There have been several lawsuits
recently regarding cases of
Mesothelioma. The
following is a brief description of what it is and the
legal issues surrounding it. Mesothelioma is an uncommon
form of cancer and is usually associated with previous
exposure to asbestos. In this disease, malignant cancer
cells develop in the mesothelium, a protective lining
that covers most of the body's internal organs. Its most
common site is the pleura, or the outer lining of the
lungs and chest cavity. Mesothelioma may also occur in
the peritoneum, which is the lining of the abdominal
cavity, or the pericardium, a sac that surrounds the
heart.
This site is designed to give you information with
respect to symptoms and diagnosis of the disease and
offer several links and other resources of help from
mesothelioma lawyers and attorneys to help you with your
claims to general information with respect to lung
cancer.
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 pleural space are often symptoms of pleural
mesothelioma. Symptoms of peritoneal mesothelioma
include weight loss and cachexia, abdominal swelling and
pain due to ascites (a buildup of fluid in the abdominal
cavity). 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.
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. A history of occupational
exposure to asbestos may increase clinical suspicion for
mesothelioma. A physical examination is performed,
followed by chest X-ray and often lung function tests.
The X-ray may reveal pleural thickening commonly seen
after asbestos exposure and increases suspicion of
mesothelioma. A CT (or CAT) scan or an MRI is usually
performed. If a large amount of fluid is present,
abnormal cells may be detected by cytology if this fluid
is aspirated with a syringe. For pleural fluid this is
done by a pleural tap or chest drain, in ascites with an
paracentesis or ascitic drain and in a pericardial
effusion with pericardiocentesis. While absence of
malignant cells on cytology does not completely exclude
mesothelioma, it makes it much more unlikely, especially
if an alternative diagnosis can be made (e.g.
tuberculosis, heart failure).
Treatment of mesothelioma using conventional
therapies has not proved successful and patients have a
median survival time of 6 - 12 months after presentation.
The clinical behavior of the malignancy is affected by
several factors including the continuous mesothelial surface
of the pleural cavity which favors local metastasis via
exfoliated cells, invasion to underlying tissue and other
organs within the pleural cavity, and the extremely long
latency period between asbestos exposure and development of
the disease.
Surgery. Surgery, either by itself or used in combination
with pre- and post-operative adjuvant therapies has proved
disappointing with a 5 year survival rate of less than 10%.
It is most useful for palliation.
Radiation. Although the tumor is highly resistant to
radiotherapy and chemotherapy, these regimens are sometimes
used to relieve symptoms arising from tumour metastases such
as obstruction of a major blood vessel.
Chemotherapy. In February 2004, the Food and Drug
Administration approved pemetrexed (brand name Alimta) for
treatment of malignant pleural mesothelioma.
Immunotherapy. Treatment regimens involving
immunotherapy have yielded variable results. For example,
intrapleural inoculation of Bacillus Calmette-Guérin (BCG)
in an attempt to boost the immune response, was found to be
of no benefit to the patient (while it may benefit patients
with bladder cancer). Mesothelioma cells proved susceptible
to in vitro lysis by LAK cells following activation by
interleukin-2 (IL-2), but patients undergoing this
particular therapy experienced major side effects. Indeed,
this trial was suspended in view of the unacceptably high
levels of IL-2 toxicity and the severity of side effects
such as fever and cachexia. Nonetheless, other trials
involving interferon alpha have proved more encouraging with
20% of patients experiencing a greater than 50% reduction in
tumor mass combined with minimal side effects.
Heated Intraoperative Intraperitoneal Chemotherapy. A
procedure known as heated intraoperative intraperitoneal
chemotherapy was developed by Paul Sugarbaker at the
Washington Cancer Institute[5]. The surgeon removes as much
of the tumor as possible followed by the direct
administration of a chemotherapy agent, heated to between 40
and 48°C, in the abdomen. The fluid is perfused for 60 to
120 minutes and then drained.
This technique permits the administration of high
concentrations of selected drugs into the abdominal and
pelvic surfaces. Heating the chemotherapy treatment
increases the penetration of the drugs into tissues. Also,
heating itself damages the malignant cells more than the
normal cells.
Legal Issues: In the United States, the average mesothelioma-related settlement was $1 million; for cases that go to trial awards averaged $6 million, according to a study by the RAND Corporation. Only a small fraction of the thousands of asbestos-related lawsuits in the United States every year are related to mesothelioma. In 2004, a bill in the United States Senate aimed an asbestos litigation reform failed to reach a floor vote. In January of 2005, Senate Judiciary Committee Chairman Arlen Specter announced he would again try to pass an asbestos litigation reform bill.
A separate bill introduced on March 17, 2005, the Fairness in Asbestos Injury Resolution Act of 2005 (FAIR act of 2005), seeks to ensure a set amount of compensation dependent on the symptoms of the victim. The range is from Medical Monitoring for victims with Asbestosis or Pleural Disease to $35,000 for victims with Mixed Disease With Impairment all the way to over $1,000,000 for Mesothelioma victims and nonsmoking Lung Cancer victims. FAIR act of 2005, full text.