Recent Study Reveals Treatment Factors Associated With Long Term Survival for Peritoneal Mesothelioma

Malignant peritoneal mesothelioma is a cancer which, like pleural mesothelioma, is caused by exposure to asbestos. Instead of attacking the pleura that surrounds the lung, this type of mesothelioma attacks the lining which surrounds the organs of the abdomen. Peritoneal mesothelioma is very rare, accounting for only approximately 500 of the 2,500 to 3,000 cases of mesothelioma diagnosed per year.

Prior studies have revealed that treatment utilizing cytoreductive surgery to remove all visible tumor in combination with intraoperative or perioperative high-dose regional chemotherapy to kill any remaining tumor cells offers the best prognosis and has become the standard of care in treating peritoneal mesothelioma.

In an effort to identify the factors that contribute to long term survival, an analysis of 211 cases of peritoneal mesothelioma from 1992 and 2010 was performed by doctors at the University of Maryland School of Medicine.

Patients treated with cytoreductive surgery and hyperthermic intraoperative peritoneal chemotherapy showed median survival of 38.4 months, with 41% surviving at least 5 years, and 26% surviving to 10 years. The use of the chemotherapy agent Cisplatin resulted in prolonged survival in all patient groups over the use of mitomycin-C which in the past was the most common agent used.

Women tended to respond better to the treatment than men. Age and completeness of resection or tumor removal also contributed to the most favorable response. Ultimately, the stage of the disease played a key role in patients’ response to treatment.

Peritoneal mesothelioma tends to offer a better prognosis than pleural mesothelioma due to the location of the disease which is surgically more accessible, but if left untreated is just as aggressive as pleural mesothelioma. Patients exhibiting the longest survival rate had regular post treatment follow-up and additional treatment at the onset

of any recurrence of the disease.

Read the full abstract here.

Peritoneal patient profiles:

• Tammy Jordan - 13 Year Survivor
• Michael Winkelman - 11 Year Survivor
• Paul Zygielbaum - 10 Year Survivor
• Sue Huff - 7 Year Survivor
• Tom Bradford - 5 Year Survivor

The Hunt for A Cure: W&C responds to WSJ article

The Wall Street Journal, which is in the business of putting asbestos trial lawyers out business, contacted me over a year ago. They wanted to run an article about my donations to medical research.

As a journalist myself in college, it didn’t take long for me to figure out their angle. They wanted to show that somehow my practice of sponsoring medical research, as opposed to spending oodles on TV and Google ads, was “fishy” if not “rotten.”

The result of that year long quest appeared today in the crusty WSJ under the byline of reporter Dionne Searcey. The title: “Mesothelioma Doctors, Lawyers Hunt for Valuable Asbestos Cases.” 

Right away you get a feel for the slant. We are “hunters.”  Now, I’ve gotten to know Ms. Searcey fairly well and my guess is she didn’t write the headline.  Contrary to the splenetic anti-lawyer bias of the WSJ’s editorial board,  Ms. Searcey actually went the extra mile to check her facts, question her own biases, and listen to contrary points of view. To her credit, she even previewed with me the accuracy of the quotes she attributed to me and others.  In sum, she has shown a degree of professionalism I did not expect from her employer, and I respect her methods greatly.

But I wanted to clarify just a few points.

First, we wouldn't be in this mess if the asbestos industry hadn’t created it.  Nor would we be fussing about the ethics of sponsoring medical research if the asbestos industry itself had not steadfastly and stupidly refused to clean up their horrific mess.

Second, if the parties responsible for the asbestos cancer mess won’t clean it up, who will? The Federal government has not invested in medical research commensurate with the size of the problem, their responsibility (for Navy vets, meso is a “service connected disability) or their own fault. Meanwhile, the number of people diagnosed with meso is “too small” for Big Pharma to justify any serious investment. The labor unions are broke. If not the patients and their advocates, who will step up? 

Third, if money curries favor, from a strict profits and losses perspective, why hasn’t the asbestos industry donated to research?  A few years ago, Dr. Cameron was invited to speak to 600 asbestos defense lawyers, insurance adjusters and company reps.  He talked about the medical and ethical benefits of sponsoring research. How much did they pony up? Zero. Now, that’s “disgraceful.”

The asbestos industry is notorious for corrupting the medical and scientific literature with false and deceptive articles they paid for designed to prove to juries that asbestos is as benign as mother’s milk. If anyone knows how to curry favor with money, it’s the asbestos industry.

It simply boggles my mind that the industry, after 50 years of wasting tens of billions of dollars on phony research and medical mercenary “experts,” still has yet to see the economic benefits from finding a cure.  Put lawyers like me out of business! Save asbestos-tainted companies from bankruptcy! Spare millions of people agony, misery and death! It makes dollars and sense.

Fourth, the only “stakeholders” that really don’t want to see a cure for mesothelioma are the legions of “bill to kill” defense lawyers. They get paid by the hour. It’s in their economic interest to drag out tedious, life-sucking litigation, as the John Johnson case sadly but clearly demonstrates.

That said, over the past 25 years, I have met several honorable defense lawyers who agree with me that their clients should indeed invest in a cure.  They agree with me that they should find a way to resolve meritorious cases early before racking up thousands and thousands in legal fees. And they agree that it makes no sense at this late date for asbestos defendants to invest in crackpot “experts” to gin up junk science to bamboozle juries, when the money should instead be invested in cleaning up their horrific mess. 

We are quick to forgive in this country.  People, like corporations, make mistakes. What’s unforgivable is the perpetuation of that mistake by stubbornly refusing to own up to it.

Finally, maybe I’m wrong about the “benefits” of keeping meso patients alive. Unfortunately, as long as certain states limit or eliminate the damages available in wrongful death cases, then the bad guys will indeed have an economic incentive to hasten their victim’s demise.  It’s no secret that here in California the asbestos companies generally settle wrongful death claims for far, far less than they do for living claims.  The law encourages this wicked behavior.  In this dark and dusty light, it’s no wonder the bad guys don’t invest in a cure.

My firm’s motto has always been: “Asbestos Lawyers for Life.”  Yes, it’s in my firm’s interest to help my clients live long and prosper.  The day that in this great country we hold in contempt efforts to cure cancer but applaud and reward the cancer creators, well, that’s a day I’d rather put off, and I don’t think I’m alone.

RGW

5/6/13

Hunters for Justice and a Cure for Meso: The John Johnson "Fight Meso" Family, sponsors of the Dana Point Grand Prix

Workers Memorial Day--Remember the Dead, Fight for the Living

In recognition of Workers Memorial Day 2013,  Worthington & Caron would like to acknowledge all of the working men and women who have been hurt, taken ill or have died in pursuit of their piece of the “American Dream”. This, of course, includes hundreds of thousands of workers who have been diagnosed with mesothelioma, lung cancer or asbestosis as a result of exposure to asbestos in the workplace.

The Occupational Safety and Health Administration (OSHA) was established on April 28, 1971 with the mission of assuring safe and healthful working conditions by setting and enforcing standards and providing training, outreach, education and assistance. The anniversary of this day has been designated Worker’s Memorial Day, a day to honor all men and women who have been injured or have lost their lives due to a workplace accident or exposure.

According to the World Health Organization approximately 125 million people in the world were exposed to asbestos at the workplace, and more than 107,000 people die each year from asbestos-related disease. One in every three deaths from occupational cancer is estimated to be caused by asbestos.

Even though OSHA established regulations regarding the handling of asbestos in the early 1970s, many manufacturers continued using asbestos in their products for many years--in some cases decades later. The OSHA regulations proved to be of some effect in reducing exposures to existing asbestos that had been installed years earlier and could be marked and cordoned off at jobsites such as factories, refineries and power plants. However, the regulations proved to be less effective in limiting exposures to new products that were used by workers or by others in their presence at jobsites. As disease caused by asbestos typically doesn’t manifest until 20 to 50 or more years after exposure, it is anticipated that the incidence of asbestos disease will remain at its current rate for years to come.

Many believe that the conduct of asbestos companies from the 1930s through the 1980s is one of the worst examples of companies placing profits ahead of public safety in our nation’s history. Worker’s Memorial Day is a powerful reminder of the importance of worker health and the need to prevent this situation from ever occurring again. 

Canada Drops Opposition to Chrysotile Addition to List of Controlled Hazardous Substances

The United Nation’s list of Controlled Hazardous Substances is maintained by an international treaty made up of representatives from around the world known as the Rotterdam Convention. The Convention’s purpose is to set standards of protocol for the regulation of global trade of hazardous materials in an effort to protect human health and the environment.

Chrysotile has been on the list of considered additions to the list of Controlled Hazardous Substances since the Convention’s first meeting in 2004. However, in order for chrysotile to be added, the vote needs to be unanimous among the represented countries. The addition of chrysotile has been strongly opposed by countries with large stakes in the asbestos industry including Brazil, Canada, China, India, Kazakhstan and Russia. Inclusion does not imply that the substance has been banned, but that its import, export and use is severely regulated.

India withdrew its objection to the addition of chrysotile at the 2011 Rotterdam Convention, but Canada, which was exporting thousands of tons of chrysotile asbestos to other countries, objected on the basis that it was a propaganda ploy by groups wishing to benefit from the trade of replacement products such as cellulose and ceramic.

That same year the last operating asbestos mine in Canada ceased operations and the Canadian government committed to lend the mine $58 million to restart production. But in 2012, the newly elected government announced it would not honor the commitment. The new Ministry also announced that it would no longer oppose the addition of chrysotile to the list of Controlled Hazardous Substances.

The sixth meeting of the Rotterdam Convention runs from April 28 to May 10, 2013 in Geneva, Switzerland. While it is unlikely that other countries in opposition will follow suit, Canada’s change in stance is an important step toward placing of public health above corporate gains.

Chrysotile asbestos is a fibrous magnesium silicate mineral that is the most abundant variety of asbestos found on earth. The largest known natural deposits of chrysotile are located in Quebec, Canada and the Ural Mountains in Russia. Chrysotile is most commonly exported to developing countries which have failed to implement proper safety regulations to protect citizens.

Due to the unyielding of vested corporate interests, the danger of chrysotile asbestos continues to remain a contentious topic. However, in February 2013, the World Health Organization and the International Agency for Research on Cancer called for an end to all uses of asbestos reiterating all forms of asbestos are carcinogenic and can cause asbestosis, lung cancer and mesothelioma.

Report Notes Unusual Side Effects from Alimta Chemotherapy

A report in the March 2013 edition of the medical journal, Lung Cancer, details two unusual side effects seen in a 77 year-old man who was receiving Alimta chemotherapy in the course of maintenance therapy for malignant pleural mesothelioma (“MPM”). One week after the patient received his seventeenth cycle of Alimta, he began suffering from neutropenic enteritis (“NE”), a potentially life-threatening condition associated with inflammation of the cecum or bowels which was treated with antibiotics. Another side effect experienced by the same patient was severe hyperpigmentation, which is the discoloration or darkening of the skin all over the patient’s body.

There are prior reports of two patients receiving Alimta in the treatment of non-small cell lung cancer who developed NE, but this is the first documented case of an MPM patient exhibiting NE. Hyperpigmentation has been documented in two previous patients receiving Alimta. But this is the first case where both symptoms/side effects were exhibited in the same patient.

Since its approval by the FDA in 2004, pemetrexed, brand name Alimta, has been routinely prescribed in combination with cisplatin or carboplatin for patients diagnosed with mesothelioma. To this day, Alimta/cisplatin remains the only FDA approved chemotherapy drug combination for the treatment of mesothelioma.

Even though it was ultimately approved, the clinical trials of Alimta/cisplatin showed only a 41% partial response rate and an increased median survival rate of only 2.8 months compared to patients treated with cisplatin alone. Furthermore, in its approval letter, the FDA noted that it’s approval of Alimta/cisplatin was limited to “use with patients who are not eligible for surgery.”

More recent published trial data reveals that a combination of surgery, radiation, and chemotherapy is almost always associated with the longest survival times. 

U.S. Surgeon General Dr. Regina Benjamin Urges Americans to Learn the Dangers of Asbestos

U.S. Surgeon General Dr. Regina Benjamin issued a statement urging Americans to learn and take precautions against the dangers of asbestos as part of Asbestos Awareness Week which took place April 1 – April 7.

The World Health Organization estimates that over 107,000 people die each year from asbestos-related disease--10,000 of those deaths occurring in the US. Almost all of us are exposed to very low levels of asbestos in the air, but most will never develop an asbestos-related disease unless directly exposed to higher concentrations.

Asbestos is banned in over 50 countries throughout the world including most of Europe and all of Australia. Asbestos has not yet been banned in the United States, most of South America, China and Asia. Mining for asbestos is banned in the US, but asbestos is still imported and used in a wide range of products.

These days, most exposures to asbestos occur from renovations performed on buildings and homes built before the 1980s, automotive work and clean-up from natural disasters. Asbestos fibers are invisible and most people are unaware that it is present in the air they are breathing.

The following is a list of “usual suspects” for containing asbestos:

• Roofing materials
• Popcorn ceilings
• Drywall and drywall mud
• Vinyl and linoleum floor tiles
• Cementious or transite pipe
• Wall or ceiling insulation
• Textured paint and patching compounds used on wall and ceilings
• Walls and floors around wood-burning stoves and fireplaces
• Hot water and steam pipe insulation
• Oil and coal furnaces and door gaskets
• Automotive brakes and clutches

This informative video shows in detail what to look out for in the home if you suspect asbestos is present.

If you suspect asbestos is present, do not disturb it, and contact an accredited asbestos abatement professional who can let you know whether it is safely contained or if it presents a danger to you and your family.

For more information on asbestos please visit the Environmental Protection Agency’s website.

Huffington Post Debunks Claims of Fraud by Supporters of the “Furthering Asbestos Claim Transparency Act”

Currently before the House of Representatives is House Resolution 982, the “Furthering Asbestos Claim Transparency Act of 2013”. Supporters of the FACT Act claim that their goal is to protect the rights of victims affected by asbestos exposure. They assert that the bill is necessary to address what they claim is “rampant fraud” in claims filed with asbestos bankruptcy trusts.

Huffington Post business writer Brian Young has examined the issue in two recent articles published on huffingtonpost.com. We believe that Mr. Young has effectively revealed how corporate interests have levied false accusations against an all-too-familiar scapegoat, asbestos plaintiffs’ attorneys, in order to pass legislation that will hurt, not help, the asbestos cancer victims they claim their bill is designed to help.

In his article, “Shedding a Tear for the Insurance Industry?”, Mr. Young reveals that the FACT Act  is supported by the American Legislative Exchange Council (ALEC). ALEC, a “non-profit” group of legislators, businesses and foundations,  is funded by corporate interests including Exxon Mobil and the Koch brothers, among others. The group pushes for legislation that supports lowering minimum wage, fights clean-energy and clean-air initiatives, and strongly opposes government involvement in the regulation of corporate activities.

In a follow-up article, Mr. Young responds to a Wall Street Journal Article which seems to take the side of the bill’s supporters. Young states, “The bill is just the next step in the insurance industry's coordinated campaign to make this debate about lawyers vs. poor, beleaguered corporations.” The truth is that there are more asbestos claims being filed not due to fraud, but due to the widespread use of this extremely dangerous mineral which these corporations knowingly exposed workers and by extension their families to. The reason these people are entitled to any compensation at all is proof to the fact that these companies had complete disregard for the health and safety of others and placed profits above human lives.”

“These companies cry that too many new claims are being filed so fraud must be occurring, although the WSJ’s article specifically identified only two isolated incidents of improper claims being submitted to asbestos bankruptcy trusts out of the 850,000 the WSJ examined that have been filed over the last 30 years.”

"ALEC and their allies in government and the media can cry their crocodile tears for the poor, downtrodden insurance companies, but I won't shed a tear for the multimillion dollar industry. Like most people, I will send my sympathies to the families of people whose loved ones suffered and died terrible deaths -- and I will cheer the lawyers who defend them when they get their well-deserved day in court."

Well said Mr. Young!!