Mesothelioma Treatment by Stage

Posted on April 16, 2012 by Steven Kazan

Some treatments come into play in nearly all cases of malignant pleural mesothelioma (MPM), while others are used much more sparingly. If you or a loved one has been diagnosed with the disease, you’re almost certainly curious to know: Which treatments will be available? Does the regimen vary by stage of illness? Will I have a choice of treatments?

These are important questions, and at Kazan, McClain, Lyons, Greenwood and Harley, we encourage you to ask them. Your doctors and legal counsel will be able to fill you in on the treatments available for each stage of mesothelioma.

MPM is measured in four stages, with the first being considered local, and the other three categorized as advanced. If mesothelioma is caught in its early stage, it is usually by accident. However, a history of asbestos exposure can help contribute to early diagnosis, since doctors know that the mineral is the sole proven cause of mesothelioma.

Many MPM patients receive chemotherapy and radiation. These modes of treatment help shrink tumors and slow malignant growth. Surgeries, on the other hand, are more dependent on MPM stage.

As a rule of thumb, the less invasive a procedure is, the more often it is used. For example, fluid draining is a very common minor surgery for MPM, one that nearly all patients will undergo. All draining surgeries end in the suffix –centesis (e.g. thoracentesis, paracentesis and pericardiocentesis). In each case, surgeons insert a needle into the chest cavity to drain built-up fluid and relieve pressure.

Surgical resections (that is, removal of tissue) are also quite common, but the extent depends on disease stage. In debulking and pleurectomy/decortication, doctors remove as much tumor mass as they can while leaving the organs mostly intact. The operations are usually utilized for stages I, II and sometimes III.

A more radical surgery, known as extrapleural pneumonectomy (EPP), comes into play when MPM is more advanced, as in stages II and III. In an EPP, surgeons take out the diaphragm muscle, the chest cavity lining, the sac surrounding the heart and one lung.

Stage IV mesothelioma is typically considered “unresectable,” meaning it is so advanced and a patient is so weak that surgery is not an option.

Two things to keep in mind:

1. There is no one-size-fits-all treatment for MPM. Every case of mesothelioma is different, and doctors take many wellness factors into account before recommending certain procedures.

2. All treatments for MPM, surgical or otherwise, are considered palliative. This is because, for now, none is curative. However, treatments ease the tumor burden and improve comfort level, two very important benefits for people living with mesothelioma.

Canada’s Double Standard on Asbestos Seen Internationally

Posted on April 9, 2012 by Steven Kazan

Asbestos, Quebec

The international community has long been aware of Canada’s double-standard policies regarding the exportation of asbestos to developing countries. With the recent passing of famous Australian mountain climber Lincoln Hall as a result of malignant mesothelioma, Independent Australia put the focus back on the Canadian government’s refusal to adjust its asbestos stance.

David Donovan, managing editor for Independent Australia, notes that while the carcinogenic material was completely banned in Australia in 1991, Canada still engages in the asbestos trade, with the exports sent to developing countries around the world.

This, despite the fact that the dangers of asbestos exposure are hardly a secret. Since the time of the ancient Greeks and Romans it has been observed that people working with asbestos were more susceptible to illnesses. Since the 1960s, it has been clear that the inhalation of the dangerous mineral fibers can lead to the development of lung cancer, asbestosis and malignant mesothelioma, diseases that kill approximately 107,000 individuals around the world each year, according to the World Health Organization.

Canada’s exploitation through exportation

A simple examination of the numbers sheds light on Canada’s double standard when it comes to the asbestos trade. Though use of the material, for all intents and purposes, is banned in the country, statistics indicate Canada exported more than 463,000 tons of the material between 2008 and 2010, the vast majority of it being sent to developing countries, according to Donovan.

In India specifically, where 48.5 percent of the asbestos is exported, asbestos cement roofing has been supported by the government as an alternative to safer options including tiles, steel or thatch.

This movement is only furthered by the actions of many Canadian officials who are backed by leaders of the asbestos industry. There is currently a push being made to reopen the Jeffrey Mine in the aptly named town of Asbestos, Quebec, which could triple the country’s production of the carcinogen.

Asbestos contradictions abound

Laurie Kazan-Allen, the Coordinator of International Ban Asbestos Secretariat (IBAS), notes the simple fact that Canada has spent millions of dollars to rid public buildings of the dangerous material while still promoting its use to the developing world highlights its contradictory stance.

“For decades, Canada has led the worldwide pro-asbestos lobby and orchestrated a marketing campaign based on industry propaganda and data provided by hired gun “scientists,” Kazan-Allen wrote in a statement provided to Independent Australia. “Even as Canadian authorities assure workers, governments and consumers that asbestos can be used safely in India, Thailand, Indonesia and elsewhere, a de facto ban on asbestos use exists in Canada.”

Mesothelioma Treatment Side Effects: Part 1

Posted on April 4, 2012 by Steven Kazan

Treatments for mesothelioma come in all shapes and sizes, from relatively minor surgeries and low-dose radiation sessions to radical operations, high-dose radiotherapy and combination chemotherapy regimens.

Each of these treatments comes with certain side effects, many of which can be dealt with at home. And those that are tougher to endure often don’t seem as bad if you know about them ahead of time. At Kazan, McClain, Satterley & Greenwood, we’ve found that the old adage is true: forewarned is forearmed.

By knowing what to expect from your mesothelioma treatments, it’s often easier to deal with them. Here are some common side effects you may experience, as well as techniques that can lessen their severity:

Fatigue. Of all the side effects that come with cancer treatments, this one is probably the most unavoidable. Nearly every treatment for mesothelioma results in fatigue – often a bone-tired exhaustion, the kind you’d expect to feel after running a marathon. Dealing with it often means, first and foremost, getting rest. Your body knows what you need. Once you’ve recovered from a treatment, an activity that will help is getting exercise. However, you need to start small – really small. Usually, a good exercise regimen will begin with a short walk or two each day. Only after a few months will you be able to handle more. For safety, consider exercising with a buddy.

Nausea. This is the side effect everyone dreads. Often caused by chemotherapy, post-treatment nausea can be surprisingly intense. To relieve the worst of it, you doctor will probably put you on a prescription antiemetic. As a basic rule, the best way to push through days of nausea is to try to eat and drink during quiet periods. It will help you keep your strength up.

Hair loss. Chemotherapy attacks fast-growing cells in the body, which means your hair follicles will likely get caught in the crossfire. Fingernails are also susceptible; they may become brittle for a while. To deal with hair loss, try cutting it short ahead of time or buying a wig after the fact. Wearing sunscreen, a hat or a scarf will protect your scalp until your hair grows back, which usually happens after two or three months.

Skin damage. Radiation therapy may leave the skin of your chest with uncomfortable damage, similar to a sunburn. Treat it as you would any sun damage: be gentle with the skin, moisturize it and keep it covered until it heals.

Related articles:

Current Mesothelioma Treatment Research and Studies

Mesothelioma Support Services and Groups: Benefits and How to Find Them

Mesothelioma and Pain: What to Expect and How to Manage It

UK Supreme Court Ruling Places Insurance Liability for Asbestos Exposure

Posted on March 29, 2012 by Steven Kazan

The Middlesex Guildhall in London is the location of the Supreme Court.

A step towards justice for asbestos victims took place this week by a ruling made by the UK Supreme Court which could allow thousands families of people who died after exposure to asbestos to have greater access to compensation.

The new ruling by a panel of five Supreme Court justices determined that insurance liability for disease sufferers should be placed at the time of asbestos exposure, rather than when symptoms appeared.

This ruling has major ramifications for people looking to obtain asbestos compensation as it can take decades for asbestos illnesses – which include malignant mesothelioma, lung cancer, and asbestosis – to manifest symptoms. By placing the liability at the time of exposure, thousands more people could be able to file claims.

One justice of the Supreme Court, Lord Clarke, said:

“The negligent exposure of an employee to asbestos during the [insurance] policy period has a sufficient causal link with subsequently arising mesothelioma to trigger the insurer’s obligation.”

Unite, which is reportedly the largest trade union in Britain and the Republic of Ireland, said that the ruling will have a positive impact for asbestos victims and their families. Unite general secretary Len McCluskey said:

“It is a disgrace that insurance companies went to such lengths to shirk their responsibilities.”

Commenting on the Supreme Court’s decision, Nick Starling, director of general insurance and health at the Association of British Insurers, said:

“Today’s ruling by the Supreme Court has confirmed what most in the industry have always understood – that the insurer on cover when the claimant was exposed to asbestos should pay the claim, rather than the insurer on cover when the mesothelioma develops.

Laurie Kazan-Allen Receives Prestigious Award for Raising Global Awareness of Asbestos Diseases

Posted on March 27, 2012 by Steven Kazan

Laurie Kazan-Allen with ADSA executive Rosemarie Vojakovic

Fighting for asbestos victims is my family’s work. I am very proud to announce that my sister, Laurie Kazan-Allen, coordinator of the International Ban Asbestos Secretariat (IBAS) since its inception in 2000, received the distinction of being named the 2012 winner of the Emeritus Professor Eric G Saint Memorial Award on Sunday, March 25 at the Annual General meeting of the Asbestos Diseases Society of Australia (ADSA) in Perth, WA.

The Emeritus Professor Eric G Saint Memorial Award has been awarded 21 times and includes medical professionals such as doctors and nurses, asbestos disease clinicians and researchers as well as representatives of the ADSA. Laurie-Kazan Allen is the only non-Australian recipient of this highly prestigious award.

Announcing the 2012 recipient, Rosemarie Vojakovic, an Executive Officier of the ADSA said:

“Over the year, our organisation (the ADSA) has greatly benefitted from information provided by our worthy recipient. Of particular importance and benefit to all Australians was information mainly relating to white asbestos and its carcinogenic properties which cause malignant mesothelioma.Our worthy recipient has represented our organisation with pride and dignity in all parts of the world and placed our organisation on the global scene.”

The award was presented to Laurie Kazan-Allen by the Honourable John Kobelke, MLA, member of the legislative assembly, the lower house of the Western Australian legislature.

The award’s namesake, Dr. Eric Saint, was born in Britain in 1918. He qualified as a medical doctor and served in the RAF in India World War II. In 1948 he went to Western Australia, where he remained until he died at age 70.

He spent his career occupied in issues related to public and occupational health including infant welfare, insects and pests and the asbestos mining industry. In the 1940s he sent a letter regarding the Wittenoom blue asbestos mine to the authorities predicting that “in a year or two, [the company of] Australian Blue Asbestos will produce the richest crop of asbestos disease in the world’s literature.” The letter came to light and was used successfully as Wittenoom miners began to litigate against the mine owners for the diseases they contracted working at Wittenoom.

Dr Eric Saint helped to found the medical school in Western Australia and is widely regarded as an iconic figure in WA history.

Mesothelioma Occupational Case Studies

Posted on March 26, 2012 by Steven Kazan

When dealing with a mesothelioma diagnosis, it can be helpful to know more about how the disease is connected to asbestos exposure. At Kazan, McClain, Lyons, Greenwood and Harley, we know that this knowledge not only allows you to seek the most appropriate medical treatment, but also gives you a better idea of the legal options available to you and your family.

Sometimes it can be hard to imagine the risks associated with certain kinds of employment. For that reason, researchers have conducted hundreds of occupational case studies over the years. These can pinpoint which types of employment carry the greatest risk of asbestos exposure and lung disease.

Early reports on asbestos risks

The first report to really hammer home the connection between asbestos and mesothelioma was published in 1960. Its authors, a trio of UK pathologists, noticed something odd in South Africa: more than 30 cases of mesothelioma, all of them clustered in the Asbestos Hills outside of Cape Province.

Using the case-control method – in which scientists survey people with a rare disease and look for shared risk factors – the group boiled the cause down to one variable: asbestos exposure. This paper unleashed a flood of ensuing case studies, each of which examined the asbestos-related risks associated with certain occupations.

Occupations at risk for asbestos exposure

Because of these reports, today we know that these occupations tend to have the highest rates of malignant pleural mesothelioma (MPM):

Construction workers
Shipbuilders
Firefighters
Insulation installers
Heating equipment handlers
Brake pad manufacturers
Demolition workers

Unfortunately, it does not take a huge dose of asbestos to cause the kind of cell damage that is linked to MPM. A case-control study published in the American Journal of Epidemiology found that even though large amounts of asbestos exposure are extraordinarily dangerous, relatively small doses of the fiber can still be more than enough to engender the fatal lung disease.

Another case study appearing in the British Journal of Cancer backed up this idea. Its authors surveyed more than 500 men with mesothelioma, all of whom had been plumbers, carpenters, electricians, painters or constructions workers. The team found that the vast majority of these patients had had occupational asbestos exposure.

However, very few had been around the fiber for all that long. In fact, just four men reported having worked around asbestos for more than five years.

For anyone who thinks they have been in contact with asbestos, however briefly, it is important to get regularly checked by a doctor. After all, the lag time between asbestos exposure and a diagnosis of mesothelioma can be deceptively long – often on the order of three or four decades.

A Pilot’s Plight from Aircraft to Asbestos Exposure

Posted on March 21, 2012 by Steven Kazan

A highly skilled airline pilot for a major carrier, Timothy Vest received a terrifying shock in September 2009 when he was diagnosed with mesothelioma at the young age of 44. He and his wife Caroline have three young children together.

Mr. Vest’s love of flying began early, as did his exposure to asbestos. His father was a senior pilot and later an executive for World Airways. Young Tim often went with his father to the World Airways hanger at the Oakland Airport on the weekends so he could see the planes being repaired. The hangar, first opened in 1973, was one of the largest in the country at the time. Tim visited the hangar twice during its construction and was exposed to the asbestos-containing fireproofing being sprayed. During subsequent trips to the hangar after it opened, Mr. Vest breathed asbestos dust from the fireproofing in the hangar, from asbestos parts and expoxy on the planes, and from the asbestos drywall products used in the office spaces. Neither Vest knew they were being exposed to this invisible toxin.

Tim Vest got his pilot’s license when he turned 16. He flew for Emery Worldwide throughout the 1990s, during which he was awarded the Civilian Air Medal by President George H.W. Bush for his work supporting Operation Desert Storm. Tim also flew relief missions to Chernobyl and Darfur. In 2001, Tim began flying for JetBlue.

Three months after his mesothelioma diagnosis, Kazan Law filed suit on behalf of Mr. and Mrs. Vest against the manufacturers of the asbestos products he was exposed to, as well as the property owner, tenant, and contractors at the hangar. [Timothy and Caroline Vest v. Allied Packing & Supply, Inc., et al. (2012) Alameda County Superior Court Case No. RG09489518]

Kazan Law was able to defeat the defendants’ two attempts to remove the case to Federal Court in Philadelphia. The trial began on February 27, 2012 against Dowman Products, Inc., which manufactured the joint compound used to build and remodel the office spaces at the hangar. The case resolved the following week during jury selection.

The good news for Mr. Vest is that his mesothelioma was caught very early. After surgery and chemotherapy, his prognosis is much better than most patients. He is spending as much time as possible with his family and staying as healthy as he can.

Inspirational Stories of Those Whose Lives Have Been Touched by Mesothelioma

Posted on March 19, 2012 by Steven Kazan

“Remember to look up at the stars and not down at your feet. Try to make sense of what you see and wonder about what makes the universe exist. Be curious. And however difficult life may seem, there is always something you can do and succeed at. It matters that you don’t just give up.” – Stephen Hawking

One of the most important parts of living with mesothelioma is knowing that you’re not alone. You have friends, family members and coworkers who care about you, not to mention other mesothelioma survivors out there who understand exactly what you’re going through.

If you could use a little uplift in your day, there are hundreds of inspirational stories out there written by people who are living with mesothelioma and not letting the disease stand in their way.

15 Year Mesothelioma Survivor

One of the most unique is the story of Paul Kraus. Born in an Austrian concentration camp in 1944, Kraus emigrated to Australia with his family. In the 1960s, he worked close to a factory that processed asbestos sheets. Then, in 1997, at the age of 53, Kraus was diagnosed with mesothelioma.

Even in the face of such a terrible disease, he has not let his illness get him down. Kraus was given less than a year to live, yet he continues to thrive even now! He has written countless books on living with mesothelioma, in which he recommends some basic dietary and lifestyle changes. Today, he lives with his wife and their two miniature schnauzers in a little town north of Sydney.

6 Year Mesothelioma Survivor

Another inspiring story is that of Debbie Brewer, a 52-year-old mother and patient activist in the UK. Though diagnosed with mesothelioma six years ago, she is still as energetic as ever.

Her secret? It’s all in the mindset. “Mesothelioma isn’t always about dying. It’s about living as well, ” she told This Is Plymouth. “I want to be around to see my first grandchild, to see my children move in to their first homes. I don’t want to leave them behind not coping.”

If you’re looking for more inspirational stories about those whose lives have been touched by mesothelioma, there are a number of places to try.

At Kazan, McClain, Lyons, Greenwood and Harley, we recommend a number of books written by survivors, including Kraus’s Surviving Mesothelioma and Other Cancers, J.R. O’Connor’s They Said Months, I Chose Years!, and the handy guidebook 100 Questions and Answers about Mesothelioma by Harvey Pass, Amy Metula and Susan Vento.

If you’d like to tell your own story to help others, you can do so here at the website of the American Cancer Society.

How Family Members Can Support Mesothelioma Victims

Posted on March 13, 2012 by Steven Kazan

At first, caring for a family member with mesothelioma can feel a little overwhelming. You might find yourself asking, Am I doing enough? Where do I start? How do I get organized? Fortunately, you’ll soon find your groove, and in the meantime there are little things you can do to make things easier for you and your loved one.

Over the years, we at Kazan, McClain, Lyons, Greenwood and Harley have spent enough time with mesothelioma patients and their families to learn that there’s no “right” or “wrong” way to support the person you love. It’s the trying that counts.

As long as you explore the best available medical and legal options, that’s a good start. However, if you find yourself exhausted, overwhelmed or at a loss for where to begin, here are some tips for supporting a loved one who has mesothelioma.

Use a planner, calendar or notepad. One of the most important parts of caring for someone with malignant pleural mesothelioma (MPM) is making sure they get all the necessary follow-up care. This usually means driving them to and from appointments for physical exams, blood tests and medical scans. By using a small planner or notepad, you can keep a schedule and even jot down questions you may have about care or treatment.

Take care of basic errands. A big side effect of both MPM and its treatments is fatigue. This means that your family member will either need help performing tasks or, in some cases, may need you to do them for him or her. Try to take care of chores and errands, even if they’re relatively minor. Buy groceries, cook meals, measure out prescriptions and, when you can, help them feed, dress and bathe themselves.

Get creative with food. At some point, they’ll start having to avoid solid foods and to eat things like soups, stews, broths, smoothies, shakes or Jell-O. To keep their appetite up, try to mix things up whenever you can. Experiment, and ask them if they’re craving anything.

Give them emotional support. Listen to them, and talk about worries or concerns. Take them to mesothelioma support groups. And of course, try to help them enjoy the little things.

Finally, take care of yourself! If you’re too frazzled, you won’t be much help to anyone. Be sure to take breaks, or to ask for help when you need it. And consider joining a caretakers’ support group, where you can meet and sympathize with other people in the same situation.

Related articles:

Mesothelioma Support Services and Groups: Benefits and How to Find Them

Nutritional Information for Mesothelioma or Lung Cancer Patients

Current Mesothelioma Treatment Research and Studies

Posted on March 5, 2012 by Steven Kazan

Malignant pleural mesothelioma (MPM) can be a difficult disease to treat. For this reason, scientists are constantly testing new and innovative therapies for the illness. At Kazan, McClain, Lyons, Greenwood and Harley, we believe that patients who know about current research and studies on MPM can make more informed decisions about their medical and legal options.

In fact, one of the busiest areas of mesothelioma research is the study of the condition’s relationship to asbestos exposure. Researchers have known for some time that the fiber is the sole proven cause of MPM. However, there has been a flurry of activity lately surrounding the mechanism by which asbestos causes mesothelioma.

Scientists are currently running dozens of cellular experiments to determine how asbestos damages cells. Many theorize that the fibers get stuck in lung cell membranes, damaging DNA, encouraging further oxidative damage and causing profound scarring. Causes aside, a central question among oncologists is whether there might be an as-yet-undiscovered treatment for MPM, one that might outdistance current therapies. Several new methods are currently being explored.

Current Mesothelioma Research Studies:

The first is based in chemotherapy. According to the American Cancer Society (ACS), researchers are testing the effects of dozens of new drugs on mesothelioma growth. Many of these substances already inhibit the the growth of other cancers – like raltitrexed, an antimetabolite that blocks rapid cellular growth, which has been used for colon cancer since 1998, according to the Mayo Clinic.

Likewise, new chemo administration methods are giving cause for optimism. The ACS notes that scientists are now trying injecting drugs (some of which are heated first) directly into mesothelioma tumors. This direct application has the potential to target carcinomas more directly and limit side effects.

Another intriguing new treatment is photodynamic therapy (PDT). In this mode of therapy, a specially formulated drug is given intravenously. Doctors allow several days to pass, giving the compound time to settle into tumor cells. Then, surgeons insert a light-emitting tube into the chest. The wavelength of light activates the drug (called a “photsensitizer”), which emits charged oxygen molecules, killing tumor cells. Though still in the trial phase, PDT is getting quite positive results.

Other targeted treatments are also being studied. For example, scientists are testing specially formulated compounds that precisely attack one step in the MPM growth cycle. A good example is the angiogenesis inhibitor, which prevents tumor cells from getting a good blood supply.

And even more futuristic treatments are in the works. In this vein, the ACS points to gene therapy, which might one day allow doctors to repair damaged lung cell DNA using specially modified viruses.

Posts by: Steven Kazan

Mesothelioma Treatment by Stage

Canada’s Double Standard on Asbestos Seen Internationally

Mesothelioma Treatment Side Effects: Part 1

UK Supreme Court Ruling Places Insurance Liability for Asbestos Exposure

Laurie Kazan-Allen Receives Prestigious Award for Raising Global Awareness of Asbestos Diseases

Mesothelioma Occupational Case Studies

Early reports on asbestos risks

Occupations at risk for asbestos exposure

A Pilot’s Plight from Aircraft to Asbestos Exposure

Inspirational Stories of Those Whose Lives Have Been Touched by Mesothelioma

How Family Members Can Support Mesothelioma Victims

Current Mesothelioma Treatment Research and Studies

Current Mesothelioma Research Studies:

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