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lungsOur team of lung cancer lawyers strives to update this blog with the latest news and developments in lung cancer treatments. We report that a new drug for non-small cell lung cancer was recently approved as a first-line treatment, along with a companion diagnostic test.

First-line therapies – also called primary treatments or induction therapies – are accepted as the best treatments for a disease; if it does not cure the disease or results in severe side effects, other therapies may be added or replaced.

On July 13, 2015 the FDA announced its approval of Iressa (gefitinib) as a first-line treatment for patients with a certain type of non-small cell lung cancer (NSCLC) characterized by gene mutations. The gene mutations cause tumors to harbor epidermal growth factor receptors, and can be detected by an FDA-approved test. NSCLC is the most common type of lung cancer and the epidermal growth factor mutations are present in about 10% of these tumors.

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surgeonOur team of mesothelioma and lung cancer lawyers knows how hard it can be to cope with and discuss a cancer diagnosis, particularly when it concerns such a devastating form. Patients with life-threatening illnesses need to speak openly with their doctors and loved ones about their priorities, treatment goals, fears and ultimate wishes. A new book, Being Mortal, aims to help patients and their families address these issues.

Mesothelioma is an extraordinarily fatal cancer; most patients are not diagnosed until the cancer is in advanced stages, aggressively spreading to other organs. Fortunately, as cancer treatments advance and new discoveries are made, mesothelioma patients (and cancer patients of all types) are experiencing better prognoses. Still, the average life expectancy for someone diagnosed with mesothelioma remains about one year.

Dr. Atul Gawande, a surgeon and prolific writer, tackles terminal cancer care in Being Mortal. As much as the book highlights case studies, financial costs, and palliative care, it is also call for reform in the philosophy of health care. Rather than encouraging doctors to overestimate survival rates and aggressive cancer treatments, Gawande leans toward enabling well-being and ensuring patients make the most of their remaining time.

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lung xrayFor several years now, cancer patients have read and heard about the potential power of immunotherapy, but have been largely unable to receive these types of treatments as they were still in research and development. At this year’s Annual Society of Clinical Oncology meeting, in a special session, a doctor presented an incredibly successful immunotherapy trial known as CheckMate 057.

This trial involved patients with non-squamous non-small cell lung cancer. The results – an overall survival rate improvement of eight to eleven months –signify a new standard of care for lung cancer patients throughout the country. Our team of lung cancer lawyers reports on the CheckMate 057 trial and its implications for those fighting cancer.

The CheckMate trial compared the drug nivolumab with a chemotherapy drug called docetaxel in lung cancer patients who had previously received treatment. The presenting doctor stood before a packed and hushed auditorium; it quickly became clear that this trial was not simply another “wait and see,” study. This was something doctors could bring back to their patients, to give them another chance to live longer than they would have with chemotherapy, radiation or surgery.

These three treatments, chemo, radiation and surgery, have been the standard of care for decades. Patients diagnosed with early-stage cancers can often be cured by surgery, by removing all of the cancerous tumors. Those with later-stage cancers are often prescribed chemotherapy and radiation, not to cure their disease, but to hopefully lengthen the amount of time they have left and lessen the severity of the disease.

An Independent Data Monitoring Committee unanimously declared nivolumab superior in overall survival versus docetaxel. Side effects were also noticeably less severe in patients receiving nivolumab over the other drug – severe adverse events occurred in just 10% of nivolumab patients, compared to 54% of docetaxel patients. Therefore, nivolumab not only contributes to better survival, but is substantially less toxic.

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chemo no moreA piece recently published by NPR highlighted an issue that we believe is critically important: access to alternative treatments for lung cancer and mesothelioma patients. Our team of lung cancer lawyers details this article and the inspiring story behind it.

The National Comprehensive Cancer Network is an association made up of 26 esteemed cancer centers in the world. The Network publishes guidelines used by oncologists throughout the country to help develop treatment plans for patients. A group of lung cancer patients recently made suggestions to change the Network’s guidelines to reflect new advances in a certain type of late-stage lung cancer.

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file000788055222Managed care and health insurance companies are trying to set cancer drugs pricing based on how well they work for patients. These so-called pay-for-performance deals with pharmaceutical companies would greatly benefit patients and families struggling with the rising cost of cancer medications.

Our team of lung cancer lawyers recently reported on the dangers of rising drug costs, particularly among cancer medications, many of which cost more than $100,000 per patient per year. Experts have been warning about the consequences of rising drug prices for the past decade and the tide is finally beginning to turn as doctors, hospitals, insurers and health managers are outright refusing to pay for or prescribe these overpriced drugs.

Traditionally, neither American doctors nor the FDA consider drug pricing when deciding whether a drug would be safe and effective in patients. Recently oncologists at Sloan-Kettering Cancer Center, one of the country’s most esteemed hospitals, refused to offer a cancer drug because of its outrageous price. The drug, Zaltrap, was nearly identical to another drug already on market but cost twice as much: $11,000 per month. And it is useless when used on its own. Zaltrap is a second-line treatment, meaning it must be used in addition to other chemotherapies.

This was the first doctor-initiated revolt against drug prices in recent memory. What happens next? One health manager, Express Scripts Holding, is arguing for one possibility: pricing drugs based on how well they work. Health managers say they should pay less when drugs do not work well in certain patients with certain types of tumors.

Currently, insurers and managers pay the same per-unit price for all cancer drugs regardless of what type of tumor it is being used to treat. Drugs work differently for different cancers, however. The drug Tarceva, for example, extends the life of pancreatic cancer patients by an average of just two weeks, though it extends lung cancer patients’ survival by about 3.5 months.

Therefore, Express Scripts is seeking to pay less for Tarceva for pancreatic cancer patients than for lung cancer patients. Tarceva costs $6,850 per month.

The U.S. spent $42.4 billion on oncology drugs in 2014. Yet, most cancer drugs provide minor survival benefits, shrinking tumors but never eradicating them fully.

Change in the Face of Public, Physician Scrutiny

Pharmaceuticals as a whole treat symptoms rather than underlying causes; this is why our national reliance on drugs has made us sicker instead or healthier, draining our healthcare system while fattening the pockets of Big Pharma.

A director at Sloan Kettering Cancer Center proposed a similar pay-for-performance model last year. He suggested dropping the price of the drug Erbitux, which typically costs $10,320 per patient, to about $420 per patient for its least-effective use (metastatic head and neck cancer).

Insurers and managers are also seeking simple price cuts, which Big Pharma has been able to avoid due to the country’s fragmented healthcare system. Other tactics include providing new drugs for free for the first few months. If the drug works, patients are then expected to pay full price; if not, the patient is free to move on to another treatment.

Many drug companies are experimenting with various alternative-pricing systems due in no small part to public dislike and distrust. Physicians know that the rise in drug prices has far exceeded drugs’ effectiveness – but a stunning number of patients do not. A study recently published showed that nearly 70% of advanced lung cancer patients did not understand that the drugs used in their treatments would not cure them.
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syringes-and-vial-1028452-m.jpgAn agreement between the Cuban Immunology Center and a New York cancer institute was recently finalized, bringing a new lung cancer vaccine to American patients. The vaccine, Cimavax, is expected to gain approval in six to eight months, with clinical trials set to begin in 2016.

Our team of lung cancer lawyers is currently investigating lung cancer claims for patients of all types, even former smokers.

The agreement was signed by New York Governor Andrew Cuomo during his visit to Cuba in April 2015. The partnership between the Roswell Park Cancer Institute and Center for Molecular Immunology in Cuba will bring the vaccine to the U.S. for the first time.

Cuba conducts some of the best and most innovative medical research in the world, particularly for vaccines and immunology. Cimavax was developed over a 25-year-period, and was made available to the Cuban public for free in 2011. One clinical trial conducted in 2008 showed that Cuban lung cancer patients who received the vaccine lived an average of 5 months longer than patients who did not receive the vaccine.

As relations between the U.S. and Cuba begin to normalize, potentially putting an end to a 55-year trade embargo, President Obama has used executive power to lift restrictions on medical and research equipment. The embargo still stands, however, and Congress will have to lift the embargo if collaborative research between the two countries can grow and evolve.

As a result of decades of diplomatic and economic sanctions, Cuba has been forced to be more innovative and creative than countries with more resources. Cuba spends a fraction of the money Americans do on healthcare, yet the average life expectancy is equal among the two nations.

Fidel and Raul Castro went to great lengths to strengthen the country’s medical research and biotechnology sectors, placing much emphasis on preventative medicine. Cuba now has one of the best immunology programs in the world, making numerous vaccination breakthroughs for meningitis, hepatitis, and now, lung cancer.

The Cuban Center for Molecular Immunology is expected to give the Roswell Park Cancer Institute all relevant data – including how it’s produced and past trial results – to submit to the FDA for approval. Fortunately, Cimavax seems to have very low toxicity and will be relatively inexpensive to produce and store.

How the Vaccine Works

Cimavax works by attacking a certain protein tumors produce into the bloodstream. When those proteins are attacked, the body naturally releases antibodies against a hormone called epidermal growth factor. This hormone typically incites cell growth, including the growth and spread of cancer cells. Therefore, Cimavax is a therapeutic vaccine, intended not to prevent cancer from occurring, but to target certain antibodies to keep tumors from growing. This can potentially keep even late-stage cancer in check, so the condition is chronic but manageable.

Researchers at the Roswell Park Cancer Institute are hoping to expand the use of Cimavax beyond this purpose, as drugs to keep cancer “chronic but manageable” already exist in the U.S. Roswell is planning to explore Cimavax’s potential to actually prevent cancer from occurring. Cuba has been unable to explore the vaccine’s preventative potential due to financial limits.
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file000685955324.jpgTalcum powder has recently been linked to ovarian and uterine cancer in women who used the product in the genital area over long periods of time. This has resulted in massive news coverage and multi-million dollar lawsuits against companies like Johnson & Johnson.

Lesser known, however, is the potential for talcum powder containing asbestos to cause asbestos-related disease, such as mesothelioma and lung cancer. Our team of talcum powder lawyers urges the public to make this risk known so exposure may be avoided at all costs.

A woman in California, Judith Winkel, was recently diagnosed with mesothelioma, which is a form of cancer caused exclusively by exposure to asbestos. Winkel believes her mesothelioma was caused by Cashmere Bouquet talcum powder, a brand Colgate sold in the mid-1990s. This particular brand of talc powder is known to be contaminated with asbestos.

Winkel and her husband sued Colgate-Palmolive Co. on five separate claims, including failure to warn and defective manufacturing. After just two hours of deliberation, the jury unanimously found in favor of Winkel on all counts and determined that Colgate acted with malice by knowingly endangering consumers using Cashmere Bouquet. Winkel and her husband were awarded $13 million in damages.

Spontaneous Mesothelioma in Women

A study published in 2014 in the American Thoracic Society Journal examined seven women diagnosed with mesothelioma who had no other source of asbestos exposure except for the use of Cashmere Bouquet talcum powder. The researchers intended to prove that Cashmere Bouquet was the causative factor in their mesothelioma development.

Researchers began by testing 50 containers of Cashmere Bouquet talc powder from a variety of sources for the presence of asbestos. They found varying amounts of asbestos in the talcum powder. One of the patients died during the course of the study; after death, her lungs and lymph nodes were tested for the presence of asbestos. Medical experts found substantial amounts of asbestos with similar core fibers of those found in the Cashmere Bouquet powder.

Researchers concluded that the patient’s mesotheliomas were caused by a combination of asbestos and talc.

Mesothelioma is most common among industrial workers who have been directly exposed to airborne asbestos, such as construction workers and pipefitters. Many people diagnosed with mesothelioma never worked in high-risk occupations, however. “Idiopathic” or “spontaneous” mesothelioma is the term for mesothelioma that occurs in the absence of any asbestos exposure.

Between 70-80% of women with mesothelioma are regarded as idiopathic, as they have no known history of asbestos exposure. Far too many women are unaware that talcum powder products like Cashmere Bouquet contained asbestos and may be the cause of their exposure.

Another, equally important possible source of exposure is through family members who work around asbestos. A 2014 study from the Danish Medical Journal found that nearly half of women diagnosed with mesothelioma were exposed to asbestos at home. Thus, this type of illness is often called “take-home” or “second-hand” mesothelioma.
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file0001428407427.jpgHundreds of thousands of Americans are diagnosed with lung cancer and mesothelioma every year, which can make it impossible to earn a living. For this reason, the Social Security Administration offers disability benefits to patients with severe illnesses and injuries. Society security lawyers at Pintas & Mullins help clients through the process of applying for SSI or SSDI.

The list of diseases and injuries the government considers disabling are detailed in the Blue Book of impairment. The Blue Books includes malignant mesothelioma, lung cancer, and pulmonary insufficiency (including asbestosis). This is just one part of how Social Security determine if someone is disabled; for adults, it also considers past work experience, age, education, severity of medical condition, and work skills.

Benefits can come from one of two programs: Social Security Disability Insurance (SSDI), or Supplemental Security Income (SSI). To be eligible for one of these programs, cancer patients must prove:

1. A confirmed medical cancer diagnosis 2. Treatment will last or has lasted at least one year 3. The patient is unable to work because of their illness
It is also helpful to include medical history, biopsy results, and reports from surgical procedures. Unfortunately, not all cancer patients are guaranteed SSDI benefits, and it is common for initial claims to be denied.

Those applying for SSDI must have paid an adequate amount of Social Security taxes. Conversely, applicants who receive an income of more than $1,090 per month may not apply for SSDI, though there is an exception for blind individuals.

SSI benefits are designed to help supplement existing income, applying to patients or families with very low incomes and limited assets. Eligible applicants must be disabled, over the age of 65 and/or blind, and with income and assets below a certain level. SSI benefits are paid through a monthly income, and the amount can vary from year to year.

There are several other ways cancer patients can receive disability benefits, including through your employer and through federal grant programs. More information can be found here. Certain patients with very severe illnesses, such as mesothelioma, may speed up their application process under the Compassionate Allowances program.

Many types of conditions qualify for the Compassionate Allowances program, including cancers, traumatic brain injury, early-onset Alzheimer’s, cardiovascular disease, and autoimmune diseases. A full list can be found here.

Pleural mesothelioma, peritoneal mesothelioma, and small cell lung cancer all quality for the Compassionate Allowances program. Although mesothelioma rates are increasing, it is still a relatively rare cancer, which leads to misdiagnoses. Mesothelioma tumors and symptoms resemble many other conditions, so even highly trained pathologists can miss detection. The only known cause of mesothelioma is exposure to asbestos, however, so anyone with a history of asbestos exposure should seek treatment and legal assistance immediately.

For those grappling with a mesothelioma diagnosis, we offer a free book that can answer an array of common questions. 101 Questions & Answers about Mesothelioma can be ordered here at absolutely no cost to you.

Processing and Denials

Most disability claims are processed through local Social Security Administration (SSA) offices and State agencies. If your claim is denied you may submit an appeal, which goes through a State Disability Determination Service or an administrative law judge. These judges work in the SSA’s Office of Disability Adjudication and Review. Applications can be made in person, by mail, online, or by telephone.
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asbestos-244234-m.jpgYarway Corp., a manufacturing company and unit of Tyco, recently filed for bankruptcy due to overwhelming asbestos liability. A judge approved its plan to pay $325 to a trust that will compensate thousands of current and future asbestos injury claims. Asbestos exposure attorneys at Pintas & Mullins explain what an asbestos trust is and how victims can apply for compensation.

After two years of negotiations, Yarway agreed to contribute all its available money to the asbestos trust after filing for Chapter 11 bankruptcy. Yarway’s parent company, Tyco, agreed to fund the remainder of the trust to total $325 million.

Yarway was established in Pennsylvania in 1908 under the name Simplex Engineering. In 1986 it was purchased by Keystone International, which Tyco acquired in 1997. The asbestos exposure claims are from various products Yarway made, sold or distributed between the 1920s and 1970s, including control valves, steam traps and gauges.

Although the company stopped using asbestos entirely in 1988, decades of asbestos-related injury lawsuits depleted its resources. In the five years between 2008 and 2013, Yarway was hit with another 10,000 asbestos claims, costing it over $182 million in legal fees.

What is an Asbestos Trust?

Companies that mined, manufactured, distributed, or sold asbestos-containing products in the past face massive liability for asbestos-related injuries today. Due to this immense legal responsibility to pay injured claimants, many have gone bankrupt.

Under the Chapter 11 Bankruptcy Code, the government established the Gypsum Asbestos Personal Injury Settlement Trust (gypsum is another type of toxic mineral). This Trust is intended to pay all valid asbestos personal injury claims against these companies that declare bankruptcy. More information on this Trust can be found here, on its website.

There is currently approximately $30 billion in U.S. asbestos trusts. When someone is diagnosed with an asbestos-related disease – mesothelioma, asbestosis, lung cancer, gastrointestinal cancer, etc. – they may sue the companies responsible for their exposure. If the company or companies responsible have filed for bankruptcy, the injured person would file a claim with its asbestos trust. All trusts are managed by trustees, who determine the amount of compensation paid to each claimant.

Most trusts have categories of disease types that determine how much the claimant receives. For example, patients diagnosed with mesothelioma would be in a different category than those with asbestosis, since asbestosis is not a fatal ailment and mesothelioma is extraordinarily fatal. Claimants must show medical evidence of their asbestos-related diagnoses as well as evidence regarding their exposure to be eligible.

Many patients were exposed to asbestos at more than one site, which may result in an asbestos lawsuit against a non-bankrupt company. Each state has its own laws on how patients file trust claims versus an asbestos lawsuit. It is critically important to hire an experienced asbestos exposure attorney who can help guide you through this process.

In 2008 alone, asbestos funds paid about $3.3 billion to victims and families. This compensation is meant to pay for past, current and future medical care, loss of quality of life, lost wages, pain and suffering, loss of a loved one, and funeral expenses. As mentioned, another $30 billion is available for patients and families.

Asbestos Lawsuits

It is important to note that these trusts are only established for companies that declare bankruptcy. There are many more companies that exposed people to asbestos that are still in operation. If the company responsible for exposure has not filed for Chapter 11, an injured victim should file an asbestos lawsuit.

One such asbestos suit in California recently concluded when Goodyear Tire & Rubber agreed to a settlement with the family of a man who died from mesothelioma. The man was a Navy aircraft repairman who worked with many asbestos-containing products throughout his career. After his death from mesothelioma in 2008, his wife and son sued several companies who contributed to his exposure and death.
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3d-judges-gavel.jpgA man diagnosed with mesothelioma recently won $1.6 million in a lawsuit against a talcum powder supplier. The man was exposed to asbestos through contaminated talc brought home on his father’s work clothing. Mesothelioma attorneys at Pintas & Mullins explain the very real dangers of this type of second hand asbestos exposure.

The plaintiff in this case, Steven Kaenzig, was regularly exposed to raw talcum powder as a child by playing and interacting with his father when he returned home from work. Kaenzig’s father worked at Shulton Inc. from 1967 to 1975, each day coming home covered in talc dust. Shulton manufactured Old Spice and Desert Flower talcum powder products.

When Kaenzig was diagnosed with mesothelioma – an extremely rare and deadly cancer – he filed suit against the company that supplied asbestos-containing talc to Shulton. His case concluded in 2013, with the $1.6 million award to Kaenzig and his wife.

The defendant, Whittaker Clark & Daniels, challenged the decision in the New Jersey Appellate Division. The three-judge panel rejected Whittaker’s challenge, saying Kaenzig’s successfully proved that Whittaker knew that the raw talc it supplied to Shulton contained asbestos, was aware that this was dangerous, and still failed to warn about the talc’s risks.

The panel also found Kaenzig reasonably proved that he was exposed to the talc dust through his father’s work clothing, since his mother cleaned his father’s clothing each day after work, sending talc and asbestos particles into the air. Asbestos-related illnesses are caused by the inhalation of airborne asbestos particles.

It is important to note that the judges in this case did not treat this asbestos exposure case any differently than any other asbestos suit. So-called second hand asbestos exposure (otherwise referred to as bystander, domestic, non-occupational or take home exposure) is not always considered credible in state courts. Fortunately, New Jersey recognizes that cosmetic talcum powder is just as likely to contain asbestos and infect bystanders as any other asbestos-containing product.

Scientific researchers agree that there is no safe level of asbestos – any amount, at any point in a person’s life, can lead to asbestosis, lung cancer, or mesothelioma down the road. Of course, the likelihood that someone will ultimately develop one of these asbestos-related illnesses increases if exposure was immense or occurred over a long period of time; but even children exposed to dust from their father’s work clothing are at risk.

This can also apply to employees who do not work directly with asbestos or asbestos-containing products, but who work in the same vicinity. Among the hundreds of studies of persons working with and around asbestos, the term “bystander” changes in definition. There are usually two types of bystanders:

1. Those working in close vicinity to workers with high rates of exposure, such as insulation work.

2. Maintenance workers and building occupants, such as family members.

Both can be used as grounds in a lawsuit claiming exposure to asbestos, but there must be a documented disease. More than 10,000 people are diagnosed with an asbestos-related illness every year, and asbestos is considered to be responsible for about half of all occupational cancer deaths.

Second hand exposure cases rely on the claim that companies knew that asbestos was dangerous but failed to ever warn employees. Because workers had no idea the dust they were taking home on their clothes could cause cancer, they took no precautions to protect their families, loved ones, and themselves, from exposure.
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