Experimental Drug Could Benefit Many Mesothelioma Patients

March 27, 2014

industria-novartis_l.jpgA new pharmaceutical manufactured by Novartis, ceritinib, is showing promising results in patients with a rare form of lung cancer. The drug targets a specific gene mutation that is present in about half of mesothelioma patients. Lung cancer lawyers at Pintas & Mullins report on this new drug and what it could mean for mesothelioma cancer care.

Ceritinib (previously known as LDK378) targets a gene known as ALK, which plays a crucial role in a small subset of lung cancers. It is somewhat similar to Pfizer's drug Xalkori, however recent reports indicate ceritinib is actually 20 times more effective in deactivating the mutated ALK gene. That report was recently published in the New England Journal of Medicine.

The study examined nearly 115 patients with ALK-mutated lung cancer, including 83 patients who had been previously prescribed to Xalkori and stopped responding to the treatment. At the end of the trial, 56% of patients responded favorably to the new treatment, with 62% of those who had been on Xalkori responded favorably. Notable side effects included dehydration, vomiting and diarrhea.

Unfortunately, patients prescribed to Xalkori typically develop a resistance to the drug, and the same seems to be true for ceritinib. The average amount of time before patients' lung cancer progressed again was about seven months.

Several other drug companies beyond are developing ALK-inhibitor drugs, including Ariad Pharmaceuticals and Chugai Pharmaceutical, which is based in Japan, and is partnering with Roche Holding. Pfizer is also in the midst of making a follow-up drug to Xalkori, which was approved in 2011. At the time, Xalkori was a milestone in lung cancer pharmaceutical development because no other drug specifically targeted the ALK gene.

Novartis has already filed for premarket approval for ceritinib to the FDA, which is reviewing the drug under its "breakthrough therapy designation." Drugs in this class are typically experimental, and may be expedited through the approval process due to striking promise in trials and high demand for terminally ill patients. A decision on the drug is expected later in 2014.

Medical researchers believe the next step will be to study and prescribe ceritinib in combination with other targeted treatments. Such drugs could include immunotherapy treatments, which are intended to activate the body's natural immune system to fight tumors.

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Women More Likely Than Ever to Suffer from Asbestos Exposure

March 25, 2014

chinese-factory-1_l.jpgIn the past, mesothelioma and other asbestos-related diseases have been predominately diagnosed in men. This is because asbestos exposure occurs most frequently in the workplace, in industries like shipbuilding, automotive repair, and construction. Now, experts are predicting that women will be suffering a larger proportion of asbestos-related illnesses. Mesothelioma attorneys at Pintas & Mullins explore how this could be.

Although asbestos is a known human carcinogen, and there has been a global attempt to ban the substance completely, it is still legal to use in the United States. Several attempts were made in the 1970s and 80s to outlaw asbestos from manufacturing, however, the asbestos industry lobbied the government until it gave in. Thanks to the deep pockets of asbestos lobbyists and the EPA's failure to protect the public, asbestos is still used in U.S. manufacturing processes.

Today, the substance is used in the making of roofing and insulation materials, car brakes, automatic transmission components and vinyl floor tiles. Asbestos exposure - in any amount - can lead to debilitating and fatal diseases like lung cancer, asbestosis, and mesothelioma.

Why are Women at Risk?

The health effects of asbestos are proven and well-researched; however, the social, psychological, and economic impacts are far less known. Mesothelioma patients are often given less than one year to live, and social isolation is common among families trying to cope. Those in more rural areas are particularly susceptible to isolation, as they have less access to formal support groups and mesothelioma-specific treatment centers.

The reason women are expected to make up a large proportion of asbestos-related disease patients is because of the shift of workforce. As stated, asbestos exposure traditionally occurred in blue-collar jobs, in which employees were predominantly men. Now, as more and more women gain manufacturing jobs, they too are vulnerable to workplace exposure.

Mesothelioma has also been reported in women employed as school teachers, who worked in buildings containing asbestos; in interior designers, who were exposed through spray-on asbestos insulation; and bakers, who were exposed by being around ovens and other heat-resistant products.

Fortunately, overall, women tend to have better prognoses compared to men, meaning that their expected outcomes are slightly better. This is because women tend to respond more favorably to treatments. One recent study concluded that women with mesothelioma lived longer after surgery than their male counterparts (27 months for women, 16 months for men).

At present, most women diagnosed with mesothelioma were exposed in 'second-hand' exposure. This type of asbestos exposure occurs when someone works around asbestos and brings home loose fibers on their work clothing (jackets, boots, bags, etc). Those in the family, such as wives or children, are then consequently exposed to the carcinogen, which can ultimately cause asbestos-related illnesses. For the same reason, women working in laundry services could be similarly exposed.

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Pintas & Mullins Applaud Mesothelioma Fighters on Rare Disease Day

February 28, 2014

5478647222_61378d0a56.jpgEach year, the last day of February marks Rare Disease Day, which is recognized and celebrated by more than 70 countries worldwide. This year, the seventh international year of recognition, the slogan is "Join Together for Better Care." Mesothelioma attorneys at Pintas & Mullins join the European Organization for Rare Diseases (EURODIS) and the international medical community in fighting to help those diagnosed with rare disease.

The main objective of establishing a Rare Disease Day is to raise awareness about the real-life impact of rare disease on public health and wellbeing. It is meant to put a human face on rare diseases, to enact change through politicians, policy makers, medical professionals, industry representatives, researchers and countless others. More than 1,000 events take place around the globe every year, with hundreds of thousands of participants hoping to advance research for rare diseases.

In the United States, rare disease research is headed by the National Institute of Health and many of its branches, including the FDA Office of Orphan Product Development and the National Organization for Rare Disorders. The U.S. identifies about 7,000 diseases as "rare," about 80% of which are genetic in origin. About half of all rare diseases affect children, who face severe challenges such as delays in diagnosis or repeated misdiagnosis, lack of support services for family, and psychological burden.

Information and research concerning rare diseases is typically insufficient; Rare Disease Day offers a glimpse of hope to fighters, strengthens their voices, and inspires continued policy actions. A disease is categorized as rare when it affects less than 200,000 American patients at any given time.

Initial misdiagnosis is common, which rings particularly true for mesothelioma, which takes decades to manifest through physical symptoms. Signs of mesothelioma include:

• Pain, swelling or lumps in the torso and abdomen
• Trouble breathing
• Unexplained weight loss

Mesothelioma is a rare form of cancer that usually starts in the lungs, however it can also originate from the tissue that lines the stomach, heart or other organs. It is often mistaken for lung cancer or other respiratory disorders, however, it is markedly different than lung cancer.

The only known cause of mesothelioma is exposure to asbestos, which is a fiber-like material that was commonly used in pipefitting, insulation and friction products until it was outlawed in the late 1970s. Every patient diagnosed with mesothelioma was, at some point in their life, exposed to asbestos, whether directly or indirectly.

At present, treatment for mesothelioma is the standard line of care for most cancers: a combination of surgery, chemotherapy, radiation, and immunotherapy or vaccines. There are some clinical trials ongoing to for mesothelioma treatment, however, research remains minimal.

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Palliative Care and Mesothelioma

February 24, 2014

acupuncture-nightingale-house-hospice-5_l.jpgCancer fighters are no strangers to physical pain and emotional turmoil, and mesothelioma victims often experience these detriments even more acutely. Palliative care programs are designed to help patients cope with all aspects of their medical diagnosis: spiritually, emotionally, physically and medically. Mesothelioma lawyers at Pintas & Mullins detail how cancer patients can uniquely benefit from palliative care programs.

Recent evidence suggests that palliative care can help lower healthcare costs and lead to better care overall. In these programs, teams of specialists care for patients with chronic or terminal illnesses beyond traditional medical assistance. Teams can include home-care aides, therapists, acupuncturists, and social workers, among many others. They are called in to treat whatever ailment the patient is suffering or assist them through other means. For example, social workers may try to help with familial conflicts, or therapists may prescribe treatments to calm anxiety and depression.

Patients who qualify for palliative care are those suffering from terminal conditions, as mesothelioma so often is, or other chronic conditions like dementia or COPD. Insurance agencies are increasingly favoring these programs, which is helping lower healthcare costs throughout the country along with fulfilling the needs of terminally ill patients.

Advocates argue that palliative programs improve care quality because they are specifically tailored to each patient, which in turn helps reduce repeat hospitalizations and other emergency situations (thus the lowered healthcare costs). Critics of these programs believe that they encourage patients to deny certain treatments that could, theoretically, lengthen their lives. Below we hash out why this is not true.

Big Insurance Adds Palliative Care

Recently, big names like UnitedHealth Group and Highmark have established palliative care programs and many more insurers are expected to follow. This is significant for obvious reasons - more options for patients - and for less obvious ones, such as how it will affect our aging population. Americans, like many other cultures throughout the world, are aging rapidly as the baby boomers enter the later stages of life and modern couples are choosing to have fewer children.

Insurers and medical professionals now have to shift priority to caring for people at the end of their lives. Reports confirm that an inordinate amount of money is spent on patients with complex diseases like mesothelioma during their final months. For example, about a quarter of Medicare's spending overall is dedicated to the last year of patients' lives, and a single day visit to an intensive care unit can cost over $4,000.

Unfortunately, mesothelioma has one of the most devastating prognoses; most patients are given less than one year to live. The Wall Street Journal found that about 65% of poor-prognosis cancer patients are hospitalized during the last month of their life. Palliative care programs typically allow patients to spend that final month at home, with the assistance of an in-home caregiver or nurse, among other specialists.

Aetna Inc. established a palliative program in 2004 and saved more than $55 million (or $12,600 per patient) in 2012 from the program. The company now offers it to any patient with medical coverage who requests it. Palliative care team members often sit in with patients during meetings with their doctors, help families make tough decisions, and coordinate complex treatment plans. They can even help draft wills and do-not-resuscitate orders.

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Experimental Lung Cancer Drug Shows Promise

February 20, 2014

mesotheliomacxr_l.pngEli Lilly recently announced promising results from clinical trial of one of its experimental cancer drugs, ramucirumab. The drug is designed to treat several different types of cancer, including lung and stomach. Mesothelioma attorneys at Pintas & Mullins look forward to further advances in cancer treatment from Big Pharma.

Experts expect ramucirumab to be Eli Lilly's next blockbuster drug, with sales expected to reach $1.5 billion by 2020. The latest trial, referred to as Revel, enrolled patients diagnosed with non-small cell lung cancer and divided them into two groups. The first group received a combination of ramucirumab and another popular chemotherapy drug, docetaxel. The second group received docetaxel and a placebo.

Results showed that patients taking ramucirumab had significantly higher overall survival rates compared to patients who took the placebo. Ramucirumab patients also showed lower rates of cancer progression and spread. Full details from the Revel trial are will be released soon at an unnamed scientific conference.

Eli Lilly plans to send an application for ramucirumab's approval to the FDA later in 2014. There have been two other studies conducted on the drug, one in colorectal cancer patients and the other in liver cancer. Results from these trials are also expected later this year.

Ramucirumab works by preventing the blood vessels that feed tumors from growing. Industry insiders note that ramucirumab will have to demonstrate that it improves overall survival by at least two months to be considered a meaningful new cancer treatment.

Lung Cancer and Asbestos Exposure

Mesothelioma is a type of non-small cell lung cancer that is only caused by exposure to asbestos. A mesothelioma diagnosis can be incredibly confusing and devastating to families, because the disease has a particularly low survival rate. Mesothelioma patients have many questions, most poignantly how and why they were ever exposed to asbestos in the first place.

Most people are exposed to asbestos in the workplace - asbestos was commonly used as an insulator in pipes, floor and ceiling tiles, insulation, friction products, and countless other industrial products. The occupations most at risk of asbestos exposure include those employed in shipbuilding, automotive repair, construction, or pipefitting.

Asbestos is a natural, white, fiber-like substance that can easily be inhaled. Once asbestos fibers enter the lungs, the often lodge themselves into the lung tissue, where they can remain permanently. Over time, often several decades, these asbestos fibers change the biology of the lungs and surrounding tissue to create cancerous tumors, and ultimately mesothelioma.

This disease is particularly insidious because many people are exposed unknowingly - for example, if their father was employed at a shipyard and frequently brought asbestos dust home on his work clothes, the entire family was at risk for exposure to asbestos. This was the case in a recent lawsuit filed in Ohio. The plaintiff, John Panza, was diagnosed with mesothelioma when he was just 40 years old.

Panza never worked with asbestos materials himself, but was exposed from his father, who died of lung cancer at age 52. Panza's father worked for three decades at Eaton Airflex Brake Company, where he frequently worked among peers who drilled and abraded asbestos-containing brake products. The products were largely made by the National Friction Products Corp., which is now the Kelsey-Hayes Company.

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Mesothelioma Update: Yoga to Reduce Fatigue, Judges Recognize Merit of 'Second-Hand' Exposure

February 3, 2014

5794094085_d987bacd78.jpgThe mesothelioma attorneys at Pintas & Mullins are always trying to keep our clients up-to-date on the most recent news out of the mesothelioma community. We recently came across two unrelated articles that we think could prove beneficial to mesothelioma patients and asbestos exposure victims throughout the country. The first centers on the medical benefits of yoga in cancer fighters, and the second on the legal permissibilitly of second-hand asbestos exposure and its harmful effects.

Researchers at Ohio State University Comprehensive Cancer Center recently led a study to determine the physical benefits of yoga in patients with cancer. Patients fighting cancer have higher rates of fatigue, inflammation, and disability than the general population, which is often attributed to lack of physical activity during and after cancer treatment.

Ohio State researchers enrolled about 200 recent breast cancer survivors, all of whom finished their last cancer treatments at least two month before the study began. The women were randomly split into two groups: the first participated in two 90-minute yoga sessions per week for 12 weeks, and the second was told to avoid yoga altogether.

At the beginning and end of the 12 weeks, the women's blood was tested for symptoms of inflammation and they were given surveys to measure their fatigue, mood, and overall vitality. By the end of the study period, the women who participated in yoga had higher scores of vitality, however there was no marked difference in rates on inflammation, mood or fatigue.

Then, another three months later, the women were tested again. These tests indicated that the women who participated in the 12 week yoga regimen were substantially less fatigued and had higher vitality scores than the group of women who did not partake in yoga. There was no difference in mood between the two groups.

Researchers noted that the women who practiced yoga were less tired and had between 13 and 20% less inflammation in their blood samples. They also stated that cancer fighters should choose low-to-moderate intensity yoga classes to avoid overexertion. Their findings were published in the Journal of Clinical Oncology.

Jury Awards Over $27 Million to Victims of 'Second-Hand' Asbestos Exposure

Exposure to asbestos is the only known cause of mesothelioma and asbestosis, however, only recently has scientific and medical researchers acknowledged the possibility that second-hand exposure can also cause these ailments. Second-hand exposure to asbestos occurs when someone who frequently works around asbestos, say, a shipbuilder or construction worker, tracts the substance home on their work clothing, and contaminates the home.

In the case of John and Jane Panza, John's father was responsible for the take-home asbestos exposure. The elder Panza worked at a brake manufacturing company, Eaton Airflex, for over three decades, and was the president of their union. Over those 30 years, Panza routinely tracked home asbestos dust on his work clothing, and eventually died of lung cancer.

His son, John Panza, was recently diagnosed with mesothelioma at just 40 years old. Mesothelioma typically takes between 20 and 50 years to develop in the body, so his exposure undoubtedly occurred when he was a young child. Panza has undergone several surgeries to treat his mesothelioma cancer, ultimately removing his right lung completely.

Panza and his wife Jane sued Eaton and the company that manufactured the asbestos-containing brake pads his father worked with every day. After an 11-day trial, the jury decided that that company, Kelsey-Hayes Co., manufactured a defective product, and failed to warn workers on the dangers of asbestos and how to avoid its risks.

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Naturally-Occurring Asbestos in the U.S. - An Illustrative Map

January 20, 2014

NOA-in-the-US.jpgMost people familiar with asbestos and mesothelioma know that exposure most often occurs in the workplace, such as in shipyards and construction sites. Lesser known is the prevalence of natural asbestos mineral deposits, many of which were previously mined before it was made illegal in 1989. Asbestos exposure attorneys at Pintas & Mullins highlight this graphic of naturally-occurring asbestos deposits from the U.S. Geological Survey (USGS). Click on image for larger view.

The USGS began publishing this information in 2004, however it is important to note that the information is not comprehensive because it is compiled from each state's individual geologic data. Because of the expansive geographic size of the state, California has by far the most asbestos occurrences, dwarfing other states in comparison with 193.

What is perhaps most surprising is the amount of former asbestos mines and projects in Arizona (46 and 49, respectively). Most of these abandoned mines and projects are in Salt River region of Gila County, Arizona, and were established to mine chrysotile asbestos. Beginning in 1913, mines in that region produced over 75,000 tons of chrysotile asbestos, and one mine was still operating as late as 1982.

Toxic Clean-Ups Delayed

Overall, 34 of the continental states report natural asbestos deposits, ranging in size and exposure potential for the surrounding community. Perhaps the most immediately dangerous is the former Lowell and Eden chrysotile mines, located in Orleans County, Vermont. These were the largest asbestos mines in the Eastern U.S., and negotiations over who will fund the clean-up project are still ongoing.

Recently, the Vermont Asbestos Group negotiated a deal with the EPA and Attorney General's Office to put $50,000 toward the clean-up. The defunct mines ceased operations in 1993, and the Vermont Group has been given until 2023 to complete its payment. Considering the devastating health effects of asbestos exposure, thirty years to complete a clean-up is unacceptable, dangerous, and negligent any way you look at it.

The current plan for this site is to flatten the piles of asbestos waste and cover them with soil and other natural materials. According to state environmental officials, "there is little to no chance all the waste will ever be totally removed." The air surrounding the site continues to be monitored.

Appalachian Exposure Concerns

There are six types of asbestos minerals, chrysotile being the most prevalent. In the Southern Appalachians, there are dozens of anthophyllite asbestos deposits. Anthophyllite asbestos is more dangerous than chyrsotile (though this distinction is relative; they both cause mesothelioma and asbestosis), and was most commonly used in composite flooring. Anthophyllite was mined from 44 sites in North Carolina and Georgia into the mid-1990s despite federal bans.

Public Health Consequences

Naturally-occurring asbestos resembles hair-like mineral fibers, and can be transported through water, wind, clothing, and cars. Simply put, the health risks of natural asbestos exposure are largely unknown. In patients diagnosed with mesothelioma and asbestosis, it is clear that, when inhaled, the fibers permanently lodge themselves deep into lung tissue, eventually causing cancers and other respiratory illnesses.

There are many concerns about new residential developments being built on top of asbestos deposits, such as those in El Dorado County, California, near Sacramento. In Libby, Montana, where one of the most devastating asbestos mines operated, about one-fifth of the population now suffers from mesothelioma and asbestos-related diseases. Another recent study of the Iron Belt mines in Minnesota concluded that there was an increased risk of death among those working in mines containing asbestos deposits. These are just a few examples.

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Mesothelioma Patients may Benefit from Meditation to Cope

January 13, 2014

7961496868_8bb4b63de5.jpgA new study recently published in the esteemed Journal of the American Medical Association (JAMA) found that meditation has the same effect of antidepressant pills on depression. Mesothelioma is a devastating cancer caused by exposure to asbestos, which typically occurs in the workplace. Given its nature, depression among mesothelioma patients is extremely common. Mesothelioma attorneys at Pintas & Mullins are always researching ways to help our asbestos exposure clients cope with the disease.

The meditation study was led by a doctor at Johns Hopkins, Madhav Goyal, who aimed to examine the effects of meditation on the brain. Dr. Goyal and his team reviewed about 50 earlier clinical trials to analyze mindful meditation and easing the symptoms of depression, anxiety, and pain. Among mesothelioma patients - and all types of cancer patients - anxiety, pain and depression can greatly reduce quality of life at the most critical time. Taking a few minutes every day to mindfully meditate, the researchers found, was just as effective as medication.

First, it is important to define what defines meditation in this context. It is not, as many assume, simply sitting in a room alone in chanting in silence. At its most basic level, meditation refers to actively training your mind to heighten awareness of thoughts and/or bodily sensations. This can be achieved through many different modes, however this study found 'mindfulness meditation' to be most beneficial. An abstract of the study can be found here.

Mo' Pills Mo' Problems

What was most interesting about this study was its comparison to the health benefits of antidepressants. One in ten Americans taken an antidepressant medication, and over a quarter of cancer patients are depressed, with about 16% taking an antidepressant. All medications carry a wide range of side effects and possible adverse events; there is no known harm that can come from meditating.

Cancer fighters are treated with a slew of medications throughout their therapy, and many drugs do not mix well together, decreasing efficacy or causing life-threatening side effects. Knowing that major depression can be treated with counseling and meditation with the same results as medication can enable patients to live healthier, more enjoyable lives while fighting their disease.

Dr. Goyal and his team found that the effect size for meditation and medication on depression was exactly the same - at 0.3 (depression has an extremely low treatment success rate). Their next endeavor will examine whether health benefits increase with more training, practice and skill between both meditation trainer and trainee.

It is worth noting that talk therapy (and especially cognitive behavioral therapy) is also known to be just as effective as antidepressant medications, and combining the two therapies seems to be most effective. It will be interesting to see the effects of meditation, combined with talk therapy, on depression symptoms.

Biologically, MRI scans show that meditation reduces activity in the amygdala, which is the part of the brain that regulates stress response. It is also linked to decreased activity in the brain's default mode network, which is typically cited as the center of unhappiness and stress. Scientists now believe that meditation enhances body awareness, changes in self-perspective, attention regulation, and emotional regulation.

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Cancer Centers Launch Startup to Treat Late-Stage Patients

December 4, 2013

8949408195_9e5fcb08cc.jpgTwo prominent cancer centers, former competitors Fred Hutchinson Cancer Research Center and Memorial Sloan-Kettering Cancer Center, recently joined with the Seattle Children's Research Institute to form a new startup. The institutions have already raised over $120 million for the new venture, Juno Therapeutics, to create treatments for late-stage cancer. Mesothelioma attorneys at Pintas & Mullins hope this new startup will focus some of its fund on mesothelioma and lung cancer treatment.

Juno's CEO recently stated that the startup will combine investment partners and renowned scientists to deliver cutting-edge cancer immunotherapy treatments. Juno is pursuing two immunotherapy approaches: the first, referred to as chimeric antigen receptor-modified T cells approach (CART), involves drawing a patient's blood and enriching it to locate T cells. Scientist them perform gene therapy on these cells so they are better equipped to target and destroy cancer cells.

This entire CART process takes only 15 days, its ultimate mission to destroy all cancerous tumors and establish a memory in the immune system so any future cancer cells will be recognized as foreign and consequently killed. The second platform is called high-affinity T cell receptors, which seeks out T cells with a naturally high-affinity to bind to specific markers on cancer cells. Once these high-affinity T cells are located, Juno scientists use gene therapy systems to transform the remaining T cells to express the same qualities to fight cancer antigens.

How Immunotherapy Could Change Cancer Treatment

Juno Therapeutics is named for the Roman goddess of protection, which is exactly what researchers are trying to achieve for their cancer patients. Researchers are confident because they have an illustrious, though short, history of immense success. Over the past year or so, scientists connected to Juno have treated about 24 patients with acute lymphocytic leukemia who were given only a few weeks to live. Using their T cell immunotherapy techniques, researchers were able to trigger molecular responses in at least 15 of these patients. Molecular response means that there was no trace of cancer anywhere in the blood after the T cell therapy.

Juno now plans to set up as many as 13 new clinical trials for patients battling various forms of cancer in the next year or so, though the specifics of these trials have not yet been announced. Several other pharmaceutical companies have expressed interest in immunotherapy, including Novartis, which has plans to commercialize a new brand of immunotherapy soon. Bristol-Myers Squibb also recently gained FDA approval for its antibody medication, Yervoy, which prompts the immune system to fight melanoma.

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Congresswoman's Asbestos Lawsuit Prompts Debate

November 26, 2013

4730728956_0c545d7335.jpgNew York Representative Carolyn McCarthy was, sadly, recently diagnosed with lung cancer. Consequently, she filed a lawsuit against several companies who she believes exposed her and her family to asbestos while she was a child. Asbestos exposure attorneys at Pintas & Mullins highlight this case to remind the public of the very real and very dangerous effects of so-called "second-hand" asbestos exposure.

People are most often exposed to asbestos through the workplace - commonly in industries such as shipbuilding, construction and automotive repair. When the asbestos dust is unintentionally brought home on the clothing, hair, boots and work gear of these workers, infiltrating the home and affecting family members, this is known as second-hand asbestos exposure.

McCarthy's father and brothers worked as boiler makers at U.S. Navy Yards and power plants while she was growing up. Asbestos was used for decades in the United States, particularly in boiler manufacturing and shipbuilding, because of its high resistance to heat, excellent insulating properties, high tensile strength, and low costs. Asbestos appears as a fiber, which is actually thousands of fibrous materials that can break off, become airborne, stick to clothing, and be inhaled most directly by the workers themselves, and later by their families.

Asbestos, Smoking and Cancer

Inhaling asbestos is the only known cause of mesothelioma, a rare cancer of the lining of internal organs, as well as asbestosis. It is also a major contributing factor to lung cancer. The McCarthy case is so hotly contested because she is a long-time smoker, known for taking cigarette breaks between votes on Capitol Hill.

Some argue that partly blaming her lung cancer on previous exposure to asbestos is baseless because of her 40-year smoking habit. Scientific evidence however, does provide some ground for her claims that it was a contributer. According to a quote in Bloomberg BusinessWeek, the rate of lung cancer in smokers who were previously exposed to asbestos is 4,000 times higher than smokers not exposed. Though the source of that number remains unclear, the American Journal of Respiratory and Critical Care Medicine recently published that smokers exposed to asbestos were at least five times more likely to develop lung cancer than unexposed smokers.

The significant increase in risk is largely related to how cigarette smoke paralyzes the cilia (slender protuberances in the lining of the windpipe that sweep debris out of the lungs). The cilium protects the lungs from toxic substances, asbestos and toxins in cigarettes alike, and when it is paralyzed, it is unable to keep the toxins out.

McCarthy filed the lawsuit against multiple asbestos manufacturers, including Pfizer, Goodyear Tire & Rubber, and the Con Edison utility, not for exclusively causing her lung cancer but for significantly contributing to it and increasing her risk. The synergistic relationship between asbestos and smoking is irrefutable, but it will be interesting to see whether a judge agrees that the companies should be held financially liable for her second-hand exposure.

This case merely reemphasizes how important it is to stop smoking, especially in those previously exposed to asbestos. A study by Queens College in New York found about a 50% decrease in lung cancer rates when insulation workers exposed to asbestos stopped smoking. That study involved over 2,000 insulation workers and focused on the synergistic relationship between smoking, lung cancer and asbestos exposure.

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Combination Therapy Best Bet to Fight Mesothelioma

November 19, 2013

6878043269_7c43349159.jpgFor a disease as complex and serious as mesothelioma, choosing a course of treatment can be stressful and overwhelming. Unfortunately, there is no one therapy that has shown drastically positive results in most patients, so doctors are often left to treat the cancer through traditional means. Recently, a team of medical scientists in Italy conducted a study that yielded excellent survival results in mesothelioma patients. Asbestos exposure attorneys at Pintas & Mullins highlight this study, along with others that were recently published to help our clients choose the correct treatment path.

The Italian study required patients to undergo radical pleurectomy/decortication (P/D) - a surgical procedure to remove tumors - followed by high doses of radiation. Radiotherapy differs from chemotherapy in several ways, although they are usually used together. Chemotherapy uses medicines or drugs to destroy cancer, while radiation uses high-energy waves or particles to destroy it. More information on radiation therapy, what it is and how it works, can be found on the American Cancer Society's website, located here.

Who can Undergo P/D and Radiation?

Typically, patients with malignant pleural mesothelioma (MPM), the most common type of mesothelioma cancer, are the best candidates for this type of treatment. The Italian researchers enrolled MPM 20 patients in their study, who first underwent radical P/D procedures and then radiotherapy. P/D surgeries remove the entire pleura lining of the affected side of the chest wall, along with the lining of the lung, diaphragm and mediastinum. During radical P/D, the diaphragm and pericardium are entirely removed.

External radiation is usually the preferred type of radiotherapy for mesothelioma patients, and is similar to an x-ray procedure but takes more time to complete. These types of therapies are usually conducted five times per week for several weeks and helps ease the pain of mesothelioma symptoms, such as shortness of breath and pain. Radiotherapy was used in these patients to identify and kill small areas of cancer that could not be seen and removed during P/D.

P/D is not used to treat peritoneal or pericardial mesothelioma, although radiation and chemotherapy can be. 19 out of the 20 patients in the Italian study also underwent chemotherapy as well, using a combination of two drugs, cisplatin and pemetrexed.

The median overall survival rate for these patients was 33 months, or nearly three years. More than half of patients enjoyed progression-free survival during this time, and only seven patients' cancer spread. Fortunately, there were no deaths associated with the P/D and radiotherapy themselves. This is significant because, at present, the majority of mesothelioma patients succumb to the disease within one year after diagnosis.

Other Treatment Options

Other surgeries available for mesothelioma patients include cytoreductive surgery and extrapleural pneumonectomy (EPP). The former is preferable for patients with peritoneal mesothelioma, and the latter for pleural. Cytoreductive surgery removes cancerous cells from the abdominal area, which may mean parts of the intestines must be removed.

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The Ideal Mesothelioma Care Team

November 11, 2013

20120120-chemo-nurse-and-patient_l.jpgThe Center for Disease Control and Prevention (CDC) estimates that, at present, about 1.3 million construction and general industry workers are being exposed to asbestos in the United States. Workers in this industry are at the highest risk because of the abundance of asbestos-containing products in popular household materials, such as insulation and floor or ceiling tiles. The team of asbestos exposure attorneys at Pintas & Mullins warns those working in construction and demolition of this risk and its consequences.

Mesothelioma is a type of cancer that affects the lining of certain organs, most frequently the lungs, and which is only known to be caused by asbestos exposure. Although asbestos is no longer mined in the U.S., it remains in homes, ships and commercial buildings in large amounts throughout the country. Mesothelioma and asbestos-caused lung cancer is the consequence of breathing asbestos fibers into the lungs, where they are lodged in lung tissue, often permanently. The fibrous materials support cancerous growth, which can take anywhere between 20 and 50 years to manifest in the body.

After the Diagnosis

Once a patient is diagnosed with mesothelioma, the treatment options and survival rates may seem overwhelming. It is important, however, to realize the importance of a comprehensive, well-rounded support team, including doctors and specialists, family, friends, and even pets. For many patients, their best chance at fighting mesothelioma is the result of effort from many difference angles.

Medically speaking, patients should seek out oncologists, pulmonologists, surgeons, radiation oncologists and pathologists that they feel extremely comfortable with. Even beyond these specialties, patients may want to consider seeking alternate opinions from physicians specializing in immunotherapy and other novel therapies. Consulting with an infectious disease expert is also highly advised, as infections are among the most common and most devastating complications of cancer treatment.

Mesothelioma treatment research is constantly expanding, with clinical trials introduced constantly in the U.S. Many patients may be eligible for participating in a clinical trial, which uses a specific group of patients to test new therapies and which often yield positive results. A full list of clinical trials that are currently enrolling mesothelioma patients may be found here.

Beyond medical treatment, mesothelioma patients also require immense emotional and spiritual support. For the lucky ones, this can be provided through family members or close-knit groups of friends. Consulting with spiritual counselors, whatever that may mean to you, can also provide this support, helping patients treat the whole person instead of just the cancer.

Along with physical debilitation, mesothelioma patients may also suffer from depression, anxiety, or other cognitive issues from the stress of a serious illness. Finding ways to ease the mind-chatter is always beneficial, but you have to find ways that work specifically for you. For some, this may be mediation, yoga, creating art or music; for others that may mean adopting a pet or traveling to a new region to experience something new.

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Dow Chemical Slammed with $6 Million Asbestos Verdict

November 7, 2013

8393281679_a06fbfd14d.jpgNearly three decades after asbestos was officially banned in the United States, lawsuits and verdicts over asbestos exposure continue to emerge in the American court system. Most recently, chemical giant Down Chemical Company was ordered to pay $5.95 million to the family of a woman who passed away from cancer caused by asbestos exposure.

Dow was found liable on all counts relating to its illegal use of asbestos and consequent employee exposure. The plant at issue in this case, located in Plaquemine, Louisiana, is the largest chemical plant in the state, and it continues to use raw asbestos.

Asbestos is known to cause cancer - namely, mesothelioma - and was completely banned in the U.S. in July 1989. Deep-pocketed companies like Dow Chemical, however, estimated that it would cost over $1 billion to convert its processes to asbestos alternatives, and successfully lobbied the EPA so it could be allowed to use raw asbestos. Most other chemical companies stopped using asbestos in favor of other, significantly less-toxic elements, in the early 1990s.

The Louisiana lawsuit was filed on behalf of Sidney Mabile, who was recently diagnosed with mesothelioma, an extremely fatal type of cancer whose only known cause is asbestos exposure. Throughout trial, Mabile's family argued that Dow knowingly exposed thousands of its workers to asbestos after it conducted a "cost per cancer" analysis.

Causing Global Exposure

Dow Chemical is also a leader in the European market, where it continues to use raw asbestos because it believes paying the mesothelioma verdicts is cheaper than converting its processing practices. The European Trade Union issued a report on the use of asbestos on the continent, where it blatantly noted that Dow has submitted "no technical case for its stance."

The Trade Union outlines that other chemical plants that made the conversion from asbestos to safer materials have not experienced a significant increase in energy consumption. Despite this, Dow continues to argue that substitution would cause a substantial difference. The Union further states that, with the exception of one Polish manufacturer, Dow is now the only company left in Europe that opposes a blanket asbestos ban.

Know Your Rights

Employees who are exposed to asbestos on the job can sue their employer or the asbestos-containing part manufacturer in a civil court case. Liability in these cases are typically based on one of three theories: first, that the entity acted negligently in using asbestos; second, that the entity violated a warranty by selling a product which it knew to be dangerous; and third, that the entity had a strict duty to sell a safe product, which it violated.

When asbestos fibers are inhaled into the lungs, they become lodged in the lining of internal organs and remain there permanently. Over long periods of time, usually several decades, those fibers turn normal, healthy tissue into cancerous tumors. Because the cancer takes so long to manifest, proving that one specific company caused the asbestos exposure can be difficult.

Mesothelioma victims who worked at companies like Dow Chemical for long periods of time have an easier time proving causation. Other mesothelioma victims may be wondering where, when and how they were exposed to asbestos. The industries at highest risk of asbestos exposure include, but are not limited to: shipbuilding, automotive, construction, demolition and building trades, insulation and pipefitting, and firefighting.

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Government Study Reports Firefighters at Higher Risk for Mesothelioma

October 29, 2013

3341603030_53b2c8e27e.jpgMesothelioma attorneys at the Pintas & Mullins Law Firm remind those who are systemically exposed to asbestos on the job that the failure to warn and protect workers from toxic exposure is against the law. In fact, lawsuits regarding asbestos exposure date back to the 1920s and continue through present day. Many companies have been accused of violating the Clean Air Act and Toxic Substance Control Act, and companies such as W.R. Grace that have exposed entire communities to hazardous asbestos have paid hefty penalties totaling millions of dollars.

The health hazards of asbestos exposure are irrefutable and complex, due in part to the long period of time it takes to manifest as cancer in the body. Mesothelioma attorneys highlight a recently published study conducted by the National Institute for Occupational Safety and Health (NIOSH) which confirms that firefighters in the United States present significantly higher cancer rates than the general population. Study authors specifically noted the elevated rates of mesothelioma incidence caused by the inhalation of asbestos fibers.

The study took place over a period of five years and included about 30,000 firefighters who have been employed in the profession since 1950. Asbestos was used quite abundantly in the United States in the housing boom of the 1950s and 1960s, until studies and reports confirmed that it caused mesothelioma cancer among other ailments. By 1973, asbestos was being phased-out across the country and throughout most of the industrialized world.

How Firefighters are Exposed

In buildings, asbestos was used for fireproofing and insulating purposes, in pipes and block insulation on facility components such as hot water tanks. Firemen and women are routinely exposed to carcinogens and other toxins, such as benzene, asbestos, formaldehyde, and other debris from older structures. The serious and life-threatening health effects of this exposure have long been suggested, and the results of this major study strengthen the scientific correlation between cancer and firefighting.

The study tracked the incidence of cancers and cancer deaths at fire departments in Chicago, San Francisco, and Philadelphia. The results signify the first time mesothelioma has been documented and confirmed to be excessive among the American firefighter population; in fact, study authors wrote that the robust connection to mesothelioma was particularly noteworthy, as the rate of mesothelioma in this population was two times greater than the general population.

Legal Options for Firefighters and Their Families

In addition to mesothelioma, firefighters in the study also showed significantly increased rates of digestive, respiratory, and urinary system cancers. A second phase of the study is currently being conducted, in which researchers examine the employment records from each station. They will examine the records to derive information on factors like specific job duties and functions to see if any patterns emerge. It is important to note that overall mortality among firefighters was no higher than the general public.

Most people assume that companies making asbestos-containing products used in American homes and businesses were unaware that asbestos directly led to cancer and other debilitating illness. This is simply not true. The largest companies knew of the potential health risks as early as the 1930's, although they did not publicly admit to it until it was revealed by third-parties through litigation.

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Speed of Tumor Recurrence can Help Predict Success of Second Surgery

October 18, 2013

221486533_8678a8d601.jpgMesothelioma attorneys at Pintas & Mullins highlight a new study recently published in the Journal of Thoracic and Cardiovascular Surgery examining the speed of tumor growth in mesothelioma patients after the first resection surgery and how it affected the second surgery's outcome. The study was conducted by researchers at Stanford University.

For patients with malignant pleural mesothelioma, initial surgeries are often recommended to attempt to remove tumors from the chest cavity. Since mesothelioma refers to the cancer of the lining of the lungs, however, surgeries can be extremely difficult and complex, unlikely to completely resect all the cancerous tissue.

Thus, if patients are physically stable and willing, doctors often suggest second surgeries to try to remove the remaining tumors and prevent spread. Stanford researchers noted that the ipsilateral hemithorax - meaning one specific side of the chest cavity - is the most common site of recurrence in mesothelioma patients.

Salvage treatment after the first surgery, sadly, is generally ineffective due to the nature of mesothelioma, its causes and lack of response to traditional cancer treatments. Researchers examined data from mesothelioma resection procedure patients who were then treated for cancer recurrence, that occurred at Stanford between 1988 and 2011.

All data from these patients, totaling over 1,100, were retrospectively reviewed for the study. The mesothelioma patients initially underwent eight an extrapleural pneumonectomy, or pleurectomy/decortication (two procedures we have written extensively about regarding the pros and cons of each).

Of the patients who returned for follow-ups, about 4% had cancerous recurrence in the chest wall that showed potential for additional resection. The average amount of time it took to detect recurrence after the initial procedure was about 16 months (ranging between 2 and 58 months). The median length of hospital stay was about three days, and the median overall survival after initial surgery was generally a good indicator of the time it took to recur. Researchers concluded that chest wall resection is a safe and at least partially effective treatment for mesothelioma, and that the time to recurrence appears to predict overall expected survival.

Mesothelioma therapy research has made great gains in the past decade or so; the disease was always treated with traditional cancer treatments, such as chemotherapy, radiation, and resective therapy. It quickly became clear that mesothelioma was not well responding to these treatments, and medical researchers looked to other modes of therapy to treat this debilitating and extremely fatal illness.

Specifically, researchers have been emphasizing targeted gene therapy and immunotherapy for patients with mesothelioma, and many clinical trials are showing immense promise. Gene therapy aims to determine and target the specific genes present or over-expressed in patients with mesothelioma, and develop a drug that can target and destroy the cancerous cells.

Immunotherapies are also receiving increased attention (most recently by Merck, AstraZeneca, Roche and Bristol-Myers Squibb). Big Pharma's new drugs, for which they are currently conducting clinical trials, are aimed at using and manipulating the body's own immune system to fight off and kill the cancer cells.

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