Mesothelioma Information

Baron and Budd - Mesothelioma Lawyers

2008-09-14T18:21:00.000-07:00

Attorney Russell Budd

Asbestos Found in Home Heating and Air Conditioning Equipment

July 21, 2008
HVAC Manufacturers Settle with Mesothelioma Victim,
Announces Baron & Budd

DALLAS, TX (July 21, 2008) The law firm of Baron & Budd, P.C. today announced that an unnamed mesothelioma patient and his family have reached a confidential settlement with several manufacturers of home heating and air conditioning (HVAC) equipment, including industry leaders Lennox, Trane and Carrier. The plaintiff developed mesothelioma, an extremely painful and fatal cancer caused by exposure to asbestos, after working for 40 years as a repairman on residential HVAC units, according to attorney John Langdoc.

“Baron & Budd has been investigating asbestos related injuries for years, and even we were surprised to discover that common residential air conditioners and heaters contained the carcinogen asbestos,” said Langdoc. “We had scientists dismantle and test some of the units—units that had no warnings or notifications that they had asbestos in them—and we were shocked to discover that they contained asbestos parts.”

The plaintiff operated a small HVAC repair business in Telephone, Texas, about a hundred miles northeast of Dallas. Over several decades, he worked at hundreds of local homes, repairing name-brand heating and air conditioning units for families in the Dallas/Ft. Worth area. During the course of the lawsuit, Baron & Budd, P.C. discovered that many of these HVAC units contained asbestos parts that released hazardous amounts of asbestos into the air during routine repair work.

According to Langdoc, the evidence that he and his colleagues turned up established that the HVAC manufacturers intentionally added asbestos parts into their equipment and never warned consumers or repairmen that the units had asbestos in them.
“Because these manufacturers have been successful in keeping this secret for so long, HVAC repairmen have been largely unaware of their asbestos exposure and the health risks their work entailed,” said Russell Budd, managing shareholder of Baron & Budd. The case was filed in Oakland, California.

Radiotherapy for malignant pleural mesothelioma

2008-09-04T19:38:00.000-07:00

E Chapman, EG Berenstein, M Diéguez, Z Ortiz

Background

Malignant pleural mesothelioma is a relatively uncommon disease, but the incidence is increasing and is expected to peak in many developed countries in the next two decades. The management of patients with malignant mesothelioma is controversial. Very few patients are suitable for any potentially curative treatment and the effectiveness of radical therapy with surgery, radiotherapy and/or chemotherapy in curing patients or prolonging survival is uncertain. The role of radiotherapy is controversial although it has been used as part of multimodal therapy. The present review will try to clarify these uncertainties.

Authors' conclusions

As radiotherapy has never been compared to chemotherapy or surgery or to best supportive care (as part of combination therapy) in a prospective, randomised trial, no data exist supporting one or the other treatment as a better option for patients with malignant pleural mesothelioma. There is a need for multicentre controlled randomised trials assessing the role of radiotherapy in the radical treatment of malignant pleural mesothelioma. The studies should be limited to patients with malignant pleural mesothelioma, classified by stage, cytology and type of radiotherapy. The type of radiotherapy should be defined in advance and variables of radiotherapy dose definition and delivery should be carefully controlled.

Plain language summary
There is no evidence that radiotherapy could help to cure or to prolong the survival of patients with malignant pleural mesothelioma.

The incidence of malignant pleural mesothelioma is increasing and is expected to peak in many developed countries in the next two decades. In 80% of the patients with malignant pleural mesothelioma there is a clear history of occupational or domestic exposure to asbestos. Very few patients are suitable for any potentially curative treatment and the effectiveness of radical therapy with surgery, radiotherapy and/or chemotherapy in curing patients or prolonging survival is uncertain. The role of radiotherapy is controversial. It has been used as a component of multimodal therapy (plus chemotherapy and/or surgery). To date the reviewers have not found any reports of randomised controlled trials (RCTs) that show that radiotherapy is an effective option for malignant pleural mesothelioma. There is a need for multicentre experimental studies assessing the role of radiotherapy in this disease.

Peritoneal Mesothelioma - Causes and Treatments

2008-08-31T22:03:00.000-07:00

PERITONEAL MESOTHELIOMA

Peritoneal mesothelioma, a cancer of the lining of the abdominal cavity, is less common than the pleural form, comprising approximately 20 to 30% of mesothelioma cases diagnosed. According to the SEER (Surveillance, Epidemiology, and End Results) database, these diagnoses are approximately 54.7 per cent male versus 45.3 per cent female, with the median age being 65-69. The latency period appears to be shorter for asbestos-exposed individuals with symptoms appearing 20-30 years after exposure rather than the 30-40 year latency more commonly associated with pleural mesothelioma.

Symptoms

Clinical symptoms at the time of presentation may include abdominal pain, abdominal mass, increased abdominal girth, distention of the abdomen, ascites (fluid in the abdomen), fever, weight loss, fatigue, anemia and digestive disturbances. Some patients complain of more non-specific symptoms for a number of months prior to a confirmed diagnosis. In a percentage of cases, peritoneal mesothelioma is found incidentally when the patient has sought help for another health problem such as gallbladder, hernia or pelvic mass.

Treatment

In recent years, multimodality treatment of peritoneal mesothelioma has become more common for a select patient population, since surgery alone and/or intraperitoneal chemotherapy alone have proven to be similarly ineffective. Cytoreductive (debulking) surgery involves the removal of all or nearly all visible tumor, and, depending on the physician’s choice, may be combined with Intra-Peritoneal Hyperthermic Chemotherapy (IPHC), intraperitoneal chemotherapy and/or radiation. Since it is not always possible to remove all tumors, the prognosis for long-term survival may be based on the completeness of cytoreduction as established by the following criteria:

Complete cytoreduction:

CC-0 No peritoneal seeding is visualized within the operative fields.

CC-1 Nodules of less than 2.5 cm persist after cytoreduction. Nodules of this size are thought to be penetrable by intracavitary chemotherapy, therefore cytoreduction is termed complete.

Imcomplete cytoreduction:

CC-2 Nodules of between 2.5 and 5 cm persist after cytoreduction.

CC-3 Nodules of greater than 5 cm or a merging of unresectable tumor nodules at any site within the abdomen or pelvis.

For patients found to have widespread disease, where surgery is not looked at as “potentially curative”, palliation of symptoms may be accomplished by debulking. Since peritoneal mesothelioma is a rare malignancy, specialized treatments should be conducted by doctors familiar with the disease.

Mesothelioma - General Info

2008-08-29T23:47:00.000-07:00

Mesothelioma: Questions and Answers

Mesothelioma is a form of cancer in which (cancerous) cells are found in the mesothelium, a protective sac that covers the body's organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos.

What is the mesothelium?

The mesothelium is a membrane that covers most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide against adjacent structures.

The mesothelium has different names, depending on its location within the body. The peritoneum is the tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the chest cavity wall. The pericardium covers the heart. The tissue surrounding the male reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.

What is mesothelioma?

Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium divide without control. They can invade and damage nearby organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.

How common is mesothelioma?

Although incidence rates have increased in the past 20 years, mesothelioma is still a rare cancer. About 2,000 new cases are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in men or women at any age.

What are the risk factors for mesothelioma?

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 to 80 percent of cases. However, mesothelioma has been reported in some individuals without known exposure to asbestos.

Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. 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.

Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.

Who is at increased risk for developing mesothelioma?

Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found 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. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

The risk of asbestos-related disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma. On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.

There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.

What are the symptoms of mesothelioma?

Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis.

How is mesothelioma diagnosed?

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

How is mesothelioma treated?

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 is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and 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, also called 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 is 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.

Are new treatments for mesothelioma being studied?

Yes. Because mesothelioma is very hard to control, the National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) that are designed to find new treatments and better ways to use current treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with mesothelioma.

People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from the Cancer Information Service (CIS) (see below) at 1–800–4–CANCER. Information specialists at the CIS use PDQ®, NCI's cancer information database, to identify and provide detailed information about specific ongoing clinical trials. Patients also have the option of searching for clinical trials on their own. The clinical trials page on the NCI's Cancer.gov Web site, located at http://www.cancer.gov/clinicaltrials on the Internet, provides general information about clinical trials and links to PDQ.

People considering clinical trials may be interested in the NCI booklet Taking Part in Cancer Treatment Research Studies. This booklet describes how research studies are carried out and explains their possible benefits and risks. The booklet is available by calling the CIS, or from the NCI Publications Locator Web site at http://www.cancer.gov/publications on the Internet.

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