Asbestos in the UK

Most of the schools in East Sussex still contain asbestos, according to the BBC.

A programme for Inside Out South East claims 185 of the county's 195 schools carry the potentially hazardous material used in many buildings in postwar Britain.

Asbestos only poses a threat to health when it is exposed and starts to crumble. Inhaling toxic asbestos fibres can cause serious illnesses, including malignant mesothelioma and lung cancer.

Every school should have a management plan, including a book showing where the asbestos is so it is not disturbed. East Sussex County Council said only schools built after January 1, 2000, can definitely be said not to contain any asbestos. Only ten schools in East Sussex are certainly unaffected, including Hoddern Junior School in Peacehaven, Telscombe Cliffs Community Primary School and Rye Primary School, which all opened after 2000. The National Union of Teachers has called for all asbestos to be removed.

Although the figures for West Sussex County Council's schools were not given in the programme, a spokesman said: "Between July 2005 and March 2008, we surveyed our complete property portfolio that contained asbestos materials.

"At a cost of £1.2 million it delivered management surveys, addressed priority findings and led to a management plan - £85,000 has been spent this year removing asbestos that has been identified through the inspection programme as having degraded such as to require removal."

The Legal History of Mesothelioma

Each year, approximately 2,000 to 3,000 new cases of mesothelioma are reported.

In the past 20 years, the number of reported cases has increased significantly. Although it can take up to 50 years for symptoms to manifest, mesothelioma patients experience a host of symptoms. These include shortness of breath, or a wheezing and hacking cough which often lead to chest or abdominal pain. In the more serious stages of this disease, individuals may have bowel blockages, anaemia, a bloody cough, and jaundice. Unfortunately, it is extremely difficult to secure accurate statistics about how many individuals suffer from Mesothelioma because in the beginning stages, the symptoms are quite similar to various other conditions. This often leads to a misdiagnosis of the disease. In addition, when an accurate diagnosis is finally made, mesothelioma has typically already progressed to a more advanced stage. Mesothelioma is most often caused by previous exposure to asbestos. In fact, 70% to 80% of mesothelioma cases are caused by this type of exposure. In most cases, the infected person was either directly or indirectly exposed to asbestos and it may have happened when they worked in a factory or lived in an environment where the chemical was present. Commonly, the affected person was unaware of the asbestos. For instance, an employer could have taken over a site that was previously used by another company to produce asbestos related materials. One could be exposed simply by washing the clothes of an employee who worked there and was directly exposed to it. There are also numerous other ways that someone can be indirectly affected.There are many asbestos related products in our homes. In the past, some companies put asbestos in home insulation, carpet pads, and other products, even thought they realized that it was potentially dangerous. This can be dangerous news for the family who lives in one of these homes. Since the beginning of the 1900’s, it was recognized that asbestos was a workplace hazard. Between 1945 and 1966, a type of commercial asbestos mining took place in Western Australia. A group of the miners were tracked in a study, and after 10 years, there were no deaths that could be blamed on Mesothelioma. However, just nine years later, there were about 85 Mesothelioma related deaths in this evaluated group. Another nine years later, the mesothelioma death count of miners in the Western Australia group had risen to a staggering 539 deaths.

1929 began the very first of the lawsuits that were brought against employers and asbestos manufacturers. The case was settled, however the lawyer agreed not to pursue any more cases. In 1960, an enlightening article was the first to point out asbestos as the main cause of Mesothelioma. The article actually referred to over 30 case studies of people who had suffered from Mesothelioma in South Africa. In Western Australia where the miners were tracked, mine waste containing asbestos was used to cover playgrounds and schoolyards. An important publication by the British Journal of Industrial Medicine in 1965 brought to light the fact that people who lived in asbestos mining towns, but didn’t work in the mines, were contracting Mesothelioma. However, the mine in Western Australia continued to pump out these harmful chemicals, practically handing them out to children, mothers, grandparents, and other people.

In the United States, the first asbestos caused Mesothelioma lawsuit was filed in 1966. This took place in Beaumont, Texas. This case was lost, however, immediately after, a co-worker of the man to file the first lawsuit filed one as well. He won and was awarded $80,000.00. During the years which followed this lawsuit, many others were filed by victims suffering from asbestos related Mesothelioma. In fact, it came to light that in most places infested with asbestos, the senior managers knew all about the link between asbestos and Mesothelioma, but hid it from the employees purposely. When the lawsuits began popping up, even more companies worked as hard as they could to cover their tracks. Many managers were not allowed to discuss asbestos related Mesothelioma at all. It was known as the “hush hush” policy. The managers knew about the link between asbestos and Mesothelioma and hid it from the employees, taking away their option of saving themselves from the damaging effects of asbestos.

In fact, a very important deposition was taken by one senior manager that proved just that.

Stating that the disease was terrible, had no cure, and that it would damage a man’s health, the manager asked other managers to keep quiet about the whole thing. His reasoning was that the men would eventually be compensated for their disease. However, there was no reason to let them know about the condition they might already have, because the company still had many years to benefit from the experience and knowledge of these men. The men were then kept in the dark about the dangers they were exposed to everyday. They were never given a chance to decide against working there because of the asbestos. They didn’t know. Basically, many years of life were taken away from these men, and with the management knowing that they would suffer because they could be “paid off” later.

In June, 1982, a retired boiler-maker of Unarco, James Cavette won a record $2.3 million dollars in compensatory awards, and $1.5 million in punitive damages. In June, 1982, Unarco filed bankruptcy. They manufactured Unibestos, which they sold to Pittsburg Corning in 1962. One of the biggest portions of the asbestos litigation history was also in 1982, when the Johns-Manville Corporation filed for Chapter 11 Bankruptcy. This company manufactured building and fireproofing materials from the time they opened in 1958. With the Chapter 11 Bankruptcy, the company was able to suspend all personal injury lawsuits filed against them.

Currently, most people know about the dangers of asbestos and what it can do to a person’s body, in addition to causing Mesothelioma. It is a known fact that the majority of Mesothelioma cases are caused by asbestos. This affects not just the people who were exposed to the asbestos at their jobs, but their family members and in some cases, others in towns that were covered somehow with asbestos, such as in the Western Australian town. Today, the cases of asbestos related Mesothelioma are taken very seriously, and companies have given up trying to hide their awareness and negligence.

As litigation continued from that first lawsuit through the 1980’s and 90’s, lawyers began representing large numbers of victims who had been exposed to asbestos and getting “mass settlements”. While this wasn’t a good thing for the companies being sued, they were able to save on transaction costs, including lawyer’s fees and other defense fees. This also made it difficult for the companies to thoroughly evaluate each and every claim. This means that particularly weak cases sailed through and received payment when they might have lost in a one-on-one lawsuit. However, very strong cases which might have been awarded much more in a one-on-one case were settled for less.

At one point in the 90’s, there was quite a lull in the number of asbestos related lawsuits filed, so most people thought that the worst of the storm was over. Many different businesses had filed bankruptcy and gone out of business, and many of the Mesothelioma victims had died. What happened next actually changed the course of the lawsuits. With the popularity of the internet growing, lawyers were getting in touch with people who suffered from asbestos related injuries, and those lawyers had a different set of targets. They began to go after the companies that were not so directly involved with the damaging asbestos. For example, the companies that produced the materials, and company owners who had purchased firms that were once used for asbestos related materials.

One victim, who was diagnosed with Mesothelioma in 2004, filed suit against Asbestos Corporation Limited.

They are the owners and former operators of several Asbestos mining companies in Canada. The plaintiff who suffered with the symptoms of Mesothelioma was a boiler room worker with the Navy for 10 years. During this time, he was exposed to asbestos frequently. He was awarded $1.1 million dollars, his wife was awarded $400,000 for loss of companionship, and they were awarded an additional $10 million dollars because the defendant acted with “oppression and malice”.

On March 8, 2006, a jury awarded James Morrison $5,150,000 for Mesothelioma. James had worked as an HVAC mechanic in the 70’s and 80’s in California. At 52 years old, and a life-long non smoker, James is dying of cancer. His condition is terminal. This is the first case ever filed against the Copeland Refrigerator Company. On May 18, 2006, a Sunnyvale man was awarded $5,900,000.00. A 74 year old business tech sued the Kaiser-Gypsum company. The victim, Robert Johnson, was exposed to asbestos when he was remodeling his homes in the 60’s, and in the 70’s when he supervised the building of his own home.

There are many cases that will be filed in the future from the 60’s and 70’s exposure era. Many of the claimants will exhibit Mesothelioma symptoms, whereas others will not. In fact, an individual may suffer from the disease and not even suspect that something is wrong for many years to come. The symptoms of Mesothelioma can take up to 50, and even 60 years, to show up. So, many of those workers are still not experiencing symptoms even though they have been exposed to asbestos. The truth is that a lot of them will begin to experience symptoms and upon going to the doctor, they will find out that they too, are victims of Mesothelioma.

The companies that are being sued are terrified of class action and individual cases like this, and today, there are still many Mesothelioma cases which have not been settled. These companies are trying to somehow stop these class action cases. They argue that they should reserve the resources they have to settle with the victims which have malignant Mesothelioma. In their view, the victims which have damaging, but not malignant conditions caused by Asbestos, are entitled to little or nothing. The difficult thing about that is this:

Even if victims do not develop malignant mesothelioma, severe asbestosis and pleural thickening can cause horrendous suffering. What essentially happens is that the victim is slowly strangled to death by his or her own lung tissue. The disease keeps getting worse as well, whether the exposure to asbestos has stopped or not. The average case today is settled at around 1 million dollars, and that figure jumps to 6 million dollars when the lawsuit goes to the courts. It’s no wonder that the companies are terrified of the lawsuits placed against them, while the families of the victims are terrified that their loved ones will not be around long enough to benefit from the settlements.

Mesothelioma Deaths

Deaths due to mesothelioma

The following information is based on Australian death rates only caused by mesothelioma. The information on deaths from mesothelioma in this section is based on the year of death, except for the most recent year, 2006, where year of registration is used.

The cause of every Australian death is certified by a medical practitioner and recorded on a death certificate. These death certificates are required by State and Territory Registrars of Births, Deaths and Marriages under jurisdiction specific legislation. On behalf of the Registrars these data are assembled, coded to the underlying cause of death, and released by the Australian Bureau of Statistics (ABS).

Figure 8 shows the age and sex distribution of those 486 decedents. Deaths among young adults are rare: in 2006 the youngest death fell in the 30–34 year age group. The graph shows that deaths due to mesothelioma were distinctly skewed towards the older age groups: this is particularly clear for the male decedents with 79% aged over 65 years at the time of death. The comparable figure for female decedents was 66%.

Trends over time, 1997 to 2006

The overall number of deaths resulting from mesothelioma generally increased over the period between 1997 and 2006. The number of deaths reached a maximum of 545 in 2004 but has since declined to 486 registered deaths in 2006. The large majority of these deaths involved men: the proportion that were male averaged 84%, with little variation from that figure over the period.

Mesothelioma test

Mesothelioma: Biopsy, Blood Test and Imaging Scans for Patients Biopsy, blood test and imaging scans are some of the common methods in detecting and diagnosing mesothelioma in people. Physicians can also use the common detection methods to determine how aggressive the spread of the mesothelioma is. Medical experts would recommend biopsy, blood test and imaging scans because they are readily accessible, accurate, and most of the results are immediately available. Biopsy Doctors will usually perform a biopsy if a prior x-ray exam of a person’s chest or abdomen showed any indications of a tumor. The biopsy method will remove living tissue from your body and the tissue will be examined under a microscope. The four common methods of biopsy are open biopsy, needle biopsy, thorascoscopy, and laparoscopy. Needle biopsy – This method uses a hallow needle inserted into the chest cavity to collect small samples of tissue from the cavity and the samples will be examined under a microscope. However, needle biopsy only has 25% to 60% accuracy because of the small size of the samples taken. Needle biopsy uses a local anesthetic on the patient during the procedure. Open biopsy – This method collects a larger sample of tissue and fluid, which makes it the most accurate and conclusive method. Bronchoscopy – This method uses a flexible, lighted tube inserted through the mouth, into the trachea, and into the bronchial tubes to remove tissue in the airways. Thoracoscopy – This method uses a telescopic-like instrument with a video camera and inserted through a small incision in the chest. Blood test There are ongoing medical researches to develop blood tests for detecting mesothelioma. However, the Mesomark blood test is the only method approved for use by the United States Food and Drug Administration. The Mesomark test uses an enzyme-linked immunosorbent assay to measure the amount of Soluble Mesothelin-Related Peptides (SMRP) in a human serum. People who have mesothelioma will have elevated levels of SMRP because the test will search for this type of biomarker in their bodies. The Mesomark test could result in early diagnosis of mesothelioma and lead to better chances of survival for patients. Imaging scans The common imaging scans to detect mesothelioma: CT scans – Computed Tomography (CT) uses several two-dimensional X-rays taken around a single axis of rotation to produce a three-dimensional image of the internal organs of the patient. This method can detect growths of mass under bones and organs that traditional X-ray scans may not detect. MRI – Magnetic resonance imaging (MRI) uses electromagnetic radiation to activate the hydrogen nuclei in the water molecules of the human tissue, which produces a signal that is spatially encoded. The scan generates two-dimensional cross- slices of images of your body. PET scans – Positron emission tomography (PET) uses a radioactive substance called a tracer injected into the bloodstream of a person. The tracer mixes with a common glucose in your body and the PET scan will detect the areas in your body consuming more glucose. A computer analysis reconstructs the concentration of the tracer in a three-dimensional space in your body. The scan then generates detailed images of the body that can detect the smallest tumor in your body. X-rays – The traditional method of scanning useful in detecting abnormalities in your skeletal system, but this scan is the most limited because it only generates a flat and two-dimensional image of your organs and tissues. X-rays can detect some abnormalities in soft tissue but they can hardly detect tumors in the brain or muscle mass. If you suspect that you or anyone you know has the symptoms of mesothelioma, a consultation with a physician is the first thing to do. The doctor will recommend what is the best diagnostic test for you and he will then refer you to a medical diagnostic center or a hospital for the tests.

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health.

Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Surgery
A part of the lining of the chest or abdomen is removed as well as some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

Radiation therapy
Radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy
This involves the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).

To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.

Mesothelioma in the United States & Australia Mesothelioma

There are an estimated 2,000 to 3,000 new cases of mesothelioma diagnosed per year in the United States. The incidence of mesotheliomas in the United States peaked in the 20-year pared from 1970 to 1990 and then stabilized.

Mesothelioma is less common in African Americans than in white Americans. The incidence of Mesothelioma increases with age. Most patients are male and over the age of 65. The disease is is 5 times more common in men than in women. Mesothelioma is rare in people under the age of 55.

Australia has one of the highest rates of mesothelioma in the world. This is due to the high rate of asbestos use and mining in Australia over many years. Up to 600 mesothelioma cases are diagnosed each year in Australia. The high incidence of the disease is not expected to decline in the short term.

Asbestos fibre production began in the 1880's and Asbestos was extensively mined in Western Australia (Wittenoom 1938-1966) and New South Wales (Baryulgil 1940-1979). Asbestos fibre was also imported from South Africa and North America.

It is estimated that One in three homes built in Australia between 1840 to 1987 contains some form of asbestos and nearly all public buildings such as hospitals and schools. Over 3,500 products containing asbestos were readily available in Australia. While Asbestos production and use has largely ceased, asbestos can still be found in the following:

* Building materials such as asbestos-cement sheeting (fibro) and paints

* Motor vehicle parts such as break linings and gaskets

* Electrical products such as hair dryers and air conditioners.

* Some textiles such as felts

According to professor Henderson of Flinders University, the number of people diagnosed with asbestos related diseases will not peak until 2020 by then there will be 13,000 cases of mesothelioma and up to 40,000 cases of asbestos-related lung cancer, amounting to 53,000 cases of incurable cancer caused by asbestos over the next 20 years.

Medical research may offer some hope for sufferers of this incurable disease. Australia is one of the most active countries in mesothelioma research. Several research programs are currently being conducted nationwide. Recently, Australian researchers developed a new screening procedure which could help people worldwide in the early detection of mesothelioma. Several Australian organisations which offer information and support for victims and their families of mesothelioma and asbestos related diseases.

Predicting result of mesothelioma patients treated with surgery with the help of gene expression tests

Surgery is one of the most effective asbestos treatment methods available for patients suffering from malignant mesothelioma. The problem with surgery is that not all patients are able to receive this kind of treatment, thus resulting in negative outcomes. Doctor Raphael Bueno of the Brigham and Women’s Hospital in Boston discovered that measuring expression ratio of four different genes could provide with the outcome of a surgical procedure in an individual before the actual procedure is performed.

Doctor Bueno is excited about gene expression ratio tests because they will allow doctors to predict things that were not able to be predicted in the past. The test is quite simple to perform with the use of special equipment that can accurately work with genes and DNA.

This new discovery has been tested by doctor Bueno on 120 different patients and the results were stunning. The test was conducted performing several diagnosis and prognosis techniques, and on several tumor samples in order to exclude the possibility that the test only turns out correct results for a small number of cases.

Combining this technique with other prognostic and diagnostic tools and procedures, the results returned were extremely accurate, doctors being able to separate patients into high and low risk groups.
Results of the testing phase

The results were very accurate for all patients, being able to predict survivability of the person after a surgical procedure. This allows doctors to perform the simple test and establish whether or not mesothelioma surgery is a suitable option for the specific individual. Here are the advantages of using such techniques:

* it allows doctors to clearly decide whether or not to perform a radical surgical procedure
* patients that are not suitable for this kind of mesothelioma treatment method will not have to put up with any kind of additional discomfort
* time will not be wasted performing a treatment method that will only cause more harm to the patient

What the author thinks

The author is certain that this new gene expression ratio test technique will provide with useful results for patients, and allow mesothelioma doctors to avoid complications and further distress to the patient. It is important that this technique be perfected and released for use for all mesothelioma patients.

The author also says that further tests are needed before the public release, but will not take very long. They need to be certain about the techniques’ benefits towards patients.

Mesothelioma In Australia

Australia has the highest per capita rate of mesothelioma cases. The worst, experts say, is yet to come, Most of the mesothelioma cases in Australia are of the malignant pleural mesothelioma type. Most of the detected cases have contracted the disease due to exposure to asbestos. When the asbestos fibers or asbestos dust is inhaled through the nose, it travels down the respiratory system. Then it settles down in the lungs. The lungs have a lining called as the mesothelium lining. When this lining comes in touch with the asbestos fibers, it starts behaving in a funny manner.

It starts dividing rapidly and it also starts having longer life spans. This causes tumors in the lungs and this condition is called pleural mesothelioma. This may be cancerous (malignant pleural mesothelioma) or non-cancerous (benign pleural mesothelioma). Australia has a very high number of malignant pleural mesothelioma cases. This is a very terrible condition and has no known cure. Since the symptoms of this disease like fever, cough, chest pain, etc. are often confused with other diseases like pneumonia; it is quite difficult to correctly diagnose this disease.

Mostly it is diagnosed only in the last stages of the cancer. The patient lives for hardly a year after the diagnosis. Also, the latency period of this disease is very long. Latency period is the period between exposure to asbestos fibers and the onset of this disease. Because of the long latency period of nearly 20 to 30 years, many times this disease is not spoken as connected to asbestos. Australia has about 16 cases per million populations of adults affected with mesothelioma every year. Also, the number of mesothelioma cases in men is much higher than women. Around 600 cases of mesothelioma are recorded every year in Australia. It is expected that in the next 10-15 years, some 13000 more mesothelioma cases will be recorded.

There is a high-risk group in Australia. The following people of Australia seem to be getting mesothelioma more as compared to the remaining population:

• Town Residents

• Builders and building laborers

• Workers of shipbuilding and dockyard

• Railway workers

• Asbestos factory workers

• Power station employees.

Though Australia has such a huge incidence of mesothelioma deaths, Australia is the world’s pioneer in undertaking lot of medical research in mesothelioma. It has found a new method of treatment that promises to reduce the mortality rate. Since, there is no cure for this disease, it is better if it detected earlier. The normal methods of treatment like chemotherapy and surgery do not work in the last stages of cancer; so it is better if the disease is detected as early as possible. The Australian researchers have invented a new Screening test that can help detect mesothelioma of the malignant pleural type. This can be used in the high-risk group to find out early evidences of the malignant pleural mesothelioma. The earlier the disease is detected, the more better the chances of survival of the patient. The Australian researchers are undertaking more and more research in the medical field of mesothelioma. Australia is a real pioneer in mesothelioma research. It is a leader and example for all the other countries. Though Australia has done So much to advance mesothelioma research, still the future of Australia is bleak.

It is expected what the number of mesothelioma deaths in Australia will continue to skyrocket till the year 2020. After this, it is expected that the mesothelioma deaths will steadily decline before finally stopping. This is mainly because of the long latency period of mesothelioma. So, even after all types of asbestos are completely banned, the effects of asbestos exposure can be felt till some 20 to 30 years later. The one advantage of all the research is that the chances of survival have increased for mesothelioma patients.

Also, the life span of the patient after the detection of the disease has increased. Previously, the patient had hardly a year left to live. However, now, due to early diagnosis, this has substantially increased. Australia should continue to undertake more research on mesothelioma for the global good. It should try to advance medical science to make new innovations in the treatment of mesothelioma. All the other countries should actively support and help Australian efforts. Australia should also make available the fruits of its efforts for the entire wide world.

Mesothelioma details

General Information / Anatomy / Function / Statistics

• Mesothelioma are tumours originating from the lining of the body cavities; this includes the chest and abdomen. Although the most common type of mesothelioma begins within the chest, this cancer should not be confused with lung cancer. Mesotheliomas arise from the serosal lining outside of the lungs within the chest or outside the bowel within the abdomen.
• About 100 new cases of malignant mesothelioma appear in Canada each year
• 30-40 cases are seen at the BC Cancer Agency each year
• Malignant mesothelioma is usually not curable

Symptoms / Signs

• Symptoms and signs from mesotheliomas depend upon location of the mesothelioma, its size and whether it is benign or malignant
• Benign forms of the disease are generally asymptomatic
• The symptomatology of malignant mesotheliomas is due to tumour growth resulting in invasion of surrounding structures and/or the production of fluid (pleural effusion, ascites, or pericardial effusion). Chest pain may be caused by invasion of the chest wall. Pleural effusion causes collapse of adjacent lung and shortness of breath.
• Symptoms of distant spread are possible, but uncommon since the tumour is usually a local problem and blood borne spread is uncommon
• Patients with more advanced disease may be ill generally with fever, night sweats and weight loss
• Involvement of the membrane around the heart (pericardium) may cause heart rhythm disturbances

Etiology / Carcinogens / Risks

• There is a definite association between asbestos and mesothelioma. The risk associated with asbestos exposure has been shown by many investigators and inhalation of asbestos poses the most serious hazard.
• In approximately 30% of mesotheliomas, no asbestos exposure can be traced
• Crocidolite (Cape blue asbestos), the main cancer causing form of asbestos, is associated with over 90% of pleural and peritoneal mesotheliomas. Other types of asbestos fibre have been associated in a less significant way.
• Individuals at highest risk are those employed in the asbestos industry; dockyard workers, especially if they dismantle asbestos-insulated steam piping; those who handle and manufacture asbestos compounds; insulators and steam fitters; and those in demolition and construction industries
• Spouses and children of asbestos workers are also at risk
• The latent interval between exposure to asbestos and development of tumour is long (15-25 years)
• Mesothelioma is not caused by cigarette smoking but asbestos exposure and cigarette smoking both increase the risk of lung cancer

Prevention

• The only method of prevention is avoidance of asbestos exposure
• Cigarette smoking should be avoided by all persons and asbestos exposed individuals should avoid cigarette smoke in particular because asbestos plus cigarette smoking can cause lung cancer

Diagnosis / Screening / Staging / Grading / Types

• The chest X-ray is a very helpful test, usually showing thickening of the pleura or pleural effusion in patients with pleural mesothelioma. Sometimes a CT scan of the chest may be required for further information.
• A pleural biopsy is essential for pathological confirmation of the disease. Although pleural fluid cytology may be abnormal, this is often difficult to interpret.
• Patients having peritoneal mesothelioma may require an abdominal surgery for exploration of the peritonial surfaces and biopsy of any lesions observed

Types

• Mesotheliomas may be of epithelial or sarcomatous. Sarcomatous types are more malignant and tend to be resistant to treatment.

Treatment

• Treatment unsatisfactory with no recent advances
• Malignant mesotheliomas are serious illnesses and cure of the disease is rare
• Survival with this type of cancer obviously varies with the extent of the disease, but overall it is in the region of one year

Surgery

• Because of the large area of pleural surfaces, complete surgical removal is rarely technically feasible. The advisability of resection is always considered at diagnosis, but only a small minority of cases are eligible for an attempted resection. Spread of disease to the chest wall, heart, or esophagus often rules out the possibility of an operation.

Radiation

• Radiation may be given for control of symptoms in a localized area. Radiation therapy does not have the power to cure this disease. Radiation cannot be given to the entire tumour because this would involve the treatment of large volumes of normal tissue and the dose of radiation required for tumour control is too high for this to be tolerated. Radiation can, however, be of value in controlling pain in a localized area.

Chemotherapy

• Benefits from chemotherapy treatments for mesothelioma are uncertain as the tumour is often resistant. The best available treatment programs do not have the power to cure any patients with mesothelioma. 20% of patients may have a temporary shrinkage of the disease with currently available drugs.

General Support and Symptom Control

• If pain is associated with mesothelioma, good drug prescriptions are available that can control this. Pleural effusions (fluid build up) can be treated by a small surgical procedure that removes the fluid, permitting re-expansion of the lung and improvement in shortness of breath. Some patients with mesothelioma may have very slow growing tumours and if symptoms are not present, it is often advisable to follow the patient with regular chest X-rays without specific therapy. When symptoms do occur, they should be assessed on an individual basis.
• Chemotherapy may be considered for treatment of recurrent thymoma

Risk Factors for Mesothelioma

Risk factors are those activities that increase the chance of getting a particular condition or disease. Scientists have found several risk factors that make a person more likely to develop mesothelioma. Malignant mesothelioma is a very rare cancer and the vast majority of cases are associated with exposure to asbestos, either its production or use in various industries and products. In fact, because asbestos is used so widely in the building and other industries, even in those cases where a history of asbestos exposure is not evident, it is likely that the victim was exposed without his/her knowledge.

Factors that are not associated with risk for developing mesothelioma are:

• Sex. Although men are more at risk for malignant mesothelioma, this is because they were more typically involved in industries mining or using asbestos.
  
  
• Race. No association ahs been shown between race and the development of malignant mesothelioma.
  
  
• Smoking. Smoking tobacco does not appear to increase the risk of developing malignant mesothelioma in those exposed to asbestos. However, smoking does greatly increase the risk of developing bronchogenic lung cancer, i.e. arising in the breathing tubes/airways

Four Tips to Help Find a Reputable Mesothelioma Lawyer

Mesothelioma is a rare form of cancer that affects the sac lining the chest (the pleura), the lining around the heart (the pericardium), or the lining of the abdominal cavity (the peritoneum). Studies have shown that people, who suffer from the disease mesothelioma, were exposed to an abundance of asbestos at one time or another in their life. Unfortunately, many people become exposed to asbestos unknowingly, usually as part of a job. Because of this, someone who has mesothelioma is often entitled to compensation. There are many mesothelioma lawyers, but the following easy tips can make it easier to find a mesothelioma lawyer.

1. Research all you can concerning mesothelioma. The more you understand the disease affecting you or a loved one, the better you will be able to judge a lawyer's expertise. A lawyer who understands many aspects about the disease is the ideal lawyer. If your lawyer understands your or your loved one's symptoms, and complications stemming from the disease, he or she will be better able to defend you. Unfortunately, some lawyers do not "do their homework" in regards to medical cases. This often leads to losing cases. A reputable lawyer will certainly know the ins and outs of the disease, so be sure to ask as many questions as you can think of.
   
   
2. Use phone books and Internet search engines to find lawyers. This may seem simple, but some people don't bother taking the time to look through many lawyers. Accepting the first lawyer that calls, or that one sees on TV is not a good idea. Searching in Google for the keyword "mesothelioma lawyer" will yield better results in the end than simply accepting whatever lawyer comes along. Giving yourself a variety of lawyers to consider will give you the best idea of who will be willing to work hardest for you, who is sincere, and who will most likely help you win your claim.
   
   
3. Read the fine print, and know your lawyer's case history. Once you are nearing your decision and narrowing down potential candidates, take your research to a new level. It is always a good idea to find out about a lawyer's case history. Additionally, it is advisable to know exactly what kind of deal the lawyer is seeking with you. Lawyers dealing with medical-related lawsuits usually do not get paid unless they win the settlement. Some lawyers request different percentages. Compare these requests and choose the lawyer that you would feel most comfortable with. Unfortunately, some lawyers might try to take advantage of an unknowing client. In order to protect your interests, and make sure you acquire the top-notch lawyer you deserve, do background research on lawyers before signing up.
   
   
4. Finally, don't be afraid to take advice. If a friend, or colleague suggests a lawyer, don't hesitate to check it out. If a friend refers you, he or she obviously has your best interests at heart, and so the lawyer is probably well qualified to take on your case. There are many groups out there for mesothelioma patients. If you or a loved one is in one of these groups, don't hesitate to ask for advice from others who have mesothelioma. Advice is often taken for granted, but it is one of the most valuable things a friend can give.

Mesothelioma is an awful disease, but there is compensation. This compensation can either be sought in a wrongful death suit or while the patient is still living. It is advisable to find a lawyer as quickly as possible because there is often a statute of limitations on filing a lawsuit. The basic idea when searching for a mesothelioma lawyer is to be as educated as possible. Know what you want, and find a lawyer that is willing to help you in any way possible. Being well informed about your disease and potential lawyers will put you on the path to compensation.

Mesothelioma in the United States

During the industrialization associated with the early 20th century in the United States, asbestos was viewed as a "wonder" product, having the capability to save lives due to its fire retardant and durability characteristics. Between 1940 and 1979 an estimated 27 million workers in the United States were exposed to asbestos fibers. Since the early 1900s industrialization of the United States brought about the mining, processing and use of more than 30 million tons of asbestos. The most prevalent use of asbestos has been in the construction industry. In 1988, 6,300,000 workers in the United States were employed in the construction trades. Two-thirds of asbestos produced in the United States is used in this construction. Carpenters, utility workers, electricians, pipe fitters, steel mill workers, sheet metal workers, boiler makers, and laborers are at risk for exposure of asbestos through construction materials; insulation coverings of pipes, boilers, industrial furnaces, and other sources. Automobile mechanics working with brake and transmission products also are exposed to asbestos. Add to this the exposure from renovating and demolition and the risk to these workers from exposure to asbestos becomes considerable. Additionally, the families of these workers were also affected through secondary exposure.

Secondary exposure occurs when asbestos fibers are released into the air and are inhaled by persons not directly working with asbestos. This secondary exposure can be as extensive and as harmful as direct exposure to asbestos workers themselves. An asbestosis prevalence of 11% in wives, 8% in sons, and 2% in daughters was reported in families of asbestos-exposed shipyard workers. Mesothelioma and other asbestos-related diseases have developed in members of workers' families whose only contact with asbestos was dust from an exposed worker's clothing. Mesothelioma and other asbestos related diseases also have developed in persons who as children lived within one-half mile of an asbestos factory. In the workplace persons not directly working with asbestos or asbestos products also have had secondary exposure to asbestos. An example is the four to 5 million shipyard workers who were exposed when insulation workers applied asbestos to ships' pipes and hulls. People in contact with work clothes of asbestos workers or with asbestos containing household products have developed pleural abnormalities. Low exposures from work-related, household, and natural sources can induce pleural plaques. For diffuse, pleural thickening, higher exposure levels might be required.

10 Ways to Manage Fear after Diagnosis

1. As you begin gathering information to make decisions, get to know the people on your medical team and make every effort to meet them in person. Turn faceless doctors into known resources. These are the people you've hired onto your team to help you. You'll find out who is the best communicator, who can answer which questions, who is available to help you when you need it most.
2. Find a doctor who communicates with you in a way that is comfortable for you, who invites your questions and takes your concerns seriously, who gives you as much or as little information as you feel comfortable with at any given moment.
3. Find out what to expect from tests, procedures, and treatments. Minimize surprises.
4. Make plans with your doctor about how to receive test results in a prompt way. If possible, try to schedule important tests early in the week, so you don't have to wait over a long weekend when lab work may slow down or doctors aren't communicating with each other.
5. Find a mammography center where the radiologist will talk with you about the results before you go home, so you don't have to wait for a letter or a call from your doctor.
6. When you know you're going to have a challenging week (a mammogram coming up or a round of chemotherapy), don't plan to do things that are stressful for you (for example: balance the checkbook, cook dinner for 20, or run a big meeting at work). Use your support systems — friends, movies, yoga, prayer — to help you get through it.
7. If well-meaning people try to tell you stories about others struggling with cancer, stop them right away and say, "I only listen to stories with happy endings!"
8. If you reach a point where difficult emotions are getting in the way of your functioning or taking care of yourself, speak with your doctor about the role of medications that might help ease your anxiety, depression, or sleeping problems.
9. Join a breast-cancer-related group. Join a place to share your breast cancer experience openly with people who understand. If you are more action-oriented, look for a breast-cancer-related athletic group, an organization that holds breast cancer education programs, or an advocacy group that lobbies for more research funding or free mammograms. Do whatever makes you feel connected to others in a positive way as a person who is moving beyond breast cancer.
10. Work on ways to feel more positive about your life. Seek out productive, life-enhancing experiences; accept yourself for who you are; and spend time with positive people who affirm who you are and how you've chosen to deal with this disease.

Symptoms of Breast cancer

Initially, breast cancer may not cause any symptoms. A lump may be too small for you to feel or to cause any unusual changes you can notice on your own. Often, an abnormal area turns up on a screening mammogram (x-ray of the breast), which leads to further testing.

In some cases, however, the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But sometimes cancers can be tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.

According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:

• swelling of all or part of the breast
• skin irritation or dimpling
• breast pain
• nipple pain or the nipple turning inward
• redness, scaliness, or thickening of the nipple or breast skin
• a nipple discharge other than breast milk
• a lump in the underarm area

These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst. It’s important to get any breast changes checked out promptly by a doctor.

Breast cancer

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop.

Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

Breast Anatomy

• Larger Version

Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor.

Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.

While there are steps every person can take to help the body stay as healthy as possible (such as eating a balanced diet, not smoking, limiting alcohol, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

Symptoms of mesothelioma

Mesothelioma often starts as a lot of tiny lumps (nodules) in the pleura, which may not show up on scans or x-rays until they are quite large. The main symptoms of pleural mesothelioma are breathlessness and chest pain. Some people find that their voice becomes hoarse and they have a cough that does not go away.

Peritoneal mesothelioma often causes swelling and pain in the abdomen.

General symptoms

Both types of mesothelioma can cause other general symptoms, such as loss of appetite, sweating (especially at night), weight loss and tiredness. As many of these symptoms can also be caused by other illnesses, your doctor will need to do a series of tests before a diagnosis can be made.

Causes of mesothelioma

Asbestos is the most common cause of mesothelioma. Up to nine out of ten cases of mesothelioma are caused by exposure to asbestos. Asbestos is a natural mineral, mined from rock found in many countries. It is made up of tiny fibres that are as strong as steel but can be woven like cotton and are highly resistant to heat and chemicals.

During the 1960s the first definite link between mesothelioma and asbestos was made. In the past asbestos was imported to the UK in large quantities. It was used in construction, ship-building and in household appliances. Asbestos was very widely used in insulation materials, such as amosite insulation board, and building materials, including asbestos cement.

When asbestos is disturbed or damaged, it releases tiny fibres that can be breathed into the lungs. Asbestos fibres are very fine and, when breathed in, they can make their way into the smallest airways of the lung, so they cannot be breathed or coughed out. Once the fibres are in the lungs, the body's defence mechanism tries to break them down and remove them, which leads to inflammation in the lung tissue.

The asbestos fibres can also penetrate through the lung tissue to settle in the pleura (the membrane around the lung). Over many years they can cause mesothelioma or other lung diseases to develop.

Asbestos fibres can also be swallowed, and some of the fibres can stick in the digestive system. They can then move into the membrane that lines the abdomen (the peritoneum), where they cause inflammation.

The people most likely to have been exposed to asbestos include:

• construction workers
• plumbers
• electricians
• boilermakers
• shipbuilders
• demolition workers
• people who worked in other places where asbestos was present and
• people who lived near to asbestos factories.

Family members of people who worked with asbestos and brought the dust home on their clothes have also sometimes developed mesothelioma.

There are three types of asbestos: blue, brown and white. Blue and brown asbestos are the types most commonly linked with mesothelioma. They are now very rarely used and cannot be imported into the UK. Originally, white asbestos was thought not to be dangerous but recent studies have now shown that it is also harmful.

In the 1980s, imports of blue and brown asbestos into the UK were stopped, and in 1999 the importation and use of all asbestos was banned. However, as mesothelioma develops so slowly, it is estimated that by 2015 approximately 3000 people will be diagnosed with mesothelioma each year. The number of people who develop mesothelioma will then start to reduce each year.

Mesothelioma does not usually develop until many years after exposure to asbestos. It can take any time from 10 to 60 years, although the average is about 30 to 40 years after exposure to asbestos.

Occasionally, mesothelioma develops in people who have never been exposed to asbestos. The other causes of the disease are not fully understood, but in rare cases the development of mesothelioma has been linked to exposure to radiation.

Research has not found any evidence that smoking increases a person's risk of developing mesothelioma. It is also thought that exposure to other building materials such as fibreglass does not increase the risk.

Mesothelioma is not contagious and cannot be passed on to other people. It is not caused by inherited faulty genes and so family members do not have an increased risk of developing it, unless they have been in contact with asbestos.

Treatment Options

While there is currently no cure available for malignant mesothelioma, there are treatments available. The types of treatments may include:

Surgery:

A common treatment of malignant mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed. Depending on how far the cancer has spread, a lung also may be removed. This operation is called pneumonectomy.

Radiation therapy:

Using high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Chemotherapy:

Using drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesothelioma, chemotherapy may be put directly into the chest (intrapleural chemotherapy).

Intraoperative photodynamic therapy:

A new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.

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The Stages of Mesothelioma Treatment

How mesothelioma is treated depends on where the cancer is, how far it has spread, and the patient's age and general health. Some typical treatments are as follows:

Localized Malignant Mesothelioma (Stage I)

If the cancer is only in one place in the chest or abdomen, treatment will probably be surgery to remove part of the pleura and some of the tissue around it.

If the cancer is found in a larger part of the pleura, treatment may entail one of the following:

• Surgery to remove the pleura and the tissue near it to relieve symptoms, with or without radiation therapy after surgery.
• Surgery to remove sections of the pleura, the lung, part of the diaphragm, and part of the lining around the heart.
• External beam radiation therapy to relieve symptoms.
• A clinical trial of surgery followed by chemotherapy given inside the chest.
• A clinical trial of surgery, radiation therapy, and/or chemotherapy.

Advanced Malignant Mesothelioma (Stages II, III, and IV)

For advanced malignant mesothelioma, treatment may be one of the following:

• Draining of fluid in the chest or abdomen (thoracentesis or paracentesis) to reduce discomfort. Drugs also may be put into the chest or abdomen to prevent further collection of fluid.
• Surgery to relieve symptoms.
• Radiation therapy to relieve symptoms.
• Chemotherapy.
• A clinical trial of surgery, radiation therapy, and chemotherapy.
• Chemotherapy given in the chest or abdomen.

Recurrent Malignant Mesothelioma

Treatment depends on many factors, including where the cancer came back and what treatment the patient received before. Clinical trials are testing new treatments.

Mesothelioma in the United States

There are about 2,000 new cases of mesothelioma are diagnosed in the United States each year. Workers who have been exposed to asbestos on the job are at risk. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases.

Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Since the early 1940s, millions of American workers have been exposed to asbestos dust. Both union and non-union workers have been affected. An increased risk of developing mesothelioma has been established among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople.

MESOTHELIOMA

For those diagnosed with mesothelioma, an asbestos-related cancer of the lining of the lung (pleura) or the lining of the abdominal cavity (peritoneum), finding a credible source of information about the disease itself and the medical options available, is of the highest priority. After years of research and synthesis of information, we have assembled a web site and packet for patients and their loved ones. We hope you find this web site helpful.

A mesothelioma diagnosis can be overwhelming, and we are here to answer any questions you might have, and to help you take the steps necessary to find the options that are best suited to your individual needs.

Our staff is experienced and knowledgeable in dealing with mesothelioma patients and their family members, and the service we provide is always with appreciation for the difficult time you are facing. Although you have found us on the Internet, rest assured there are real people here to help.