Insurance Discrimination Against Victims of Abuse

The Medical Information Bureau (MIB) is
a data bank of medical and nonmedical
information on nearly 15 million Americans,
collected from the MIB’s 800 insurance
company members.
The companies send the MIB information
you have written on applications, enrollment
forms, and requests for upgrading coverage
for health, life or disability insurance. The MIB
also records information from medical exams,
blood and lab tests, and hospital reports,
when such information is legally obtainable.

Kinds of Annuities

There are several ways to categorize
annuities, and any one annuity may fit into
several categories.
Immediate Annuities
With an immediate annuity, you pay a single
premium and immediately start receiving
payments at the end of each payment period,
which is usually monthly or annually.
Deferred Annuities
With a deferred annuity, you pay one or
more premiums over what is often called the
accumulation period. The premiums you pay
and the interest credited to the premiums goes
into a fund called an accumulation fund. There
may be a minimum guaranteed interest rate at
which your money will accumulate during the
accumulation period.
The annuity payments you will receive begin at
a future point in time called the maturity date.
You will receive payments during a time period
called the payout period or annuitization phase.
You do not pay income taxes on the interest
earned during the accumulation period unless
you draw on its cash value. These taxes are
deferred until the payout period.
Fixed Annuities
A fixed annuity provides fixed-dollar income
payments backed by the guarantees in the
contract. You cannot lose your investment
once your income payments begin. The
amount of those payments will not change.
With fixed annuities, the company bears the
investment risk.
Equity Indexed Annuities
These are a form of annuity, either immediate
or deferred, that earns interest or provides
benefits that are linked to an external equity
index, such as Standard and Poor’s 500
Composite Stock Price Index. When you
purchase an equity-indexed annuity, you own
an insurance contract—not shares of any stock
or index.

Traditional Life Insurance

You have a choice of two traditional types of
life insurance: Term or Whole Life.
Term Insurance
A “term policy” involves coverage purchased
for a specific time period and pays a death
benefit only if the policyholder dies during
the time for which the policy is written and
premiums are paid.
A term policy:
Provides more life i XX nsurance coverage for
your premium dollar in the early years.
XX Pays benefits only if the insured dies
during the coverage period.
XX Does not usually accumulate cash value.
XX Is suitable for large amounts of coverage
for specific periods (i.e., one, five, 10 or 20
years, etc.) or to age 60 or 65.
Useful for:
XX Parents of young children
XX People with large financial obligations and
home buyers
With term insurance, coverage ends after
the specified term in your policy is reached,
unless it includes a provision allowing you to
renew your policy without providing evidence
of insurability, such as passing a physical
exam. However, your premiums will increase
as you age.
A term insurance policy may be convertible.
This means you can exchange the policy for
a whole life policy without providing evidence
of good health. Although the premium for the
whole life policy will be higher initially, it will
remain the same for the rest of your life.
Whole Life
Whole life insurance, a “whole life policy,” or
“permanent insurance” involves coverage
effective for the entire life of the policyholder.
A whole life policy pays a death benefit when
the policyholder dies, regardless of his or
her age.
Key Characteristics:
XX Provides a fixed amount of life insurance
coverage and a fixed premium amount.
XX Benefits are payable upon the death of the
insured or on the maturity date—often the
policyholder’s 100th birthday.
XX Coverage can increase only with the
purchase of an additional policy, or, if
available, through additional riders
or dividends.
XX Policy coverage is provided for life.
XX Premiums are paid at a fixed rate
throughout your lifetime, if the policy
remains active.
Life

Life Insurance

A life insurance policy allows you to set aside money now to provide a measure of
financial security for your family upon your death. It can help your family meet the
financial needs previously covered by your income.
If you decide to buy a life insurance policy, you should decide how much
protection you need and can afford, and what kind of insurance policy to buy.
The main purpose of a life insurance policy is to provide survivor benefits
for beneficiaries.

Home health care policy

This type of policy covers services
prescribed by a physician and from a
Medicare-certified or state-licensed home
health care service. The care must help with
activities of daily living or the supervision
or protection of a patient with cognitive
impairment (such as Alzheimer’s disease
or senility). Some policies offering nursing
home coverage automatically offer home
health care as well. Some companies offer
home health care as an option or rider to
a long-term care policy. A few companies
offer policies covering only home health
care. You may obtain more information
about policy options from your agent.
Nursing home care policy
This limited-benefit insurance policy offers
an alternative for some people and covers
either one level or several levels of care.
In Florida, the levels of care include
custodial, intermediate and skilled (defined
in the Glossary). Cognitive impairment or
the inability to perform one or more of
the activities of daily living will activate
the benefit.

Long-term care insurance

Long-term care encompasses a wide range
of medical, personal and social services.
A person may need this care if they suffer
from prolonged illnesses, disabilities or
cognitive impairment. Private insurance
companies offer individual or group
long-term care insurance policies that
provide benefits for a variety of services
not covered by your regular health
insurance, or by Medicare or Medicare
supplement insurance.

Limited benefit insurance

These policies cover certain expenses
from specifically named illnesses, injuries
or circumstances. For example, cancer
policies pay benefits for the actual
treatment of cancer. Some also pay benefits
for conditions or diseases caused or
aggravated by cancer or its treatment.

Accident insurance

These policies cover death, disability,
hospital and medical care resulting from
an accident. A common variation called
“accidental death insurance” can pay
additional benefits for death due to motor
vehicle or at-home accidents.

Hospital confinement indemnity insurance

These policies pay a fixed amount or
indemnity for each day, week or month you
stay in a hospital. Such policies pay a flat
amount for benefits.
Disability income insurance
These policies pay a weekly or monthly
income for a specific period if you suffer
a disability and cannot continue or obtain
work. The disability may involve sickness,
injury or a combination of the two. Most
disability insurance plans coordinate
with Social Security benefits and workers’
compensation to eliminate duplication
of coverage.
You may select a disability policy that
includes an elimination period, or length
of time that you must wait after a covered
illness begins, before receiving benefits.
The longer the elimination period, the lower
your premium. Premiums may also vary
depending upon your occupation (and the
risks involved) and your age. For example, a
high-rise construction worker would likely
pay higher premiums than a florist.
When buying a disability policy, you should
find out the company’s definition of a
disability and the requirements that must
be met. Individual and group disability
income policies must provide coverage for
a policyholder or eligible dependent who
becomes disabled.

Supplemental Health Insurance

These policies provide coverage beyond,
or in addition to, what your basic policy
provides. You should use these policies as
supplements, rather than substitutes, for
basic medical insurance. Some policies
include elimination periods, which means
companies will pay benefits only after you
stay in the hospital for a specified number
of days.

TYPES OF MAJOR MEDICAL COVERAGE

Group Plans
Fulfilling your insurance needs may prove
relatively simple if your employer offers
a group plan or a choice of plans. Group
plans cover several people or groups under
one policy. You will receive a certificate
that acts as your policy when you obtain
insurance through a group plan. Most
group policies are suitable for the average
person and may include provisions to cover
family members.
Businesses with one to 50 employees have
access to guaranteed-issue group plans,
often referred to as small group health
coverage. Guaranteed-issue coverage for
a one-life group (a self-employed individual
with no eligible employees) is only available
during the month of August each year, with
the policy being effective on October 1.
These plans are available to small-business
employers regardless of the health claims
experience of an employee group or the
health status of an employee. Insurance
companies and HMOs that offer small group
coverage must offer employers the option
of purchasing a basic or standard plan.
Most insurers or HMOs offer other healthbenefit
plans in addition to the basic and
standard plans.

Mesothelioma Diagnosis

A variety of techniques and technologies may be used to diagnose malignant mesothelioma. The aggressive nature of the disease demands an early diagnosis to maximize treatment options, but its unique behavior pattern and relative rarity among the general population often works against such early identification. In its earliest stages, mesothelioma typically presents in non-specific ways and is often misdiagnosed because of this non-specific presentation. The majority of patients only receive a diagnosis after the disease has progressed to Stage III or Stage IV. Because of this tragic situation, improvements in our ability to definitively determine a diagnosis are among the most important goals in contemporary mesothelioma research and a large number of studies are actively investigating novel diagnostic techniques.

The following pages provide an overview of the most common methods used to diagnose pleural mesothelioma or peritoneal mesothelioma. We begin by describing the initial evaluation of symptoms indicative of the disease and then we move into detailed discussions of the various procedures involved in its identification.

Initial Evaluation of Mesothelioma Symptoms

Pleural mesothelioma is the most common form of the disease, so an initial evaluation of symptoms will likely be due to pulmonary-related issues. Due to mesothelioma’s relative rarity in the general public, it’s important for a physician to learn about any prior asbestos exposures that the patient is aware of so he or she can complete as full a medical history and workup as possible. This type of communication between the patient and doctor is important so that the earliest possible detection of mesothelioma can be made: if the doctor does not suspect malignant mesothelioma initially, he or she may not be able to diagnose the disease early enough to maximize prognosis.

In addition to constructing this medical profile and detailed history, a complete physical examination will be performed. During a physical exam your doctor may look for the following:

• Breathe Sounds: by listening to the chest cavity as the patient inhales and exhales, the doctor may note differences in the sounds of a patient’s breath from normal breath sounds. This could indicate the presence of a pleural effusion, or another restriction of lung capacity.
• Vocal Sounds: The doctor may listen to the chest cavity while having the patient make vowel sounds - comparing the sound resonance in the right and left chest cavities. Muted, or dull, sounds between the cavities could also be an indicative of effusions or another other lung restriction.
• By tapping on the chest area a doctor may notice a dull, solid thumping sound, rather than a hollow resonance. This may also indicate the presence of fluid, or a mass, in the chest cavity.

However, there are often very few signs during an initial physical exam that would identify the presence of mesothelioma. On the basis of patient symptoms, medical history, the presence of specific risk factors—such as work environment and known asbestos exposure—and the results of a complete physical examination, the doctor is likely to schedule one or more of the methods described below to determine if the disease is present.

Imaging Technologies

There are many available technologies that allow doctors to view organs and tissue that might show the presence of fluid or tumors. Imaging technologies are important techniques not only for diagnosing mesothelioma, but for tracking patient response to treatments.

• X-Ray Imaging
  Due to the ubiquity of the machines and their relative low lost, x-rays are usually the first test given for many patients. X-rays do not have enough resolution to identify mesothelioma, but they may indicate the presence of a pleural effusion or hint at the existence of a pleural or lung malignancy.

  Learn more: Mesothelioma Diagnosis: X-Ray Imaging

• Computed Tomography (CT)
  A computed tomography (CT) scan uses x-rays and computers to give more sophisticated and detailed pictures of the insides of our body than conventional x-rays. CT is considered the gold-standard imaging test for mesothelioma diagnosis.

  Learn more: Mesothelioma Diagnosis: Computed Tomography (CT)

• Magnetic Resonance Imaging (MRI)
  Magnetic Resonance Imaging (MRI) uses a strong magnetic field and radiowaves to scan the body. MRI provides much better imaging of soft-tissue contrast than does CT and is often used for staging and surgical planning.

  Learn more: Mesothelioma Diagnosis: Magnetic Resonance Imaging (MRI)

• Positron Emission Tomography (PET)
  Positron Emission Tomography (PET) scans measure functional and metabolic activity in the body, and are most commonly used to identify the presence of distant metastases.

  Learn more: Mesothelioma Diagnosis: Positron Emission Tomography (PET) Scan

• PET-CT (Integrated Positron Emission Tomography – Computed Tomography)
  PET-CT is a cutting-edge imaging technique that combines PET scans and CT scans in one machine. This allows the physician to precisely register the functional imaging of PET with the anatomical imaging of CT to provide a more complete understanding of a patient’s individual disease status.

  Learn more: Mesothelioma Diagnosis: PET-CT (Integrated Positron Emission Tomography – Computed Tomography)

Biopsy Procedures

• Thoracoscopy
  A tissue sample of a pleural or pericardial tumor can be obtained during a thoracoscopy. A thoracoscope, a telescope-like instrument connected to a video camera, is inserted through a small incision into the chest, along with small surgical tools. The doctor can see the tumor through the thoracoscope and can use special tools to take a tissue biopsy.

  Learn more: Mesothelioma Diagnosis: Thoracoscopy

• Laparoscopy
  A laparoscopy can be used to see and obtain a biopsy of a peritoneal tumor. In this procedure, a flexible tube is attached to a video camera that is inserted into the abdominal cavity via small incisions.

  Learn more: Mesothelioma Diagnosis: Laparoscopy

• Bronchoscopy
  A bronchoscopy may be performed if pleural mesothelioma is suspected. In this process, the doctor inserts a flexible lighted tube down the trachea, and into the bronchi to check for masses in the airway. At that time, small samples of abnormal-appearing tissue may also be removed for testing.

  Learn more: Mesothelioma Diagnosis: Bronchoscopy

• Mediastinoscopy
  During a mediastinoscopy, a patient has a lighted tube inserted under the sternum (chest bone) at the neck level and then moved down into the chest. The surgeon can see the lymph nodes and take tissue samples to check for cancer. This procedure can also help the physician determine if you have lung cancer or mesothelioma.

Early Signs of Mesothelioma

bout half of patients diagnosed with mesothelioma have no symptoms. Many patients who do experience symptoms ignore them because they attribute the signs to other ailments, such as colds or flu.

In fact, the early symptoms of mesothelioma are indeed flu-like. They include:

• Cough
• Shortness of breath
• Pain in the chest or in the lower back
• Fever
• Fatigue
• Abdominal pain, weight loss, and nausea and vomiting (symptoms of peritoneal mesothelioma)

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.

Early Detection

Most cases of mesothelioma are diagnosed in Caucasian males between the ages of 50 and 70 who worked in industries known to have used asbestos from the 1940s until the late 1970s. The following groups were likely to be exposed to asbestos in the workplace prior to 1980:

• Shipyard workers
• Employees of asbestos mines and mills
• Employees of companies producing asbestos products, such as insulation
• Workers in the heating and construction industries

If you were employed in one of these categories and you experience the early symptoms of mesothelioma listed above, you should seek the advice of a physician immediately. If you suspect that you have been exposed to asbestos, you may want to be examined by a doctor even if you do not have symptoms.

Early Screening

Your doctor will begin with a thorough physical exam and a discussion of your medical history, including any known exposure to asbestos. If your doctor suspects that you have mesothelioma, he or she will initially perform the following tests:

• X-rays of the chest or abdomen
• CT (computed tomography) scans
• MRI (magnetic resonance imaging)

These tests will be done on the chest or abdomen, depending on the symptoms you are experiencing. Performing these initial screenings will determine if more invasive procedures are required to treat your condition.

Risk Factors

The major risk factor for mesothelioma is exposure to asbestos. In cases of mesothelioma, 70 to 80 percent of people diagnosed had an identifiable exposure to asbestos. Exposure to certain types of radiation as well as to a chemical related to asbestos known as zeolite has also been related to incidences of mesothelioma.

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.

When to Worry

If you have a history of asbestos exposure and are experiencing the early symptoms of mesothelioma, it is important that you consult a physician. If you have a history of asbestos exposure and no symptoms, it may still be advisable to discuss your medical history with your doctor. As a general rule, you should always discuss any health concerns that you may have with a doctor, preferably one who is familiar with your medical history.

What to Do Next

If you are diagnosed with mesothelioma, first know that you are not alone. There are 2,000 to 3,000 new cases of mesothelioma diagnosed every year. Second, explore this website and learn as much as you can about the disease, its treatment and prognosis. Be sure to talk to your doctor about any questions you may have, now and as your treatment progresses. The more knowledge you have, the more empowered you will feel. Knowledge will also help you take better care of yourself and improve your chances of beating this disease.

Mesothelioma Prognosis

The overall prognosis for individuals with mesothelioma is not very good. The disease has among the lowest five year survivability rates among different cancers and remains extraordinarily difficult to treat. While research is ongoing and our knowledge of the disease is definitely increasing faster than it ever has, doctors know an actual cure is still years away. However, large variabilities exist in many mesothelioma patients and there are people who have lived full lives after their diagnoses.

Mesothelioma Prognosis: Statistics

When mesothelioma is examined in purely statistical terms, the prognosis figures are discouraging. Pleural mesothelioma typically presents in an advanced stage of progression with a ten-to-fourteen month lifespan expectation from diagnosis. Peritoneal mesothelioma often presents with a slightly more optimistic lifespan expectation and patients surviving two to five years are not uncommon. However, after five years, statistics show survivability dropping to well below thirty percent.

Statistics, however, do not tell the whole story. There are a variety of factors in the development of a patient’s mesothelioma prognosis and subtle differences among these factors can have a dramatic impact on the course the disease will take. The statistical models used in mesothelioma often miss the extraordinary differences between a person’s stated prognosis/diagnosis and the way in which the disease actually impacts his or her life. While rare, it is not unknown for an individual to live for ten or sometimes even twenty years after a diagnosis of mesothelioma.

Mesothelioma Prognosis: Biology of the Disease

The most important disease-specific prognostic factors for patients with mesothelioma involve the form of mesothelioma as presented and the histological subtype of the presented disease. Of the two major forms of mesothelioma, pleural mesothelioma generally presents with a worse prognosis than peritoneal mesothelioma does. The physiological reasons for this difference are not completely understood, but a major factor is the histological aspect of the cancer. Pleural mesothelioma presents about fifty percent of the time with an epitheloid histologic subtype, twenty percent of the time with sarcomatoid subtype and the remaining thirty percent is the biphasic subtype, which is a combination of the previous two subtypes. Peritoneal mesothelioma presents in the vast majority of diagnoses with the epitheloid subtype. This is significant because epitheloid mesothelioma responds more favorably to treatment than sarcomatoid mesothelioma or biphasic mesothelioma does. Thus, with the majority of peritoneal cases featuring the most treatable histological subtype, one would expect for it to have a better overall prognosis. Conversely, with only half of pleural cases involving the most treatable subtype, one would also expect a generally worse prognosis.

Mesothelioma Prognosis: Patient Status

Along with the biological aspects of mesothelioma as presented, another set of important prognostic factors includes the stage of the disease at diagnosis, the health of the patient and his or her age. All three will have a major impact on life expectancy and the future course of the disease.

Stage of the Disease

The stage of disease at diagnosis is a crucial factor in the development of the patient’s prognosis. As with all forms of cancer, early detection is important, but this is especially true of mesothelioma. Because mesothelioma generally resists curative treatment, doctors can manage the disease more efficiently if they have caught it in its early stages. The diffuse nature of the disorder means advanced tumor progression will invade large areas of tissue, making treatment even more difficult. Mesothelioma presents with symptoms shared by a number of other diseases and often goes undiagnosed because of these similarities. An early diagnosis is absolutely crucial if one hopes to control the disease.

Performance Status

Another important prognostic factor is the overall health of the person, with the patient’s age an important sub-factor in this determination. Generally, the healthier a patient presents, the better he or she will respond to cancer treatments and the better chances he or she has of longer survival. When grading a patient’s health, doctors develop a figure known as a patient’s “performance status.” There are a number of competing scales used to gauge this, but the scale sponsored by the World Health Organization goes from 0 to 5, with 1 and 4 being the general limits of description.

Performance Status Measurements

Number	Description
0	Asymptomatic
1	Symptomatic but completely ambulant
2	Symptomatic, <50%>
3	Symptomatic, >50% in bed, but not bedbound
4	Bedbound
5	Death

Performance status is revisited at multiple times during the course of treatment. It is initially developed after diagnosis and is then updated in response to the patient’s reaction to the treatment regimen he or she is a part of.

Mesothelioma Prognosis: Exceptions to the Statistics

As we said above, the statistical prognosis of mesothelioma is generally not in the patient’s favor. Seen only as a set of numbers, many people are understandably disheartened when they learn about their diagnosis. However, notable exceptions to these statistics do exist. Among the most famous of these exceptions was Dr. Stephen J. Gould of Harvard University. Dr. Gould was an internationally respected paleontologist and evolutionary biologist who conducted important research in both of these fields. Dr. Gould was diagnosed with peritoneal mesothelioma in 1982. After an initial period of depression, motivated by all of the negative statistics he read regarding his diagnosis, he became determined to not let the statistics regarding life expectancy rob him of all hope. When he died in 2002, it was from another form of cancer, totally unrelated to his mesothelioma. Dr. Gould has written about his experience with peritoneal mesothelioma and his determination to not let simple statistics dictate his reaction to his diagnosis in the essay, “The Median Isn’t the Message.” We recommend Dr. Gould’s essay for everyone who has been diagnosed with this disease, or with any other form of cancer.

Dr. Gould’s experience certainly may not be standard, but his hopeful approach to his disease cannot be discounted.

Mesothelioma Prognosis: Conclusion

As you can see, there are a number of factors that can impact the determination of a mesothelioma prognosis. The biologic facts of the disease as presented and the individual characteristics of the patient are all important co-factors and have serious implications for overall prognosis. Along with these factors, improving treatment regimens are another major element in one’s prognosis. There is still no cure for mesothelioma, but the treatments are improving, as is our knowledge of the actual mechanisms of the disease itself. Doctors are hopeful that we can translate our growing knowledge of the disease into more effective treatments and, therefore, better prognoses for patients.

Mesothelioma Cure

Mesothelioma is a serious and rare cancer that occurs in individuals exposed to asbestos. Mesothelioma victims have either inhaled or swallowed asbestos fibers which then travel through the lung and become lodged in the pleura, the thin, saran wrap-type membrane lining the lungs. Mesothelioma can also develop in the abdominal (peritoneal) area of the body.

Mesothelioma is a rare disease in the general population, with between two thousand and three thousand new diagnoses every year. However, it is not rare among the workers in certain trades or industries and their families. Malignant mesothelioma affects men more often than women with the average age at diagnosis being 60 years. Symptoms of mesothelioma may not appear for 30-50 years after exposure to asbestos.

Mesothelioma is a highly aggressive cancer, resistant to many current cancer treatments. Because mesothelioma is a rare cancer as well, the medical community has had difficulty comparing the value of the different treatments. A problem with treating mesothelioma is that the tumor spreads along surfaces, nerves and blood vessels. This makes it hard for treatment to rid the patient of all of the disease. Patients are often referred to specialists who work with them and their doctors to determine the best treatment.

There is no known cure for mesothelioma. However, with an early diagnosis and appropriate care, the patient may get some relief from their symptoms. Palliative treatment is available through surgery, radiation and chemotherapy. Since diagnosis of mesothelioma is often made once the disease is too advanced for surgery, a combination of chemotherapy and radiation are often used to improve survival time.

The average survival time varies from 4 - 18 months. Each case is unique, and the length of survival depends on:

• The diagnosed stage of the tumor.
• The age and general health of the victim.
• whether surgery is an option.

Participation in a clinical trial may offer more treatment options.

Asbestos Removal from Homes and Businesses

Asbestos is universally recognized as a health hazard and is highly regulated. The substance is a carcinogen that causes lung cancer and mesothelioma. Asbestos was widely used until the 1970s in hundreds of building products because of its tensile strength, as well as its chemical and thermal resistance. Thus, it can be found in thousands of U.S. homes and commercial buildings.

An estimated 1.3 million employees in the construction trade and other industries face significant asbestos exposure on the job. The worst exposures occur in the construction industry, especially when asbestos is removed or disturbed during a building renovation or demolition. Employees also face exposure to asbestos during the manufacture of asbestos products including textiles, insulation and other building materials, and during automotive brake and clutch repair work, where asbestos products are commonly used.

Asbestos is extremely hazardous to workers who handle it and to others who happen to be in the area when it gets into the air and is inhaled into the lungs. Because of this hazard, laws have been enacted to prevent asbestos exposures. Many states have imposed asbestos notice and removal requirements:

• Building owners may be required to have their buildings inspected for asbestos before construction, renovation and demolition activities.
• Construction contractors - Before bidding or starting any construction work, contractors may have to obtain a written asbestos report from the building owner or owner's agent.
• Homeowners are often exempt from these requirements but may be required to provide asbestos information to contractors and others that work in their homes.

Asbestos Removal
Because of the dangers posed from handling asbestos, if you discover asbestos in your home or business, you should never attempt to remove it on your own. Companies across the U.S. specialize in the removal of this hazardous substance. The link below contains a state-by-state directory of asbestos removal companies.

Asbestosis

Asbestosis is a noncancerous illness caused by asbestos exposure. The disease occurs when the fibers get lodged in the victim’s lungs, the body tries to protect itself against the fibers which results in the development of scar tissue. In turn, the scar tissue diminishes the lung’s capacity for oxygen. Asbestosis is a progressive disease, and as the lungs’ capacity decreases, victims suffer shortness of breath, coughing, fatigue, chest pain, weight-loss and heart problems. Asbestosis victims may be symptom free and the disease is detected by x-rays.

Asbestosis is a chronic inflammation of the parenchymal tissues of the lungs. The condition occurs after long term exposure to asbestos, usually from working in a mine or other workplaces where asbestos is found. Those who suffer from this condition often have severe shortness of breath, and have a higher risk of developing lung cancer.

The inflammation is due to an immune response in the body, which becomes chronic, and leads to the deposit of fibrous tissues around the asbestos fibers. These fibrous masses eventually start to show symptoms, resulting in shortness of breath and, in rare cases, respiratory failure.

There is currently is no cure for asbestosis, however, the symptoms of the disease can be managed. Treatments for the disease involve preventing further complications of the disease and treating its symptoms. Bronchodilators that open up the bronchial tubes and allow passage of air are used to ease shortness of breath. The patient may also receive supplemental oxygen. Respiratory treatments that remove secretions from the lungs may also be used. Coughing is treated with humidifiers, breathing therapies and chest percussion to loosen and thin bronchial.

Products Containing Asbestos

There are six types of asbestos — three of which have been used commercially:

• white asbestos(chrysotile)
• blue asbestos(crocidolite)
• brown asbestos(amosite)

Over 90% of all asbestos ever used was the white asbestos.

The following is a general list provided by the Environmental Protection Agency intended to show the types of materials containing asbestos. It does not include all products containing asbestos.

• Cement Pipes
• Cement Wallboard
• Cement Siding
• Asphalt Floor Tile
• Vinyl Floor Tile
• Vinyl Sheet Flooring
• Flooring Backing
• Construction Mastics (tile, carpet, ceiling tile,etc.)
• Acoustical Plaster
• Decorative Plaster
• Textured Paints/Coatings
• Ceiling Tiles and Lay-in Panels
• Spray-Applied Insulation
• Blown-in Insulation
• Fireproofing Materials
• Taping Compounds (thermal)
• Packing Materials (for wall/floor penetrations)
• High Temperature Gaskets
• Laboratory Hoods/Table Tops
• Wallboard
• Fire Blankets
• Fire Curtains
• Spackling Compounds

• Elevator Equipment Panels
• Elevator Brake Shoes
• HVAC Duct Insulation
• Boiler Insulation
• Breaching Insulation
• Ductwork Flexible Fabric Connections
• Cooling Towers
• Heating and Electrical Ducts
• Pipe Insulation (corrugated air-cell, block, etc.)
• Heating and Electrical Ducts
• Electrical Panel Partitions
• Electrical Cloth
• Electric Wiring Insulation
• Chalkboards
• Roofing Shingles
• Roofing Felt
• Base Flashing
• Thermal Paper Products
• Fire Doors
• Caulking/Putties
• Adhesives
• Laboratory Gloves
• Joint Compounds
• Vinyl Wall Coverings

A wide array of workers were exposed to asbestos including shipyard workers, factory workers, pipefitters, sheet metal workers, plumbers, laborers, machinists, mechanics, powerhouse workers, and electricians. One cloud of dust from asbestos products can contain millions or billions of fibers, and even a small amount of asbestos can cause lung damage.

The dangers of asbestos were known to many of the companies that made these products as early as the 1920s. However, asbestos was sold and used without warnings up until the 1980s — when most asbestos products were banned in the United States and other countries.

A wide array of workers were exposed to asbestos including shipyard workers, factory workers, pipefitters, sheet metal workers, plumbers, laborers, machinists, mechanics, powerhouse workers, and electricians. One cloud of dust from asbestos products can contain millions or billions of fibers, and even a small amount of asbestos can cause lung damage.

Click here to view a more complete list of trades that were at risk for exposure.

Government And State Asbestos, Mesothelioma, And Cancer Research Funding Or Legislation

Overview: Mesothelioma is a serious cancer that occurs in individuals exposed to airborne asbestos fibers. Even small amounts of asbestos and infrequent exposure can create a risk for contracting mesothelioma or other asbestos-related diseases. Mesothelioma is highly aggressive and is resistant to many cancer treatments. Currently there is no known cure for the disease.

Research and clinical trials are being conducted in the hopes that doctors and pharmaceutical companies can find ways to improve a patient's health and cancer care. Research requires significant funding, and support from government agencies. Often additional legislation is required to maintain progress.

Asbestos focus groups continue to work with the government to target asbestos-laden sites for cleanup and removal of asbestos, lead-based paints, and other harmful chemicals, while focusing on educating the public on the hazards of asbestos. The year 2009 has seen activity among federal agencies and state governments, with renewed attention to medical research as well as asbestos education and cleanup.

Federal

The National Cancer Institute (NCI) has been allocated approximately $1.3 billion for projects funded under the American Recovery and Reinvestment Act (ARRA) of 2009. A total of $59 billion from ARRA has been allocated for health care.

NCI will provide grant opportunities for enhancing and augmenting research through administrative and competitive supplements. The NIH has identified "Challenge Areas" that itemize knowledge gaps, scientific opportunities or research methods that would benefit from an influx of funds.

One such area is in genomics. The grants will be provided for "studies that examine the physician utilization and/or patient acceptability of new cellular, molecular and genomics technologies in clinical and public health settings and the potential impact of these technologies on cancer outcomes such as incidence, progression, mortality, survival, and quality of life."

Senators Edward Kennedy (D-MA) and Kay Bailey Hutchison (R-TX) introduced the 21st Century Cancer Access to Life-Saving Early Detection, Research and Treatment (ALERT) Act at the end of March.

ALERT establishes a National Cancer Program that will focus on an "expanded, intensified, and coordinated cancer research program." The bill also allows for an increased focus on the prevention of cancer caused by occupational or environmental exposure to carcinogens.

By a unanimous vote on March 5, 2009, resolution S.RES.57, which declared the first week of April as "National Asbestos Awareness Week," passed in the Senate.

Linda Reinstein, Executive Director and Co-Founder of the Asbestos Disease Awareness Organization (ADAO), the leading organization for support of asbestos victims, said ADAO "will continue to work with Congress to educate Americans until we finally ban the deadly fibers once and for all."

STATE

Washington : Washington state will allocate approximately $4 million from the American Recovery and Reinvestment Act (ARRA) to the Tacoma Housing Authority for the renovation and removal of asbestos in seven public housing units. In addition, the project will redevelop another 140 units. The project is expected to employ over 150 people and will aid in the training for additional asbestos abatement professionals.

Texas : In April, the Texas Senate passed the mesothelioma Senate Bill 1123. The bill will allow those people that have been exposed to asbestos to more easily seek damages. The bill stipulates that the claimants must be diagnosed with mesothelioma, and must produce technical evidence regarding the level of asbestos exposure. The bill lowers standard of proof that asbestos injury attorneys must meet to establish that their clients developed cancer due to asbestos.

Asbestos Frequently Asked Questions

Why Was Asbestos Used in Building And Insulation Products?

The primary reason that asbestos was used in building products was as a binder or filler material. It was cheap and easily available. It is stringy and resilient, and thus made a good binder. Its resilience also reduced the breakage of the products between the factory and the worksite. In pipe covering and other materials, asbestos created air pockets which provided heat resistance.

Asbestos was marketed for its fire-resistant qualities. In reality, at approximately 1200 degrees, asbestos transforms into an inert mineral. Other materials were available, even in the 1930s and thereafter, that could have been used (and, in fact, were used) as substitutes for asbestos without any sacrifice in product integrity or heat resistance. The asbestos industry peddled asbestos as a “magic mineral,” creating a demand for the material, without advising of the dangers of exposure. As a result, thousands of American workers were injured and killed. It was unnecessary and could have been avoided.

If you have been diagnosed with Mesothelioma, you should explore your legal options. You have a right to compensation from those companies that knowingly placed you and your family at risk.

What is Asbestos?

Asbestos is a mineral that was crushed and milled into a fine particulate, and then shipped to corporations for use in building and insulation materials. Asbestos mines around the world, many in Canada, produced over 250 million tons of asbestos for use in the United States between 1890 and 1970. Of the six types of asbestos, three have been used commercially: white (chrysotile), blue (crocidolite) and brown (amosite) asbestos. Over 90% of all asbestos ever used was the white asbestos. Asbestos was added to a variety of products including insulation, automotive brakes, fireproofing, pipe covering, cements, refractory materials, gaskets, floor tiles and joint compounds.

“A common form of magnesium silicate which was used in various construction products... Asbestos exposure (caused by inhaling loose asbestos fibers) is associated with various forms of lung disease [including mesothelioma]... its extremely fine fibers are easily inhaled, and exposure to them over a period of years has been linked to cancers of the lung or lung-cavity lining and to asbestosis, a severe lung impairment.”

—National Association of Certified Home Inspectors

During the installation, repair, maintenance, renovation or removal of asbestos materials, these products were cut, scraped, sanded and otherwise altered, creating dust which was then breathed in by the laborers working with and around these materials. Some materials, such as cements, were mixed at job sites using raw asbestos fibers so the respirated fibers were in a pure form. Dust from these products also traveled throughout the buildings, factories and ships where they were being used, so asbestos fibers remained airborne for weeks. Even after the fibers settled, the clean-up process on the sites, where refuse and other matter was swept up, would re-suspend the dust and fibers in the air—where they were again breathed-in by workers in the area.

Exposure to asbestos is the direct cause of multiple diseases — with mesothelioma perhaps the most tragic. Tens of thousands of individuals, especially working men and woman, have died from Mesothelioma in just the last couple of decades and there are 2000 – 3000 new diagnoses every year.

The dangers of asbestos were known to many of the companies that made these products as early as the 1920s. However, asbestos was sold and used without warnings up until the 1980s — when most asbestos products were banned in the United States and other countries. Alternative materials were available during the entire period of awareness that could have been used in place of asbestos.

A wide array of workers were exposed to asbestos including shipyard workers, factory workers, pipefitters, sheet metal workers, plumbers, laborers, machinists, mechanics, powerhouse workers, and electricians. One cloud of dust from asbestos products can contain millions or billions of fibers, and even a small amount of asbestos can cause lung damage.

Often, individuals won’t recall how they were exposed to asbestos, and many mistakenly believe that they were not exposed to asbestos at all. A careful examination and review of a person’s work and life history often reveals exposures to asbestos products that may not be readily apparent.

Asbestos is so toxic that mesothelioma has been diagnosed in family members whose only exposure came from contact with the fibers that adhered to the clothes of the worker/tradesperson who actually worked with asbestos products.

Understanding Your Prescriptions

There is currently no cure for mesothelioma, so most treatments are designed to slow the progress of the cancer or alleviate the discomfort associated with the disease. Treatments aimed solely at increasing patient comfort are termed palliative care and are an important aspect of mesothelioma medications.

One of the most important aspects of your treatment for mesothelioma is communicating with your physician. It is very important that you are able to talk to your doctor and ask any questions you may have about your condition or treatment. Many doctors encourage patients to bring a list with them of any questions that arise between appointments. It is imperative to your treatment that you keep all appointments with your doctor, as well as any appointments for labs or treatments. Your doctor will want to monitor your progress as well as any side effects from your medications very carefully.

You should thoroughly discuss your medical history with any doctor who is prescribing medications for you, especially if it is the first time you have seen this particular physician. You should make a list before your appointment of all your prescription medications, over-the-counter medications and supplements (both herbal and nutritional) and give it to your doctor. Many medications interact with each other and this may worsen your condition or adversely affect the effectiveness of your medications.

After discussing your condition with you, your doctor may recommend some of the following medications:

Pemetrexed is a chemotherapy drug that slows the growth and spread of cancer cells. The use of pemetrexed has been used successfully to decrease pain and extend the lifespan of mesothelioma patients. It is most commonly administered by injection at a doctor’s office, clinic or hospital.

Cisplatin is a platinum-containing compound that slows or stops the growth of cancer cells. It is most commonly administered intravenously by an experienced healthcare professional. Cisplatin has been shown to be very effective in the treatment of mesothelioma, especially in conjunction with pemetrexed, but the patient must be monitored carefully for side effects as overuse of this drug can be fatal.

Endostatin is an Angiogenic Inhibitor that slows the growth of cancer cells by depriving them of an adequate blood supply. Because mesothelioma cells rely on a large number of blood vessels to grow, researchers believe that Endostatin will be an effective treatment for mesothelioma and other fast-growing cancers.

Gemcitabine is an antimetabolite, which prevents the production of certain proteins that tumors require for growth. It is used most commonly to treat pancreatic cancer and lung cancer (including mesothelioma). Gemcitabine is administered intravenously in a doctor’s office or hospital.

Epirubicin is an antineoplastic which works by interfering with the growth of cancer cells by allowing the body to kill them. It is usually given as an injection by a healthcare provider at a doctor’s office, hospital or clinic.

Intrapleural Interferon Gamma is injected directly into the lung cavity which has shown to be effective in early stages of diffuse malignant mesothelioma. The action of this drug is not completely understood, so consult your doctor for information on the following common side effects: diarrhea, fatigue, flu-like symptoms, headache, joint pain, muscle pain, nausea and discomfort at the injection site.

Doxorubicin is an antineoplastic medication that slows the growth and spread of cancer cells. Doxorubicin should only be administered by qualified healthcare providers in an office, hospital or clinic.

There are additional drugs being developed and tested for the purpose of cancer treatment. Your oncologist should be a good resource for more information on these experimental medications.

living with mesothelioma

“The Median Isn’t The Message,” by Stephen J. Gould

Dr. Stephen J. Gould was an internationally-renowned paleontologist and evolutionary biologist who lived a healthy and productive twenty years after he was diagnosed with peritoneal mesothelioma in 1982. When Dr. Gould died in 2002, he died from an entirely unrelated form of cancer. In 1985 he wrote the following essay about his diagnosis and experience with the disease.

It is a wonderful essay about his determination to not let simple statistics determine his response to mesothelioma. Many cancer patients, not just those diagnosed with mesothelioma, have been inspired by Dr. Gould’s life and words.

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“The Median Isn't The Message”

My life has recently intersected, in a most personal way, two of Mark Twain’s famous quips. One I shall defer to the end of this essay. The other (sometimes attributed to Disraeli), identifies three species of mendacity, each worse than the one before—lies, damned lies, and statistics.

Consider the standard example of stretching the truth with numbers - a case quite relevant to my story. Statistics recognizes different measures of an “average” or central tendency. The mean is our usual concept of an overall average - add up the items and divide them by the number of sharers (100 candy bars collected for five kids next Halloween will yield 20 for each in a just world). The median, a different measure of central tendency, is the half-way point. If I line up five kids by height, the median child is shorter than two and taller than the other two (who might have trouble getting their mean share of the candy). A politician in power might say with pride, “The mean income of our citizens is $15,000 per year.” The leader of the opposition might retort, “But half our citizens make less than $10,000 per year.” Both are right, but neither cites a statistic with impassive objectivity. The first invokes a mean, the second a median. (Means are higher than medians in such cases because one millionaire may outweigh hundreds of poor people in setting a mean; but he can balance only one mendicant in calculating a median).

The larger issue that creates a common distrust or contempt for statistics is more troubling. Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more “real” and the only proper basis for action—if it feels good, do it—while intellect gets short shrift as a hang-up of outmoded elitism. Statistics, in this absurd dichotomy, often become the symbol of the enemy. As Hilaire Belloc wrote, “Statistics are the triumph of the quantitative method, and the quantitative method is the victory of sterility and death.”

This is a personal story of statistics, properly interpreted, as profoundly nurturant and life-giving. It declares holy war on the downgrading of intellect by telling a small story about the utility of dry, academic knowledge about science. Heart and head are focal points of one body, one personality.

In July 1982, I learned that I was suffering from abdominal mesothelioma, a rare and serious cancer usually associated with exposure to asbestos. When I revived after surgery, I asked my first question of my doctor and chemotherapist: “What is the best technical literature about mesothelioma?” She replied, with a touch of diplomacy (the only departure she has ever made from direct frankness), that the medical literature contained nothing really worth reading.

Of course, trying to keep an intellectual away from literature works about as well as recommending chastity to Homo sapiens, the sexiest primate of all. As soon as I could walk, I made a beeline for Harvard’s Countway medical library and punched mesothelioma into the computer’s bibliographic search program. An hour later, surrounded by the latest literature on abdominal mesothelioma, I realized with a gulp why my doctor had offered that humane advice. The literature couldn’t have been more brutally clear: mesothelioma is incurable, with a median mortality of only eight months after discovery. I sat stunned for about fifteen minutes, then smiled and said to myself: so that’s why they didn't give me anything to read. Then my mind started to work again, thank goodness.

If a little learning could ever be a dangerous thing, I had encountered a classic example. Attitude clearly matters in fighting cancer. We don’t know why (from my old-style materialistic perspective, I suspect that mental states feed back upon the immune system). But match people with the same cancer for age, class, health, socioeconomic status, and, in general, those with positive attitudes, with a strong will and purpose for living, with commitment to struggle, with an active response to aiding their own treatment and not just a passive acceptance of anything doctors say, tend to live longer. A few months later I asked Sir Peter Medawar, my personal scientific guru and a Nobelist in immunology, what the best prescription for success against cancer might be. “A sanguine personality,” he replied. Fortunately (since one can’t reconstruct oneself at short notice and for a definite purpose), I am, if anything, even-tempered and confident in just this manner.

Hence the dilemma for humane doctors: since attitude matters so critically, should such a sombre conclusion be advertised, especially since few people have sufficient understanding of statistics to evaluate what the statements really mean? From years of experience with the small-scale evolution of Bahamian land snails treated quantitatively, I have developed this technical knowledge - and I am convinced that it played a major role in saving my life. Knowledge is indeed power, in Bacon’s proverb.

The problem may be briefly stated: What does “median mortality of eight months” signify in our vernacular? I suspect that most people, without training in statistics, would read such a statement as “I will probably be dead in eight months”—the very conclusion that must be avoided, since it isn’t so, and since attitude matters so much.

I was not, of course, overjoyed, but I didn’t read the statement in this vernacular way either. My technical training enjoined a different perspective on “eight months median mortality.” The point is a subtle one, but profound—for it embodies the distinctive way of thinking in my own field of evolutionary biology and natural history.

We still carry the historical baggage of a Platonic heritage that seeks sharp essences and definite boundaries. (Thus we hope to find an unambiguous “beginning of life” or “definition of death,” although nature often comes to us as irreducible continua.) This Platonic heritage, with its emphasis in clear distinctions and separated immutable entities, leads us to view statistical measures of central tendency wrongly, indeed opposite to the appropriate interpretation in our actual world of variation, shadings, and continua. In short, we view means and medians as the hard “realities,” and the variation that permits their calculation as a set of transient and imperfect measurements of this hidden essence. If the median is the reality and variation around the median just a device for its calculation, the “I will probably be dead in eight months”may pass as a reasonable interpretation.

But all evolutionary biologists know that variation itself is nature’s only irreducible essence. Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and medians are the abstractions. Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because I know that variation itself is the reality. I had to place myself amidst the variation.

When I learned about the eight-month median, my first intellectual reaction was: fine, half the people will live longer; now what are my chances of being in that half. I read for a furious and nervous hour and concluded, with relief: damned good. I possessed every one of the characteristics conferring a probability of longer life: I was young; my disease had been recognized in a relatively early stage; I would receive the nation’s best medical treatment; I had the world to live for; I knew how to read the data properly and not despair.

Another technical point then added even more solace. I immediately recognized that the distribution of variation about the eight-month median would almost surely be what statisticians call “right skewed.” (In a symmetrical distribution, the profile of variation to the left of the central tendency is a mirror image of variation to the right. In skewed distributions, variation to one side of the central tendency is more stretched out - left skewed if extended to the left, right skewed if stretched out to the right.) The distribution of variation had to be right skewed, I reasoned. After all, the left of the distribution contains an irrevocable lower boundary of zero (since mesothelioma can only be identified at death or before). Thus, there isn’t much room for the distribution’s lower (or left) half—it must be scrunched up between zero and eight months. But the upper (or right) half can extend out for years and years, even if nobody ultimately survives. The distribution must be right skewed, and I needed to know how long the extended tail ran - for I had already concluded that my favorable profile made me a good candidate for that part of the curve.

The distribution was indeed, strongly right skewed, with a long tail (however small) that extended for several years above the eight month median. I saw no reason why I shouldn’t be in that small tail, and I breathed a very long sigh of relief. My technical knowledge had helped. I had read the graph correctly. I had asked the right question and found the answers. I had obtained, in all probability, the most precious of all possible gifts in the circumstances - substantial time. I didn’t have to stop and immediately follow Isaiah’s injunction to Hezekiah—set thine house in order for thou shalt die, and not live. I would have time to think, to plan, and to fight.

One final point about statistical distributions. They apply only to a prescribed set of circumstances - in this case to survival with mesothelioma under conventional modes of treatment. If circumstances change, the distribution may alter. I was placed on an experimental protocol of treatment and, if fortune holds, will be in the first cohort of a new distribution with high median and a right tail extending to death by natural causes at advanced old age.

It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die—and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy—and I find nothing reproachable in those who rage mightily against the dying of the light.

The swords of battle are numerous, and none more effective than humor. My death was announced at a meeting of my colleagues in Scotland, and I almost experienced the delicious pleasure of reading my obituary penned by one of my best friends (the so-and-so got suspicious and checked; he too is a statistician, and didn’t expect to find me so far out on the right tail). Still, the incident provided my first good laugh after the diagnosis. Just think, I almost got to repeat Mark Twain’s most famous line of all: the reports of my death are greatly exaggerated.

Cancer Nutrition

New Tuna Salad

By replacing the pasta in tuna salad with beans, you eliminate cooking time and make a healthier version of an old favorite.

Preparation time: 15 minutes.

Serves five as a main dish.

Ingredients:
• One 15-ounce can of garbanzo beans (chickpeas), drained and rinsed well
• One 15-ounce can of great northern or navy beans, drained and rinsed well
• Two 6-ounce cans of chunk light tuna, drained and chopped
• 2 large tomatoes, seeded and coarsely chopped
• 1 cup pitted black olives, coarsely chopped
• ½ medium red onion, finely chopped
• 1 tablespoon extra-virgin olive oil
• Juice of one lemon
• Fresh black pepper, to taste.

Instructions:
1• Drain and thoroughly rinse chickpeas and beans.
• Drain tuna.
• Place chickpeas and beans into a large bowl with tuna, chopped tomatoes, chopped olives, finely chopped red onion, olive oil, and lemon juice.
• Stir to combine.
• Add fresh ground black pepper, to taste.
• Serve and enjoy!

Healthy eating habits are vital for mesothelioma patients. However, many cancer treatments have side effects that can weaken the appetite, causing weight loss, fatigue and an overall decline in health. Good nutrition can help maximize energy, stave off infection and provide the strength patients need – when they need it the most.

Many people don’t know that nutritional guidelines for someone fighting cancer are very different from those recommended for a healthy person. Insufficient calories and protein are often problems, so the focus should be on eating enough food to maintain energy. Patients who are struggling to eat should consult with a doctor or nutritionist – but the following general suggestions may be helpful:

• Find one or two things you can tolerate and stick with those foods until you can handle additional items
• Incorporate liquid meal supplements
• Drink at least six to eight cups of liquid each day
• Avoid foods that may irritate side effects caused by your treatment – for example, lowering fiber if chemotherapy-related diarrhea is an issue, or eliminating acidic fruits or vegetables if radiation aggravates your throat

mesothelioma support & help

Studies have shown that cancer patients who actively discuss their health issues, life concerns, and emotions show both mental and physical improvement. While the medical professionals are focused on your treatments, you need to ensure that you, and your family, are receiving the support you need. Family and friends are an invaluable support structure for mesothelioma patients, but participating in cancer support groups can connect patients and can help individuals learn from shared experiences.

Finding the right support resources is not only important for the patient but also for the mesothelioma caregiver. Financial concerns, changing family roles, and anxiety can place additional strain on family members.

There are therapists who are experienced in helping families cope with serious illnesses and grief management. Including a trained counselor as a part of your support structure can help provide you with options at a time when it might seem there aren't many options.

Support groups can provide a confidential environment where patients and caregivers can get emotional support, and practical advice on everyday questions such as the management of treatment side effects.

These support groups provide counseling, education and communication for victims of life-threatening diseases.

Association of Cancer Online Resources (ACOR)
The Association of Cancer Online Resources (ACOR) manages a mailing list for mesothelioma patients.

Link: http://www.acor.org/support.html

Lung Cancer Alliance
The Lung Cancer Alliance is the only national non-profit organization dedicated solely to patient support and advocacy for people living with lung cancer or those at risk for the disease.

Link: http://www.alcase.org/facing/support.html

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American Institute for Cancer Research (AICR)
The American Institute for Cancer Research (AICR) Cancer Resource provides information to cancer patients and their families.

Link: http://www.aicr.org/site/PageServer?pagename=cs_resources

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Cancer Care Counseling
Cancer Care Counseling provides free professional counseling for individuals or professionally facilitated support groups.

Link: http://www.cancercare.org/get_help/counseling.php

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AMC Cancer Center - Cancer Information and Counseling Line (CICL)
The AMC Cancer Research Center and University of Colorado Cancer Center have operated a toll-free Cancer Information and Counseling Line (CICL) for over 25 years, staffed by masters-trained and licensed counselors. To speak with a counselor through CICL,
call 1-800-525-3777 (Monday-Friday 8:30-5:00 MST).

Link: http://www.amc.org/now-education.html

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Hospice Education Institute
The Hospice Education Institute offers Hospicelink, which maintains a computerized database and up-to-date directory of all hospice and palliative care programs in the United States. A free telephone number (800-331-1620) offers referrals to hospice and palliative care programs, and provides general information about the principles and practices of good hospice and palliative care.

Our Website also contains general information on Hospice Care as well as a Directory of State Hospice Associations.

Link: http://www.hospiceworld.org/

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The Wellness Community
The Wellness Community is an international non-profit organization dedicated to providing free support, education and hope to people with cancer and their loved ones.

Link: http://www.thewellnesscommunity.org/

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Medical News Today
The latest Asbestos and Mesothelioma News articles published daily by Medical News Today.

Link: http://www.medicalnewstoday.com/sections/asbestos/

Information for Patients & Families

Exposure to asbestos, even in very small quantities, can cause mesothelioma or asbestosis. The most common form of mesothelioma is pleural mesothelioma, which accounts for seventy to eighty percent of all mesothelioma diagnoses. While a rare disorder in the general population, mesothelioma is not rare among individuals exposed to asbestos. There are two to three thousand new diagnoses of mesothelioma every year.

Most mesothelioma victims were exposed to asbestos in the workplace and were never aware of its dangers (Occupational Hazards - Shipbuilding and Asbestos). Unlike many other predominantly pulmonary-related cancers, cigarette smoking has no known causative affect on mesothelioma incidence.

One of the most difficult aspects of mesothelioma to come to terms with is its long latency period, which is the period of time between first exposure to asbestos and the diagnosis of the disease. Mesothelioma typically develops 10 to 70 years after the initial exposure.

Mesothelioma Doctor Explains Symptoms, Diagnosis & Treatment

Mesothelioma Information

As with any disease or health condition, mesothelioma researchers have, over time, collected statistical information about mesothelioma. These statistics can help us learn about the proclivities of the disease and its incidence and potentially help future patients as we learn more about mesothelioma.

Incidence of Diagnosis

New cases of mesothelioma are diagnosed in between 2,500 and 3,000 Americans each year. These numbers, while significant, would indicate that mesothelioma is still a relatively rare disease, though incidence is expected to rise in the next decade according to projections.

Age at Diagnosis

The first diagnosis of mesothelioma typically occurs in men and women between the ages of 50 and 70 years. Mesothelioma patients, certainly, have been diagnosed at ages younger than 50 and older than 70, but diagnoses for those age groups are considered statistical anomalies.

Does Mesothelioma Occur in a Particular Sex or Racial Demographic More than Another?

Mesothelioma is much more common in men than women, due mostly to occupational asbestos exposure being more common among men of industrial labor sites. That is not to say, however, that women cannot be diagnosed with mesothelioma. In fact, recent evidence suggests that mesothelioma incidence in women may rise in the coming years as secondary exposures to asbestos can manifest in the form of a positive mesothelioma diagnosis. Also of note is that mesothelioma is much less common among African Americans than white Americans, the reasons for which researchers are still investigating.

What are Typical Patient Survival Rates Following a Mesothelioma Diagnosis?

As mesothelioma is often diagnosed in its advanced stages, the prognosis is sometimes poor with life expectancy being little more than a year following diagnosis. If diagnosed early enough however, patient prognoses increase dramatica

Publish Post

lly. Patient survival rates are often contingent on the treatments available to the particular patient. Early-stage tumors eligible for surgical resection, for instance, will result in improved prognoses over those diagnosed with later-stage disease. As new therapies and treatments are researched and employed in the future, it is realistic to anticipate an improvement in patient survival rates.

Veterans and Mesothelioma Cancer

Among all those individuals in the United States stricken with mesothelioma cancer, veterans represent the group of people with the highest rate of the disease. The reason why is simple. Asbestos, the only known cause of mesothelioma, was used by the U.S. military for literally hundreds of applications. From the 1930s until the late 1970s, veterans - especially those who worked aboard ships or in shipyards - were regularly exposed to hazardous asbestos, a naturally-mined substance whose sharp fibers can be inhaled and can penetrate the lungs, causing scarring and, eventually, tumors.

The branch of the service one served in does not matter. Asbestos was present in many locations owned or frequented by members of the U.S. Armed Forces. Because exposure was unavoidable for some, mesothelioma remains one of the most serious diseases affecting veterans, particularly those who served between World War II and the Vietnam Conflict.

Navy

U.S. Naval veterans are the most seriously affected by asbestos of any group of military men and women. This is because these were most often the individuals who worked both aboard ships and in shipyards. Ships were strewn with asbestos. The mineral could be found in many parts of each ship, from the galley to the gun rooms. Because of its excellent heat-resistant properties it was used in insulation, to cover pipes, as an adhesive, in floor and ceiling tiles, in gaskets and valves, and wrapped around boilers - just to name a few of its many uses. Members of the U.S. Navy were exposed daily and it was not unusual for them to breathe in airborne fibers, which would later result in a diagnosis of mesothelioma.

Army

Even though members of the U.S. Army didn't generally serve aboard ships, they were still exposed to a variety of asbestos-containing materials. Asbestos was inexpensive and readily available, so the government used it in many of the buildings that lined the Army bases in this country and oversees, mainly as insulation. As buildings aged, the material became damaged or crumbly, resulting in airborne dust and the inhalation of tiny, sharp particles of asbestos. As a matter of fact, anyone living or working in an old or ill-repaired base facility - even today - may be susceptible to developing the disease.

Marines

Traditionally, the U.S. Navy and the Marines have enjoyed a close relationship, working side by side, especially in times of war. For that reason, many Marines served on U.S. naval ships, incurring many of the same dangers face by Navy veterans. Asbestos exposure in the tight quarters of ships caused some U.S. Marines to develop mesothelioma, an asbestos-caused cancer. As with members of the Army, Marines may have also encountered asbestos in buildings in their camps or bases.

Air Force

Members of the U.S. Air Force may have encountered asbestos-containing parts in airplane engines, brakes, and other pieces of equipment that were insulated with the mineral to make them more fire and heat resistant. Anyone who serviced or repaired these planes or machinery may have inhaled asbestos dust on a regular basis. In addition, the mineral was used in housing for members of the United States Air Force and their families, largely because it was cheap and easy to come by.

Diagnosis

How do medical professionals diagnose mesothelioma?

If you believe that you may have mesothelioma, a qualified medical professional will use a variety of diagnostic tests and methods to confirm the presence of the disease.

Medical history review and exam

The first step that your health professional will take in evaluating you for an asbestos related disease is to obtain a full medical history to determine the level and severity of risk factors and presenting symptoms. This interview will look consider among other things, where you were exposed to asbestos, the length of exposure and the amount of asbestos that you were exposed to.

In addition, he/she will perform a medical exam to look for signs and symptoms of various forms of mesothelioma. For example, if pleural mesothelioma is suspected the doctor will look for fluid in the chest, peritoneal mesothelioma often shows fluid in the abdomen and pericardial mesothelioma presents with fluid in the area of the heart.

Diagnostic imaging tests

Chest x-rays are used to identify abnormalities in the lungs including unusual thickening, mineral deposits and fluid in the chest area. If these conditions are present then it may be evidence that mesothelioma has developed.

Diagnostic image tests like x-rays, CT scans and MRI's are useful in determining more information about the cancer including how far it is progressed. Each method provides another piece of information to your doctor to assist in making an accurate diagnosis. CT scans are capable of providing images of the same location from many different angles. MRI technology uses magnetic fields rather than x-ray to provide additional views.

Testing fluid and tissue samples

If fluid build-up in the chest, abdomen or heart area is present, your doctor may want to obtain a sample. To accomplish this he/she will use a long needle to obtain fluid from the target area. The fluid will then be sent to the lab for analysis.

If fluid build-up in the chest, abdomen or heart area is present, your doctor may want to obtain a sample. To accomplish this he/she will use a long needle to obtain fluid from the target area. The fluid will then be sent to the lab for analysis.

A bronchoscopy procedure may be recommended for patients who are suspected of having pleural mesothelioma. For this medical test, a soft tube illuminates the trachea and bronchi to determine if any masses are present in the airways. If deemed necessary, the technician my take sample of tissue that appears to be abnormal for further testing.

If lymph node involvement is suspected which is common with lung cancer, patients may also undergo a mediastinoscopy. This procedure is similar to a bronchoscopy in that a soft tube enters the body under the chest bone and illuminates the chest area. In this way, the surgeon can examine lymph nodes for abnormalities, check to see how far disease may have progressed and when necessary help diagnose lung cancer vs. mesothelioma.

Diagnosing mesothelioma is never easy. Fluid build up alone in the chest, belly or heart regions is not enough to confirm a diagnosis. Tissue samples obtained from biopsy procedures are also difficult to discern because mesothelioma cancer cells often resemble other types of cancer. For this reason, specialized laboratory procedures are often employed to identify certain chemicals that are known to exist with mesothelioma and high powered laboratory equipment is used to examine the smallest details of cancer cells to confirm that mesothelioma is present.

How Mesothelioma Affects Veterans

For decades, the men and women of the Armed Forces of the United States have defended our country, both in times of war and in times of peace. Veterans put their lives on the line each and every day, both on the battlefront and at the many U.S. military bases located around the world.

Some hazards of life in the military are quite obvious. Others are not so apparent. One of the many silent dangers that our veterans faced was the decades-long widespread use of asbestos by the armed forces. Military members were often unaware that this hazard lurked nearby. Asbestos has put many veterans' well being at risk, causing aggressive diseases that affect quality of life and shorten lives as well.

Asbestos was used by the military for many years, with especially extensive use during the years of World War II and the Korean Conflict, when shipbuilding was at its peak. In fact, about 4.3 million Americans worked in shipyards during World War II and because of the daily tasks they performed, many were at risk for developing asbestos-related diseases, including asbestosis and the cancer known as mesothelioma.

Indeed, asbestos could be found literally anywhere aboard a military ship, from the boiler room to the galley to the soldiers' quarters. While the soldiers who lived and worked aboard the ship - including gunmen, boilermen, and firemen - were susceptible to inhaling asbestos, those who built the ships were even more prone to developing the diseases associated with the toxic mineral. That included tradesmen such as pipefitters, plumbers, mechanics, shipfitters, electricians, welders, boilermakers, and many others.

There have even been cases of military base secretaries and others who did not work directly with the ships developing mesothelioma through second-hand exposure to the mineral. That means they may have inhaled asbestos dust from the clothes and hair of others who worked on the base or perhaps because an abundance of asbestos was regularly circulating through the air. Loved ones of shipyard workers have also been known to develop the disease due to the same secondary exposure.

Because mesothelioma can remain dormant for several decades, many veterans who served during the 1950s to the 1970s are just being diagnosed with the disease. These brave men and women were unaware that they would face such a demon in their later years when they should be enjoying retirement and extra time with their family. Mesothelioma is particularly difficult to battle, and though treatments are gradually improving, these veterans face a painful death, generally within a year or two of their diagnosis.

In the meantime, there has been much controversy surrounding the U.S. government and their responsibility to those who have developed mesothelioma and other asbestos diseases during their service to the country. While the Veterans Administration offers some guidance to afflicted personnel, it is clear that more must be done to support the veteran crippled by mesothelioma, including compensation for medical expenses, loss of income, and suffering.

Biphasic Mesothelioma

Biphasic mesothelioma is the second most common cellular form of this disease, accounting for 20 to 40 percent of all known cases. As the name implies, biphasic mesothelioma is a mixture of two types of cancer cells.

Characteristics

Unlike the more common epithelioid type, biphasic mesothelioma cells lack a specific structure. This type of mesothelioma is a mix of epithelioid and sarcomatoid cells. Whereas the former has a clearly visible nucleus and is found in uniform, organized arrangements and tend to be of a single shape, sarcomatoid cells are more oval or oblong shaped and have no easily identifiable nucleus. Although both types are present in a biphasic tumor, they have a tendency to form in differentiated groups; they are not usually found in the same area of the tumor.

Diagnosis and Treatment

Mesothelioma is exceptionally difficult to diagnose, which is why it is usually not discovered until it has reached an advanced stage. It is important to confirm a history of asbestos exposure, as mesothelioma symptoms are similar to a wide range of respiratory illnesses.

The primary physician usually takes an x-ray; if there is cause for concern, the patient is referred to a radiology lab, where more advanced images are taken. If abnormal areas are discovered, a tissue sample, or biopsy is taken to confirm the diagnosis.

A recent test developed by a Japanese biotech company, called MESOMARK™, may help pathologists in diagnosing mesothelioma at an earlier stage, when it is most treatable.

Treatment in most cases is limited to palliative ones, since the disease is usually diagnosed too late for surgery. Mesothelioma is usually treated with some combination of radiation and chemotherapy; surgical techniques may be used to relieve the symptoms, but in the later stages are usually not effective in treating the disease.

Sarcomatoid Mesothelioma

Mesothelioma is a cancer that attacks the lubricative layer lining the inside of the chest and abdomen and the internal organs. Pathologists categorize cases according to levels of criteria, which are as follows:

Location:

• Lungs (pleural)
• Abdomen (peritoneal)
• Heart (pericardial)

Stage:

• Stage I - Cancer cells have started to form
• Stage II - Cancer has spread locally
• Stage III - Cancer has spread to adjoining areas
• Stage IV - Cancer has begun to metastasize

Cellular Structure:

• Epithelial (organized and structured)
• Sarcomatoid (random and irregular)
• Biphasic (a mix of epithelial and sarcomatoid)
• Desoplastic (a variation of the sarcomatoid variety)

Cellular structure is determined by an actual visual examination of the cells under a microscope.

About Sarcomatoid Mesothelioma

Sarcomatoid Mesothelioma accounts for approximately 10 to 15 percent of all diagnoses. The cancer cells in this case are elongated and spindle-shaped, and are arranged in a rather haphazard way. Sarcomatoid cells also lack a nucleus, unlike epithelioid cells, which have clearly visible nuclei.

The desoplastic variety of sarcomatoid mesothelioma is difficult to distinguish from healthy tissue in many cases, making an accurate diagnosis challenging.

Diagnosis

Once symptoms have been cataloged and a history of asbestos exposure determined, the next step is to look inside the body - initially with x-rays, followed up by more sophisticated imaging such as CT scans or MRIs. If these images reveal serious abnormalities, a biopsy (tissue samples) will be ordered. These are examined and analyzed at a lab, which usually confirms or contradicts the diagnosis.

When it comes to the sarcomatoid mesothelioma, traditional methods of biopsy pose additional challenges; the normal "needle core" method often results in false information, as sarcomatoid cells are often similar in appearance to benign fibrous tissue. Additionally, histological methods of diagnosis often make it difficult to distinguish between sarcomatoid mesothelioma and other types of unrelated sarcomatoid cancers.

A precise and accurate diagnosis is vital, because a misdiagnosis can lead to an inappropriate course of treatment being prescribed; it is a good idea to get a second and even a third opinion if mesothelioma is suspected.

Treatment Options

Although the details will differ depending on the individual case, all forms of cancer are treated through some combination of surgery, radiation therapy, and chemotherapy. How these are administered depends on the location and stage of the cancer.

Unfortunately, sarcomatoid mesothelioma is notoriously resistant to treatment, and prognosis is not good. Average survival rates between diagnosis and death is seven months.

Epithelial Mesothelioma

Epithelial mesothelioma cells have a definite structure with visible nuclei. This is the most common variant of this type of cancer, accounting for about 60 percent of all cases. This type of mesothelioma develops when malignant cells develop on any of the mesothelial linings. When examined under a microscope, these cells are of a uniform size and shape, and resemble normal, healthy epithelial cells.

Epithelial mesothelioma cells also bear a strong resemblance to adenocarcinoma cells, which are also associated with lung tissue. Patients who have been diagnosed with adenocarcinoma should also be examined for mesothelioma as well.

Variants

Papillary mesothelioma is an example of epithelial mesothelioma; other variants include any of the following:

• Signet Ring
• Single File
• Adenoid Cystic
• Glandular
• Tubulopapillary
• Histiocytoid
• Microcystic
• Macrocystic
• Glomeruloid
• Diffuse - NOS
• Small Cell
• Deciduoid
• Pleomorphic
• In Situ
• Mucin Positive
• Well-Differentiated Papillary
• Gaucher Cell-Like

What differentiates these various types are the shape, size and formation of the cells. This can determine what course of treatment is appropriate for the patient's situations.

Epithelial Mesothelioma and Asbestos

Once asbestos fibers are inhaled, they become lodged in the lung tissue, where they remain indefinitely. Mesothelioma is associated with hard, crystalline amphibole asbestos, which consists of hard, needle-like fibers that literally bore through lung tissue over time, causing chronic inflammation that ultimately results in malignancy. The disease has a very long latency period, which can be anywhere from five to seventy-five years. The symptoms of the disease are also similar to other respiratory illnesses, which is why mesothelioma has historically been so difficult to diagnose.

Mesothelioma Cell Types

Malignant mesothelioma can also be classified by different cancer cell types, each of which tends to behave differently. There are three classifications assigned to mesothelioma cell types.

Epithelial Mesothelioma is the most common cell type and accounts for approximately 50-75% percent of all diagnosed cases each year. These cells are uniform in shape, with an elongated pattern that makes them easily distinguishable when viewed under high magnification. These cancers are adenocarcinomas, malignancies which are more commonly associated with pure lung cancers as opposed to cancers of the mesothelium.

Sarcomatoid mesothelioma is a less common cell type, accounting for between 7 and 20% of diagnosed cases each year. These cells grow forth out of supportive structures, such as muscles and bones.

Biphasic mesotheliomas are those with a mix of epithelial and sarcomatoid cell types. Treatment options do not vary greatly between cell types, but often sarcomatoid mesotheliomas are more difficult to treat as a result of the surrounding affected tissues from which they spread.

Thoracoscopy and the use of special stains can be helpful in identifying cellular classifications, though obtaining adequate tissue samples often require more invasive surgeries.

Risk Factors

What are the risk factors for malignant mesothelioma?

There are several risk factors that increase the likelihood that a person will develop mesothelioma. The primary risk factor is asbestos exposure. Exposure to this very harmful substance can significantly enhance the chances of contracting the disease. Other secondary factors include exposure to radiation, zeolite, simian virus 40 (SV40) and tobacco. We discuss each of these risk factors in more detail below.

Asbestos

Exposure to asbestos is the leading risk factor associated with mesothelioma. Asbestos is an insulating material comprised of magnesium-silicate mineral fibers. It was favored by builders and contractors for many years for its low heat conductivity and resistance to melting and burning. Since researchers have identified more and more links between mesothelioma and exposure to asbestos, the material is now less widely used. Prior to this discovery, however, millions of Americans have experienced serious exposure to this harmful substance.

Over 700,000 schools and buildings in the United States today contain asbestos insulation as reported by the US Environmental Protection Agency. Asbestos exposure doesn’t stop there, however. Asbestos is often found in ship yards, manufacturing facilities, railway facilities and construction sites. Blue collar workers are at the highest risk for developing mesothelioma due to occupational exposure and include those who work in mines, factories, shipyards, construction sites, railroads and for insulation manufacturers and gas mask manufacturers. The occupations most widely affected are miners, factory workers, railroad workers, ship builders and construction workers - especially those who install asbestos containing insulation. Sometimes family members related to the workers receive second hand exposure to asbestos from the dust and fibers that were brought home on the workers clothes and also become at risk for contracting mesothelioma.

Serpentine fibers and amphiboles are the 2 primary types of asbestos used. Chrysotile is a form of serpentine fiber and the most frequently used. These fibers tend to be curly and flexible. Amphibole fibers, however, are generally straight and thin and usually comprise one of five types: crocidolite, amosite, anthrophylite, tremolite, and actinolyte. The crocidolite type of Amphiboles is thought to be the leading contributor to cancer caused by asbestos. Serpentine fibers are dangerous as well, however, and have also been linked to mesothelioma.

Some research points to the fact that inhaled asbestos fibers cause a physical irritation resulting in cancer rather than the cancer being caused by a reaction that is more chemical in nature. As fibers are inhaled through the mouth and nose they are cleared from the body by adhering to mucus in the nose, throat and airways and then get expelled by coughing or swallowing. The Amphibole fibers (long and thin) do not clear as easily and it is therefore thought that they can embed into the lining of the lungs and chest and result in mesothelioma.

Asbestosis (scar tissue in the lungs) or lung cancer can also be caused by the inhalation of asbestos fibers. In fact, people exposed to asbestos are seven times more likely to develop lung cancer over the general public. Workers who sustain high levels of asbestos exposure are more likely to die from asbestosis, lung cancer or mesothelioma than any other disease. It is also believed that the action of coughing up and swallowing asbestos could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma. Mesothelioma has been found to exist in other organs of the body as well such as the larynx, pancreas and colon, but those instances are extremely limited compared to lung cancer incidents.

The chance of developing mesothelioma is in direct proportion to the duration and amount of asbestos exposure that an individual sustains. Those who are exposed to high levels of asbestos at a young age, for long periods of time have a greater risk of being diagnosed with mesothelioma than those who have short, low level exposure. Another important consideration is that Mesothelioma can take a long time to manifest. Often, twenty to forty years can elapse from the time of exposure to diagnosis. Genetic factors can also play a role which explains why not everyone exposed to asbestos develops and asbestos related disease.

Radiation

Thorium dioxide (Thorotrast), a substance used in x-ray tests in the past has reported links to pleural mesothelioma and peritoneal mesothelioma. The use of Thorotrast has been discontinued for many years due to this discovery.

Zeolite

Some mesothelioma cases in the Anatoli region within Turkey have been linked to Zeolite, a silica based mineral with chemical properties similar to asbestos found in the soil there.

Simian Virus 40 (SV40)

Some scientists have found the simian virus 40 (SV30) in mesothelioma cells from humans and have been able to create mesothelioma in animals with the virus. The relationship between this virus and mesothelioma is still unclear, however, and further research is being conducted to gain clarity on this potential link.

Tobacco

Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing lung cancer (as much as fifty to ninety percent higher). Research indicates that lung cancer is the leading cause of death among asbestos workers.