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So you have been told by your physician that you have contracted a disease with a somewhat scary name, Mesothelioma. Just exactly what is mesothelioma, and how does one get it? And finally, what options do you have for treatment of this disease?
We will explore some scientific authorities in order to define the cause and effects of mesothelioma. Additionally, some treatment options will be discussed. At the outset, should the reader decide, options are presented here in the format of an advertisement for the reader.
Mesothelioma is increasing the United States as well as Europe.
Researchers from Leeds in the UK have reported that the incidence of mesothelioma is increasing and that the prognosis is worse than ascertained in selected studies from referral institutions. The details of this study appeared in an early online publication in Thorax on January 17, 2008.1
Most of the recent publications concerning malignant mesothelioma involve clinical trials of palliative chemotherapy carried out in referral centers. However, the demographics of such referral patients may not represent the entire population of patients presenting with mesothelioma in the community at large.
The current study looked at all the patients with mesothelioma in a population of 750,000 during a four-year period between 2001 and 2005. These authors identified 146 cases of mesothelioma with the following characteristics:
* 77% were male, and the median age was 74 years (36-93).
* 63% had a performance status of 2 or better at diagnosis.
* The median survival from diagnosis was nine months.
* 75% of patients had symptomatic pleural effusion at the time of diagnosis.
* 42 patients had a surgical resection with a recurrence rate of 14%.
* 73 patients received radiation therapy.
* Seven patients, six of whom had received radiation therapy, developed biopsy tract invasion.
* 54 patients were considered eligible for chemotherapy but 28 declined treatment.
* Overall entry into a clinical trial or treatment with chemotherapy was 18%.
These authors suggested that patients with mesothelioma were presenting at an older age with worse performance scores than previously reported. They suggested that 37% were suitable for palliative chemotherapy but less than 20% accepted. They suggested that thorascopic pleurodesis was associated with a relatively low recurrence rate. Radiation did not appear to prevent biopsy tract recurrence.
Source: http://professional.cancerconsultants.com
How does one contract Mesothelioma?
Source:http://www.cancerbackup.org.uk/Cancertype/Mesothelioma/Causesanddiagnosis/Causes
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.
What are the treatment options?
Source:
http://www.cancerbackup.org.uk/Cancertype/Mesothelioma/Treatment/Treatmentoverview
Once the doctors know the stage of the mesothelioma they will be able to plan the most appropriate treatment.
The treatment for mesothelioma depends on whether it is only in one place or has spread. Currently, there is no cure for mesothelioma, unless it can be removed by an operation. Unfortunately, when mesothelioma is diagnosed, it has usually already spread beyond the point where it could be removed surgically.
The usual treatment for mesothelioma in this situation is active symptom control.
Radiotherapy may be used as part of treatment to try to cure mesothelioma. Most often it is used to control symptoms. Chemotherapy can also be used to control symptoms and to slow the growth of mesothelioma.
Multidisciplinary team
If your tests show that you have mesothelioma, you will be looked after by a multidisciplinary team. This is a team of staff who specialise in treating mesothelioma and in giving information and support. It will normally include:
- surgeons who are experienced in chest surgery
- specialist nurses who give information and support
- oncologists – doctors who have experience in mesothelioma treatment using chemotherapy and radiotherapy
- symptom-control specialists
- radiologists who help to analyse x-rays
- pathologists who advise on the type and extent of the cancer.
Other staff will also be available to help you if necessary, such as:
- physiotherapists
- counsellors and psychologists
- social workers
- dietitians.
Together they will be able to advise you on the best course of action taking into account a number of factors. These include your age, general health, and how the mesothelioma is affecting you.
Occasionally your doctors may offer you a choice of treatments. Sometimes people find it very hard to make a decision. If you are asked to make a choice, make sure that you have enough information about the different treatment options, what is involved and the side effects you might experience, so that you can decide what is the right treatment for you.
Remember to ask questions about any aspects that you do not understand or feel worried about. You may find it helpful to discuss the benefits and disadvantages of each option with your cancer specialist, nurse specialist or with the nurses in your cancer support service.
If you have any questions about your own treatment, don't be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a close friend or relative with you.
Second opinion
Even though a number of cancer specialists work as a team to decide on the most suitable treatment, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel that it will be helpful. The second opinion may take some time to organise and may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will be helpful.
If you do go for a second opinion, it may be a good idea to take a friend or relative with you, and to have a list of questions so you can make sure your concerns are covered during the discussion.
Giving your consent
Before you have any treatment your doctor will explain its aims to you. You will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form, you should have been given full information about:
- the type and extent of the treatment you are advised to have
- the advantages and disadvantages of the treatment
- any other treatments that may be available
- any significant risks or side effects of the treatment.
If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some treatments are complex, so it is not unusual for people to need their treatment to be explained more than once.
Patients often feel that hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you and the staff should be willing to make time for you to ask questions.
You can always ask for more time to decide about the treatment, if you feel that you can't make a decision when it is first explained to you. You are also free to choose not to have the treatment, and the staff can explain what may happen if you do not have it.
Benefits and disadvantages of treatment
Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.
Although cancer treatments can cause side effects, these can usually be controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. For the few people with early-stage mesothelioma, surgery and radiotherapy may be given with the aim of curing the cancer.
However, in most people with mesothelioma, the cancer is at a more advanced stage and any treatment given is with the aim of controlling it, which for some people may lead to an improvement in symptoms and a better quality of life. But, for some people in this situation the treatment will have no effect upon the cancer and they will get the side effects of the treatment without any of the benefit.
When a cure is not possible and the aim of treatment is to control the cancer for a period of time, it may be difficult to decide whether to go ahead with treatment. Making decisions in these circumstances is always hard, and you may need to discuss your treatment and symptom control in detail with your doctor.
What are your legal options?
Source:http://www.mesothel.com/pdf/Asbestos_Issue_Commentary.pdf
A mesothelioma client is on a ship whose hull has been breached. His first instinct is to rush
for the nearest medical “lifeboat” that promises to extend his life. Do lawyers have a duty to
advise their meso clients about the best available medical treatment “lifeboat?”
Every lawyer who represents mesothelioma clients knows that the patient and his family
are in the throes of crisis. We know that eventually the tumor will take our client’s life. We
also know that the tort system puts a premium on a longer “damaged” life. The longer a
terminal patient lives, the greater the damages, and the greater chance the case will be resolved
at, or near, trial, where settlement values usually peak.
The “longevity” premium is especially high in California, where the law allows an in extremis
plaintiff to get to trial within four months, but then penalizes his estate if the cancer kills him
before the jury renders a verdict.2 The legislature has exacted a “penalty” of sorts by stripping
the family of any right to recover damages for the pain, suffering, disfigurement, and
anguish that their mortally wounded loved one endured while alive.
Regardless of intent, the California legislature has rewarded tortfeasors whose bad conduct
kills instead of maims –– (hence, the sick joke here: “If you run your car over a guy, check
the rear view mirror. If he’s still moving, shove it in reverse.”) In the litigation world of winners
and losers, if the measure is strictly money, the defendants enjoy an economic windfall when their victim perishes. The victim earns a chance at a full recovery only if he survives, and thus lawyers clearly have a pecuniary interest in their client’s longevity.
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