing some relief from the bothersome side affects of the disease, such as coughing, shortness of breath, and chest pain.
Years ago, doctors opted for single chemotherapy treatments for the disease. Unfortunately, they yielded little more than approximately a 15% success rate, providing minimal relief to the mesothelioma patient. More recently, oncologists and research scientists have determined that the best way to fight mesothelioma is through combination chemotherapy.
Types of Mesothelioma Chemotherapy
There are various types of chemotherapy including:
- Neoadjuvant chemotherapy - is used to shrink a tumor prior to surgery or radiation therapy.
- Adjuvant chemotherapy - is used after surgery or radiation therapy to destroy remaining cancer cells.
- Systemic chemotherapy - uses anticancer drugs to destroy cancer cells throughout the body (hence the term “systemic”) as opposed to localized area. The drugs enter and circulate through the bloodstream after being administered orally, intravenously, or injected into a muscle.
- Intraperitoneal chemotherapy - involves the direct injection of anticancer drugs into the abdominal cavity using a thin tube.
- Intracavity chemotherapy - is an innovative approach to chemotherapy that is similar to intraperitoneal chemotherapy. The anticancer drugs are directly injected into the chest or abdominal cavity, where they can be administered at higher doses without causing the toxic effects they would if administered systemically through the bloodstream. The chemotherapy is then heated to increase its ability to kill cancer cells.
Pleurodesis is a mesothelioma treatment aimed at stopping fluid build-up in the lungs, therefore easing shortness of breath.
A medical procedure routinely used for the treatment of recurrent pleural effusion (excess fluid that surrounds the lungs), pleurodesis is performed by the addition of a number of chemicals and agents into the pleural cavity, which first causes inflammation (pleuritis), and then causes the pleurae to stick together. Talc is the most frequently used agent because it has been shown to result in fewer complications while delivering a high rate of success (90-96%).
There are two options in performing pleurodesis:
- If the doctor believes that a patient does not fall into the high risk category, pleurodesis may be performed outside an operating room during hospitalization. A sedative and general anesthetic will be given to the patient and a chest tube will be inserted to drain any existing fluid. Depending on the extent of the fluid, this process may take a few days. When all the fluid is removed, the talc or doxycycline will be inserted through the chest tube and clamped to avoid leakage. A suction device is then used to bring the two lung surfaces together. The biggest disadvantage of a non-surgical pleurodesis is that the chest tube may be in place for several days, which is quite uncomfortable, prompting the need for painkillers.
- If your doctor chooses to perform pleurodesis in the operating room, you will be given a general anesthetic. A thoracic surgeon (a doctor who specializes in diseases of the chest) will make an incision in the chest and insert a video-assisted thorascope to assist in viewing the inside of the lung. The video will also help the doctor to insert the chemical agent directly onto the pleural surface. This procedure carries all the risks of any surgery, including allergies to anesthesia, infection, or bleeding.
All these measures are intended for provoking an inflammatory reaction of the parietal and visceral pleural surface that will promote obliteration of the pleural space (namely pleurodesis). This ensures that pleural liquid cannot be repeatedly accumulated. It should be taken into account that before performing pleurodesis, it is required to make total drainage and absolute re-expansion of the lung. You may or may not be a candidate for this procedure. If your lung capacity is already seriously diminished, pleurodesis may not work for you.
In order to battle mesothelioma, it takes an expansive arsenal of weapons and precise methods of attack to be successful. Modern treatments have begun to employ immunotherapy, which works with the body’s immune system to help fight mesothelioma and control how the patient’s body reacts to certain cancer drugs.
Your immune system is a series of body responses that ward off infections and diseases. Immunotherapy (or biological therapy) attempts to build up your immune system to fight cancer cells. It may involve gene therapy, monoclonal antibodies, or cytokine proteins such as interferons and interleukins.
- Gene Therapy - A gene therapy approach is designed to treat mesothelioma by correcting the genes that allow a cancerous tumor to grow, potentially controlling tumor size and spread. A number of gene therapy clinical trials are currently underway around the country.
- Monoclonal antibodies - Monoclonal antibody therapy is the most widely used form of immunotherapy for cancer available today. This is a passive immunotherapy, meaning it uses antibodies created in the laboratory rather than by the patient's own immune system, and does not require the immune system itself to actively fight the cancer.
- Cytokine proteins - Cytokines are proteins which occur naturally in the human body, and which are are similar to hormones. The cytokine protein Interleukin–2 (IL2) is capable of stimulating the growth of immune system cells called “T–cells.”
Experimental Mesothelioma Treatments
In addition to conventional treatments for mesothelioma, there are clinical trials available to affected individuals not yet available to the general public. Experimental therapies include:
- Photodynamic therapy - One of the newest and most exciting types of therapy for mesothelioma is called photodynamic therapy (PDT). Sometimes referred to as photoradiation, photochemotherapy, or phototherapy, photodynamic therapy (PDT) is a mesothelioma treatment that involves the use of a drug called a photosensitizing agent, activated by exposure to light and used to destroy cancer cells. Depending on the extent of your disease, your doctor may suggest photodynamic therapy for the treatment of your mesothelioma.Photodynamic therapy begins with the injection of a photosensitizing drug. This drug is administered intravenously into the bloodstream, and over a period of 24 to 72 hours the drug travels throughout the body and is absorbed by cells.After the drug administration phase, the patient is treated with light of a specified wavelength that reacts to the photosensitizing drug present in cancer cells. A physician simply shines a beam of light on the affected area, which may last anywhere from a few minutes to an hour. During treatment, cancer cells absorb the light, which causes them to produce a form of oxygen that is highly reactive. The oxygen eventually enters nearby cancer cells and damages them, resulting in death of the affected cells. In addition, photodynamic therapy can also destroy cancer cells by damaging blood vessels that are present in tumors, thus preventing cancer cells from absorbing nutrients.Photodynamic therapy is much less invasive than surgery and results in less scarring than many traditional therapies. It can also be precisely targeted at a particular area. Unlike conventional radiation therapy, which can cause burns and other concerns when repeated, PDT can be used over and over again in the same area without causing damage.Breakthroughs linking PDT with successful treatment of mesothelioma are on the horizon. Recently, doctors have begun experimenting with a procedure that involves the use of photodynamic therapy during surgery to help prevent the recurrence of cancer on large surfaces. Such surfaces would include the peritoneum (lining of the abdomen) and the pleura (lining of the lung), two areas usually affected in mesothelioma patients.Special photosynthesizing drugs are administered into the patient’s body which make the body sensitive to certain light wavelengths. The drugs react with light to produce a type of oxygen that is toxic to cancer cells.
- Anti-angiogenesis therapy - employs the process your body uses to build new blood vessels. When tumors grow, they must use angiogenesis to create blood vessels so they get enough blood to survive and grow. Anti-angiogenesis therapy uses drugs to interfere with the angiogenesis process of tumors to decrease their blood flow and limit growth.
- Gene therapy - originally developed to help people with genetic disorders, modern clinical trials have begun using several types of gene therapy to treat mesothelioma. These therapies typically use a genetically altered virus to change the way cells normally behave to either make cancer cells susceptible to non-toxic drugs or to bolster the body's immune system to fight cancer.
- Immunotherapy - involves training the patient’s immune system to recognize cancer cells and attack them. Currently there are three main types of immunotherapy: active, passive, and non-specific.
Treatment by Stage
Stage 1 Mesothelioma Treatment
- At this stage, surgical intervention is most commonly recommended for pleural mesothelioma patients. Likely procedures to be performed include pleurectomy/decortication, orextrapleural, or pneumonectomy. After surgery, doctors may further evaluate the patient to determine of chemotherapy or radiation therapy is necessary.
Stages II & III Mesothelioma Treatment - Unfortunately, stages II & III mesothelioma cancer cannot be cured. At this point, medical treatment focuses on alleviating the severity of the symptoms and keeping the patient as comfortable as possible. Clinical trials at some of the larger mesothelioma clinics in the country may offer different treatment options for patients in these stages.
Stage IV Mesothelioma Treatment - At stage IV, the cancer has metastasized throughout the body to other organs and cannot be cured. Symptoms generally increase in severity and pain management becomes the primary focus of the medical team. Many families find that it is helpful to seek out additional support through a local Hospice program, which will focus on providing care, developing a pain management protocol, and providing support for both the patient and family members during this difficult time.
Though researchers continue to develop new ways to diagnose and treat mesothelioma, there are a number of techniques that have been on the scene for several decades. One such technique, thoracentesis, was developed in the late 19th century and is still used today.
Thoracentesis treatment reduces the fluid associated with pleural effusion, in turn reducing the pressure on the lungs and chest wall. To perform this procedure, a syringe or catheter is inserted into the space between the lung and chest wall, and the fluid is aspirated (or removed).
The needle is normally inserted from the back, between the ribs and into the lung area. A small patch of skin is sterilized and numbing medication is injected into the area where the thoracentesis needle will be inserted. The procedure is short and relatively painless, and complications are rare. The medical terminology used to describe the results of the thoracentesis procedure is "pleural fluid aspiration."
Thoracentesis can be performed as either a bedside or outpatient procedure. In most cases, the patient sits and leans forward with arms and head supported. A local anesthetic is injected into the skin and deeper tissues until the needle reaches pleural fluid. Then the thoracentesis needle is inserted to this depth, which is the space between the pleural layers, and a catheter tube inserted through the needle. The needle is generally removed to reduce the risk of complications.
Thoracentesis is a relatively safe and painless procedure that removes the fluid buildup of a pleural effusion. Although thoracentesis does not treat or cure mesothelioma, it can be very helpful for diagnosing the underlying cause of the effusion and for dealing with patients' symptoms. Unfortunately, not every mesothelioma patient is a candidate for thoracentesis. Talk to your doctor to determine whether or not this procedure will be helpful for you.
Onconase Chemotherapy Treatment
Recently, Onconase has made its way to the forefront as a potential drug of choice among the medical community for combating mesothelioma and easing the suffering and debilitating symptoms traditionally accompanied by chemotherapy.
The lead drug candidate of the Alfacell Corporation, Onconase, is currently in clinical trials and has recently been touted as a potential chemo-preventive agent in the fight against malignant pleural mesothelioma. In January 2007, Onconase received orphan drug status from the U.S. Food and Drug Administration (FDA).
Onconase is a ribonuclease protein developed from the eggs of the leopard frog. The drug is designed to enhance the anti-cancer effects of traditional chemotherapy, allowing lower doses to be effective and producing fewer side effects. Even though the drug works more slowly than other chemo drugs, its lower toxicity levels mean no hair loss, anemia, nausea or other common side effects usually associated with standard chemotherapy drugs.
Onconase is also one of the first embryonic stem cell products to reach the final stages of testing. Doctors hope to soon be using Onconase in place of Doxorubicin, a chemotherapy drug with crippling side effects that have a serious effect on the patient’s quality of life.
Brachytherapy is a form of radiotherapy and considered an advanced form of mesothelioma treatment. This therapy has been in use for more a century; doctors use it in some circumstances as an alternative to external radiotherapy and surgical treatment.
Brachytherapy is a type of radiation therapy that involves the implantation of tiny radioactive rods in or near tumors. It is most commonly used to treat cervical, breast and prostate cancers, as well as cancers of the head and neck, but has also been used to treat mesothelioma.
An advantage of brachytherapy is that the radioactive rods placed inside tumors (often referred to as "seeds") emit radiation across short distances of approximately one centimeter. This treatment allows for the delivery of a strong and highly-concentrated dose of radiation directly to tumor cells, but causes very little damage to surrounding healthy cells and tissue. Because of this, healthy tissue is spared and side effects are less severe.
Types of Mesothelioma Brachytherapy
Brachytherapy may be temporary or permanent:
Temporary - For temporary brachytherapy, the radioactive material is placed near the tumor for a pre-determined length of time and then removed. Your oncologist will determine whether it is to be administered in high-dose or low-dose.
Permanent - Permanent brachytherapy, also known as seed implantation, involves the placing of tiny radioactive pellets or seeds in or near a tumor and leaving them there permanently. The pellets are minuscule, usually about the size of a grain of rice. After several weeks, the radioactivity diminishes and the now harmless seeds remain in the body. There is no danger associated with the remaining pellets.
Few side effects occur with brachytherapy though the patient may experience pain, bruising, and swelling at the treatment site. Most side effects last for only a few days and are mild in comparison to external beam radiation.
Mesomark Blood Test
A new blood test for mesothelioma called Mesomark™ is now available to patients in the United States, Europe, New Zealand, and Australia.
Mesomark™ is an easily performed blood test that uses an enzyme-linked immunosorbent assay to measure the amount of soluble mesothelin-related peptides (SMRP) in human serum. SMRP is a biomarker that is produced by mesothelioma cells, and this biomarker may be elevated in the serum of patients who have mesothelioma. The detection of the biomarker through a blood test can help attain an early diagnosis, resulting in more treatment options and a better prognosis for patients.
The Food and Drug Administration (FDA) approved the Mesomark™ assay to help monitor response to treatment in malignant mesothelioma patients. “The Mesomark™ test signifies the beginning of a new era in monitoring mesothelioma malignancies," said Dr. W. Jeffrey Allard, vice president and chief scientific officer of Fujirebio Diagnostics. "As the first in-vitro test for patients with this aggressive disease, it will enable doctors to more accurately detect recurrence and monitor treatment of patients."
In addition to detecting the presence of mesothelioma in yet-to-be-diagnosed patients, the Mesomark™ blood test may also be used to monitor the success of treatments in patients who have already been diagnosed with the disease. These tests will also help determine the next course of treatment. For more information on the Mesomark™ test, consult your oncologist, who can also help you find out where the assay is available and if you are a candidate for the test.
Cisplatin, a chemotherapy drug, is one of the available treatments for mesothelioma. When combined with Alimta, Cisplatin is a highly effective chemotherapy treatment.
Approved for use by the Food & Drug Administration (FDA) in 1978, Cisplatin was one of the first in a series of drugs that would help to revolutionize the treatment of cancer. By cross-linking DNA in a variety of ways, Cisplatin makes it impossible for rapidly dividing cancer cells to duplicate their DNA for the purpose of cellular replication (mitosis). The damaged strands of DNA initiate a naturally occurring chain reaction that culminates with programmed cellular death (apoptosis). When Cisplatin is used in combination with Alimta, it is the only FDA approved drug used for the specific treatment of malignant pleural mesothelioma.
Cisplatin Side Effects
The following Cisplatin side effects are common (occurring in greater than 30%) for patients receiving Cisplatin:
- Nausea and vomiting - Nausea may last up to 1 week after therapy. Anti-nausea medication is given before the infusion, and a prescription is also given for use after.
- Kidney toxicity - Effects on kidney function are dose related, observed 10-20 days after therapy, and are generally reversible.
- Blood test abnormalities - Low magnesium, low calcium, low potassium.
- Low white blood cells - This may put you at increased risk for infection.
- Low red blood cells (anemia)
Other drugs similar to Cisplatin include Carboplatin, generally used to treat cancer of the lung, head and neck, and Oxaliplatin, which is most often used to treat colorectal cancer. As with any mesothelioma cancer drug, your doctor will decide whether or not Cisplatin is a beneficial option for treating your cancer.
In the medical community, effusion refers to the escape of fluid from a vessel into a body cavity. Mesothelioma patients may experience certain types of effusion as a result of their exposure to asbestos.
One of the most common symptoms of mesothelioma is a pleural effusion, or an accumulation of fluid between the parietal pleura (the pleura covering the chest wall and diaphragm) and the visceral pleura (the pleura covering the lungs). Both of these membranes are covered with mesothelial cells which, under normal conditions, produce a small amount of fluid that acts as a lubricant between the chest wall and the lung. Any excess fluid is absorbed by blood and lymph vessels maintaining a balance. When too much fluid forms, the result is an effusion.
Mesothelioma patients may also develop pericardial effusion, a condition that occurs when an abnormal amount of fluid is present in the pericardium, the sac surrounding the heart. This can put pressure on the heart, causing reduced heart function. Patients with pericardial effusion may experience chest pains and the feeling of pressure on the chest. A procedure known as pericardiocentesis may be utilized to treat the condition. The procedure involves the removal of fluid from the pericardium.
Mesothelioma effusion can be detected easily. When a doctor taps the chest area of the patient the sound it makes is not hollow as it should, but full and dull. Also, some basic X-rays will be useful in diagnosing the condition. Effusion is one of the basic symptoms of mesothelioma that should be a clear sign of cancer to any doctor.
Drugs & Medications
A diagnosis of mesothelioma will normally be followed by several discussions with your oncologist. Such topics of discussion will cover prognosis and treatment options to battle the disease. More often than not, the course of treatment can include a variety of mesothelioma medications including:
- Alimta - Medication that interferes with the growth of cancer cells and slows their spread in the body. Alimta can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill.
- L-NDDP (aroplatin) - Medication made to exceed the usefulness of other platinum drugs like Cisplatin that are limited by toxicity and drug resistance.
- Endostatin - naturally-occurring 20-kDa C-terminal fragment derived from type XVIII collagen. It is reported to serve as an anti-angiogenic agent, similar to angiostatin and thrombospondin. Endostatin has been shown to inhibit a tumor's ability to grow blood vessels without destroying normal healthy cells.
- Intrapleural interferon gamma - An anti-cancer drug, Interferon Gamma is directly administered into the affected area.
- Photodynamic therapy (PDT) - is a type of cancer treatment based on the premise that single-celled organisms, if first treated with certain photosensitive drugs, will die when exposed to light at a particular frequency. PDT destroys cancerous cells by using this fixed frequency light to activate photosensitizing drugs which have accumulated in body tissues.
- Gene Therapy - By accessing the genetic code that predisposes some cells to become cancerous when exposed to asbestos, gene therapy attempts to understand why proteins within cells cause them to be resilient to cancer, while others do not.
Surgical procedures involved in the treatment and diagnosis of mesothelioma are divided into three main categories:
- Diagnostic surgery - In order to validate a mesothelioma diagnosis, diagnostic surgery is required. The procedure requires tissue removal from the affected area for examination by a histopathologist. Once thoroughly tested, the histopathologist is able to determine the type of mesothelioma and the appropriate treatments that will be needed.
- Curative surgery - These procedures are performed with "curative intent." Their goal is removal of all gross disease, with the knowledge that microscopic disease will most likely remain. Adjuvant therapy (another form of treatment in addition to the primary therapy) is typically aimed at eliminating residual disease.
- Palliative surgery - is similar to curative in that it is conducted to remove cancerous tissue. It is conducted on patients in whom the mesothelioma cancer has advanced beyond the point that it is considered curable; the purpose of the surgery is to relieve difficult symptoms.
Mesothelioma Treatment Side Effects
As the years pass and doctors and research scientists discover more and better drugs and procedures, they have tried to devise methods and medications to lessen the side effects of treatments. In general, people who have cancer in the 21st century suffer less from unpleasant side effects than patients did 10 to 20 years ago.
Surgery for mesothelioma is a major operation. After lung surgery, air and fluid tend to collect in the chest. Patients often need help turning over, coughing, and breathing deeply. These activities are important for recovery because they help expand the remaining lung tissue and get rid of excess air and fluid. Pain or weakness in the chest and the arm and shortness of breath are common side effects of lung cancer surgery. Patients may need several weeks or months to regain their energy and strength.
Most mesothelioma patients undergoing chemotherapy feel tired, and even exhausted. You may want to have a friend or relative drive you to your chemotherapy appointment. Besides providing emotional support, he or she can make sure you get home safely. If possible, try to minimize projects or chores for the first few days after a mesothelioma chemotherapy treatment. Consider planning your day so that you get plenty of rest. Some cancer patients say that yoga or meditation is helpful and calming during this stressful time. Doctors also recommend very light exercise such as a short walk to keep you in balance and lessen fatigue.
Mesothelioma radiation therapy stops the growth of rapidly dividing cells, such as mesothelioma cancer cells. Since normal cells in the lining of the bowel also divide rapidly, radiation treatment can stop those cells from growing, making it difficult for bowel tissue to repair itself. As bowel cells die and are not replaced, gastrointestinal problems develop over the next few days and weeks. Symptoms of acute enteritis usually get better 2 to 3 weeks after treatment ends.
Photodynamic therapy makes the skin and eyes sensitive to light for 6 weeks or more after treatment. Lung cancer patients are advised to avoid direct sunlight and bright indoor light for at least 6 weeks. If patients must go outdoors, they need to wear protective clothing, including sunglasses. Other temporary side effects of PDT may include coughing, trouble swallowing, and painful breathing or shortness of breath. Lung cancer patients should talk with their doctor about what to do if the skin becomes blistered, red, or swollen.
Nutrition plays a vital role in a mesothelioma patient’s well-being. By consuming enough essential nutrients, including vitamins, minerals, protein, carbohydrates, fat and water, the patient will benefit by feeling better and remaining stronger.
Maintaining a good diet is very important when an individual is being treated for mesothelioma. A patient needs to be as strong as possible in order to deal with often difficult cancer treatments, and eating the right foods as well as taking vitamins, herbs and other supplements under the supervision of a doctor can go a long way in strengthening the body.
If you have been diagnosed with mesothelioma, it is important to discuss a nutritional plan with your doctor. This can be as important as radiation, chemotherapy or other forms of cancer treatment. With the right nutritional plan, chances of survival can greatly improve.
Mesothelioma Nutrition Tips
In addition to eating a balanced diet, use the following tips to help strengthen the body’s ability to function well and fight disease:
- Avoid alcohol in excess amounts.
- Monitor weight carefully, not only being sure to stay trim, but also being sure to avoid becoming too thin.
- Learn about safe food preparation techniques.
- Cut the "bad" fats from your diet, opting instead for "good" fats, such as olive oil.
- Choose fruits and vegetables daily (these food groups should represent the bulk of your diet, approximately 50 percent).
- Avoid processed foods, like prepackaged meals.
- Make healthy choices when eating out, opting for low-carb or vegetable-based meals when possible.
- Monitor the types of fish you eat, choosing species low in mercury.
- Buy products that are organic.
- Do not eat fast food.
- Cut tobacco products out of your life.
- Take a multi-vitamin every day.
- Include adequate amounts of fiber in your diet.
If you or someone you love is suffering from mesothelioma, it is important to understand the unique nutritional needs of people in this situation, which differ significantly from those of a healthy person. A patient’s nutritional needs also vary depending on the type and stage of mesothelioma treatment a patient is undergoing.
Whether it is mesothelioma, asbestos-related lung cancer, or some other malignancy, most cancer patients suffer not only from the pain of the disease itself, but more often from the side effects and discomfort brought on by chemotherapy and radiation treatments. Several studies have been conducted over the past several years that demonstrated the palliative effects of massage therapy on cancer patients in helping them to deal with the above mentioned symptoms.
In the realm of alternative therapies for mesothelioma treatment, massage has always been popular. While massage certainly does not offer a cure for mesothelioma or any cancer, it has been shown to have positive effects on those that are suffering from the pain and distress of cancer and other serious diseases.
Massage therapy can help reduce pain, control stress, and improve quality of life for those dealing with mesothelioma. Massage can also help relieve the nausea that many patients suffer when undergoing chemotherapy. Massage therapy takes many forms - from relaxing to therapeutic. Seek the type that best suits your symptoms and personal preferences.
Before you try treating your mesothelioma with an alternative therapy, you should discuss its possible benefits and side effects with your doctor. If you are using any alternative mesothelioma treatment, you should tell your doctors about it. These alternative treatments should never be used instead of medical treatment. Be aware that these therapies may be expensive; some are not paid for by health insurance. You should consider asking the therapist for evidence of how the therapy has helped others, possibly by giving you references.
One of the more common complementary therapies used by patients with asbestos cancer is aromatherapy. Aromatherapy is not for all patients and offers no cure for the disease. However, when used in conjunction with other more traditional therapies, aromatherapy has helped many cancer patients lives become much more manageable as they battle their disease.
The practice of integrative oncology is becoming increasing prevalent in clinics and cancer centers across the United States. Integrative oncology stresses not only the use of traditional therapies like chemotherapy and surgery, but also alternative, preferential treatments that assist patients in overcoming symptoms of the cancer or traditional therapies. Of the more common practitioners of alternative therapies are mesothelioma cancer patients. Among the methods utilized by some mesothelioma patients is aromatherapy, which can lend itself to a sense of calmness and peace, which can aid sleeplessness and restlessness.
Like most complimentary and alternative therapies, aromatherapy appears to be primarily a palliative mesothelioma treatment; such treatments can be of assistance in coping with the side effects of chemotherapy and radiation treatments, and may indeed have some positive effect on the patient’s emotional and psychological state. This in turn has had the effect of lowering patients’ blood pressure, respiration rate, and anxiety levels.
Of course, this treatment is not for everyone. Alternative medicines are still highly criticized by those who solely believe in conventional medical treatments. It is important for patients to be aware of all available treatment options. Though researchers are still studying the effects of essential oils on the body, promising results in small-scale studies have been recorded.
In recent years, researchers have learned a great deal about how cancer cells differ from normal cells. In an effort to find drugs without the potentially severe side effects of chemotherapy, medical professionals have now discovered drugs which target the tumor itself while sparing the body’s normal cells. One such group are the anti-angiogenesis drugs.
Angiogenesis inhibitors encompass a group of drugs that block angiogenesis, the development of new blood vessels. Solid tumors are unable to grow beyond the size of a pinhead without the formation of new blood vessels to supply the nutritional needs of the tumor. By blocking the development of new blood vessels, the inhibitor cuts off the tumor’s supply of oxygen and nutrients, halting its continued growth and possible spread to other parts of the body. Unlike standard chemotherapy drugs, anti-angiogenic drugs are not toxic to most healthy cells, so they can be given without interruption. This may help these drugs be more effective in the treatment of cancer.
The most successful anti-angiogenic drug to date has been Endostatin. According to the manufacturers of the drug, Endostatin is a natural anti-angiogenic protein that has been shown to inhibit the growth of blood vessels, thereby starving cancerous tumors. Researchers have also discovered that when the drug is repeatedly administered, it consistently shrank primary tumors and, unlike traditional chemotherapy treatments, showed no drug resistance over time.
Alimta, also known by the generic name “Pemetrexed,” has been one of the most exciting developments in treatment of mesothelioma in recent years. It is the first and only medicine sanctioned by the FDA specifically to treat mesothelioma.
Alimta is a new drug that has been used to help stop the rapid growth of mesothelioma cancerous cells within a patient's body. Alimta hit the market in 2004, and since then it has been helping cancer patients that have mesothelioma improve and to stop the spread of this deadly disease. It has been shown to successfully help patients live longer and happier lives just by taking Alimta.
Alimta Side Effects
Expect to experience all or some of the side effects listed below. Some will be mild to moderate while others may be severe, but thanks to new drugs and other therapies, chemo side effects have indeed become more manageable.
- Blood and bone marrow problems
- Skin rash
- Sores in the mouth
Alimta is most generally administered along with Cisplatin, a chemotherapy drug. Together, these two drugs have been known to extend the life of asbestos cancer patients by several months, and are beneficial in controlling mesothelioma symptoms, such as discomfort and breathing difficulties. As with any mesothelioma treatment method, your doctor must determine whether or not you are a good candidate for Alimta treatment.
Navelbine (Vinorelbine) Treatment
Navelbine, one of the most recent chemotherapy drugs for mesothelioma cancer available today, is from a group of drugs known as plant alkaloids. These drugs work by stopping the cancer cells from separating into two new cells, therefore blocking the growth of the cancer. Navelbine may be used in tandem with another chemotherapy drug from a different family of medications.
The chemotherapy drug Navelbine (also called Vinorelbine) may turn out to be a more effective treatment of mesothelioma cancer than other chemotherapy treatments such as Cisplatin. Recently researchers in Great Britain found that vinorelbine produces significantly less toxic effects than other chemotherapies when used to treat the symptoms of mesothelioma. Additionally, the results of a clinical study conducted at St. Bartholomew's Hospital in London strongly suggests that Navelbine may also prolong the lives of people with mesothelioma.
Navelbine works specifically by inhibiting the development of cell structures; without microtubule structures, cells do not function properly and die. Essentially, Navelbine tells the cell to develop without this crucial element, causing the cell to abort, halting further growth. Navelbine, like all chemotherapy drugs, may disrupt the growth of cancer cells in patients with malignant mesothelioma.
Navelbine Side Effects
Unfortunately, Navelbine can damage normal healthy cells, and can cause unpleasant side effects including:
- Low blood counts - Your white and red blood cells may temporarily decrease. This can put you at increased risk for infection or anemia.
- Nadir - Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
- Nausea or vomiting
- Muscle weakness
- Peripheral neuropathy (numbness in your fingers and toes) - may occur with repeated doses. This should be reported to your healthcare provider.
- Hair loss
- Low platelet counts - This can put you at increased risk for bleeding.
- Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
Mesothelioma and other cancer patients have successfully used meditation techniques to control the symptoms of the disease as well as the side effects of mesothelioma treatment.
In no way does meditation offer a cure for cancer, but during the last two decades, studies have shown that it does help to decrease pain, anxiety, stress, blood pressure, and insomnia. Meditation has been shown to be very helpful in addressing anxiety and stress. Specific studies conducted over the years note an increase in brain activity in the area linked to positive emotional states in those who meditate as compared to those who do not.
Benefits of Meditation Therapy
All forms of meditative practice have the same beneficial components:
- Deep relaxation
- Highly focused concentration
- Altered state of consciousness
- Suspension of left-brain functions
- High and sustained level of self-awareness
Cancer patients who limit themselves to the kind of meditation that does not involve strenuous activity should have no problem with this alternative mesothelioma treatment. The biggest complaint is a feeling of light-headedness and sometimes disorientation (researchers note that individuals with previous mental health problems experience the disoriented feeling more than others.). If you would like to attempt a more physical form of meditation, such as yoga, tai chi, or qigong, you should consult your doctor before signing up for any classes or sessions.
The goal of gene therapy is to get at the root cause of a disease. Instead of dealing with the errant effects of faulty genes after the fact, gene therapy attempts to deliver the proper instructions to your cells, avoiding the negative affects altogether.
The initial goals of gene therapy are to address hereditary genetic disorders; diseases specifically tied to our genes. Initially, it was thought that our genes were "fixed blueprints" for our bodies that remained unchanged throughout our life. As it turns out, genes are more complicated and changing than that. The sun, smoking, chemicals and other factors can all damage our DNA and result in mutations that cause faulty genetic behavior. Because of this, many diseases not originally seen as candidates for gene therapy are, indeed, potential targets, including malignant mesothelioma.
In the case of mesothelioma, exposure to asbestos is the environmental factor that leads to development of this lethal cancer. There can also be a natural genetic predisposition to mesothelioma cancer, however, and smoking has proven to be an additional aggravating factor for the disease. Mesothelioma can have multiple types of gene damage contributing to its development and complicating attempts to develop genetic science that will help control or cure the disease.
Mesothelioma Gene Therapy Process
Mesothelioma gene therapy treatment is a four-step process:
- In mesothelioma, the cancer attacks the fragile membranes on the surface of the lung and the opposing chest wall. These membranes form the pleural cavity.
- To kill the cancer, researchers first insert a tube through the patient's chest wall into the cavity and inject an adenovirus.
- The injected adenovirus carries a gene that forces the pleural cells to make the enzyme thymidine kinase (TK).
- The patient is then injected with the antiviral drug ganciclovir. The drug kills only those cells making TK, thus knocking out the cancer.
The use of gene therapy for mesothelioma is still a subject for research rather than established treatment procedures. The theory of gene therapy seems to align itself well with cancer treatment, however the fact that mesothelioma is a "multifactorial" disease with several contributing factors along with asbestos requires multi-faceted treatment. Gene therapy may prove to be most effective when utilized in conjunction with chemotherapy and radiotherapy, providing an attack on the cancerous tissue with several approaches.
Gemcitabine is a relatively new chemotherapy drug for mesothelioma. It is currently in clinical trials with many mesothelioma patients in combination with Cisplatin, Alimta and Epirubicin. Gemcitabine is believed to be the most effective drug in the treatment of mesothelioma cancer.
Gemcitabine is a nucleoside analog or look alike, also called an antimetabolite, used as a chemotherapeutic drug. It is produced by Eli Lily and Co., and marketed under the name ‘Gemzar.’ Nucleosides are molecules in the body that are the building blocks for the bases that make up DNA and RNA. These are bases that are linked to sugar molecules that can have a phosphate group added by enzymes called kinases in a cell.
As a treatment for mesothelioma, Gemcitabine is used in combination with other drugs to have the desired effect. The duration of the infusion is typically around 30 minutes, and the patient may need weekly sessions, lasting for up to seven weeks in all. However, this may vary depending on the stages of mesothelioma the person is in, and the type of cancer he is suffering from.
Gemcitabine reduces the effectiveness of a patient’s immune system. If you are taking Gemcitabine, be sure to avoid contact with people who have colds or other infections. Also, be sure to keep your doctor informed of any side effects you may be experiencing.
The physical pain caused by mesothelioma is perceived by some as impossible to bear. Many patients and their families are unaware of the fact that there are effective solutions for controlling cancer pain, and often with a combination of medicines physical pain can be managed.
Mesothelioma is undoubtedly a horrific condition, more so in the later stages of the disease. Pain Management for mesothelioma is one of the most challenging parts of treating this disease in order to improve the quality of life for victims. Part of the trouble stems from the fact that the drugs required to treat mesothelioma pain can cause almost as much discomfort as the disease itself or can negatively interact with pain-relieving drugs.
In the early stages, pain is usually controlled with over-the-counter products such as aspirin, acetaminophen, or ibuprofen. Although surgery, chemotherapy, and radiation are used to arrest the disease process and alleviate the initial pain symptoms, the treatments themselves may not be pain-free. The needs of the patient and the type of procedure done will determine the kinds of medication that can be given.
Advanced mesothelioma is far more complicated to treat. Doctors usually use one of two routes to attempt to bring relief to victims enduring the agony of advanced malignant mesothelioma. Increasingly powerful opiate drugs such as morphine fentanyl, vicodin, oxycodone, and hydromorphone are strong enough to eliminate a great deal of pain, but have to be strictly monitored by a doctor.
A patient is the only one who knows best where the pain occurs, when it occurs, or how intense it is and what could help him/her during this time of pain. Maintaining a graph or a journal will help in keeping a close eye on the pain and help in better management. Once you notice a pain pattern and document it in your journal, it will become easier for your doctors to treat your pain. The patient can discuss this in detail with the medical team who can come up with an effective plan for pain management. Also inform your doctor if you develop any new kind of pain or problem so it can be promptly looked into and managed.
The type of medicine and the method by which the medicine is administered will depend on the type and cause of the pain. What follows is an overview of the types of medicines used to relieve pain:
- Mild to moderate pain - Nonopioids: Many of these medications are available over-the-counter (without a prescription); others require a prescription. Some drugs included in this category are acetaminophen, aspirin, and ibuprofen. Check with your doctor before using these medications, especially if you are on chemotherapy.
- Moderate to severe pain - Opioids: Also known as narcotics, these may include morphine, fentanyl, hydromorphone, oxycodone, meperidine, codeine, and methadone. These drugs are available through prescription only. Nonopioids may be used in conjunction with opioids for moderate to severe pain.
- Breakthrough pain - Rapid-onset Opioids: Available by prescription, this is a short-acting opioid (such as immediate-release oral morphine) which relieves pain quickly. It is used with a long-acting opioid for persistent pain.
One Man’s Fight with Mesothelioma: Wall Street Journal Video
Click on the following link to view an excellent video by the Wall Street Journal on the heartbreaking last days of Bill McQueen, a Texas surgeon and U.S. Air Force Veteran who lost his life to mesothelioma in 2013.
Our Experience - Mesothelioma Litigation
Why You Should Choose Schmidt & Clark, LLP
"Our law firm has substantial expertise in the highly specialized field of occupational Asbestos exposure litigation."
There are many law firms in the United States that advertise their legal services for Mesothelioma lawsuits, however most of these law firms do not actually litigate them. You can contact our law firm with confidence in knowing that we have earned the nationwide respect and recognition from our peers for the successful representation of Mesothelioma victims and their families.
If you or a loved one have been exposed to Asbestos and developed a form of Asbestos related cancer such as Mesothelioma or other related disease, you should contact us immediately. You may be entitled to compensation and we can help.
Who is at risk for asbestos exposure?
Mesothelioma is found in people who are chronically exposed to asbestos material. Those who are at the highest risk of developing mesothelioma are the people who directly handle asbestos material at their job. This group includes:
- vehicle mechanics
- construction workers
- shipyard workers
- other workers in the building trades
Once mesothelioma is suspected through imaging tests, it is confirmed by pathological examination. Tissue is removed, put under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. If further examination is warranted, the following tests may be done:
Thoracoscopy - For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller. If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.
Peritoneoscopy - For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.
If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
Biopsy - If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.
Mesothelioma in Veterans
Among all those individuals in the United States stricken with mesothelioma cancer, veterans represent the group of people with the highest rate of the disease. The reason why is simple. Asbestos, the only known cause of mesothelioma, was used by the U.S. military from the 1930’s to the late 1970’s for literally hundreds of applications.
It is now apparent that hundreds of thousands — perhaps millions — of veterans were exposed to the toxic material as part of their military service. Asbestos was present in many products used by military members and civilian contractors when they built military facilities and ships, or maintained military vehicles. Common asbestos-containing products included:
- Flooring products
- Steam pipes
- Hot water pipes
- Brakes and clutches
- Boilers, turbines, and generators
The branch of the service one served in does not matter. Asbestos was present in many locations owned or frequented by members of the U.S. Armed Forces. Because exposure was unavoidable for some, mesothelioma remains one of the most serious diseases affecting veterans, particularly those who served between World War II and the Vietnam Conflict.
According to the U.S. Department of Veterans Affairs, there are currently 25 million living individuals who have served in the United States armed forces. Hundreds of thousands, if not millions of these living veterans were exposed to toxic asbestos-containing materials during military service.
Those who may have been directly or indirectly in contact with asbestos fibers include Navy shipyard workers, other military branches and even civilian workers employed on or off shore in different commands. Research shows that specific jobs exposed workers to asbestos. These include machinists mates, machinery repairmen, and those who worked in boiler rooms. There is a higher rate among those workers on different Navy ships for contracting the deadly disease. This was due to asbestos being used more frequently in shipyards than any other military location in the country. Since mesothelioma and other lung related diseases are triggered in later stages of life, veterans who were involved in the military between 1940 and 1970 are those who are at an increased risk.
Naval records for asbestos-containing materials used in shipyards, ship construction or ship repairs still exist and are used in investigating mesothelioma, asbestosis, and asbestos cases. Military specifications have helped to identify many asbestos-containing products for veteran asbestos claims.
Veterans and civilian employees may have encountered asbestos while doing a number of jobs aboard the ships, including welding, pipefitting, plumbing, electrical work, insulating, and much more. Furthermore, those who were involved with the repair of ships when they returned from battle were constantly exposed to damaged asbestos, which releases tiny asbestos particles that can be inhaled and later cause scarring and even cancerous tumors. Almost no one who worked at U.S. shipyards was exempt from asbestos exposure.
Marine Corp. Vets
Unfortunately, marine veterans may be at risk of developing asbestos-related diseases such as mesothelioma due to the military’s high use of asbestos during the 1940s through the 1970s.
Marines are at risk of asbestos exposure because of the extensive use of asbestos in all types of products. Asbestos was used in insulation, pipes and wiring in all types of construction, from industrial to residential. At one time, the military had a mandate in place calling for the increased use of asbestos-containing products in their projects.
Marine units regularly worked together with Navy crews, utilizing Navy aircraft carriers as their base from which to fly fighter-bombers on ship to shore missions. As a result, they would live on these ships for the extent of the mission. This close-working affiliation between the Marines and the Navy puts Marine veterans at just as high of a risk of asbestos related illness as those veterans who served in the Navy. In fact, even Marines that never set foot on a Navy vessel are at risk of asbestos exposure. Asbestos was commonly used in the cement pipes, ceiling tiles and insulation in the barracks where Marines spent their time.
Military veterans and civilians with asbestos-related illnesses usually find themselves in difficult circumstances when trying to obtain help and compensation for their unnecessary illness. At the present time, mesothelioma is not readily acknowledged as a service-linked medical disorder. Veterans can apply for Veteran Affairs (VA) benefits for asbestos-related illness, but must supply evidence that their exposure happened at the time of their military service.
Merchant Marine Veterans
Between the late 1920s and 1975, many of the ships used by the merchant marines contained large amounts of asbestos for fireproofing and insulation. When the asbestos materials onboard merchant marine ships were disturbed, they could cause asbestos fibers to become airborne. Because asbestos is extremely toxic, inhaling or ingesting these fibers could lead to mesothelioma, asbestosis, or lung cancer.
Merchant vessels are essential to everyday life in America. Each day, ships depart from the country's many ports to deliver goods to other countries. In addition, other merchant vessels arrive at our nation's ports with items from other countries that have become essential to our well-being. Tankers carry petroleum for our refineries and other large vessels tote coal or iron ore. Also, in time of war, the military largely depends on ships to bring them the supplies they need, no matter where they're stationed.
As if wartime dangers aren't perilous enough in and of themselves, most merchant mariners are also at great risk for contracting mesothelioma and other diseases, primarily because material used to insulate military ship boilers and piping contained (and sometimes still contains) asbestos. Therefore, those who interact directly with the vessels' onboard machinery, piping, engines, boilers and furnaces are especially susceptible to developing a deadly asbestos cancer disease such as mesothelioma,lung cancer and asbestosis. More specifically, the engineers who install, repair and run the engines, generators, boilers, pipes and pumps, and the oilers and QMED's who lubricate the machinery are at greater risk than the pilots, sailors and officers and mates who generally have more of a navigational role about the ship.
Mesothelioma in Oil Refinery Workers
The process of refining crude oil into gasoline and other products is essential to modern life, but it could be deadly to the lives of thousands of people who have worked in oil refineries. There are about 2000 cases diagnosed in the U.S. each year, and a disproportionate number of them are found in former oil refinery workers.
The rate of asbestos cancer among refinery employees who worked in the profession prior to the asbestos warnings of the 1970s is considerable. Oil refinery workers have been diagnosed with such diseases as pleural plaques, asbestosis, and mesothelioma. Sadly, though many refinery managers knew about the dangers of asbestos, workers were often not warned and several decades later, many are paying the price with their lives.
As a result of their continual asbestos exposure, oil refinery workers have been shown to have a higher risk of malignant mesothelioma than other types of industrial workers. In fact, a British study of more than 45,000 oil refinery workers who had worked in the industry for at least a year between 1946 and 1971, found ‘significantly elevated’ rates of mesothelioma and other asbestos-related diseases.
Another NIH study conducted in 2000 and published in the American Journal of Industrial Medicine found a 96-100% correlation between mesothelioma and job-related asbestos exposure among oil refinery maintenance workers. The same study also found two cases of asbestos-related lung cancer among these workers for each case of mesothelioma.
As of 2009, there were 141 operational oil refineries in the U.S. producing more than seventeen and a half million barrels a day. All of these facilities were constructed before 1976, several years prior to the federal government’s widespread regulation of asbestos. Although the U.S. is no longer building new oil refineries, asbestos is still present in existing facilities.
Mesothelioma in Power Plant Workers
Utility workers involved in the operation and maintenance of utility powerhouses and other facilities have been exposed to asbestos products in alarming numbers.
Those who work in power generating facilities - particularly electricians, pipe-fitters, boilermakers, and other repair/maintenance personnel - are among those industrial workers at greatest risk for contracting asbestos-related diseases. According to the Center for Health Statistics, malignant mesothelioma victims made up over three percent of the workers who die of work-related causes, with the most common form being pleural mesothelioma, a cancer that affects the lining of the chest.
Because many of the machines in a power plant generate or give off extraordinary heat, asbestos was often used gratuitously as an insulation and protection against fire. Additionally, asbestos may be found inside many power plant machines. Even the walls, floor tiles, and ceiling tiles in a power plant may be sites of exposure for the power plant worker.
Many power plants across the U.S. have been renovated and asbestos has been removed. However, some plants still contain asbestos. Workers should be particularly diligent when working in older plants to ensure that they are not exposed. Respirators or filtering masks should always be worn.
Mesothelioma in Electricians
Electricians are exposed to many hazards, including the risk of electrocution and the chance of exposure to deadly chemicals and substances like asbestos.
While new products used by electricians no longer contain asbestos, those in the profession are often faced with the task of working in buildings that were constructed prior to the asbestos warnings; therefore, materials encountered may contain the dangerous material.
Asbestos was widely used in electrical insulation due to the fact that it does not burn. Electricians often engage in activities such as drilling and cutting in the course of their work. These activities, when performed on asbestos-containing materials, can lead to the release of asbestos fibers. Asbestos fibers are typically not visible to the human eye and can be easily
inhaled. Once inhaled, the fibers can become trapped in the lungs and lead to cancers such as lung cancer and mesothelioma.
As the dangers of asbestos were not well-known or were often covered up, electricians may not have worn protective masks to keep them from inhaling airborne fibers. Asbestos-containing items encountered by electricians may include:
- Cement Siding
- Cement Wallboard
- Acoustical Plaster
- Decorative Plaster
- Textured Paints
- Ceiling Tiles
- Electrical Cloth
- Electrical Panel Partitions
- Electrical Ducts
- Electric Wiring Insulation
- Thermal Paper Products
- High Temperature Gaskets
- Spackling Compounds
Today's electricians understand that it is necessary to wear protective masks or respirators while working around products that may contain asbestos. However, electricians of days gone by were not so attuned to the mineral's danger, so most did not wear any sort of protective gear. Decades later, cases of asbestos-caused diseases, such as mesothelioma, are on the rise among electricians.
Mesothelioma in Plumbers
The widespread use of asbestos in America in the 1960s, 70s and early '80s, particularly in building and construction, meant that plumbers and other workers involved in asbestos removal, renovation, or maintenance work that disturbs existing asbestos would remain at risk.
Plumbers deal with equipment and parts that must insure the smooth running of hot and cold water to various fixtures within a home or small commercial building. Furthermore, these parts must remain resistant to major changes in temperature or corrosion. For that reason, pipes - even those in homes - were often insulated with asbestos-containing materials, particularly in structures built prior to the 1980s. Asbestos may also be found in pipe fittings, pipe coatings, and water heater filaments that were installed before the asbestos warnings of approximately 30 years ago.
Since plumbers often worked in close, cramped spaces without protective gear, they often inhaled asbestos particles as they cut asbestos paper, sawed, soldered and joined pipes or sanded down block insulation, resulting in the release of tiny and sometimes lethal airborne asbestos fibers. Sadly, this kind of toxic inhalation often results in asbestos-related lung diseases such as asbestosis, mesothelioma, and lung cancer.
Homeowners who decide to tackle plumbing jobs should be diligent about protecting themselves and their family members as well, especially in old homes, and should be informed as to local laws about the removal and disposal of asbestos-containing materials before they begin a plumbing job inside the home.
Mesothelioma in Boilermakers
Because of their exposure to asbestos on the job, boilermakers are one of the at-risk occupations for mesothelioma. Since boilermakers maintain, install, and repair boilers or other large vessels that hold either liquids or gasses, they have come in close contact with a number of asbestos-contaminated materials.
A boilermaker is someone who maintains, installs, and repairs boilers or other large vessels that hold either liquids or gasses. The job of a boilermaker can be difficult and dangerous, sometimes involving hours spent in damp, cramped quarters, working with potentially hazardous acetylene torches and other tools. Many years after the first boilers were manufactured and installed in commercial buildings and residences, thousands have suffered from serious diseases, largely due to the fact that their working environment was contaminated with asbestos.
Companies that manufactured asbestos-containing boilers from approximately the 1920s until the 1970s include:
- Babcock & Wilcox
- Combustion Engineering
- Foster Wheeler
- Erie City
- Cleaver Brooks
Many of these companies also manufactured asbestos-containing gaskets, refractory lining materials and insulation for the boilers, all used to create an absolutely heat-resistant environment for the boiler but causing potential harm to the boilermaker.
It was rare for boilermakers to use any kind of protective equipment, as many employers failed to communicate to employees the dangers of asbestos exposure. The result is that thousands of boilermakers are now contending with mesothelioma, lung cancer and other conditions related to asbestos exposure. If you happen to be one of them, or if you have lost a loved one to asbestos cancer, you are entitled to pursue legal remedies that may result in financial compensation for health problems.
Mesothelioma in Auto Mechanics
Sadly, auto mechanics are one set of workers that are presumed to bear an exceptionally high risk of mesothelioma. Mechanics are potentially exposed to short chrysotile fibers during the installation and repair of asbestos-containing brakes.
The nature of auto mechanic work lends itself to creating asbestos dust. Unfortunately, not all workers are educated in the occupational risks and hazards associated with working in an auto shop and believe that if they do not directly inhale dust that they will not be affected. Nothing could be further from the truth. Many modern auto shops do provide respirator gear, but a lot of mechanics believe they "get in the way" or are unattractive.
Auto Parts Potentially Containing Asbestos
For many years, automobile parts that needed insulation from heat and friction were manufactured from dangerous asbestos, due its exceptional heat-resistant qualities. Such parts included:
- brake linings
- clutch facings
- transmission components
- disc brake pads
- drum brake linings
- brake blocks
Additionally, the families of auto mechanics might also be at risk for mesothelioma, as the asbestos fibers get embedded in the clothes of the worker. When he or she goes home, the fibers travel along. Then, the family breathes in the fibers and receives the same exposure. If you work in an industry or have worked in an industry with asbestos exposure and have any symptoms or any concerns about mesothelioma, please talk to your doctor about your concerns.
Mesothelioma in Aircraft Mechanics
Aircraft mechanics and repairmen are high risk jobs for developing mesothelioma because they work first hand with asbestos containing parts.
Many airplane parts were historically made with asbestos because of its light weight and tensile strength. In 1981, the Navy began to replace asbestos-containing parts on Naval aircraft with parts that did not contain asbestos, but many aircraft mechanics and repairman had already been exposed to asbestos. Because of the nature of asbestos, renovations and retrofitting aircraft with non-asbestos-containing materials also carries a high risk of asbestos exposure.
Naval aircraft mechanics aboard aircraft carriers faced additional asbestos exposure from the asbestos insulation that was used so extensively on ships built prior to the 1980s. Aircraft mechanics working in shops where construction was going on faced construction-related asbestos exposure in addition to the asbestos released as a result of their own work.
If you have worked as an aircraft mechanic, particularly in retrofitting aircraft, you may have been exposed to asbestos and are at risk of developing mesothelioma. Your doctor should be aware of your history of working with asbestos. Many of the symptoms of those diseases are similar to the symptoms of milder illnesses, which can delay a proper diagnosis and reduce your options for treatment. Making your doctor aware of your possible asbestos exposure may enable an earlier diagnosis and open avenues of treatment that are not effective once the disease has progressed.
Mesothelioma in Blacksmiths
Because blacksmiths work with heated materials, they have historically had to use asbestos-containing materials. Those who worked as blacksmiths before the 1980s were at an extremely high risk of being exposed to asbestos in a number of different ways.
Throughout the 20th century, the use of asbestos caused blacksmiths to be exposed to tiny airborne particles that flaked off panels or other asbestos items they worked with. When asbestos flakes off and is inhaled, the dust makes its way into the person's lungs where it can cause any number of diseases including asbestosis, pleural plaques, or mesothelioma. It can also get on the person's hair, clothing, or shoes and be transported home. Thus family members may also be at risk of asbestos exposure even if they don't work in the blacksmith shop themselves. Once in the lungs, it causes tissue irritation and eventual scarring.
Asbestos has been proven to cause pleural mesothelioma, a rare cancer caused by asbestos exposure. A number of blacksmiths have developed pleural mesothelioma as a result of working with asbestos-contaminated materials. Those who have worked as a blacksmith may have been exposed to asbestos and are at risk of developing pleural mesothelioma. Such persons at risk should make their doctor aware of their potential asbestos exposure to have regular checkups for signs of asbestos disease.
Mesothelioma in Children
When people think of mesothelioma, they typically picture an older adult who has been exposed to asbestos. Yet the disease can, in rare cases, also strike children.
The latency period of mesothelioma can be many years, so often diagnosing children with mesothelioma can be difficult because they have not lived that long. However, there have been rare cases and studies that detected mesothelioma in children. Because the prognosis is poor, doctors need to carefully diagnose mesothelioma in their youngest patients.
It is important to understand that mesothelioma is not inherited through genes, therefore just because your mother or father has it does not mean it is automatically passed on. Mesothelioma is also not contagious. There have been cases where children have been diagnosed with mesothelioma, but it is through contact with asbestos.
In some cases, parents who worked in manufacturing or construction companies have exposed children to asbestos through clothing. When at work, the asbestos becomes trapped in either the clothing or other accessories, and when brought home the transmission occurred through the air. The asbestos-contaminated air could then be breathed in by a child.
In other cases, homes built between the 1920s and 1980s may have attics that contain asbestos insulation known as vermiculite. Older roofs may contain asbestos that would then be breathed in. If there is ever a question whether or not your house contains asbestos, it is always best to hire a licensed professional asbestos inspector.
It is vital that you pay attention to your child and to be able to recognize any signs of mesothelioma that he or she might exhibit. Remember that doctors are still largely uncertain of what causes mesothelioma in children, so don't hesitate to have a doctor check on your child if you see any of the signs or symptoms.
Mesothelioma in Bricklayers
Though asbestos is no longer in use in the manufacture of construction products, bricklayers faced the dangers of asbestos inhalation on the job for several decades. Furthermore, a bricklayer who is working on the repair or restoration of an old building where asbestos is present in bricks, blocks, or mortar may be exposed to tiny airborne asbestos products while on the job, even decades after use of the toxic mineral was halted.
Like most construction workers, bricklayers are at higher risk of exposure to asbestos than the general population. Among the ways that bricklayers may have been exposed to asbestos are:
- Hand mixing compound and mortar that contained asbestos fibers
- Demolition of old walls containing asbestos
- Being in the vicinity of construction work that disturbed asbestos
- Cutting and breaking firebrick and mortar containing asbestos
- Working with asbestos-containing products
Additionally, bricklayers who specialize in building furnace walls and other similar structures may also encounter dangers from old fire bricks that contain asbestos, so care should always be taken when demolishing these structures and protective gear should be worn at all times. Exposure to asbestos through any of these means could result in a diagnosis of mesothelioma later in life.
Mesothelioma in Aeronautical Engineers
Aeronautical engineers work to maintain, update, and retrofit airplanes with modern equipment and materials. This activity potentially brings the aeronautical engineer into contact with asbestos.
Asbestos is used in many different ways in the aeronautics industry because of its heat resistance, light weight, and high tensile strength. That places those who work in the aeronautics industry at risk of exposure to asbestos, particularly those who work with and around aeronautical equipment, and in and around engines. The aeronautical industry is making efforts to find suitable replacements for asbestos in aeronautical and aircraft parts, but currently, many parts of aircraft that are subjected to high temperatures are still made with asbestos.
Aircraft parts made from asbestos
Among the aircraft parts that are made with asbestos:
- Brake linings
- Seating gaskets
- Fire barriers
In addition to asbestos on the airplanes, asbestos liners were used until 1993 in some airfield runway lighting systems. Gaskets were stored at airfields, potentially infecting anyone entering the storage unit. People working to change out the gaskets are at a greater risk of having been exposed to high levels of airborne asbestos.
Anyone who works in or around aeronautical plants, including design engineers, is at some risk of being exposed to asbestos and the hazards it presents. If you have worked as an aeronautical engineer for the aeronautical or aerospace industries, there is a chance that you may have been exposed to asbestos while working with and around equipment that is typically used to maintain, manufacture, or retrofit airplane and spacecraft engines.
Mesothelioma in Civil Engineers
Civil engineers encounter a variety of different scenarios while on the job that may put them in contact with asbestos. Despite the fact that there have been no new uses of asbestos since the late 1970s, civil engineers that worked with construction material prior to that time may have regularly been exposed to the hazardous material.
A civil engineer is one of the oldest type of engineer. They are responsible for designing, building, and maintaining all of the public infrastructures necessary for a growing population. Civil engineering covers a number of specialties, such as water resources, the environment, construction, and transportation. Any of these positions could have brought civil engineers in contact with asbestos and products containing asbestos, and therefore put them at risk of developing an asbestos related illness like asbestosis or mesothelioma.
In the past, a visit to any construction site was almost certain to expose the visitor to asbestos. Few contractors understood the dangers of asbestos and almost no one took any safety precautions to reduce the amount of asbestos dust floating in the air. Since asbestos was so widely used, both as a construction material and as parts of the equipment used for construction, asbestos fibers were thick and heavy in the air.
Even those who began practicing the art of engineering after the U.S. government issued warnings about asbestos use may still encounter the toxic mineral when working where asbestos is still present and has not yet been substituted for a safer material. This could happen in any place at any time, so engineers working in scenarios that may include old asbestos should always take precautions, including donning face masks or respirators where necessary.
Mesothelioma in Carpenters
The carpentry industry has long been one of the major users of asbestos and asbestos-containing projects. For decades, before asbestos warnings were issued in the 1970s, those who worked in construction, including carpenters, were facing constant exposure to this hazardous material.
Sadly, almost every construction product that carpenters used prior to the mid-1970s or early 1980s may have contained asbestos. In addition, because many other construction products contained asbestos, it is likely that carpenters working on residential and commercial building sites worked in asbestos-laden environments on a daily basis. Though many companies and company owners knew of the dangers of asbestos, workers were rarely supplied with safety equipment like masks and respirators, which would have curtailed the inhalation of airborne asbestos fibers.
Carpentry products containing asbestos included wallboard, gypsum, floor tiles, shingles, paint, paper, and cement. Using power tools further exacerbated the exposure risks because using a power saw, for example, to cut wallboard was likely to generate a large amount of dust that contained asbestos particles that could become airborne. Until the mid-1980's, when the dangers of asbestos exposure became evident, many carpenters were unaware of the risks and did not take appropriate safety measures. Today, carpenters use masks and respirators to avoid risking exposure to potentially harmful asbestos fibers.
Undertaking any type of remodeling project these days requires an inspection to be performed to see if asbestos exists in the structure. If so, proper asbestos abatement protocol must be followed before work can begin. It is generally advised to call on the services of an asbestos removal specialist if asbestos is suspected to exist.
Mesothelioma in Automobile Workers
In Detroit and elsewhere, the high rate of mesothelioma and other deadly illnesses in America's auto factory workers continues to be a growing concern.
A link between auto workers and cancer began gaining attention in the 1970s. During this time, asbestos-related cancers such as mesothelioma began cropping up in an unusual number of industry employees. The cause, as it turns out, is the extended amount of time that auto employees spent working around asbestos-laden brake pads and clutch plates.
Brake linings are made with asbestos because of the level of heat resistance that asbestos adds to the material of which the linings are made. Workers who handled and installed the brake linings were exposed to asbestos dust from the product. In addition, many other auto parts may have contained asbestos. As a result of handling those parts, including packing and unpacking, installing, sanding, buffing, polishing, grinding and drilling them for installation, asbestos fibers may have been released into the air.
Many people assume that asbestos is banned for use in the United States, but that is only partially true. Asbestos has been banned for many uses, but it is still used in many products, including brake linings. In addition, while asbestos may not be used in manufacturing parts made in the United States, many of the parts used in automobiles are manufactured elsewhere, such as countries that do not have the same standards for asbestos use as the United States.
Mesothelioma in Construction Workers
Unfortunately, people working in the construction industry in the past used many products that exposed them to asbestos. From insulation & welding rods to floor and ceiling tiles, anyone working in construction faced asbestos exposure on a regular basis.
Construction has always been a high-risk industry. But one of the greatest risks for construction workers, especially those involved in the renovation or repair of older buildings, is the risk of exposure to asbestos and mesothelioma. Thousands of construction workers have died from diseases caused by work with asbestos.
Although the Occupational Safety and Health Administration (OSHA) and the Environment Protection Agency (EPA) have taken various regulatory actions over the years to try to protect construction workers from asbestos, EPA data suggests that the risk remains high. In 1971, OSHA established a permissible exposure limit (PEL) for asbestos of 12 fibers per cubic centimeter of air. That was reduced to just 0.1 f/cc in 1994, but OSHA inspection data collected in 2003 found that 20 percent of air samples collected from construction job sites exceeded allowable levels.
In addition to the lack of restriction on the use of asbestos throughout most of the 20th century, most construction companies did not provide their workers with protective equipment and clothing to prevent their workers from being exposed to asbestos. Indeed, construction workers were often employed in environments that were heavily laden with airborne asbestos fibers, and these fibers were inhaled by unprotected workers on a daily basis.
Since asbestos is not banned in the United States, asbestos-containing construction materials are still used in new construction. However, construction workers face a greater risk for asbestos exposure when they work on residential or commercial buildings that were constructed before the 1980s. The danger of asbestos exposure is heightened as buildings age because asbestos construction materials become friable over time, meaning that the asbestos crumbles easily and the fibers have an increased tendency to become airborne.
Mesothelioma in Firefighters
Firefighters are at risk of asbestos exposure because of its frequent use in older structures and its ability to linger in the air even after a fire has been extinguished.
Unlike so many other dangers faced by firefighters, the threat of asbestos is subtle and insidious. There is seldom any warning sign to tell a firefighter that they have been exposed to a toxic hazard. Asbestos is a hidden danger and firefighters are usually exposed to asbestos in situations where they have every reason to believe they are safe.
In the initial stages of extinguishing a fire, the burning asbestos may become damaged to the point where the fibers are easily released into the air. Once exposed into the air, it is easy to breathe it, where it becomes lodged in tiny sacs lining organs, and the victim is not able to breath or cough them out. Most protective equipment that firefighters use will eliminate the exposure risk. Often, in a real emergency, firefighters must surrender their protective gear in order to aid a victim, therefore exposing themselves.
In the secondary stages of extinguishing a fire, some firefighters may get rid of the protective gear because it is uncomfortable. The danger here is that the remaining debris may still contain a high level of asbestos and may release it when overturned.
Another risk firefighters face is when buildings scheduled for demolition are intentionally used (and burned) for training purposes. Although removing all regulated asbestos materials from such buildings before they are burned is now required by regulations of the National Emissions Standards for Hazardous Air Pollutants, this was not always the case. If such material is missed, the fire can release asbestos fibers into the air.
Mesothelioma in Pets
If you've noticed your pet has been exhibiting symptoms that include breathing problems, coughing, and difficulty exercising, and a member of your household has worked with asbestos and carried it into your home, your pet may indeed have an asbestos-related disease.
If you have mesothelioma, you may have wondered whether or not your pet might be at risk for developing the disease as well. These days, unfortunately, more and more cases of second-hand exposure to asbestos dust have resulted in diagnosis of mesothelioma for members of households where at least one member worked with the toxic mineral and brought it home on their clothes. Wives, siblings, children...anyone who may have breathed in the dangerous dust is at risk for developing an asbestos-related disease.
Despite some differences, mesothelioma in pets heavily resembles mesothelioma in humans. Like humans, mesothelioma in pets most commonly develops in the pleura, the internal lining that surrounds the lungs. Although rare, cases have been recorded in the peritoneum, which lines the abdominal cavity, and the pericardium, which lines the heart.
If you notice any of these symptoms in your pet, and have reason to believe your pet may have been exposed to asbestos, it is best to see a veterinarian. Upon diagnosis, a veterinarian may advise a range of treatments, such as thoracentesis (removal of fluid around the lungs), chemotherapy, or palliative treatments to alleviate pain. Unfortunately, due to the high cost of treatment and the extreme low probability that treatment will help, veterinarians may recommend euthanasia in many cases.
Asbestos in Plastics
Plastics are among the most useful and advanced materials of the 20th century. Unfortunately, plastic products have also long been associated with health hazards through the toxic materials of which they are composed and unstable compositions which may release these toxins. One of the more common toxins associated with plastic composition is asbestos.
Asbestos was used in plastics for the same reasons it was used in other compounds. The mineral has long been known for its durability and fire and heat resistant qualities. The inclusion of asbestos in certain plastic products was thought to make products safer and longer-lasting. Asbestos could be found in plastics such as PVC, nylon, and polypropylene.
Most often, those at risk of asbestos exposure are not the consumer or those who use these plastics, but those who are involved in the plastics molding process. While mixing compounds, plastic workers regularly dealt with friable asbestos fibers (asbestos fibers are considered friable if they are able to be inhaled or released air into the air). Those who have worked in plastics moldings or are regularly dealing with damaged or destroyed plastics products may also be at risk for asbestos inhalation.
Asbestos exposure continues to be a real risk in the production of plastics. Those who have worked within this industry should watch their respiratory health closely and have their lung health checked regularly by an appropriate physician or breathing specialist.
Asbestos in Insulation
Insulation, used in a myriad of applications, has long been associated with asbestos. In fact, for years those who installed insulation were referred to as "asbestos workers" because the majority of the materials they worked with daily contained the dangerous mineral.
Homeowners do everything possible to protect their home from fire and other dangers; to keep it warm in the winter and cool in the summer. Insulation plays a part in all of these issues and it’s clear that good insulation can keep a home safe and comfortable.
Unfortunately, asbestos insulation can be found wrapped around any number of items or pieces of equipment where heat or fire was a concern including boilers, generators, furnaces, ovens, pipes, and electrical wires. Insulators and anyone else working on or around those particular pieces of equipment may have been exposed to the asbestos insulation.
Insulators, construction workers, and those who worked in insulation factories were not the only ones who were at risk of exposure to asbestos from insulation. Homeowners, especially those who complete do-it-yourself projects, may be at risk, even though asbestos warnings issued in the late 1970s reduced the use of many kinds of asbestos. Homeowners tackling their own remodeling jobs may encounter old or "friable" insulation in attics, wrapped around wires or pipes, or elsewhere in their homes. If the proper precautions are not taken during certain projects, homeowners may expose not only themselves to airborne asbestos fibers but also expose family members who also live in the home.
Asbestos in Ceiling Tiles
Between World War II and the 1970s, asbestos was widely used to make ceiling tiles heat-resistant. While asbestos in construction materials is not currently banned in the U.S., it is not typically used in new construction because of liability issues and health concerns. However, asbestos ceiling tiles are still present in thousands of buildings, including residences and schools.
Unfortunately, asbestos ceiling tiles were used for much of the 20th century. That is, until the 1970s when the government began issuing warnings and guidelines concerning the use of asbestos products. Ceiling tiles can often be found in many older structures, including schools, office buildings and homes.
Ceiling tiles typically use a type of asbestos called amosite as a fire retardant, as well as another type of asbestos called chrysotile. Asbestos cannot be visually identified in ceiling tiles, but a simple rule is to assume that all ceiling tiles installed before 1981 contain asbestos fibers. It is not recommended that homeowners remove ceiling tiles in older houses without first sending a sample to be tested for asbestos fibers. If the ceiling tiles are intact and undamaged, there is less health risk than if the ceiling is damaged, because ceiling tiles will not release asbestos fibers unless they are damaged in some way. If a ceiling is drilled, broken, sawed, or removed, it may release asbestos fibers, so asbestos management practices must be employed if it is determined that ceiling tiles contain asbestos.
Anyone who attended or worked in a school that had asbestos ceiling tiles may also have been exposed. Such exposure may have occurred if the repair or replacement of these tiles was done improperly. A number of different companies manufactured asbestos-containing ceiling tiles and some are clearly marked and easy to identify. Others are not so easy to spot, so caution should always be used when removing old ceiling tiles that may contain asbestos.
The Asbestos Cover-up
Industry has known all about the deadly effects of asbestos for decades but covered it up. Manufacturers and users did everything possible to conceal just how deadly it is, particularly for those exposed on the job.
Despite the vast historical documentation that exposure to asbestos causes serious health conditions, the toxic mineral was heavily mined and processed into thousands of industrial and domestic products for many decades. Beginning in the late-1800s, commercial asbestos mines started operations across the globe. The booming Industrial Revolution fostered immense innovation in the application of asbestos, and the companies producing these products began to see increasing profits. It didn’t take long for the asbestos business to develop into a major industry, complete with soaring profit margins, thousands of employees, and merciless CEOs.
As early as the 1930s, executives at companies where asbestos was used daily were already covering up the fact that employees were being sickened and dying from asbestos-related diseases. They hid or destroyed memos about the dangers of asbestos, ignored doctor's reports, and quietly offered compensation to individuals affected by their daily work with the hazardous mineral, making them promise never to tell their co-workers about their disease.
Legislation finally was implemented to control the use of asbestos in the 1970s. Successful lawsuits against asbestos companies were brought and continue to this day. Unfortunately, this was too late for many who had been exposed to asbestos for years. Because the incubation period for these diseases, especially mesothelioma, is about 15-30 years, workers had no idea of their condition and found out too late that they were gravely ill.
When diagnosed, mesothelioma victims have less than 24 months to live. Symptoms arise when the disease is in its advanced stages, therefore, eliminating the chance to cure the cancer. Mesothelioma is 100% lethal. This is the fate that the heartless companies bestowed upon their dedicated workers.
There is no single product in day-to-day use at work or at home that needs to be made from or contain deadly asbestos -- yet over 3,000 workplace and home-based products contain this poison. It is possible to eliminate the use of asbestos by redesigning the job or product, or by using another, safer material.
Today there are myriad of alternatives to products that contain asbestos. So, when remodeling a home or renovating an office building, there are many choices to be considered. Many of them are "green," providing a safe alternative for the environment as well as for the individuals inside the building. Most are readily available and can be provided by a contractor.
The implementation of eco-friendly products can reduce annual energy costs in the household by 25 %. Many cities in the United States have begun adapting to the green paradigm in hopes of instilling environmentally sustainable building products that achieve a healthy home. Green alternatives to asbestos include the use of lcynene foam, cotton fiber and cellulose. Cotton fiber is made from recycled batted material and treated to be fireproof. A water based spray polyurethane foam, lcynene features no toxic components.
If asbestos is suspected in the home, the best advice is to leave it un-disturbed as this can make its fibers go airborne. A professional home inspector can determine the best course of action. If removal is necessary, a licensed abatement contractor who is licensed in handling dangerous materials will perform the removal. The Environmental Information Association has further information in regards to the removal, inspection of asbestos and green sustainable methods of construction.
Being a rare cancer, mesothelioma is now spreading fast among people of all ages and races due to asbestos exposure. According to the latest statistics report by the United States National Cancer Institute, mesothelioma is diagnosed in 2,000 to 3,000 people every year and with the passage of time, this figure is expected to rise as more and more people are falling victim to asbestos exposure.
- Mesothelioma has a long latency (inactive) period of anywhere between 15 – 50 years.
- Experts predict that mesothelioma diagnoses will continue to increase in the United States for at least another 10 to 20 years.
- While many countries have banned certain forms of asbestos, an estimated 5,000 asbestos-containing products exist today.
- As many as 8 million people in the U.S. have already been exposed to asbestos and it continues to pose a serious threat to workers in certain occupations.
- One study of asbestos insulation workers reported a mesothelioma death rate up to 344 times higher than the general population.
- Most mesothelioma victims die within 18 months of diagnosis. Mortality is swift not because the cancer is fast-growing but because it usually is far advanced by the time it is detected.
- Poor prognostic variables include: non-epithelial histology, older age (greater than 75 years), pleural primary, chest pain at presentation, poor performance status, and elevated platelet count (greater than 400,000/mcL).
- By the year 2030 there are estimates that asbestos will have caused 60,000 instances of mesothelioma and around 250,000 other cancers that result in death.
- Over half a million asbestos and mesothelioma injury claims have been filed to date.
- Mesothelioma statistics are very grim and shocking. However, it cannot be denied that these figures are true and the number of people suffering from mesothelioma is expected to rise as more and more people are getting exposed to asbestos. It is very important that these statistics are studied carefully and people who are at the highest risk of mesothelioma or suffering from it are given proper help and treatment.
Remission is the state of absence of disease activity in patients who have a chronic illness. Remission does not mean that the cancer has been completely cured; rather it typically refers to the response of cancer to treatment that is being administered. There are two different types of remission. Complete remission refers to the complete disappearance of the cancer after treatment. Partial remission signals shrinkage of the tumor or disease, without completely disappearing.
Many long-term survivors of mesothelioma indicate they drastically changed their diet and added daily supplements to enhance their immune system. Many of these same survivors promote the efficacy of alternative treatments as part of their regimen and several have shunned conventional treatments such as chemotherapy, radiation, or surgery.
Additionally, there has been a case reported of spontaneous remission of mesothelioma in Australia. The 61-year old woman, a patient of Dr. Roger K. Allen of the Wesley Medical Centre, went into a rapid remission. The physician suggests that what caused the remission was the patient’s own immune system as well as “cell-mediated immunity.” Further study may lead to immunotherapy as a method of treatment leading to the remission of this type of cancer.
With the advent of new medications, improved treatments, early detection methods and clinical trials, remissions are becoming more common. Additional money is now being spent on mesothelioma research and support groups nationwide are receiving more donations.
There are a number of factors involved in determining the life expectancy of mesothelioma cancer patients, and every patient has a unique case. Because medical professionals are in a constant search for advances in treatment options and ways to increase the life expectancy of mesothelioma patients, affected individuals today have a far better outlook than just five years ago.
Research scientists and doctors have struggled to improve the life expectancy for mesothelioma patients for decades. While there is no definitive cure for mesothelioma, patients may elect to undergo intensive treatment that may help prolong their life expectancy or improve the patient’s overall quality of life.
Factors Affecting Life Expectancy with Mesothelioma
The life expectancy of a mesothelioma patient is affected by numerous factors including:
- Age of diagnosis - Age plays a huge role in life expectancy. Younger patients are usually physically stronger and may have few other health concerns and are more easily treated. Older mesothelioma victims, on the other hand, may already be plagued with a number of other ailments that affect the geriatric population, including heart disease, diabetes, high blood pressure and more.
- Latency - Mesothelioma latency is usually estimated as being roughly 15 to 40 years, although there have been cases in which the mesothelioma cancer latency was as short as five years and as long as 50 years after the exposure to asbestos fibers occurred.
- Smoking - Smoking and asbestos exposure (whether it is in the present or many years ago) is a very serious combination. The repercussions may include lung cancer or lung-related illnesses such as mesothelioma.
- Types of mesothelioma - There are three major types of mesothelioma an individual can develop. The most common form is pleural mesothelioma, which affects the lining of the lungs. Other forms of the disease include peritoneal and pericardial mesothelioma, which affect the lining of the abdomen and heart. Since pleural mesothelioma affects the most mesothelioma patients, more knowledge and research about this form of the cancer is present to utilize when detailing a treatment plan, often times making a pleural life expectancy much longer.
According to generally accepted medical research, approximately 10 percent of mesothelioma patients will live for at least five years after they are diagnosed. The average survival rate for a mesothelioma patient is approximately four to 18 months after diagnosis. While there is currently no cure for mesothelioma, many patients elect to undergo treatment following diagnosis to combat further development and ease the symptoms of the cancer.
Mesothelioma Survival Rate Factors
Understanding the average mesothelioma survival rate can be difficult because various factors influence the data. Survival rates may be influenced by the level of the cancer’s development, the size of the tumor, and whether or not surgery may be performed.
Sadly, reading statistical information about survival rates can be discouraging to mesothelioma patients and their loved ones. It is important to keep in mind that research and studies are being conducted to help in the fight against mesothelioma. Treatment options continue to improve and exciting developments continue to surface, providing hopes to mesothelioma patients everywhere.
Prognosis (Long-Term Outlook)
The stage at which a mesothelioma patient is diagnosed can have a very big impact on the prospects for long-term survival. Receiving a diagnosis during the early stage not only influences a patient’s chances of beating the cancer, but improves their odds of positively responding to treatment.
The best way to avoid a poor mesothelioma prognosis is through early detection. Unfortunately, mesothelioma is not generally diagnosed until the latest stages of development because of the amount of time it takes for patients to display symptoms associated with the disease. As a result, the prognosis for the majority of patients is poor, but many doctors can recommend treatment options such as surgery, chemotherapy, and radiation to help combat the disease.
Doctors usually address mesothelioma in terms of stages, ranging from stage one to stage four. Unfortunately, once the cancer has reached stage three or four, treatment options not only become more limited but less effective as well. In addition to the stage of cancer and the age of the patient, other factors that affect prognosis include:
- The type of mesothelioma
- The size of the tumor
- The location of the tumor and whether it can be surgically removed
- The extent of other symptoms, including fluid in the lungs or abdomen
- Whether or not the patient is a smoker
Malignant mesothelioma is typically diagnosed in individuals over 55 years old, though there are some exceptions. Some patients already have multiple medical problems caused by advancing age, making treatment even more difficult.
Though some life expectancy factors cannot be improved, advancements in pleural mesothelioma treatment are improving life expectancies for many patients. Medical professionals are always seeking out and testing new methods to improve the prognosis, which is primarily achieved through clinical trials and research. These trials test new medications and treatment options, and have been largely successful in benefiting mesothelioma patients.
As well, advancements in the early diagnosis of mesothelioma are opening up more treatment options to a greater number of patients. Early detection allows a more aggressive treatment track, and this can greatly improve life expectancy. Some of the more aggressive treatment options include surgery, chemotherapy, and radiation.
For decades, scientists have been studying the latency period of malignant mesothelioma. While researchers agree that no amount of asbestos is safe, numbers seem to indicate that the level of exposure, not the length, may determine who will get the disease and how long it may remain latent.
One of the primary challenges in diagnosing mesothelioma is its latency period, or the amount of time between initial exposure to asbestos and the appearance of symptoms. Of all forms of cancer and asbestos disease, the mesothelioma latency period is by far the longest, usually measured in decades.
According to most experts, in the case of mesothelioma the latency period ranges from 20 to 50 years after initial exposure to asbestos occurred, though there have been instances when the time period was shorter or longer. Due to the long latency period associated with the cancer, those exposed to asbestos during the 1950s, '60s and '70s are beginning to demonstrate mesothelioma symptoms today, decades after they were exposed to asbestos.
Mesothelioma Latency Period
Mesothelioma's latency period is classified into three groups of patients. Here is how health care professionals categorize them:
- 1. Patients with high levels of exposure of a short duration
- 2. Victims with high levels of exposure of long duration
- 3. Sufferers with low levels of exposure of long duration
The highest asbestos burden and the shortest latency times have been shown in patients who were occupationally exposed during jobs surrounded by asbestos and insulation industries and in shipyards. Although asbestos consciousness and mesothelioma information have significantly improved, the very long latency period of mesothelioma is a critical factor that contributes to its poor prognosis. This is why the disease remains unnoticed for a long period of time compared to other forms of cancers. All cancers tend to have a better prognosis when discovered early.
Scientists are still researching to find ways through technological advances that can aid in the discovery and treatment of this aggressive cancer, but there’s no chance to turn back the clock and prevent exposure that may have happened decades ago. When the disease finally reveals itself in physical symptoms, it has likely progressed to an advanced stage during this latency period.
Finding a Cure
A mesothelioma cure seemed almost unattainable not long ago, but this negative outlook is beginning to change. Doctors and cancer specialists are constantly working towards the development of a cure and instilling mesothelioma hope in patients. During this search to find a cure for mesothelioma, stories of survival continue to surface, renewing hope and determination.
Cancer specialists and other doctors have been working feverishly towards a cure for malignant mesothelioma. While a way to completely eliminate the cancer from the body does not presently exist, there are several successful mesothelioma treatment programs as well as clinical trials that are working towards developing a way to eliminate this unfortunate form of cancer.
Treatments for patients of malignant mesothelioma commonly fall in line with treatment of other lung and lung-related cancers. Curative treatments are those which remove the cancer from the body completely. While there are no cures for mesothelioma, any treatment could theoretically be curative, so long as it is successful in completely removing the cancer from the body. While the treatment may be curative, it is important to remember that curative treatments do not rule out the recurrence of the disease.
While curative treatments may not prevent the disease from recurring, it is important to be aware of current initiatives that are working towards a total cure for the disease. There have been instances of unique treatment programs that have prevented the recurrence of the disease for several years. Paul Krauss was diagnosed with mesothelioma in 1997 and given only a few months to live by his physician. Today, Paul Krauss is still alive and active and has dedicated himself towards spreading awareness of the disease and working with others in developing treatment programs that would be as successful as his has been.
Misconceptions/Myths of Mesothelioma
Unfortunately, there are many misconceptions about malignant mesothelioma. Whether you've been diagnosed with this tragic disease or are simply curious, it's important to learn as much as you can, and to get the facts.
When a cancer is relatively rare and unknown by many, misconceptions and myths may develop that many come to believe are factual. What follows is a list of common mesothelioma misconceptions and factual explanations to address the myths:
Myth - Asbestos Is Banned, So No One Uses It Anymore
Contrary to what many people believe, this is simply not true. Asbestos regulations in the United States have gotten more stringent, but there remain over 3,000 consumer goods that contain asbestos. Many of these products can be found in your local hardware or home-improvement store. Caulking, joint compound, roofing shingles, drywall and gaskets are just a few of these products that may still have asbestos within them—although it might not be listed as “asbestos,” but instead be labeled by the manufacturer as “Canadian fiber” or “chrysotile,” which is simply one of the forms of asbestos.
Myth - Mesothelioma is a type of lung cancer
Though mesothelioma commonly affects the pleural lining of the lung, the cancer is not a lung cancer. Mesothelioma develops in the mesothelium, a membrane that lines many body organs and cavities, including the lungs, the abdominal cavity and the heart sac.
Myth - Chrysotile is a safe form of asbestos
Researches have shown that all forms of asbestos including the largely used Chrysotile are effective in causing mesothelioma, lung cancer, asbestosis etc.
Myth - Mesothelioma only develops in men
Mesothelioma occurs in both men and women. According to the American Cancer Society, mesothelioma affects men five times more often than women. This may be because asbestos use was prevalent during a time when women in the workforce were less common. Since asbestos exposure often occurred on the job, men were likely exposed to the mineral more often, increasing the incidence of mesothelioma in men. However, once World War II began, more and more women began to enter the workplace in occupational settings where asbestos exposure was common, leading to an increase in the development of mesothelioma in women nationwide.
Myth - Smoking causes mesothelioma
With so much mesothelioma information available, you might think this false conception would already be exposed. Smoking does not cause mesothelioma. Smoking can weaken the lungs and immune system, and when a person has asbestos exposure, the development of mesothelioma lung cancer can occur. Smoking can cause lung cancer, but not asbestos lung cancer.
Myth - Malignant mesothelioma is not treatable
Mesothelioma lung cancer is treatable and several options are available. Common avenues of treatment include mesothelioma chemotherapy, radiation, and even surgery. With new research and developments coming out all the time, patients can take advantage of experimental treatments. Massage therapy and acupuncture offers alternative ways to treat asbestos symptoms. Malignant mesothelioma is treatable and options are available to provide you with comfortable care and possibilities of surviving this disease.
Myth - You have to work with asbestos for years to be affected
This myth may be another one which stems from asbestos diseases' long latency periods. Since so many mesothelioma sufferers are only diagnosed when they are at or nearing retirement age, it may seem as though it takes years of occupational exposure to cause the cancer. Yet this is a fallacy, since there are also many cases in which the sufferer experienced only temporary or limited exposure. No matter the amount of asbestos particulate the patient has inhaled or ingested, the disease takes a similar amount of time to manifest. Of course, the sheer amount of asbestos inhaled over a lifetime of working around it, compared to occasional exposure, can increase the chances of contracting mesothelioma. But one instance of exposure can be enough to spur the onset of this devastating disease, although it may not become evident until decades later.
Coping with Mesothelioma
Each person's experience with mesothelioma is unique, but it is certain that once one is diagnosed, life is forever altered. Just as each person's mesothelioma treatment is individualized, so too is the coping strategy he or she will develop.
When you hear that you have been diagnosed with mesothelioma, your first inclination will probably be that your “normal” life is about to change, and in some respects, this may be true. You will have to come to terms with your diagnosis in your own mind, and then tell family and friends. There will be appointments to keep, mesothelioma treatment decisions to make, and medical bills to pay. Familiar routines may become disrupted or absent altogether. How you successfully contend with these difficulties, or how you “cope,” can be one of the most important steps you will take in maintaining a positive outlook on life.
Mesothelioma Coping Strategies
The following strategies are recommended for all mesothelioma patients:
- Learn relaxation techniques
- Share your feelings honestly with family, friends, a spiritual advisor or a counselor
- Keep a journal to help organize your thoughts
- When faced with a difficult decision, list pros and cons for each choice
- Find a source of spiritual strength
- Pray or meditate
- Find time to be alone
- Go for walks
- Remain involved with work and leisure activities as much as possible
As time passes, the individual with mesothelioma and the people around them will start to develop their own unique ways of coping. This may involve having to accept that this disease will not be cured. For those left behind, this will mean coming to terms with loss of a loved one - this will involve the pain of anticipation (anticipatory grief) and then the pain that follows death of someone we love.
The single most important factor in dealing with grief is that you are not alone. As well as the support of family and friends, there are professional services via the medical team and charitable/support/religious groups.
Types of Mesothelioma Doctors
After you’ve been diagnosed with mesothelioma, your world will seem as if it’s full of doctors. While all the doctors will undoubtedly have your best interests in mind, understanding exactly what each one does can be confusing to a new cancer patient.
Here’s a list of specialists you’ll probably encounter before and after your mesothelioma diagnosis:
- General Practitioner - Your doctor may not be a specialist in the field of cancer, but is normally your first point of contact. He or she is also the person that can provide much of your medical history and details to any specialists or consultants who are dealing with you. Your doctor is the person that will refer you to a cancer care team or specialist following your initial visit and diagnosis.
- Oncologist - Doctors will typically refer suspected mesothelioma patients to a cancer specialist, known as an oncologist. The oncologist will diagnosis the type and stage of mesothelioma and determine the best therapy.
- Radiologist - Radiologists may take part in performing a number of tests on a patient in the area that may be in question. These types of testing include a CT scan, x-ray, ultrasound or an MRI. Radiologists have daily contact with patients that are potentially ill and their families.
- Pulmonary therapist - A pulmonary therapist is trained to help patients maintain or improve lung function. Even where surgery is not advised, pulmonary therapists can help mesothelioma patients to strengthen their lungs and learn to compensate for lung function lost to cancer.
- Psychologist - Receiving a diagnosis of mesothelioma is, needless to say, an emotional experience. Psychologists help patients sort through their various responses to a mesothelioma diagnosis. Mesothelioma patients who work with a psychologist show the strength to face their future and deal with the serious issues that mesothelioma brings to any patient and his or her family.
Mesothelioma Health Team
A diagnosis of mesothelioma brings with it one of the most difficult challenges you or your loved one will ever face. One of the most important things to remember is that there are resources to help with every aspect of care, and that you or your loved one is at the center of the health care team that will provide help in many different forms.
If you have been diagnosed with mesothelioma, there are a million things that come to mind ranging from what type of treatments you should obtain, to what mesothelioma specialist to attend, to what cancer center offers the best clinical trials for your case. Your health care team consists of mesothelioma doctors, nurses, social care workers, psychologists, home care specialists and nutritionists that can all assist you while you progress through these difficult times.
Cumulatively, these individuals can provide comprehensive services from diagnostics to surgery to pain relief. Many of the experts at mesothelioma treatment centers are pioneers in new research for the improved treatment of this asbestos-related disease. They utilize this knowledge to serve the needs of patients and their families.
Mesothelioma treatment centers often conduct clinical trials, which are designed to measure the efficacy of promising new drugs or other treatments. Together with your health care team, you may investigate the possibility of joining one of these trials. Or you may benefit from the advancements such trials have made in the treatment of mesothelioma.
Finally, as the leader of your care team, the relationship you have with the doctor you choose will be extremely important to you. Are you comfortable with this doctor? How does s/he answer your questions? Do you feel comfortable with the surroundings and the other medical professionals in the office or hospital? You may spend a significant amount of time working with your team, and they will play a central role in your treatment, so you have a right to choose a mesothelioma doctor and team you have confidence in.
Although most individuals diagnosed with mesothelioma have a survival rate of a year or less from the time of diagnosis, cases of patients living past their predicted survival date are continuing to surface. With each survivor story that comes to light, current mesothelioma sufferers are gaining a little more hope about their future.
There have been a number of patients that have survived far beyond the usual one year survival period and a handful that have even been cured, with no trace of the aggressive cancer several years after treatment (though recurrence is always possible). Research seems to show one common thread – the immune system. Studies of those who have either survived or been cured of the disease reveal that most of these patients participated in some sort of therapy that enhanced their immune system. Some treatments included clinical trials in immunology while others involved alternative therapies dealing with the immune system.
With this philosophy in mind, some researchers believe treatments that improve the immune system can stabilize and even cure the disease. Currently, this is the most prevalent theory in explaining why some patients continue to live a healthy life while mesothelioma is in remission and why others have apparently defeated the disease.
With the numbers steadily rising for those infected with diseases caused by asbestos contact, more resources and guidance are available. The more educated people become, the better doctors can determine what methods would be most effective in treating those who have been contaminated with asbestos fibers.
Family and friends are always important when you have mesothelioma, but you may also find it beneficial to be in contact with others who share similar challenges. It has been shown that emotional support and open patient discussion of issues helps cancer patients' quality of life.
Mesothelioma Support Services
In addition to family and friends, mesothelioma patients should consider the following possible support services:
- Religious Leaders - Members of the clergies of many faiths are trained to deal with the concerns of mesothelioma patients: pain, fear of death, feeling alone, and searching for meaning.
- Home Care Services - State and local governments offer many services useful after cancer treatment. A nurse or physical therapist may be able to come to your home. Check the phone book for non-profit and for-profit social services, health services or aging services.
For loved ones of mesothelioma patients, support groups are also helpful in dealing with both financial and emotional stress. Some cancer support groups are for family members and friends only, while others encourage loved ones to attend with the patient. Many cancer support groups are free, though some require a small fee. Check with your insurance company to see if they can cover the cost.
While mesothelioma cancer has been around for quite some time, doctors and research scientists have only just begun to receive the necessary funds to improve treatment options for the disease. Fortunately, successful clinical trials and other research procedures have presented many new treatments for those suffering from mesothelioma.
Many organizations are involved in the research of mesothelioma, including the companies that are responsible for the use of asbestos. Many people that have been diagnosed with mesothelioma have now discovered that they can claim compensation for being exposed to hazardous asbestos by companies, which means that these companies have a responsibility to help with the research.
A great deal of research into mesothelioma goes into learning about the effects of asbestos upon cells, and how the cells are changed by exposure to this material. By learning how healthy cells are corrupted by asbestos, we hope to learn more about how this cell corruption can be prevented or minimized.
Medical professionals worldwide are currently involved in clinical trials, and each trial depends upon the extent and spread of the disease. Some trials are performed on those who have been diagnosed reasonably early, while others on patients who were not diagnosed until the latter stages of the disease. It is important for scientists to find a treatment that is effective, not only on those who are diagnosed early, but on all patients who suffer from this killer disease.
The research carried out into mesothelioma will hopefully mean that future generations of suffers can be saved, even if they are diagnosed with the disease. The research carried out is extremely costly, and is often sponsored by associated companies such as drug companies and research groups as well as by the government. Research into the contraction of the disease - and its subsequent development - will ultimately enable professionals to devise the most effective mesothelioma treatment.
With mesothelioma on the rise, and new cases of this cancer coming to light on a regular basis, mesothelioma litigation has become a multi-billion dollar industry in compensation claims against manufacturers of asbestos as well as the companies that may have exposed staff to this carcinogenic substance without adequate protection and warning.
Mesothelioma litigation is premised upon the liability of manufacturers of asbestos and asbestos products, for the harm caused by exposure to those products. It was once thought that mesothelioma litigation had peaked, but due to the fact that thirty or more years can pass before asbestos disease manifests itself, large numbers of new cases are filed each year. Many companies have been forced into bankruptcy since the litigation of these cases began.
A lawyer who handles mesothelioma cases will typically be able to resolve the case within a year. Many of the firms which take these cases do so on a national level, and can often select the best state in which to file a lawsuit for a client who was exposed to asbestos at more than one location, commencing litigation in association with a local attorney.
Mesothelioma has a solid, thirty-year body of case law and precedent from which mesothelioma lawyers have been able to draw on in order to successfully argue their clients' cases. While no attorney can guarantee you a multi-million dollar settlement, you should know that history and the evidence are on your side. Do your due diligence: choose a lawyer who has knowledge and experience in mesothelioma litigation, and make sure you have a strong case with credible evidence if you want to try to receive justice.
- April 6, 2018 - J&J Ordered to Pay $37 Million in Talcum Powder Mesothelioma Lawsuit - A New Jersey state jury has ruled against J&J and one of its talc suppliers, Imery Talc America, Inc., in a lawsuit filed by a man with mesothelioma, awarding him $37 million in compensatory damages after determining that his use of talcum powder caused the cancer.
- November 8, 2016 - A jury in Los Angeles has returned an $18.07 million verdict against talc supplier Whittaker Clark & Daniels for its role in causing a man’s development of mesothelioma. According to the lawsuit, plaintiff Phillip Depoian was diagnosed with both peritoneal and pleural mesothelioma in May 2015 after years of using a variety of talc-containing cosmetic products including Old Spice, Clubman, King’s Men and Mennen Shave Talc. The verdict is believed to be the largest award on record for a lawsuit alleging mesothelioma from cosmetic talc exposure.
As new cases of mesothelioma are being diagnosed everyday, a large number of lawsuits are filed for compensation. Though nothing can compensate for the sufferings and loss of life of mesothelioma victims, they and their grieved family members can get some solace if they are awarded an appropriate compensation. If you or any of your loved ones are a victim of this deadly disease, you can recover compensation. There are numerous examples of mesothelioma verdicts wherein victims been awarded compensation reaching into millions of dollars.
The only way to discourage unscrupulous corporations that ignore their workers’ and customers’ safety in the pursuit of profits is to make it expensive for them to do it. This is the purpose of punitive damages. Punitive damages often make up the vast majority of mesothelioma verdicts because the defendants act so horrendously, and because the defendants are often massive corporations with a lot of money.
In connection with the vast number of lawsuits pending before the courts, as well as the average individual mesothelioma compensation award extending well above $1,000,000 USD, the environment for mesothelioma litigation claims has never been better. Indeed, closer examination of settlements and verdict awards in various state and federal court venues, as well as the mesothelioma lawyers and mesothelioma law firms obtaining such results in favored jurisdictions, places plaintiffs in a position to obtain optimal results.
Some cases related to mesothelioma litigation can be extremely complicated, and specialized lawyers are necessary to handle the entire litigation process. It is best to establish contact with a mesothelioma law firm as early as possible, so that the benefits, the suing process, and the amounts a victim can obtain can be worked upon as early as possible.
Mesothelioma was recognized as a legitimate cause of death by the U.S. government in 1989 and consequently commercial use of asbestos was banned. This happened after numerous researchers unquestionably proved that mesothelioma is a deadly cancer caused by asbestos exposure. For people who are suffering from mesothelioma, the good news is that now they can get compensated for all their medical expenses and treatment.
Unfortunately, you cannot fight the legal battle on your own. You will require a professional, experienced, and reputable mesothelioma lawyer to help you fight your case and get you fair compensation from the responsible source of asbestos exposure.
Mesothelioma victims are given a legal right to claim monetary compensation from the asbestos industry. Often, this figure goes into the millions on the basis of cause and rights of the claims. To claim monetary compensation from the asbestos industry, you need to hire a law firm that specializes in mesothelioma cases. The legal proceedings costs are set on the basis of contingency, so you do not need to pay any money to the law firm until you win your case.
The sooner you get started learning about your mesothelioma treatment, financial and legal options, the better off you will be. You are not alone nor are you powerless in this fight against mesothelioma. The team of mesothelioma lawyers at Schmidt & Clark, LLP have helped asbestos and mesothelioma victims nationwide recover settlements and jury trial verdicts.
Filing a Mesothelioma Lawsuit
Over the years, many people who have worked with asbestos have filed mesothelioma lawsuits and have successfully claimed millions of dollars in compensation. Anyone who has contracted mesothelioma as result of exposure to asbestos may be eligible to file a mesothelioma lawsuit and should contact a legal specialist as early as possible.
Those who may be eligible when it comes to filing a mesothelioma lawsuit are people who have contracted the cancer as a result of direct exposure to asbestos, those that have contracted mesothelioma as a result of secondary exposure, and those that have lost loved ones as a result of asbestos-related cancer.
Although you may think that the actions taken by corporations that may have led to the development of mesothelioma by many people amount to criminal acts of negligence and indifference, a mesothelioma lawsuit falls under the legal category of torts, or personal injury law. This is actually to your advantage, because the standard of proof is less than that of criminal cases.
The time an individual has to file a claim varies from state to state, but generally the time limit is one to two years from diagnosis. It is important that you check on the time limitation for your state and act within the limitations, otherwise you may not be eligible to claim. If you are claiming on behalf of the deceased, time limitations still apply and it is probably even more important to act quickly because of the time limits and the research required by the lawyer.
Do I Qualify to File a Claim?
When a diagnosis of mesothelioma is verified, the affected individual can seek legal assistance from those specializing in mesothelioma cases. Victims can seek compensation from the asbestos industry, which can be made to pay for financial security for surviving family members.
There are two types of legal assistance one can seek. One is a personal injury case where the victim is still living; the second is a wrongful death case where the individual has already died and any member of his family would act as a representative. Only if asbestos exposure is linked to a particular job-site can a worker’s compensation claim be filed against an employer. The victim must be able to prove without a doubt that his illness was caused by exposure to asbestos.
It is important that the plaintiff discloses all information, such as work history, time frame of exposure, types and brands of asbestos, name of employer, name of co-workers, diagnosis, prognosis, and all other information related to his/her mesothelioma cancer. Providing the lawyer with the correct and complete information will aid in quickly determining the appropriate course of legal action, help him form a solid foundation of the victim’s case and may speed up the process of litigation.
One must remember that time is of the essence when filing compensation claims due to mesothelioma illness. Statute of limitation states that a claim must be filed within a short period of time (ranging from one to three years depending on what state the victim resides in) from the date of initial diagnosis. Waiting too long in the filing of claims can result to making it impossible for you to recover any form of compensation.
Though all lawsuits are different, most asbestos cases progress in a similar manner. Once you've decided to proceed with an attempt to obtain compensation for your asbestos-related injuries, the process should be similar to the one outlined below.
The mesothelioma case process, when broken down, can be understood as a simplistic order of operations. There are six main steps:
1. Filing: You must file a lawsuit with the court. The defendant will be contacted with your claim.
2. Responses: The defendant in the case will give a response to your claim.
3. Discovery: After initially filing the lawsuit, both legal teams will gather information regarding the case. In most cases, the defendant's legal team will ask you to answer questions, both written and on videotape (which can even be performed in the comfort of your home).
4. Setting a Trial Date: If the case goes to trial, a date will be set.
5. Settlement: Before the trial starts, the defendant's lawyers may offer to resolve the case for a set amount of money. However, this initial offer amount may be low in comparison to future offers. The defendant may make a better settlement offer during trial.
6. The Trial: The trial process varies depending on where you file a claim. In many cases, it is not necessary for the plaintiff to appear in court.
In all, a typical case can take months to years, depending on its complexity. An experienced mesothelioma attorney can probably give you a fair idea of just how long your particular case may take to come to settlement.
There are a number of possible sources of financial assistance and/or compensation for people with mesothelioma.
In both mesothelioma trial verdicts that find for the Plaintiff and cases that settle before trial, the amount awarded or settled on is based on compensation for two kinds of loss: economic loss and non-economic loss.
Economic loss refers to the financial damages resulting from the illness or death of a mesothelioma victim due to wrongful action. This type of financial loss includes:
- Medical expenses - doctor and hospital bills, medications, insurance co-pays and deductibles, medical devices and home health care.
- Lost wages – the pay the victim loses beginning when they have to miss work or stop working as a result of their illness, through to their expected retirement. This can also include lost retirement pay and social security.
- Loss of household services – these are the services the family or spouse depended on the victim to do before they got sick, and will have to find someone else to take care of. This could include services such as yard care, car or house repairs, cooking, child care and much more.
- Other miscellaneous expenses - that apply to each individual case.
Non-economic damages, on the other hand, are non-monetary losses that can be more difficult to quantify, but no less important. They include:
- Pain and suffering
- Mental anguish
- Physical impairment
- Loss of companionship
- Loss of enjoyment of life
- Loss of consortium
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 one’s past, as well as the different work locations where exposure may have occurred and names of co-workers.
Not only does mesothelioma progress rapidly, but rules of legal procedure, known as statutes of limitation, require that a claim be filed within a short window of time from the date of initial diagnosis. If you wait too long, it may be impossible to recover for any of the financial, physical and emotional hardships, regardless of the amount and strength of the proof gathered.
Frequently Asked Questions (FAQs) about Mesothelioma
- What is Mesothelioma?
Malignant mesothelioma is a disease in which a cancerous tumor grows on the mesothelium - the sac lining the internal body cavities. The specific type of mesothelioma is named for the tissue where the cancer started.
- What is the difference between pleural mesothelioma and peritoneal mesothelioma?
Pleural mesothelioma starts in the chest, in the pleura that surrounds the lungs (outer lining of the lungs and internal chest wall). It makes up about 70% of mesothelioma cases. Peritoneal mesothelioma starts in the lining of the abdominal cavity.
- What are the symptoms of mesothelioma?
Mesothelioma begins as small nodules on the lining of lungs. These nodules grow larger and slowly cover the entire pleural lining, eventually completely encasing the lungs. In earlier stages of tumor growth, symptoms are non-specific such as fever and night sweats. Initially, the disease may be mistaken for pneumonia. Gradually increasing tumors often lead to accumulation of fluid into the pleural cavity (known as pleural effusion). The right sided chest involvement is slightly more common. The fluid compresses the lungs and leads to progressive shortness of breath and dry cough. Sometimes, a large amount of fluid accumulates rapidly within hours leading to a sudden onset of breathlessness. In advanced cases, patients may complain of chest pain due to a spread of the cancer to the bony chest wall.
- Who is at risk of asbestos exposure?
Those at greatest risk for asbestos exposure are people who worked in the asbestos, construction, and shipbuilding industries. Millions of people have suffered exposure to asbestos due the proliferation of the over 3000 products know to contain asbestos.
- How much exposure does it take to get mesothelioma? What is the latency period?
Very little exposure can result in mesothelioma. Sometimes people who worked with asbestos for as little as one or two months get mesothelioma. The "latency period" refers to the time between asbestos exposure and diagnosis of the disease. For mesothelioma, the latency period can be decades long, and people exposed in the 1940s, 50s, 60s, and 70s are now being diagnosed.
- How common is mesothelioma?
Approximately 3,300 new cases of mesothelioma are diagnosed in the United States each year according to a report published in 2008. Data as to incidence vary considerably, but the annual incidence of mesothelioma in the adult male population of the United States is estimated to be 7 to 13 per million. Mesothelioma is 5 times more common in men than in women. It is often diagnosed at 60 to 70 years of age but the disease can appear in either men or women at any age. 2,000 Americans die each year as a result of mesothelioma.
- Does exposure to asbestos only lead to mesothelioma?
While mesothelioma is sadly a common consequence of asbestos exposure, it is not the only condition caused by this deadly material. Another condition called asbestosis is often caused by inhaling asbestos particles.
- What is asbestosis?
Asbestosis is the accumulation of scar tissue in the lungs caused by asbestos particles. Over time, this scar tissue will overwhelm the lung and cause lung and heart failure.
- What treatments are available for victims of asbestos-related illnesses?
While the there are no cures for mesothelioma or asbestosis, medical science makes advances every day in diagnosing and treating these devastating conditions.
- What are clinical trials, and how do they affect mesothelioma patients?
A clinical trial is a research study using volunteers. A clinical trial tests the effectiveness and safety of a new procedure or drug, including proper dosage and side effects. Taking part in a clinical trial may prolong or improve a mesothelioma patient’s life. On the other hand, clinical trials deal with experimental drugs or procedures that may have negative results or be ineffective.
- What should people do if diagnosed with an asbestos-related disease?
Victims should follow all the directions of their doctors, but they should also contact an attorney to see if they have reason to pursue legal action against the party responsible for their injuries.
Do I Have a Mesothelioma Lawsuit?
The Toxic Tort Litigation Group at our law firm is an experienced team of trial lawyers that focus exclusively on the representation of plaintiffs in mesothelioma lawsuits. We are handling individual and group litigation nationwide and currently accepting new cases in your area.
If you or a loved one have been exposed to Asbestos and developed a form of Asbestos related cancer such as Mesothelioma or other related disease, you should contact us immediately. You may be entitled to compensation and we can help.