Why There Are So Many Mesothelioma Lawsuits

Asbestos is a naturally-occuring fibrous mineral of metamorpic hydrous magnesium silicate. The term “metamorphic” is used to describe a process of extreme heat and pressure which creates specific secondary patterns of minerals with new chemical and/or physical properties. As the primary rock is heated and recooled, silicate crystals align in long rows of mineral fibers, which easily separate into tiny shards thinner than a human hair. Asbestos fibers are not a health risk as long as they are undisturbed. However, when asbestos is undergoes natural weathering, or is mined and processed, the microscopic particles waft into the air and cause disease if they are inhaled.

Asbestosis occurs when asbestos particle by an inhaled irritates natural defence mechanisms of the body, scarring and causing inflammation which eventually restricts the function of lung. Mesothelioma is a malignant tumor of the membranes surrounding the heart, lungs and abdominal cavity. Asbestos can also cause cancer of the mouth, throat, esophagus, larynx, stomach, lung and lymphoid tissue.

Asbestos exposure can also cause non-fatal illnesses such as asbestos warts, caused when asbestos fibers are lodged in the skin, causing lumps of scar tissue to form around the irritant in the same manner as they do in the lungs to cause asbestosis; pleural plaques, discrete, sometimes calcified fibrous lesions which can be seen on X-rays but are too small to cause breathing impairment; and diffuse pleural thickening, which can cause breathing impairment if it is extensive.

Due to its fire resistant properties, asbestos has been used historically for household and industrial purposes. It has been found woven into burial cloths in ancient Egypt, and Charlemagne reportedly had a tablecloth made of asbestos which he would throw into a fire to clean.

In World War II asbestos was considered so important by the War Department that it was considered a strategic material, and many American workers were exposed in the World War II boom in shipbuilding. After the war, it was widely used in the construction industry.

In modern Western society, it was used for such diverse purposes as lamp wicks, brake shoes, oven insulation, electrical hotplate wiring and home insulation, roofing and flooring. For instance, some kinds of vermiculite used in home insulation into the 1970s contained asbestos. The EPA banned this product in 1977.

When a home owner discovers asbestos in an old home, it should not be a cause for immediate panic. If the asbestos looks intact and is not pulverized, it is best to leave it alone. However, because of legal liability, schools and businesses containing asbestos usually must undergo a costly removal process, hazardous in itself because disturbing the stable asbestos product causes fibers to fill the air. Special equipment must be used to insure that the removal process does not cause health problems where non existed before.

Most industrialized nations have reduced or banned the use of asbestos for at least 30 years and now use fiberglass or woven ceramic fiber as a substitute, but since asbestos-caused disease has a latency period of up to 50 years, patients are still presenting with these illness today. Every year in America, approximately 3000 new cases of mesothelioma are diagnosed, and 550 deaths occurs due to asbestosis. According to the March 1991 Report of the Judicial Conference Ad Hoc Committee on Asbestos Litigation, asbestos exposure has caused the deaths of approximately 200,000 to 265,000 Americans.

Asbestos use peaked in the United States in 1973, when 1 million tons of the material were used. The EPA attempted to institute a complete legal ban on the use of asbestos products in 1989; however, this ban was largely eviscerated by the US 5th Circuit Court of Appeals in 1991, and some restricted use of asbestos, albeit in fewer products than than before, resumed. Therefor, even today some workers are being exposed to this toxic material.

Asbestos is a serious continuing concern to the Environmental Protection Agency, and their website has detailed information on asbestos and its removal.

Concerns about the health risks of asbestos exposure date back to 1898, when the Chief Inspector of Factories of the United Kingdom reported to Parliament in his Annual Report about the “evil effects of asbestos dust”. He noted that the “sharp, glass like nature of the particles” when allowed to remain suspended in the air, “have been found to be injurious, as might have been expected”. In 1906 a British Parliamentary Commission confirmed the first cases of asbestos-related deaths in Bristish factories and called for improved ventilation and other safety measures. In 1918 an American insurance company produced a study showing premature deaths in the asbestos industry in the United States and in 1926 the Massachusetts Industrial Accidents Board processed the first successful compensation claim by a sick asbestos worker.

Today, lawsuits claiming compensation for asbestos-related illnesses are a growth industry in the legal profession. An internet search of “mesothelioma lawyer” yields 1,910,000 results. The original manufacturers of asbestos products have long since been driven into Chapter 11 bankruptcy; plaintiffs have now turned to suing corporations with peripheral connections to asbestos products. More than 70 American corporations have filed Chapter 11 bankruptcy in due to asbestos liability claims.

Since the 1970’s, approximateley 6% of all lawsuits filed in American courts have been asbestos-related. The lawsuits now facing the courts have been described as “an elephantine mass” by the US Supreme Court, and are expected to cost between 200 to 275 billion dollars to settle. Asbestos liability is one of the largest issues facing the global insurance industry today.

Most epidemiological studies expected the number of lawsuits to peak in the 1990s, but this has not occurred, either because of the long latency period of asbestos-related diseases, or because legal action is becoming more popular among asbestos-exposed members of the public due to high-profile legal cases and widespread advertising by attorneys who specialize in this cases.

Many complaints are created by representatives of industries facing lawsuits and also the insurance firms WHO will be expected to pay them that the asbestos-lawsuit industry is rife with fraud, with less that half of all payouts reaching the plaintiffs. Aggressive, ambulance-chasing lawyers are said to exaggerate medical disability and coach clients on their testimony.

The group of plaintiffs includes not only ill people, but also those who have merely have a history of asbestos exposure and want compensation for potential future health risks. According to the American Academy of Acturaries Mass Tort Work Group, more than 100 million Americans have been exposed to asbestos in their workplace during the past century.

Information on Clinical Trials for Mesothelioma

Clinical trials on Mesothelioma aim to evaluate the effect of asbestos upon cells, and how the cells are changed by exposure to this material. Learning the mechanism of asbestos reactions in the body helps to answer many important questions. Clinical Trials also help to optimize treatment and provide newer ways for early diagnosis.

Some Recent and Current Clinical Trials from Around the World Include:

Phase II Feasibility Study of EPP (Extrapleural Pneumonectomy) with Intraperitoneal Heated Cisplatin / Intraoperative Intrathoracic with Sodium Thiosulfate: This study involves a treatment consisting of EPP (removal of both the lung and its lining) followed by chemotherapy (Cisplatin) administered in the operating room. The drug is introduced into the chest and abdomen for one hour after the surgical removal of the cancer. The goal in this study is to use EPP to surgically remove the Mesothelioma and to use the chemotherapy to contain the local spread of the disease.

Randomized Phase II Feasibility Study of Decortication / Pleurectomy without and with Intraperitoneal Heated Cisplatin / Intraoperative Intrathoracic with Sodium Thiosulfate Followed by Adjuvant Cisplatin / ALIMTA® This study is for patients who are surgical candidates for a decortication / pleurectomy (removal of the lining of the lung and visible disease) but are unable to undergo a pneumonectomy (removal of the lung). 

Patients will be randomized into one of two treatment groups. Group 1 will undergo pleurectomy/decortication followed by chemotherapy (cisplatin) administered in the operating room (Cisplatin will be introduced into the chest and abdomen for one hour after the surgical removal of the cancer). Six to eight weeks following surgery, chemotherapy (ALIMTA® plus Cisplatin) will be administered. Group 2 will undergo pleurectomy/decortication. Six to eight weeks following surgery, chemotherapy (ALIMTA® plus Cisplatin) will be given.

Phase III Study of Onconase and doxorubicin Versus doxorubicin Alone, For Patients With Malignant serosa or serous membrane mesothelioma WHO Have Had No over One previous therapy program.

Alimta & Gemcitabine the purpose of this clinical trial is to determine any side effects of these drugs and to test the safety of the treatment. It will also ascertain whether the treatment can prolong the lives of mesothelioma patients, assess whether the combinations of these drugs alters the size of the tumor and whether patients feel any improvement whilst receiving the treatment.

Neoadjuvant Pemetrexed Disodium and Cisplatin followed by Surgery and Radiation Therapy: The purpose of this clinical trial is to study the effectiveness of this treatment followed by surgery and then radiation therapy. The trial also hopes to determine whether the therapy will shrink the tumor and also monitor for any side effects. 

The process will entail an infusion of pemetrexed disodium and an hourly infusion of Cisplatin every three weeks for up to four courses. This is to be followed by Surgery within 3-8 weeks of completion of chemotherapy, radiation therapy beginning 4-8 weeks after surgery and three monthly evaluations for two years.

Intra pleural BG00001: The purpose of this clinical trial is to monitor the effect of treatment on the body’s ability to fight cancer, to study effectiveness of treatment on patients with malignant pleural mesothelioma or malignant pleural effusions, and to monitor for any side effects. The process will entail the placement of a catheter between the lung and chest wall through which treatment will be administered. 

Weekly evaluation for one month; followed by fortnightly evaluation for one month and monthly evaluation for four months ensues. After this, patients will receive six monthly evaluations for fifteen years.

Erlotinib on Patients with Solid Tumours or Liver/Kidney Dysfunction: The purpose of this trial is to assess whether or not the treatment hinders the growth of cancer cells, to assess the effectiveness of the treatment on patients with metastatic or unresectable solid tumors and to assess any side effects from the treatment. The process will entail a once-daily administering of treatment by mouth for as long as benefits continue.

PTK787/ZK 222584: For patients with Unresectable Malignant Mesothelioma. The purpose of this trial is to assess the positive effects of this drug on the growth of tumor cells, to study the effectiveness of the drug on patients and to assess and monitor any side effects. The process will entail administering the drug once daily by mouth for as long as benefits are evident. Evaluations are bi-monthly for a year; four monthly for a year; and twice yearly for a year.

SS1 (dsFv) – PE38 Immunotoxin (for advanced cancer patients): The purpose of this trial is to assess the maximum dose of treatment that can be safely administered to patients with advanced malignancies, monitor and evaluate their response to the treatment and to determine the effects of the drug upon the test group.

Clinical trials are a hope for Mesothelioma patients that a better cure is not far away. The objective behind the trials is to develop new diagnostic tools, new therapeutic agents and effective modalities of treatment.

Treatment Options For Mesothelioma

The Treatment of mesothelioma is a great challenge for surgeons. There are basically three modes of treating any mesothelioma:

1. Surgical removal of the tumor
2. Chemotherapy agents to fight the cancer
3. Use of high-dose x-rays or other high-energy rays to kill cancer cells. (Also called radiation therapy.)

These treatment modalities can either be used alone or in combination. The choice of treatment is patient specific depending upon various factors such as the stage of mesothelioma, its origin and location, metastasis if any and its extent, the pathological findings and also the patient’s age and his expectations.

Surgery

Removal of the cancerous growth is the commonest option, however the type of surgery depends upon the expected results of the surgery.

Chest Tube Drainage and Pleurodesis

Chest tube drainage and pleurodesis is usually effective for a symptomatic relief from pleural effusion. Pleural effusion at times is persistent and recurrent after initial drainage of the fluid. To combat this problem, the pleural space is usually closed using talc slurry or any other sclerosing agent that produces an adhesion.

Pleuroperitoneal Shunt

Shunts can be placed to remove the fluid collection in the pleura. For this purpose a catheter that runs from the pleural to the peritoneal cavity is placed under the skin. This is more often a palliative procedure.

Pleurectomy

Pleurectomy, when used as a palliative procedure, is helpful for people whose tumor growth restricts proper lung expansion. It can be an effective way to control fluid collection.

Potentially Curative Surgeries for Pleural Mesothelioma

Pleurectomy/Decortication - The goal of this surgery is to remove all gross tumor in stage I and selected Stage II. Some cases may require a simultaneous removal of lung (known as pneumonectomy). This usually happens when the tumor cannot be removed without the removal of lung tissue.

For Peritoneal Mesothelioma:

Cytoreductive Surgery is used in combination with a form of chemotherapy called IPHC. The objective of the surgery is to remove all or nearly all of the gross or visible tumor in the peritoneal cavity. The abdominal cavity is then treated with IPHC or Intra-Peritoneal Hyperthermic (heated) Chemotherapy (IPHC).

Chemotherapy

The use of chemotherapeutic agents to kill cancer is not new, however it cannot be considered as a curative treatment for mesothelioma. In mesothelioma, chemotherapy can be used to stop the spread or to slow down the tumour growth, to reduce the tumor size prior to surgery, or to wipe out remnants of disease process after surgery. In palliative care, it may be used to relieve symptoms. Chemotherapy is a treatment of choice for people who are unfit for surgical procedures.

Alimt (Pemetrexed)

Alimta (pemetrexed) is a new multi-targeted antifolate drug, which has been lately approved by the Food and Drug Administration (FDA) for use with Cisplatin. Alimta in combination with Cisplatin is used either for malignant pleural mesothelioma which is unresectable or if the patient is unfit for surgery. The This drug works by jamming the enzymes necessary for DNA copying and cell division. The drug is safe enough to be administered on an outpatient basis every 21 days. 

Alimta is administered as a 10-minute IV infusion followed by a 2-hour infusion of Cisplatin. Researchers claim that patients treated with a combination of Alimta and Cisplatin have longer remission periods and have had less pain and shortness of breath than patients treated with cisplatin alone. This phase III trial however revealed that a decrease in white blood cells might occur as a side effect of the chemotherapy.

Radiotherapy

Radiation therapy may be used alone or in combination with other treatment modalities. In radiation therapy, radiation is used to kill cancer cells and shrink tumors. External radiation uses a source of radiation that is outside the body. On the other hand, internal radiation involves inserting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found. 

Intensity Modulated Radiation Therapy (IMRT) is an aggressive combined modality approach, in which x-rays of varying intensities in conjunction with computer generated images are used to deliver targeted radiation directly to cancer cells, while reducing the amount of radiation to the surrounding healthy tissue. Radiation can also be used as palliative therapy to limit the spread of the tumor. This is mostly used in cases where an infective line is left open by invasive procedures.

It is important to note here that with recent advances in research and clinical trial, newer options of treatment are emerging practically every day. Several of these have further been discussed in the following chapter, which deals with clinical trials.

Asbestos: Every Day Jobs That Put You At Risk

People are affected by asbestos when they breathe the micro fibers. These fibers can have long term affects to your health. There have been many cases of people coming down with Mesothelioma 20 and 30 years after being exposed to asbestos. 

Asbestos is not a thing of the past. It’s still used in many manufacturing processes and well as in building components. The following is a list of the top occupations that are putting people at risk. If you work in one of these occupations, or have in the past, it’s wise to get regular screenings. 

1. Any job that includes the manufacturing of asbestos, for example insulation, plumbing supplies, roofing components or other building materials.
2. Mechanics are at risk due to asbestos in the brake and clutch linings.
3. Tile contractors are at risk due to the dust from cutting some types of tile.
4. Oil refinery workers, rail yard and power plant workers can be at risk from various sources.
5. Shipyard and/or ship builders are at risk due to the asbestos in pipe insulation and other sources.
6. Steel mill workers can come into contact with Asbestos from a variety of insulation and clothing. Asbestos is a great insulator and is used widely in jobs that require a person to be around high temperatures.
7. Navy veterans can also be at risk as can Maritime workers.
8. Construction workers can be at risk, especially those who do demolition of older buildings.

Who else Should be Concerned?

Brick layers, plumbers, sand blasters, sheet metal workers, millwrights, welders, painters, Longshoremen, merchant marines, grinders, electricians, drywall contractors, miners, drillers, building inspectors and maintenance personnel are a few more people who are at risk. Remember, it doesn’t take a lot of exposure to affect your life years down the road. 

You may also be putting your family at risk. There have been cases where workers family members came down with Mesothelioma even though they were nowhere near the job sites. Evidence suggests that the family members were affected by the Asbestos fibers that came in on the workers clothing, hair and/or shoes. 

Get routine screenings if you’re in one of these high-risk professions and take every precaution (such as respirators and special clothing) to protect yourself and your family. This article is not intended to be medical advice. It’s for informational purposes only and you should see a qualified medical doctor should you have concerns about your health.