New Depo Limit Law To Become Effective January 1st---What a Difference a Year Makes!

On January 1, 2013, California Code of Civil Procedure Section 2025.290 will become effective limiting plaintiff depositions in most civil cases to no more than seven (7) hours over two days, or 14 hours of total testimony.

Previously there were no state-wide statutory limits on the length of plaintiff depositions. This omission in the law often allowed defense counsel to subject plaintiffs to prolonged and repetitive questioning, causing undue stress and exhaustion.

The new law was motivated by the plight of John Johnson, a 68 year-old veteran of the U.S. Marines and retired plumber who was diagnosed with mesothelioma and filed a lawsuit against the companies responsible for his asbestos exposure in October 2011. In the case, we presented a declaration from Dr. Robert Cameron imploring the court to limit Mr. Johnson’s deposition to 12 hours, as Mr. Johnson was a stage III patient who had just emerged from an 11 hour surgery and was undergoing post-surgery radiation. Dr. Cameron warned the court that interrogation in excess of 12 hours would “hasten his demise.” The court limited the deposition to 20 hours but later granted another 5 hours over our objections and a second declaration from Dr. Cameron.

The deposition began on December 19, 2011 and, after 10 sessions conducted over 35 days, was concluded on January 23, 2012. As predicted by Dr. Cameron, the rigors of the process produced a dramatic decline in Mr. Johnson’s condition. Knowing that unless he completed the mandated 25 hours, none of his testimony could be used in the lawsuit which would be his wife Sue’s only source of financial support, Mr. Johnson could not be deterred from finishing the job. Mr. Johnson passed away less than 24 hours after completing the deposition.

This unfathomable, but not unanticipated, result was a rallying call for Worthington& Caron, P.C. and other plaintiffs’ attorneys who had long sought to impose reasonable limits on defense deposition questioning. Working together with the support of Mr. Johnson’s wife, Sue Johnson, the effort gained media attention and finally the support of key California lawmakers. The measure was passed by the California legislature on August 29, 2012 and signed into law by Governor Jerry Brown on September 17, 2012.

As 2012 comes to an end, we reflect back on the tragic events involving John Johnson and extend our warmest and sincerest wishes to his family as they spend their first Holiday season without him. We hope they find some satisfaction in knowing that their government took notice of their nightmare and acted quickly and decisively to keep other Californians from enduring it in the future.

Section 2025.290 is a long-overdue measure which provides a defense to the basic civil liberties of asbestos cancer patients and other seriously injured plaintiffs. These are people for whom time is precious. They want to get well. They can’t work. They have mounting bills. They weren’t looking for a lawsuit but, like John Johnson, have no other potential source of financial resources. We applaud the California legislature and Governor Brown for the protections that injured plaintiffs will get to begin enjoying in the New Year!

John M. Caron

December 20, 2012

New Biomarker May Allow Earlier Diagnosis of Mesothelioma

Mesothelioma can be difficult to diagnose and early diagnosis is even more challenging due to the long latency period and similarity of symptoms to many common ailments. Researchers of the New York University Langone Medical Center have identified a new biomarker, the protein fibulin-3, which may allow for earlier diagnosis, higher efficiency of treatment and a more optimistic prognosis.

Researchers compared fibulin-3 levels from plasma and effusion samples from 142 patients with mesothelioma, 136 cancer-free individuals who had been exposed to asbestos, 93 patients with effusions not due to mesothelioma, and 91 patients with cancers other than mesothelioma.

Effusion fibulin-3 levels were significantly higher in patients with pleural mesothelioma than in patients with effusions not due to mesothelioma.  The fibulin-3 levels were able to distinguish patients with mesothelioma from those with benign effusions due to other cancer types or non-diagnosed persons who had been exposed to asbestos with a sensitivity of 100% and a specificity of 94.1%.

In 18 patients, fibulin-3 levels fell after surgery, the biomarker could prove to be an efficient tool for not only earlier diagnosis, but also monitoring mesothelioma patient’s response to therapy or disease progression. Click here to read the abstract of this study.

Pacific Meso Center’s 5k Walk & BBQ—A Rousing Success!

This past Sunday, the Pacific Mesothelioma Center hosted the Inaugural 5k Walk & BBQ at Paramount Ranch in Agoura Hills to raise awareness about mesothelioma and to pay tribute to those who have fought the disease or are still fighting. PMC’s sole aim is to discover new treatments for malignant pleural mesothelioma and to improve mesothelioma victims’ lives and longevity.

More than 200 family members, friends, and colleagues gathered in the Old West Town, formerly the site of numerous westerns filmed during Hollywood’s Golden Age, and set off for the hills for the scenic 5K walk/hike/run. The sun was high and the way steep, but our determination won out over the 90 degree weather and our efforts were well rewarded with some of the best BBQ in the West and the musical stylings of Karen Tobin and her country band.

PMC’s original fundraising goal was $25,000. At last count, this event has raised a whopping $66,900 and the donations are still coming in! The top fundraising team was no other than the McCarthy clan with their team Irish Stampede, in loving memory of Gerald McCarthy.

Team Evens in honor of Randy Evens

Also supporting the cause was Team Evens which was made up of family and friends of Randy Evens. Team Evens included Randy's wife Ginny and daughters Laura and Diana.  Team Evens was proud to boast that no matter the distance, they would keep on walking to get the word out and to chase down a cure. There were other great friends and gracious clients of ours also in attendance, including: the Ganoe family and friends, the Belvedere family and friends, the Jarvis family and friends and Kay Simmons-Gilpatrick.

It was admirable to see these families band together to honor their loved ones and give something back to help future victims. I tip my hat to thee. And my sore feet.

Dr. Cameron Proposes IMIG Consensus Statement on the Role of Surgery in Mesothelioma Treatment

Recently several hundred doctors and scientist from all over the world with an interesting in mesothelioma met in Boston to discuss, among other things, the role of surgery in treating meso patients (the "IMIG" group).

Earlier, a paper had been published out of the UK that questioned the merits of extrapleural pneumonectomy (EPP)  as compared to chemotherapy alone (the trial didn't offer pleurectomy/decortication).  The IMIG group pointed out various flaws in the design and operation of the trial.  In particular, the clinical trial, the first of its kind anywhere, had terrible trouble over a period of three years recruiting the 50 patients it needed for a pilot trial. The MARS group's plan was to follow up the pilot study with a full blown and statistical meaningful mega-trial of 670 patients. They never got there. 

Of the 50 meso patients they did recruit, many of those did not complete the arm of the study they started (ie. surgery only or chemo only), or they crossed over (from surgery to chemo, or vice versa) during the trial. 

The MARS authors to their credit did acknowledge this deal-breaker problem. They went so far as to question whether a clincial trial of this kind was ever feasible at all in the real world, where patients simply don't want to be "guniea pigs" even in the greater interests of medical advancement. A clinical trial of this scope has never even been attempted in the US.

In the US, patients have many choices, and it remains "muddy" what the best option is across the board for the "average" meso patient.  Dr. Cameron and Dr. Sugarbaker have publically disagreed over which surgery is "better" - ie. EPP vs Pleurectomy/Decortication. However, both agree today that the role of surgery is to remove as much tumor as you can see (what Dr. Sugarbaker has coined "complete macroscopic resection" (MCR)).  Dr. Cameron has been a long time advocate of pulling up his sleeves and pulling out a much tumor as he can see, without watching the clock, noting that "negative margins" was and always will be a pipedream for a meso surgeon.

I encourage you to read the draft proposal submitted by Dr. Cameron, which is based on an earlier draft proposed by Dr. Sugarbaker.  Although there are stylistic differences, both agree that surgery should be performed along with adjuvant care to attack the unseen tumor cells that remain in the body after surgery.

As Dr. Cameron tactfully writes: "The exact surgical procedure should be based on disease distribution, surgeon preference and experience, and institutional experience and should be performed with a morbidity and mortality consistent with published literature." 

As a patient, before making your decision (e.g., chemo only? What chemo? Surgery? What operation? By whom and where?),  the IMIG Group has also recommended that you follow these important guidelines:

• Pathological diagnosis including histologic subtype should be established by tissue biopsy.
  
• Clinical staging be performed prior to initiation of therapy and should include PET with lymph node sampling and/or MRI as indicated.
• The type of surgery (EPP, P/D, etc) should be based on clinical factors as well as individual surgical judgment and expertise.
• Complete surgical stating should include hilar and mediastinal lymph node removal.

To review a complete text of Dr. Cameron's proposed IMIG consensus statement, please click here.  The IMIG board will review all comments and submit the final approved version for publication in a suitable journal with collective authorship.  Doctors as well as patients need and deserve this kind of up-to-date education. We applaud Dr. Cameron and Dr. Sugarbaker, as well as all the other doctors, who have participated in this project.

RGW

10/16/12

Cause-Specific Mortality in Relation to Chrysotile-Asbestos Exposure in Chinese Cohort

The dangers of chrysotile asbestos continues to remain a contentious topic,

especially among defendants who argue that chrysotile is a “safe” fiber.

Chrysotile represents 95% of all asbestos ever used and is currently the

only type of asbestos commercially being used in the world. Its uses include

textile products, friction and heat resistant materials, cement and rubber

products.  China happens to be one of the biggest consumers of asbestos and

have consequently experienced an alarming rate of asbestos-related disease

and asbestos-related death among exposed workers.

In this study, scientists evaluated a group of 577 workers from a

chrysotile-textile plant in China from between 1972 to 2008. Their analysis

indicated that exposure to chrysotile asbestos was closely associated with

excess mortality from cancer and respiratory diseases compared to an

occupational control group and the Chinese national level. Furthermore, the

study found that increased mortality was associated with the amount of

chrysotile exposure, number of exposure years, age at first exposure year

and other variables, such as smoking history and birth year.

In summary, chrysotile asbestos continues to be highly carcinogenic to

humans as illustrated by the study's cohort's increased mortality from lung

cancers and nonmalignant respiratory diseases which resulted exclusively

from chrysotile asbestos exposure. Click here to view this study.

Sarcomatoid Predominant Malignant Pleural Mesothelioma: An Institutional Approach and Experience

As presented by Dr. Robert Cameron at the 11^th International Conference of the International Mesothelioma Interest Group (iMig)  
Boston, MA – September 11-14, 2012

Sarcomatoid-predominant malignant pleural mesothelioma is an especially difficult tumor to control. Thoracic surgeons at UCLA seeking to improve the poor prognosis that comes with this incredibly aggressive cancer looked at the treatment of non-mesothelioma pleural sarcomas, which is typically treated with chemotherapy followed by surgery and radiation.

Doctors identified four patients with sarcomatoid-predominant malignant pleural mesothelioma who had received pre-operative therapy before undergoing the lung-sparing pleurectomy/decortication procedure. Three of these patients utilized Ifosfamide/Adriamycin and one patient Cisplatin/Pemetrexed/ Veglin. Three-fourths of these patients were found to have pathological responses with 80-99% necrosis, or tumor death, which is not often seen with standard Cisplatin and Pemetrexed.

Multimodality approaches that utilize Ifosfamide/Adriamycin seem to be the optimal treatment strategy for sarcomatoid-predominant malignant pleural mesothelioma patients. In addition, patients who originally are not eligible for surgery may become so if they see 80% or higher necrosis and remain free of metastatic growth following chemotherapy. Click here to view this abstract.

Thermal Therapy in the Treatment of Malignant Pleural Mesothelioma

As presented by Dr. Robert Cameron at the 11^th International Conference of the International Mesothelioma Interest Group (iMig)  

Boston, MA – September 11-14, 2012

Thermal therapy has been used in cancer therapy for decades and hyperthermic chemotherapy perfusion, specifically, has been used in the treatment of mesothelioma but without data as to the optimal conditions.

In a study performed at UCLA, doctors sought to define in vitro the most effective strategy for the use of thermal therapy in pleural mesothelioma. They exposed three human mesothelioma cell lines to varying hyper and hyperthermic conditions using either a standard metabolic MTS absorbance assay or a standard clonogenic (which is a microbiology technique for studying the effectiveness of specific agents on the survival and proliferation of cells). Each cell line was then expanded and exposed to varying combination of hyperthermia, hypothermia and/or chemotherapy – using chemotherapy agents cisplatin, gemicitabine, and/or pemetrexed.

Their findings show that thermal therapy appears to be most effective when using hypothermia rather than hyperthermia, and chemotherapy appears to be most effective when using two drug combinations over one individually. Click here to view this abstract. 

The Timing of Chemotherapy in the Multimodality Treatment of Malignant Pleural Mesothelioma

As presented by Dr. Robert Cameron at the 11^th International Conference of the International Mesothelioma Interest Group (iMig)  

Boston, MA – September 11-14, 2012

Chemotherapy used in multimodality treatment of malignant pleural mesothelioma is typically performed within 4-6 weeks prior to or after surgery, and various strategies have been used with regard to the timing of chemotherapy within a multimodality treatment.

Doctors at UCLA identified 121 patients who had undergone the pleurectomy/decortication surgery followed by adjuvant radiation therapy and received chemotherapy only after the first recurrence of the disease. The results of receiving delayed chemotherapy were comparable or better to those reported for “trimodality” therapy including the recent MARS trial. These findings suggest that a more rational and conservative approach to multimodality treatment of patients with malignant pleural mesothelioma may be warranted.

Multimodality Therapy is the combination of surgery, radiation, and chemotherapy; and for malignant pleural mesothelioma patients eligible for surgery, is almost always associated with the longest survival rates. Survival of patients who receive this type of treatment varies from 16 to 22 months, depending on the staging, type of surgery, cell type, as well as other factors. Click here to view this abstract.

Percutaneous Outpatient Cryoablation for Localized Recurrent Pleural Mesothelioma Following Lung-sparing Pleurectomy and Decortication Surgery

As presented by Dr. Robert Cameron at the 11^th International Conference of the International Mesothelioma Interest Group (iMig) 

Boston, MA – September 11-14, 2012

Recurrence for patients with malignant pleural mesothelioma is extremely high following surgery, most patients are ineligible for repeat surgery and management of mesothelioma is among the most challenging of cancer therapies. Many of our clients have experienced good results with post-surgery cryoblation therapy. (including Martha Munoz, Patricia Crawford and Sylvia Ramirez) 

Cryoablation for localized recurrent malignant pleural mesothelioma following surgery can be performed safely as an outpatient procedure. It is a minimally invasive procedure, which uses a needle to target argon gas directly to the tumor killing the cells it touches in a relatively safe and quick manner. It can be performed on multiple lesions at a time and is also a safe and relatively quick method to control pain and improve the patient’s quality of life.

Doctors at UCLA have published a promising study with the International Mesothelioma Interest Group which identifies 24 UCLA patients who have received one or more cryoablation treatments for localized recurrence of malignant pleural mesothelioma following surgery with or without adjuvant therapy. The patients in the study were found to have a minimal morbidity rate of 5.6%, a very high efficacy rate of 95.3%, and an impressive overall survival rate of 36.1 months.

Currently only a handful of centers specialize in the use of cryoablation in the management of mesothelioma, most notably diagnostic radiologists, Dr. Fereidoun Abtin and Dr. Robert Suh at UCLA.

Meso Empowerment Exclusive: Dr. Cameron shares his brilliant insights on breakthrough moments at IMIG Conference in Boston or, Galileo is Smiling

Dr. Robert Cameron
iMig 2012

Dr. Robert Cameron, thoracic surgeon and mesothelioma specialist, was kind enough to provide us with his tweets as he attended the recent IMIG conference in Boston. His “boots on the ground” tweets were simply too compelling to leave alone so we followed up and asked him to elaborate

If you’re reading this, you’re no doubt aware of Dr. Cameron’s pioneering efforts to re-introduce “rationality” to the macho “bigger is better” mentality that unfortunately has tended to dominate meso surgery in the US. Although his pleurectomy/decortication (P/D) model is now becoming not only accepted but strongly endorsed, it wasn’t always this way.

I remember vividly at a meeting among surgeons 12 years ago where his fellow surgeons literally shussed Dr. Cameron when he tried to speak up against powerful, East Coast-driven forces who decreed that their big gnarly “extra-pleural pneumonectomy” (EPP) was as unassailable as a papal decree. For years, Dr. Cameron toiled away, mainly in the dark, while the spotlight remained brightly fixed on the “curative” EPP. But he never lost faith.  Like so many myth busters of lore (Galileo comes to mind), Dr. Cameron’s belief that removing the tumor and sparing the lung was the only rational way.

I can’t speak for Dr. Cameron, but for this cancer warrior, it feels good that his brethren have finally embraced the P/D on which Dr. Cameron based his career and his passion.

Here’s a few of the good doctor’s tweets and the follow up.

Enjoy the read and keep questioning, searching, learning and leaning towards the light.

*   *   *   *   *  

IMIG 2012: for the future of treatment of mesothelioma: the future is clearly immunotherapy!

Why is Dr. Cameron so optimistic? Let’s ask.

Dr. Cameron: Although we are only just now learning how to harness the power of immunotherapy, there is already evidence from decades ago that something as simple as stimulation with IL-2 into the pleural space can result in survivals that have rivaled "trimodality therapy" with median survivals as long as 28 months.

Furthermore, the immune system when it does work has been shown in other cancers, such as melanoma and renal cell carcinoma, to eradicate even bulky disease. We are now on a new learning curve with better understanding not only of what it takes to stimulate an immune response but what it takes to reverse the tumor-mediated escape mechanisms present at the actual tumor site. With the accelerated development in this field that has happened over the last few years, we should make good progress in the near future.

*   *   *   *   *  

IMIG 2012: Steven Albelda confirms that immunotherapy is a very promising treatment for mesothelioma.

Dr. Steven Albelda
iMig 2012

No need for explantion here. Dr. Cameron’s succinct appraisal speaks for itself. Good news! I remember years ago when I was a director on MARF feeling proud to help sponsor Dr. Abelda’s futuristic benchwork research. Smart guy. Good guy. Glad Dr. A is on the team.

David Sugarbaker: "Can't we all just get along and operate on mesothelioma?"

Funny question, coming from the Pope of the EPP himself who for years dominate the conversation, owned the paradigm, and didn't give much heed to his few naysayers. Let’s face it, we love a title fight between heavyweights, so I couldn’t resist asking Dr. C for his reaction to the EPP’s loudest and most cocksure advocate sudden plea for tolerance. Is Dr. S presuming that surgery, no matter what form it takes, must be bedrock of every treatment regimen for meso?

Dr. Cameron: Despite the continued lack of randomized prospective trials showing exactly what, if any, benefit that surgery offers, Sugarbaker must be feeling the heat of all the mounting data that EPP is not necessary.  In my view, he’s now trying to deflect that argument and avoid controversy by calling on all surgeons regardless of which operation you perform to tell medical oncologists and pulmonologists that surgery forms the cornerstone of treatment.

*   *   *   *   *  

IMIG 2012: David Sugarbaker admits that "EPP has no superiority" as an operation over pleurectomy and decortication

Dawgies! Is this one of those “Yes, the earth revolves around the sun” belated acknowledgements? So, Dr. C, why is this such a big deal (picture me feeding the tiger a little red meat).

Dr. Cameron:  “You're kidding right? Most of the posters at this meeting were people trying to do EPPs because they are all under the impression that the "data" shows that it is better.  [Which unfortunately means that for too many ‘get her done’ surgeons with yank-the-lung-it is the earth continues to be the center of the universe….].

*   *   *   *   *  

IMIG today: Sugarbaker admitted that he is now doing 2/3 pleurectomies for mesothelioma....a huge change from a few years ago

This is a radical reversal. We asked Dr. C if he knew whether the Titan of Tri-modal had ever publically debunked or disparaged PD for meso?

Dr. Cameron: “I’m not sure he’s ever disparaged the P/D for meso directly but he has said that the only curative operation for the disease was the EPP. “

*   *   *   *   *  

Pac Meso Center’s Presentation: "The timing of chemotherapy in the multimodality treatment of malignant pleural mesothelioma" received praise from IMIG.

Congratulations!  To read the abstract of this presentation (by Dr. Cameron), please click here.

Note, it was great to learn that the other surgeon who helped form MARF back in the day (1999), Dr. Harvey Pass, one of the most talented, gifted and intelligent doctors on the planet, complemented the presentation and agreed that chemotherapy may not be such a crucial part of "trimodality" therapy (patient ALWAYS want to avoid chemo; losing their hair, nausea, vomiting, etc.) Thank you Dr. Harvey Pass, one of my heroes in the topsy-turvy turbulent Mesoworld.

Our Presentation: Percutaneous outpatient cryoablation for localized recurrent pleural mesothelioma was likely the highlight of IMIG meeting

This is great news. My law firm is particularly proud of this since cryoablation has been used successfully on several of my meso clients (including Martha Munoz, Patricia Crawford and Sylvia Ramirez) who were relieved and impressed with it’s ease, efficiency and results.

The Pacific Meso Center is currently writing two papers that will be published soon. Consequently, since journals won’t publish anything that’s already been publically circulated, the PMC cannot a this time post it’s powerpoint slides on the internet. Dr. Cameron did however reveal, happily, if not surprisingly, that Dr. Sugarbaker mentioned cryoablation specifically as one of the highlights of info being presented. High praise from the High Priest of Meso! And well should the Big Guy be impressed – preliminary data show that the practice for recurrent patients was effective in 95% of the cases.

*   *   *   *   *  

David Sugarbaker TOTALLY BACKS OFF his beloved EPP to "MCR" Macroscopic Complete Resection, which is code for pleurectomy and decortication

We asked Dr. C to flesh out what this means for the typical meso patient. The backstory of course is that Dr. C has always pointed out that total eradication of all tumor is a pipe dream and they only reasonable goal was the removal of all “visible” tumor? (Note to patients – make sure your surgeon is wearing telescopic lens gear).

Dr. Cameron:  Yes, that’s been my common sense approach, but the EPP crowd never embraced this until now. This basically recognizes that what I have said for decades is actually now widely accepted and people like even Dr. Jablons who abandoned P/D for EPP were bowing to peer pressure not acting on data.”

Well, dear readers, hope you enjoyed the ride. It’s been fun. Please drop us a line if you want to learn more. In the meantime, praise hope!

RGW

Sept. 18, 2012

Roger G. Worthington

California Measure Imposing Reasonable Limits on Length of Plaintiff Depositions Moves Closer to Becoming Law!

The Worthington Law Firm has long advocated for reasonable limitations on the length of time that asbestos companies can question asbestos cancer patients. At this time, there is no state-wide rule that limits the amount of time that asbestos company lawyers can question asbestos cancer patients in the context of a pre-trial discovery depositions.

This “anything goes” policy has led to wide-spread abuse. Asbestos company lawyers have typically prolonged depositions well over 20 to 30 hours, over the course of 10 to 15 days – even when the patient’s doctor has warned of the deleterious impact of such interrogation.

Finally, on August 29, 2012, at the urging of plaintiffs attorneys, California lawmakers passed a bill that would impose state-wide limits on the length of plaintiff depositions.  The general rule would limit defense questioning of a plaintiff to seven hours of total testimony. In asbestos illness cases where a physician attests that the plaintiff’s illness raises substantial medical doubt of survival beyond six months, defense questioning would be limited to two days of no more than seven hours of testimony each day, or 14 hours of total testimony.

The Worthington Firm, along with other plaintiffs attorneys, had pushed for a limit of seven hours across the board, or at least for all asbestos cancer cases, similar to the rule that applies in Federal Court and many states such as Texas. While this was rejected by the legislature, we would nevertheless consider this new law just, fair and humane measure to curb abusive and deleterious deposition practices.

Under existing law, asbestos company lawyers are entitled to assume that depositions are limitless. If the new law is passed, 14 hours will be the presumed limit in most cases, with the ability to seek even shorter limits on a case-by-case basis with a doctor’s declaration.

The bill now moves on to Governor Jerry Brown who has not taken a position on the matter. It is hoped that Governor Brown will realize how the absence of California law on this subject has permitted defense attorneys to needlessly and cruelly capitalize on the physical frailties of injured plaintiffs.

We strongly urge Governor Brown to sign the bill into law. 

Governor Brown can be reached online at http://govnews.ca.gov/gov39mail/mail.php, and his mailing address is c/o State Capitol, Suite 1173, Sacramento, CA 95814. We encourage you to drop a note to Gov. Brown urging him to support a bill that will curb deposition abuse.

Roger G. Worthington, P.C. – Longtime Supporter Of The Pacific Meso Center – Donates $100,000 For Mesothelioma Research

I am pleased to continue my support of the the "Punch" Worthington Laboratory (PWR Lab) at the David Geffen School of Medicine in honor of my father, David "Punch" Worthington, Ph.D. with a contribution of $100,000.

The PWR Lab is the home of exciting new research on novel strategies for the treatment of mesothelioma and other occupational cancers.

In 2005, I was proud to help launch this vital research effort in honor of Punch who was diagnosed with asbestosis and lung cancer. Punch obtained a Ph.D. in Genetics but left a promising career in academia to pursue his true love: labor union organizing and advocacy. His memory lives on through the efforts of Dr. Robert Cameron and his staff.  Thank you Dr. Cameron!

RGW

July 31, 2012

Pacific Meso Center 5K Walk and BBQ - October 14, 2012

In December of 2011, The Pacific Meso Center recently announced the opening of its new state-of-the-art mesothelioma research laboratory.  The lab was dedicated solely to discover new treatments for malignant pleural mesothelioma.  The research laboratory will provide laboratory-to-the-bedside research with a goal to improve mesothelioma victims’ lives and longevity.

On Sunday, October 14th 2012, the PMC is holding their inaugural 5K walk and barbeque to raise awareness about mesothelioma and to pay tribute to those who have fought the disease or are still fighting. All proceeds benefit the PMC’s laboratory at UCLA and PMC’s laboratory on Santa Monica Boulevard.  Click here for more information.

Join us as we, together with the Pacific Meso Center, walk-the-walk and talk-the-talk in finding new and better ways of treating malignant pleural mesothelioma.

Sunday, October 14th 2012

Paramount Ranch

2903 CORNELL RD, Agoura Hills, California 91301

Registration opens 10:00 a.m.

Walk commences 11 a.m. – 12:00 p.m.

BBQ in the old Western Town 12:00 p.m. – 1:30 p.m.

Feel free to contact Clare Cameron at 310-478-4678 or email her at ccameron@phlbi.org

Tour Des Chutes Raises $125,000 for Cancer Survivorship

TdC emcee Roger Worthington
interviewing Karsten Hagen,
a 43 year old prostate
cancer survivor.  One year after
his prostatectomy, Mr. Hagen
feels great and has
even improved his performance
in the time trial.

On a brilliant day with alternating sunny blue skies and rumbling thunderstorms, the 8th annual Tour Des Chutes sent a strong message that, when it comes to surviving cancer, you are not alone.

Over 1,400 riders, from 16 states and ranging from age 2 to 93, pinned their numbers on and rode from 8 to 100 miles for somebody they know who has cancer or died from it. It was a picture perfect day, with the majestic snow capped Cascade Mountain Range as the soaring backdrop.  The riders rode with a purpose: as in life, there were moments of reverence, a time to put the head down and grind away, and those special moments when the exuberance could barely be contained.

The TdC has come a long way in a short time. The Pacific Meso Center is proud to be a yellow jersey sponsor for the fourth year in a row. Last year, the TdC raised over $100,000, a record many thought would be tough to break. But this year, thanks to the generous support of sponsors like the PMC, the TdC exceeded expectations by raising over $125,000. 

Since the TdC is an all volunteer effort, the lion share of that net revenue goes directly to a cancer survivorship at the St. Charles Medical Center in Bend, Oregon. St. Charles provides cancer treatment as well as a bevy of useful support programs for both patients and their loved ones.  A few of the these programs include a monthly DEFEAT cancer dinner, a Young Adult Survivor Network (age 18-40), the Soaring Spirits Camp (a fun retreat for children at nearby Suttle Lake), Nurse Navigators, Cancer and the Arts, and the Support Sisters and Brothers network, a mentorship program that matches one year survivor "veterans" with newly diagnosed patients.

Every finisher was greeted by a
 throng of supporters who
jubiliantly clanged their cowbells.
Cancer survivors got a special
treat - a beautiful yellow
rose. Over 100 of the
1400 participants were
cancer survivors.

On a day filled with joy, laughter, music, food and good old fashioned exercise induced salty sweat, there was unfortunately one dark cloud. The man who hatched the idea at his kitchen table with a few friends in 2004, Gary Bonacker, himself a brain tumor survivor, was forced to sit this years' event out. Gary was struck by a seizure a few days earlier and hospitalized.  Dozens of friends wore a picture of Gary on their jersey to show their love and support for this incredibly strong, resilient and inspiring pillar of the community.  We wish him (another) speedy recovery.

The organizers have reason to feel optimistic. The trend is upward and to the right. Ridership is up. The volunteer army is swelling. The organization gets crisper every year. The food and beverages are always top notch, as are the musicians who provide the upbeat entertainment. Several titans from the medical and pharmaceutical worlds have taken notice of this up and coming fundraiser in Central Oregon.  Next year, we hope we can report not only more riders, but also more sponsorship money.  None of it would be possible without the leadership of Gary and his devoted crew of directors and volunteers.  

Thanks to everybody who helped make the 8th Annual Tour Des Chutes the best one ever.

Cheers!

  

RGW

7/15/2012

A Tribute to a Meso Patient Champion: Pastor Thurl Charles Van Kirk

Pastor Thurl Charles Van Kirk

Although the odds were always stacked against him, Pastor Thurl Charles Van Kirk defied the survival statistics for mesothelioma. He fought a courageous battle for four and a half years before passing away on May 25, 2012. In 2008, he was diagnosed with biphasic mesothelioma, an aggressive form of mesothelioma which is typically considered to be inoperable. Under the direction of UCLA surgical oncologist Dr. Robert Cameron, Pastor Van Kirk underwent an experimental chemotherapy regimen. Although the side effects were grueling at times, the chemotherapy proved to be effective in eradicating the inoperable constituents of the tumors. Pastor Van Kirk was then able to undergo a lung-sparing pleurectomy /decortication surgery with Dr. Robert Cameron in September 2008.

Through the years, Pastor Van Kirk enjoyed a remarkable period of no tumor recurrence. But like many cancer patients, his experiences were not without their share of uncertainties and concerns. He beat the odds statistically and attributed his success to the innovative treatment approaches of Dr. Cameron and the UCLA Comprehensive Mesothelioma Program.

According to Pastor Van Kirk, "There are all kinds of miracles. Mine happened to be the kind that comes from great science, lucky timing, and the best mesothelioma doctors on the West Coast."

Much loved by his community and parishioners, Pastor Van Kirk served as senior pastor of the Rim of the World Community Church from 1985 until he retired in 2010. He and his wife Diane raised their three daughters in the mountain community of Running Springs. Pastor Van Kirk was interred with military honors at the Riverside National Cemetery. The service was unsurprisingly well-attended by Pastor Van Kirk’s family, friends and community, a testament to a man who lived his life and led his congregation by example and the positive influence he had on others. The words shared by those in attendance conveyed the profound love and respect for Pastor Van Kirk and the chasm he leaves behind in their hearts.



Riding with Pastor Chuck in his beautiful Shelby GT

I was blessed to have had the privilege of representing Pastor Van Kirk and getting to know what an extraordinary person he was. I will always remember his infectious laugh and thoughtful and generous nature. He proved to be a tremendous source of information and inspiration for countless newly-diagnosed patients who were struggling to cope with their illness

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A couple years ago, Pastor Van Kirk shared the following with me:

Yes, attitude is everything.  At times my hardest struggle is just to get up in the morning.  Deep, throbbing pain in my side demands attention.  So I pop some pain meds and lay back down pondering what heaven will be like when we receive new bodies that never break down, get sick, wrestle with illness or suffer! 

Pastor Chuck, while I share with so many others in the sadness of your loss, it brings a smile to my face to know that you will be enjoying an eternity of skiing, hiking, woodworking and hot-rodding in your Shelby convertible in your new body!

John Caron

June 11, 2012

UCLA Mesothelioma Care Employs Lung-sparing Surgery and Unique Treatment Approach

UCLA’s Mesothelioma treatment program focuses on research and experience and has pioneered the use of therapies, such as immunotherapy and cryoablation which have led to significant advances in care. At UCLA, basic science and clinical research have suggested some unique approaches that are helping to make inroads in the management of mesothelioma.

“UCLA has developed a program to treat these unusual tumors — including the very rare sarcomatoid type — that centers on lung-sparing surgery and treating the disease as a chronic illness, focusing on treatments that improve our patients’ quality of life,” explains Robert B. Cameron, M.D., FACS, professor and director of UCLA’s Comprehensive Mesothelioma Program.

About 15 percent of mesothelioma cases are of the sarcomatoid type, which tends to be both invasive and metastatic. As a rule, surgeons will not operate on these patients as the cancer is difficult to remove and the  patients have not typically fared well with any treatments.  Click here to learn more.

2nd Annual Symposium on Lung Sparing Therapies for Malignant Pleural Mesothelioma Brings Together an International Panel of Medical Specialists, Patients and Caregivers

Dr. Robert Cameron

The Pacific Meso Center, in conjunction with The Office of Continuing Medical Education of the David Geffen School of Medicine at UCLA, held the 2nd International Symposium on Lung-Sparing Therapies for Malignant Pleural Mesothelioma on May 14, 2012 in Santa Monica, California. The Worthington Law Firm was proud to once again be a platinum sponsor of this unique medical seminar focusing on rational treatment options for patients with pleural mesothelioma (MPM) 

Dr. Robert Cameron, Director of the UCLA Comprehensive Mesothelioma Program and Chief of Thoracic Surgery at the West Los Angeles Veterans’ Administration, served as the course organizer and chair. Dr. Cameron has over 19 years of experience treating patients with MPM. He has been an ardent supporter of lung-sparing therapies, including the pleurectomy/decortication surgical procedure, and a number of complementary adjuvant therapies with the goal of treating the deadly disease like a chronic illness, similar to hypertension and diabetes.

“Seeing The Light” About Lung-Sparing Pleurectomy/Decortication

This year’s speakers included Dr. Raja Flores, Chief of Thoracic Surgery at Mt. Sinai Medical Center in New York. Dr. Flores explained that, based on the training he received at Brigham and Women’s Hospital/Dana Farber Cancer Institute in Boston where Dr. David Sugarbaker serves as Chief of Thoracic Surgery, he was “biased” toward extrapleural pneumonectomy (EPP). The EPP is a radical surgery which involves removal of the pleura-based tumor along with the adjacent lung, diaphragm and portions of the pericardium.

Dr. Flores explained that a few years ago, he learned about what Dr. Robert Cameron had been doing with the pleurectomy/decortication (PD) procedure, a much less radical surgery for MPM in which the pleura-based tumor is carefully removed and the healthy lung is spared. A closer look and appreciation for Dr. Cameron’s approach prompted Dr. Flores to review all available data comparing EPP to PD. 

Dr. Robert Cameron
and Dr. Raja Flores

While Dr. Flores was not surprised to learn that surgical mortality rates for the less radical PD were lower, he was surprised to learn survival rates for PD were marginally better than EPP. Furthermore, the survival rates for PD were as good if not better than EPP for patients with Stage I, Stage II, Stage III and Stage IV tumors.

After reviewing this data, Dr. Flores said he had “kept an open mind” about PD. He performed a number of PD’s and found that he was usually able to achieve the same level of tumor resection, even when tumor was present in the fissures and around the aorta.

Dr. Flores jested that he “loves” doing EPP, which is a much faster procedure, and “hates” doing PD, which is a much more meticulous and lengthy procedure. But he stated that he now favors PD because he believes that in most instances it will provide the patient with a better quality of life. Harder for the doctor, but better outcomes for the patient!

Dr. Flores was joined by Dr. Cameron for a Q&A session where it was revealed that these two mesothelioma specialists had never spoken until a few days before the symposium. The two of them acknowledged that the only randomized trial involving EPP, the 2011 MARS trial from the U.K. which found no advantage to EPP over alternative lung-sparing therapies, has been shot down by many in the U.S. including Dr. David Sugarbaker. Dr. Flores acknowledged that for many surgeons, ego comes into play and they are compelled to do the biggest and most aggressive operation.

Dr. Flores stated that, in his mind, “there must be a difference in survival by a number of years in order to justify doing a big surgery like EPP.” Because the statistics do not reveal any increased survival over PD irrespective of staging, Dr. Flores now approaches every MPM surgery with the intention of doing a PD.

Other Lung-Sparing Therapies

Symposium attendees were also treated to presentations concerning important developments in other lung-sparing therapies and diagnostic techniques for MPM.

Dr. Anne S. Tsao, Director of the Mesothelioma Program at MD Anderson Cancer Center in Houston, Texas discussed recent developments in the identification of molecular or biological markers to determine what treatments are best for a particular MPM patient.

Dr. Michael Fishbein, Chief of Pathology at the David Geffen School of Medicine at UCLA, spoke about the challenges of diagnosing MPM and the use of immunohistochemical staining.

Dr. Nir Hoffman, Director of Thoracic Anesthesiology at the David Geffen School of Medicine at UCLA, discussed the specialized anesthesiology techniques that must be used during a PD. Dr. Hoffman noted that the level of specialized skill required from the entire surgical team, not just the surgeon, emphasizes the need to have a PD done at a treatment center that has established expertise with the procedure. This is a critical factor as it often takes 2 or 3 times longer to perform a PD and an EPP, which means in many cases the anesthesiologists will need to work in shifts.

Dr. Courtney Broaddus, Chief of Pulmonary and Critical Care Medicine at the University of California at San Francisco spoke about recent developments in the use of molecular agents to “prime” tumor cells in order to enhance the effectiveness of systemic treatments for MPM.

Dr. Robert Cameron also spoke about future therapies involving the genetic altering of stromal cells, which are the non-cancerous cells within a cancerous tumor. He is investigating whether altered stromal cells inserted following removal of the tumor during a PD could create an environment which makes it more difficult for tumor cells to grow, thereby reducing the incidence of tumor recurrence. Dr. Cameron plans to continue this research at the Pacific Meso Center.

Dr. Warren Grundfest, Professor of Bioengineering, Electrical Engineering and Surgery at UCLA, spoke about his exciting research into a system to identify and eradicate tumor cells which remain following removal of the tumor during a PD. The system would use fluorescent lifetime imaging to identify tumor cells that remain once the tumor has been removed and then treat these cells intraoperatively via liquid nitrogen cryoablation. The goal would again be to reduce the incidence of tumor recurrence following surgery. Dr. Grundfest plans to continue this research at the Pacific Meso Center.

Dr. James Moore, Professor of Anesthesiology at the David Geffen School of Medicine at UCLA, spoke about long term pain management options for MPM.

Nurse Anne Rorie from the Comprehensive Mesothelioma Program at the David Geffen School of Medicine at UCLA spoke about the initial evaluation and treatment of pleural effusions, which often precede a diagnosis of MPM.

Non-Medical Presentations

Symposium attendees were also treated to a number of non-medical presentations that were of great interest to those involved in the treatment of, or whose lives have been affected by, MPM.

Dr. James WaterNaude, a Public Health Medicine Specialist from South Africa, gave an informative and disturbing presentation about this history of asbestos mining in South Africa and the resulting incidence of MPM and other asbestos-related illness in the country.

Linda Reinstein, President of the Asbestos Disease Awareness Organization, gave a timely presentation on global trends and challenges in preventing environmental and occupational asbestos exposures. Many in attendance were surprised to learn that asbestos use had still not been banned in the U.S. Ms. Reinstein has long been a leader in the effort to ban asbestos in the U.S. and abroad.

Clare Cameron, Executive Director of the Pacific Meso Center, gave an informative and optimistic presentation on the Pacific Meso Center’s ambitious research agenda and the ways in which patients and families can support this much needed research.

The Patient’s Perspective—Patricia Crawford

The symposium concluded with an uplifting presentation from 5-year mesothelioma survivor, and Worthington Law Firm client, Patricia Crawford. Pat is a shining example of Dr. Cameron’s approach to using a combination of lung-sparing therapies to treat MPM as a chronic illness.

Pat underwent a PD performed by Dr. Cameron at UCLA in January 2008, followed shortly by 5 weeks of radiation treatments. Since then, Pat has been closely monitored by Dr. Cameron and has received over 25 cryoablation treatments performed by Dr. Fereidoun Abtin, a Thoracic Radiology doctor with the UCLA Comprehensive Mesothelioma Program, to knock down early signs of tumor recurrence.

Pat credited Dr. Cameron and his team with saving her life and allowing her to be present for the births of five great-grandchildren and the weddings of four of her grandchildren. She also shared many priceless family moments that she has experienced over the last five years. Pat vowed to keep on fighting, promising that “as long as Dr. Cameron and Dr. Abtin stick by me, I’ll keep giving it all I have!”

The Premier Conference on Rational Treatment Options for MPM

In its second year, the Pacific Meso Center’s Symposium on Lung-Sparing Therapies has quickly established itself as the premier conference on current and future rational treatments for MPM. The conference serves as an unrivaled source of information on lung-sparing therapies for physicians and doctors alike.

The Pacific Meso Center plans to release videos of the symposium presentations on its website www.pacificmesocenter.org in the coming weeks.