We are California mesothelioma attorneys with years of success recovering millions for San Diego mesothelioma patients and their families. Because San Diego has been such a hub of activity for the United States Navy, many people who were exposed to asbestos at San Diego ship repair facilities and Naval bases have been afflicted with mesothelioma.
Our attorneys have been representing mesothelioma patients for 25 years.
We have obtained hundreds of millions of dollars in settlements and jury awards for our clients in asbestos lawsuits.
San Diego sites where our clients have worked include the 32nd Street Naval Base, North Island Naval Air Station, Campbell Industries Shipyard, San Diego Marine Shipyard, Triple A Shipyard, National Steel Shipyard, San Diego County Courthouse, the San Diego County Jail, San Diego Juvenile Courthouse Complex, San Diego County Mental Health Center, University of San Diego Hospital, San Diego Health Services Complex, among many others. We have a vast library of information about these and many other San Diego sites, that includes information about the types and brands of asbestos products used at each location.
We represent mesothelioma patients and their families. Mesothelioma is a very serious form of cancer, and families who have been touched by mesothelioma have many challenges ahead. Whatever treatment options a mesothelioma patient chooses, treatment is expensive. A mesothelioma diagnosis can often mean financial hardship without some kind of legal assistance. Our experienced asbestos attorneys can help provide fast compensation to San Diego area families impacted by mesothelioma. The financial resources we make available allow our clients to focus on fighting mesothelioma, beating the odds, and enjoying time with their loved ones.
Every mesothelioma patient’s exposure to asbestos is different. Some, such as insulators, shipyard workers, or boilermakers, had jobs that obviously involved working with asbestos. However, many mesothelioma victims we have represented have not known how or when they were exposed to asbestos until our lawyers completed an extensive asbestos exposure investigation.
By getting to know each client as an individual, and by learning each client’s personal story of asbestos exposure, we can show which asbestos companies were responsible for causing the mesothelioma. As lawyers for people with mesothelioma we hold the asbestos industry accountable for the damage their asbestos products have done. Many people with mesothelioma who first contact us mistakenly believe the asbestos companies did not know their asbestos products caused cancer until the 1970's or 1980's.
This is unfortunately not true. Documents our lawyers have obtained in litigation show that manufacturers of asbestos products knew the workers in their own factories were getting asbestos related lung cancer and mesothelioma from asbestos as early as the 1930's and 1940's, yet they hid this knowledge. It is a modern tragedy that most cases of mesothelioma and other asbestos cancers could and should have been prevented. While we cannot undo the harm that asbestos has caused, our mission as mesothelioma attorneys is to hold the wrongdoers accountable, and to recover the maximum compensation possible for our mesothelioma clients.
Our lawyers represent not only people who have been diagnosed with mesothelioma, but also spouses, sons and daughters of people who have died from mesothelioma. If you or a loved one has been diagnosed with mesothelioma cancer, please contact us as soon as possible. One of our lawyers will fly to your home within a few days. In most cases, you will not have to travel or even appear in court. Our lawyers will investigate your case, meet with you and take video depositions. You will not have to pay any attorneys’ fees unless we obtain a financial settlement for you. Call our toll-free number or fill out the contact form on this page to consult with an experienced asbestos lawyer at no cost about financial assistance available to mesothelioma patients.
Mesothelioma Attorneys serving clients in San Diego California
Mesothelioma Lawyers
A diagnosis of mesothelioma is often overwhelming for the patient and their family. Filing a mesothelioma lawsuit shouldn't add to that.
Are you looking for a mesothelioma lawyer to handle your mesothelioma or asbestos-related cancer claim?
I would like to speak with an attorney about a possible case
Please contact us, and we'll be happy to speak with you, with no obligation, about your case.
Mesothelioma Lawyers
David P. Chervenick
Lane A. Clack
Lee W. Davis
Holly L. Deihl
Kenneth J. Fryncko, Jr.
Carrie L. Furlan
James J. Bedortha
Cori J. Kapusta
Jason E. Luckasevic
Bruce E. Mattock
Mark C. Meyer
Terrence M. O'Brien
Leif J. Ocheltree
Peter T. Paladino Jr.
Joel Persky
Christine Lynne Salon
John T. Tierney III
Craig L. Vandergrift
Thomas W. White
Goldberg, Persky, & White have the:
legal knowledge and experience,
proven track record,
attentive staff, and
aggressive attorneys
to help defend your legal rights.
Why you should trust a GPW mesothelioma lawyer with your case
GPW's mesothelioma lawyers have been involved in asbestos lawsuits since 1978. As one of the pioneers in asbestos litigation, we have an intricate and thorough knowledge of the ever-growing body of evidence and and changing legal guidelines. It is a knowledge built up over the last quarter century and constantly being added to by our attorneys and dedicated staff.
Having represented many individuals diagnosed with mesothelioma or asbestos-related lung cancer, as well as other asbestos-related diseases, GPW is uniquely qualified to prepare, try, and defend your case, providing you and your family with piece of mind and always treating you with compassion.
Our mesothelioma lawyers will focus on defending of your rights and ensuring you recieve just compensation, so that you can focus on your health and family. Just as you seek mesothelioma specialists to coordinate your treatment, finding a qualified attorney experienced in mesothelioma cases is equally important.
I have an asbestos disease and want to file a lawsuit, what should I do?
You need to contact a lawyer as soon as possible because every state has a statute of limitations... [read our Mesothelioma Lawsuit FAQs] Please let us know if you have any questions, whether about our qualifications or otherwise, and we'll be happy to answer them.
If you or someone you know has an asbestos-related disease, you owe it to yourself to make sure that your rights are protected. Your rights vary depending on many factors such as your residence, where you were exposed to asbestos, and the location of the responsible asbestos companies. Each state has its own laws and governs the law differently. Each state also has its own deadlines for allowing victims of asbestos disease to file lawsuits, called statutes of limitation and statutes of repose.
Malignant Mesothelioma, California Mesothelioma Lawyers
Mesothelioma is rare form of cancer caused by asbestos exposure. The disease might have been preventable had the asbestos industry acted responsibly decades ago to protect the public from the dangers of asbestos. Unfortunately for the estimated 3,000 Americans diagnosed with mesothelioma each year, the asbestos industry hid the dangers of asbestos from the public for decades after it knew of the risks.
In these pages you will learn about the asbestos tragedy in the United States and how it has affected the lives and health of countless American workers and their families. You will also read about how people are exposed to asbestos, including the types of work sites where asbestos was once common and the trades that worked with and around asbestos-containing products. And you will learn how Baron & Budd was one of the first law firms in the country to fight for the rights of asbestos victims and is still widely recognized as a national leader in asbestos litigation to this day.
For nearly three decades, in courtrooms across the country, Baron & Budd has championed the rights of mesothelioma victims. Here are just a few examples of some of the results we have achieved for our mesothelioma clients:
The cases described here reflect the net amounts of the judgments or settlements our clients received after the deduction of attorneys fees and expenses-in other words, what our clients actually received. The actual settlement or verdict would be higher. These cases were all handled by Baron & Budd attorneys serving as lead counsel.
Specific Results Depend on the Facts of Each Case.
$10,603,661.00 Received by Client after Attorney’s Fees and Expenses for a gentleman who developed malignant mesothelioma as a result of his exposure to joint compound as a construction worker. This case went to trial and resulted in a significant verdict in favor of the gentleman, his wife and children that was listed by a national legal publication as one of the top verdicts in the U.S. that year. The case subsequently settled.
$6,356,942.00 Received by Client after Attorney’s Fees and Expenses, for the widow of a man who died at the age of 50 after developing asbestos-related mesothelioma. He was exposed to asbestos while serving in the Navy aboard nuclear submarines during the 1960s. This case went to trial against the manufacturer of an asbestos-containing pipe covering product. The jury awarded a significant verdict, which was affirmed on appeal.
$4,380,755.00 Received by Client after Attorney’s Fees and Expenses, for an ironworker who worked at a number of industrial sites throughout his career and who was diagnosed with mesothelioma at the age of 79.
Mesothelioma Symptoms
Symptoms of mesothelioma may not occur for 30 to 50 years after an individual is exposed to asbestos. Unfortunately, the early symptoms of mesothelioma are often non-specific and can sometimes be confused with other illnesses such as pneumonia. Part of the reason that Mesothelioma is often misdiagnosed is that many of the symptoms are similar to pneumonia, including shortness of breath, persistent cough and chest pain. These similarities can sometimes lead to a delay in a mesothelioma diagnosis. Making matters more difficult is the fact that some patients show no symptoms of their mesothelioma.
When symptoms of mesothelioma do appear, they often manifest themselves as shortness of breath and chest pains. The exact symptoms will often depend on which area the mesothelioma is affecting. For instance, some symptoms of peritoneal mesothelioma include weight loss, abdominal pain, bowel obstruction, anemia and fever.
ONLY A DOCTOR CAN PROPERLY DISGNOSE MESOTHELIOMA
IF YOU THINK YOU HAVE ANY OF THESE SYMPTOMS, YOU SHOULD CONTACT A DOCTOR IMMEDIATELY.
Who needs to be examined for Asbestosis or Mesothelioma?
Individuals who have been exposed to asbestos (or suspect they have been exposed) dust on the job or at home via a family contact should inform their physician of their exposure history and any symptoms. Asbestos fibers can be measured in urine, feces, mucus, or material rinsed out of the lungs. A thorough physical examination, including a chest x-ray and lung function tests, may be recommended.
It is important to note that chest x-rays cannot detect asbestos fibers in the lungs, but they can help identify any lung changes resulting from asbestos exposure. Interpretation of the chest x-ray may require the help of a specialist who is experienced in reading x-rays for asbestos-related diseases. Other tests also may be necessary.
As noted earlier, the symptoms of asbestos-related diseases may not become apparent for many decades after exposure. If any of the following symptoms develop, a physical examination should be scheduled without delay:
Shortness of breath;
A cough or a change in cough pattern;
Blood in the sputum (fluid) coughed up from the lungs;
Pain in the chest or abdomen;
Difficulty in swallowing or prolonged hoarseness; and/or
Significant weight loss.
Mesothelioma Alerts
FDA Safety Changes: Pemetrexed Injection (Alimta)
By Yael Waknine, November 3, 2006
November 3, 2006 — The US Food and Drug Administration (FDA) has approved drug safety labeling revisions to advise of the potential for dose-limiting myelosuppression in patients receiving treatment with pemetrexed injection.
Pemetrexed Injection (Alimta) Linked to Dose-Limiting Myelosuppression
On July 28, the FDA approved safety labeling revisions for pemetrexed injection (Alimta, made by Eli Lilly and Company) to warn of the risk for myelosuppression associated with its use. Bone marrow suppression is usually the dose-limiting toxicity, as manifested by neutropenia, thrombocytopenia, and anemia (or pancytopenia).
The FDA advises that dose reductions for subsequent cycles be based on nadir absolute neutrophil count, platelet count, and maximum nonhematologic toxicity observed during the previous cycle.
Pemetrexed injection is indicated for use with cisplatin in the treatment of patients with malignant pleural mesothelioma whose disease is unresectable or who are otherwise not candidates for curative surgery; it is also indicated as a single agent for the treatment of patients with locally advanced or metastatic non–small cell lung cancer after prior chemotherapy.
Mesothelioma Treatments
While there is currently no known cure for malignant mesothelioma, treatments are available with the most common being surgery, chemotherapy and radiation therapy.
Your doctor will recommend one treatment or a combination of therapies that are best for your situation. The course of treatment will depend on a number of factors including the location of the disease, the stage of the disease, your age, overall health and your preferences.
The information provided throughout this website is for your information only, and should NOT take the place of a full medical diagnosis.
Mesothelioma Treatment Types
As in all forms of cancer treatment, there are traditional modalities for the treatment of mesothelioma, as well as experimental, non-traditional options.
Traditional Mesothelioma Treatment Options
» Surgery (physical removal of the cancer)
» Chemotherapy (using drugs to fight the cancer)
» Radiation Therapy (using high-dose x-rays to kill cancer cells)
Doctors will often use two or more of these treatment courses jointly to provide the maximum likelihood of success. This multi-modal approach holds the most promise for survival of malignant mesothelioma patients. Trimodality therapy, in which all three of these modalities are used, is considered the most effective, and aggressive, approach.
Non-Traditional Mesothelioma Treatment Options
» Photodynamic Therapy
» Gene Therapy
» Immunotherapy
The following pages provide information on all of these treatment options.
mesothelioma clinic
What is the UAB Mesothelioma Clinic?
The UAB Mesothelioma Clinic is a component of the UAB
Comprehensive Cancer Center, which provides complete care for
mesothelioma patients, including diagnosis, treatment and
supportive care services. The Clinic is committed to improving the
outlook for mesothelioma patients through novel clinical trials
and the education of patients about the disease. The Mesothelioma
Clinic Director, Francisco Robert, M.D., is a Medical Oncologist
with specific expertise in the diagnosis and treatment of lung
cancer and mesothelioma.
What does the Mesothelioma
Clinic provide?
Dr. Robert has a team of Cancer Center staff with expertise in
surgery, radiation therapy, pathology, radiology, social services,
and nursing who are available to provide their special expertise
as appropriate. Dr. Robert provides the initial patient assessment
and consultation with appropriate review of pathology slides and
x-rays, confirmation of the diagnosis, selection of additional
studies if needed and recommendations for treatment and supportive
care. Depending on the extent of disease and the patient's general
health, treatments may include surgery, radiation and/or
chemotherapy. It is important that patients consider participating
in a clinical trial, which may make additional treatments
available. Supportive care may be an important component in the
management of mesothelioma patients.
What is Mesothelioma?
Mesothelioma is an aggressive form of cancer in which cells of the
mesothelium (the membrane that covers and protects most of the
internal organs) become abnormal, form tumors and grow without
control or order. The disease usually affects the surface of the
lung or less
commonly the lining of the abdomen. The disease is relatively
uncommon, with 2,500 to 3,000 new cases diagnosed in the United
States each year.
Are new treatments for
mesothelioma being studied?
Yes. During the past five years researchers have gained many new
insights about mesothelioma. One promising drug is Alimta
(Pemetrexed), an experimental drug that has shown promise in
treating advanced mesothelioma. Because mesothelioa is difficult
to control, many new treatment strategies are being studied. UAB
Comprehensive Cancer Center scientists are examining several
different approaches in the laboratory, including: -Developing new
drugs that slow the growth and spread of mesothelioma cells. -
Creating a vaccine to stimulate the immune system to attack
mesothelioma tumors. -Exploring gene therapy strategies for
treatment. After further study, these approaches will be developed
into clinical trails to investigate whether the treatment is safe
and effective for patients. The UAB Mesothelioma Clinic and the
UAB Comprehensive Cancer Center currently have clinical trials for
the treatment of mesothelioma. It is important that Cancer Center
doctors see patients soon after diagnosis to enable them to
develop the best treatment plan.
Are there specific risk factors for
developing mesothelioma?
Working with asbestos is the major risk factor for mesothelioma.
Approximately 80% of mesothelioma is associated with asbestos
exposure - specifically occupational asbestos exposure. However,
the disease has been reported in some individuals without any
known exposure to asbestos.
What are the key statistics about mesothelioma?
Recent reports show that an estimated 2,500 to 3,000 new cases per year of mesothelioma are diagnosed in the United States each year. Although mesothlioma is relatively uncommon, projections show that its incidence is expected to rise over the next decade.The first diagnosis of mesothelioma on average occurs between 50 - 70 years of age. Mesothlioma affects men more often than women mostly dues to increased occupational exposure. The disease is also less common in African Americans than it is in white Americans. As mesothelioma is disease that is difficult to detect in its early stages, often the disease is advanced at its first diagnosis. Accordingly, the average survival period using current treament protocols is a little over one year. When fortunate enough to find the cancer early and treat it aggressively, chances increase significantly of reaching the two year survival point. Approximately 20% or patients diagnosed with mesothelioma are able to achieve a five year survival rate.Those who live at least five years after their cancer is diagnosed have a good chance to continue living a productive life for many additional years. As treatment therapies continue to advance for mesothelioma, we can expect survival rates to continue to improve as well for those recently diagnosed.
Mesothelioma News Center
Asbestos Exposure
Asbestos and mesothelioma: worldwide trends. Lung Cancer. 2005 July
Towards the end of the 20th century, governments in many developed countries banned or seriously restricted the use of asbestos. As a result, global asbestos producers have engaged in aggressive marketing campaigns to sell asbestos to developing countries; consumption of white asbestos is increasing in Asia, Latin America and the Commonwealth of Independent States. In most of the countries, there is little, if any, control on hazardous asbestos exposures from occupational, environmental and domestic sources. It is likely that the lethal asbestos harvest which is occurring in the U.S. , the UK and Australia will be reproduced in the developing world. More Information
Asbestos and peritoneal mesothelioma among college-educated men. Int J Occup Environ Health. 2005 Jul-Sep
The proportion of peritoneal mesotheliomas among all mesotheliomas has been decreasing, leading some to suggest that peritoneal mesothelioma occurs only after high levels of exposure to asbestos. To investigate the relationship between asbestos exposure and the development of peritoneal mesothelioma, a case-control study examined 40 cases of primary peritoneal mesothelioma from a single institution. This series differed from previous reports in that 75% of the cases and controls had attended college. Results show an odds ratio of 6.6 for asbestos exposure among this group of primary peritoneal mesothelioma cases with relatively slight asbestos exposures. More Information
Mesothelioma in household members of asbestos-exposed workers: 32 United States cases since 1990. Am J Ind Med. 2005 May
Mesothelioma is significant as an indicator of asbestos exposure, as a continuing major cause of death in those exposed, and as a risk following lesser exposures. One such exposure is living in the household of an asbestos worker, and coming into contact with fibers brought home on his/her body, clothing, etc. This study reports 32 household-exposure mesothelioma cases, diagnosed since 1990. Relationships were wife (15), daughter (11), son (3), sister-in law (1), niece (1), and boarder (1). Occupations of the workers included shipyard (13), insulator (7), and other (12).Latency was greater than 40 years in 27 cases.Mesothelioma resulting from household exposure is a continuing problem. It is more likely to present in the elderly, after latencies of >40 years. More Information
Mesothelioma: the aetiological role of ultrathin fibres and repercussions on prevention and medical legal evaluation Med Lav. 2005 Jan-Feb
The most important knowledge that must today be taken as certain is the fact that mesothelioma is not caused, as is the case for asbestosis, by all the fibres that are inhaled, but only by the ultra-thin fraction of these fibres, having diameter of 0.2 microm and length of only a few microm. Only fibres of this class of size can cross the pulmonary-pleural barrier and are, therefore, the causal agent of mesothelioma and other benign pleural manifestations (plaques).[This] means that any assumption of the disease being avoidable must be discarded, at least up to the second half of the 1980s because until then this class of fibres, which today must be considered as the true causal agent of the neoplasm, was not visible under the optical microscope, nor could such fibres be measured or eliminated from the atmosphere of working environments. The filter materials available both for fixed ventilation systems and for individual protective masks were not able to block the ultrathin fibres and were therefore only efficacious for the prevention of asbestosis and probably pulmonary carcinoma. It was only with the use of highly efficient HEPA filters and "absolute" filters towards the end of the 1980s that efficacious protection against all size classes of respirable fibres became possible in industrial plants. More Information
Biological Markers
Diffuse malignant mesothelioma of the peritoneum.Cancer. 2005 Oct 4
In the current study, the authors report the clinicopathologic features of patients with peritoneal diffuse malignant mesothelioma (DMM) who were treated in a uniform fashion at a single institution to assess prognostic factors.No biologic markers were found to be of prognostic significance. More Information
Expression and prognostic significance of hypoxia-inducible factor 1alpha (HIF-1alpha) in malignant pleural mesothelioma (MPM). Lung Cancer. 2005 Sep 14
Malignant pleural mesothelioma (MPM) is a highly chemoresistant cancer with a poor prognosis.HIF-1alpha does not appear to predict survival; however, this study suggests that bioreductive drugs should be investigated in clinical trials of MPM. More Information
Detecting common gene expression patterns in multiple cancer outcome entities. Biomed Microdevices. 2005 Sep
In an analysis of four prognostic cancer studies, involving breast cancer, leukemia, and mesothelioma, we are able to identify 42 genes that show consistent up- or down-regulation in patients with a poor disease outcome. These genes complement the set of previously published candidates for universal prognostic markers in cancer. More Information
P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma. Clin Cancer Res. 2005 May
Biphasic histology, increased mitotic rate, and p16 loss were independently associated with poorer survival in peritoneal malignant mesothelioma. Among the trimodal treated patients, increased mitotic rate was associated with increased risk of death. More Information
Diagnosis
Malignant mesothelioma: current status of histopathologic diagnosis and molecular profile. Expert Rev Mol Diagn. 2005 Sep
Malignant mesothelioma of the pleura is a relatively rare neoplasm that has been estimated to account for 20 deaths per million males per year in North America and Europe . A causative association has been well established with asbestos exposure. Paradoxically, the incidence of this tumor continues to rise despite public efforts to reduce, contain or eliminate exposure to asbestos fibers over the past few decades...Surprisingly, for a disease that currently has no known cure, one of the major problems still lies in establishing the correct diagnosis. Diagnosis acquires a particular relevance in light of the medicolegal ramifications of this disease, and diagnosis of malignant mesothelioma is still fraught with difficulties. Despite the advances in modern diagnostic techniques, no specific markers or morphologic features exist that are exclusive to these tumors. More Information
Primary diagnosis of malignant mesothelioma by fine-needle aspiration of a supraclavicular lymph node. Diagn Cytopathol. 2005 Aug
To our knowledge, there have only been two reported cases in the literature where fine-needle aspiration (FNA) of a lymph node was the primary mode of diagnosis of malignant mesothelioma. We describe a 40-yr-old male in whom the primary diagnosis of malignant mesothelioma was made by FNA of a supraclavicular lymph node...Our case demonstrates that FNA can be a simple and invaluable method of diagnosis in those unusual cases where diagnosis of malignant mesothelioma has not already been made before lymphadenopathy. More Information
Localized malignant mesothelioma. Am J Surg Pathol. 2005 July
Localized malignant mesotheliomas are uncommon sharply circumscribed tumors of the serosal membranes with the microscopic appearance of diffuse malignant mesothelioma but without any evidence of diffuse spread. Little is known about their behavior. We report 23 new cases. The mean age at presentation was 63 years, and the sex ratio was approximately 2:1 (male/female).After surgical excision of the tumor, 10 of 21 patients with follow-up data were alive without evidence of disease from 18 months to 11 years after diagnosis. Patients who died had developed local recurrences and metastases, but none had diffuse pleural spread. Localized malignant mesotheliomas should be separated from diffuse malignant mesotheliomas because of their localized presentation, quite different biologic behavior, and far better prognosis. More Information
Malignant pleural mesothelioma: staging systems. Lung Cancer. 2005 July
Malignant pleural mesothelioma has a very specific growth pattern invading the pleural surfaces and neighboring structures. For this reason precise estimation of tumor volume and description of local extension are particularly difficult. Different staging systems have been introduced, and the most widely used are discussed. Restaging of mesothelioma after induction therapy is even more complicated and still controversial. The recently described, modified response evaluation criteria in solid tumors (RECIST) criteria are presently the most accurate for response evaluation. More Information
Malignant mesothelioma with a pronounced myxoid stroma: a clinical and pathological evaluation of 19 cases. Virchows Arch. 2005 Jul 14
Mesothelioma with a pronounced myxoid stroma has been identified as a morphological pattern that might portend a better prognosis. Reports on this type of cases are few. Its clinical and pathological features are not defined. In this study, we identified 19 such cases from a series of 234 pleural mesotheliomas and performed a comprehensive clinical and pathological analysis.Overall, the median survival rate was 36 months (median follow-up time, 17 months), and the 2-year survival rate was 79%...These findings show that myxoid mesotheliomas represent a group of epithelioid mesotheliomas that have retained the secretory activity of normal mesothelium. Patients may present at different stages, but survival appears to be superior to that of epithelioid mesotheliomas in general. Our study emphasizes the need for better attention to histologic subtypes, particularly in the context of prognostically or therapeutically oriented investigations of this lethal disease. More Information
Survival
Survival of malignant pleural mesothelioma cases in the Tuscan Mesothelioma Register, 1988-2000: a population-based study. Eur J Cancer Prev. 2005 June
This study analyzed survival of Tuscan residents ( Italy , 3.5 million population) diagnosed by histological examination with malignant pleural mesothelioma (MPM) during the period 1988-2000, and recorded in the Tuscan Malignant Mesothelioma Register.Therapeutic information was available for patients of the period 1997-2000. There was no significant difference in survival between treated versus untreated patients. More Information
Treatments
A phase II study evaluating the cisplatin and epirubicin combination in patients with unresectable malignant pleural mesothelioma. Lung Cancer. 2005 Oct
Few chemotherapeutic agents have demonstrated their efficacy in malignant mesothelioma. The cisplatin plus doxorubicin combination has one of the highest response rates. Epirubicin is an anthracyclin, analogous to doxorubicin, with a different toxicologic pattern. As there are no data on the activity of the combination cisplatin plus epirubicin in malignant mesothelioma, the European Lung Cancer Working Party (ELCWP) designed a phase II study with response rate as primary objective.Median survival was 13.3 months. More Information
Limited efficacy of imatinib mesylate in malignant mesothelioma: A phase II trial. Lung Cancer. 2005 Oct
Twenty-five patients with histologically proven malignant mesothelioma participated in a trial of imatinib mesylate (Glivec) with a starting dose of 400mg per day taken orally, up to a maximal dose of 800mg. No responses were observed in the patient group, while three patients showed prolonged (>6 months) stabilization of disease. The median survival time was 398 days (range 88-840); the median time to progression was 63 days (range 29-275). Side effects of the medication were mild and included edema, nausea, constipation and diarrhea. We conclude that further investigation with monotherapy imatinib in mesothelioma is not warranted. More Information
Bowel Complications in 203 Cases of Peritoneal Surface Malignancies Treated With Peritonectomy and Closed-Technique Intraperitoneal Hyperthermic Perfusion. Ann Surg Oncol. 2005 Sep 21
Peritonectomy and intraperitoneal hyperthermic perfusion (IPHP) are increasingly used in the management of carcinomatosis of various sites of origin. We analyzed the risk factors for bowel complications with primary anastomoses and the closed technique for IPHP.Bowel complications are not increased when primary unprotected anastomoses are performed during peritonectomy and IPHP when the closed technique is used. Male sex, duration of the procedure, and no previous systemic chemotherapy are independent unfavorable risk factors. More Information
A median sternotomy approach to right extrapleural pneumonectomy for mesothelioma. Ann Thorac Surg. 2005 Sep
We assessed the feasibility of a median sternotomy approach as an alternative to thoracotomy in right-sided resections. Over a 15-month period, this approach was attempted in 10 cases. In 7 of them, the entire procedure was completed without additional thoracotomy access. There were no postoperative deaths in this group. At median follow-up of 8 months, we have not encountered tumor progression in the scars. More Information
Radiation recall dermatitis with pemetrexed. Lung Cancer. 2005 Aug 16
Pemetrexed has recently been approved for use in combination with cisplatin as first-line chemotherapy for malignant pleural mesothelioma (MPM). Radiation therapy is frequently administered to the thoracic orifices and no data are available about the interactions between radiotherapy and pemetrexed. We report the first case of radiation recall dermatitis occurring after pemetrexed chemotherapy in a patient with MPM previously treated with radiation therapy to the thoracoscopy and drainage orificies.Pemetrexed could also act as a radiosensitizing agent that should be used with care for several weeks after radiotherapy. More Information
Gene therapy of mesothelioma. Expert Opin Biol Ther. 2005 Aug
Despite improved diagnostic skills and new chemotherapeutic regimens, malignant mesothelioma (MM) remains a pathological disease with survival expectations after diagnosis remaining < href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16050782&query_hl=1" target="_blank">More Information
Triplet chemotherapy with cisplatin, gemcitabine and vinorelbine for malignant pleural mesothelioma. Jpn J Clin Oncol. 2005 Aug
We investigated the use of triplet combination chemotherapy with cisplatin (CDDP), gemcitabine (GEM) and vinorelbine (VNR) for the treatment of Japanese patients with MPM [malignant pleural mesothelioma].The median survival time and survival rate at 2 years for all patients were 11 months and 50%, respectively. More Information
Hemithoracic radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma. Int J Radiat Oncol Biol Phys. 2005 Jul 28
Pleurectomy/decortication with adjuvant radiotherapy (RT) is not an effective treatment option for patients with MPM. Our results imply that residual disease cannot be eradicated with external RT with or without brachytherapy and that a more extensive surgery followed by external RT might be required to improve local control and overall survival. More Information
Photodynamic therapy as an adjunct to surgery for malignant pleural mesothelioma. Lung Cancer. 2005 July
Malignant pleural mesothelioma (MPM) is increasingly observed in industrial countries. Despite concerted efforts and combined treatments including surgery, chemotherapy and irradiation patients eventually succumb from relentless local progression of the disease. Recent publications have demonstrated an improved response rate with the cytostatic agent pemetrexed which will be tested in a neoadjuvant setting followed by surgery. However, effective tumor control requires new loco-regional treatment modalities, eventually in combination with neoadjuvant chemotherapy. Intraoperative photodynamic therapy (PDT) of the chest cavity has been proposed as an attractive treatment concept for MPM since a selective treatment of the tumor bed following resection has the potential to improve local tumor control.Refinements of PDT for mesothelioma will depend on a more detailed understanding of the pathways for preferential sensitizer accumulation within the tumor as well as on synergistic effects between PDT and chemotherapeutic agents. More Information
Women
Malignant peritoneal mesothelioma in women: a study of 75 cases with emphasis on their morphologic spectrum and differential diagnosis. Am J Clin Pathol. 2005 May
Seventy-five malignant mesotheliomas of the peritoneum in women were reviewed to highlight their morphologic spectrum. The patients ranged from 17 to 92 (mean, 47.4) years of age. The clinical presentation was usually abdominal or pelvic pain, abdominal swelling (sometimes due to ascites), or a pelvic mass.Many tumors had foci that, viewed in isolation, resembled so-called well-differentiated papillary mesothelioma, and accordingly that diagnosis should be made cautiously.The varied morphology of peritoneal malignant mesotheliomas may raise a broad differential diagnosis, but in most cases the resemblance to other tumors is limited. Histochemistry, immunohistochemistry, and electron microscopy may provide important aid, particularly when tissue is limited, but should be needed only occasionally. More Information
Mesothelioma News Center
Asbestos Exposure
Asbestos and mesothelioma: worldwide trends. Lung Cancer. 2005 July
Towards the end of the 20th century, governments in many developed countries banned or seriously restricted the use of asbestos. As a result, global asbestos producers have engaged in aggressive marketing campaigns to sell asbestos to developing countries; consumption of white asbestos is increasing in Asia, Latin America and the Commonwealth of Independent States. In most of the countries, there is little, if any, control on hazardous asbestos exposures from occupational, environmental and domestic sources. It is likely that the lethal asbestos harvest which is occurring in the U.S. , the UK and Australia will be reproduced in the developing world. More Information
Asbestos and peritoneal mesothelioma among college-educated men. Int J Occup Environ Health. 2005 Jul-Sep
The proportion of peritoneal mesotheliomas among all mesotheliomas has been decreasing, leading some to suggest that peritoneal mesothelioma occurs only after high levels of exposure to asbestos. To investigate the relationship between asbestos exposure and the development of peritoneal mesothelioma, a case-control study examined 40 cases of primary peritoneal mesothelioma from a single institution. This series differed from previous reports in that 75% of the cases and controls had attended college. Results show an odds ratio of 6.6 for asbestos exposure among this group of primary peritoneal mesothelioma cases with relatively slight asbestos exposures. More Information
Mesothelioma in household members of asbestos-exposed workers: 32 United States cases since 1990. Am J Ind Med. 2005 May
Mesothelioma is significant as an indicator of asbestos exposure, as a continuing major cause of death in those exposed, and as a risk following lesser exposures. One such exposure is living in the household of an asbestos worker, and coming into contact with fibers brought home on his/her body, clothing, etc. This study reports 32 household-exposure mesothelioma cases, diagnosed since 1990. Relationships were wife (15), daughter (11), son (3), sister-in law (1), niece (1), and boarder (1). Occupations of the workers included shipyard (13), insulator (7), and other (12).Latency was greater than 40 years in 27 cases.Mesothelioma resulting from household exposure is a continuing problem. It is more likely to present in the elderly, after latencies of >40 years. More Information
Mesothelioma: the aetiological role of ultrathin fibres and repercussions on prevention and medical legal evaluation Med Lav. 2005 Jan-Feb
The most important knowledge that must today be taken as certain is the fact that mesothelioma is not caused, as is the case for asbestosis, by all the fibres that are inhaled, but only by the ultra-thin fraction of these fibres, having diameter of 0.2 microm and length of only a few microm. Only fibres of this class of size can cross the pulmonary-pleural barrier and are, therefore, the causal agent of mesothelioma and other benign pleural manifestations (plaques).[This] means that any assumption of the disease being avoidable must be discarded, at least up to the second half of the 1980s because until then this class of fibres, which today must be considered as the true causal agent of the neoplasm, was not visible under the optical microscope, nor could such fibres be measured or eliminated from the atmosphere of working environments. The filter materials available both for fixed ventilation systems and for individual protective masks were not able to block the ultrathin fibres and were therefore only efficacious for the prevention of asbestosis and probably pulmonary carcinoma. It was only with the use of highly efficient HEPA filters and "absolute" filters towards the end of the 1980s that efficacious protection against all size classes of respirable fibres became possible in industrial plants. More Information
Biological Markers
Diffuse malignant mesothelioma of the peritoneum.Cancer. 2005 Oct 4
In the current study, the authors report the clinicopathologic features of patients with peritoneal diffuse malignant mesothelioma (DMM) who were treated in a uniform fashion at a single institution to assess prognostic factors.No biologic markers were found to be of prognostic significance. More Information
Expression and prognostic significance of hypoxia-inducible factor 1alpha (HIF-1alpha) in malignant pleural mesothelioma (MPM). Lung Cancer. 2005 Sep 14
Malignant pleural mesothelioma (MPM) is a highly chemoresistant cancer with a poor prognosis.HIF-1alpha does not appear to predict survival; however, this study suggests that bioreductive drugs should be investigated in clinical trials of MPM. More Information
Detecting common gene expression patterns in multiple cancer outcome entities. Biomed Microdevices. 2005 Sep
In an analysis of four prognostic cancer studies, involving breast cancer, leukemia, and mesothelioma, we are able to identify 42 genes that show consistent up- or down-regulation in patients with a poor disease outcome. These genes complement the set of previously published candidates for universal prognostic markers in cancer. More Information
P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma. Clin Cancer Res. 2005 May
Biphasic histology, increased mitotic rate, and p16 loss were independently associated with poorer survival in peritoneal malignant mesothelioma. Among the trimodal treated patients, increased mitotic rate was associated with increased risk of death. More Information
Diagnosis
Malignant mesothelioma: current status of histopathologic diagnosis and molecular profile. Expert Rev Mol Diagn. 2005 Sep
Malignant mesothelioma of the pleura is a relatively rare neoplasm that has been estimated to account for 20 deaths per million males per year in North America and Europe . A causative association has been well established with asbestos exposure. Paradoxically, the incidence of this tumor continues to rise despite public efforts to reduce, contain or eliminate exposure to asbestos fibers over the past few decades...Surprisingly, for a disease that currently has no known cure, one of the major problems still lies in establishing the correct diagnosis. Diagnosis acquires a particular relevance in light of the medicolegal ramifications of this disease, and diagnosis of malignant mesothelioma is still fraught with difficulties. Despite the advances in modern diagnostic techniques, no specific markers or morphologic features exist that are exclusive to these tumors. More Information
Primary diagnosis of malignant mesothelioma by fine-needle aspiration of a supraclavicular lymph node. Diagn Cytopathol. 2005 Aug
To our knowledge, there have only been two reported cases in the literature where fine-needle aspiration (FNA) of a lymph node was the primary mode of diagnosis of malignant mesothelioma. We describe a 40-yr-old male in whom the primary diagnosis of malignant mesothelioma was made by FNA of a supraclavicular lymph node...Our case demonstrates that FNA can be a simple and invaluable method of diagnosis in those unusual cases where diagnosis of malignant mesothelioma has not already been made before lymphadenopathy. More Information
Localized malignant mesothelioma. Am J Surg Pathol. 2005 July
Localized malignant mesotheliomas are uncommon sharply circumscribed tumors of the serosal membranes with the microscopic appearance of diffuse malignant mesothelioma but without any evidence of diffuse spread. Little is known about their behavior. We report 23 new cases. The mean age at presentation was 63 years, and the sex ratio was approximately 2:1 (male/female).After surgical excision of the tumor, 10 of 21 patients with follow-up data were alive without evidence of disease from 18 months to 11 years after diagnosis. Patients who died had developed local recurrences and metastases, but none had diffuse pleural spread. Localized malignant mesotheliomas should be separated from diffuse malignant mesotheliomas because of their localized presentation, quite different biologic behavior, and far better prognosis. More Information
Malignant pleural mesothelioma: staging systems. Lung Cancer. 2005 July
Malignant pleural mesothelioma has a very specific growth pattern invading the pleural surfaces and neighboring structures. For this reason precise estimation of tumor volume and description of local extension are particularly difficult. Different staging systems have been introduced, and the most widely used are discussed. Restaging of mesothelioma after induction therapy is even more complicated and still controversial. The recently described, modified response evaluation criteria in solid tumors (RECIST) criteria are presently the most accurate for response evaluation. More Information
Malignant mesothelioma with a pronounced myxoid stroma: a clinical and pathological evaluation of 19 cases. Virchows Arch. 2005 Jul 14
Mesothelioma with a pronounced myxoid stroma has been identified as a morphological pattern that might portend a better prognosis. Reports on this type of cases are few. Its clinical and pathological features are not defined. In this study, we identified 19 such cases from a series of 234 pleural mesotheliomas and performed a comprehensive clinical and pathological analysis.Overall, the median survival rate was 36 months (median follow-up time, 17 months), and the 2-year survival rate was 79%...These findings show that myxoid mesotheliomas represent a group of epithelioid mesotheliomas that have retained the secretory activity of normal mesothelium. Patients may present at different stages, but survival appears to be superior to that of epithelioid mesotheliomas in general. Our study emphasizes the need for better attention to histologic subtypes, particularly in the context of prognostically or therapeutically oriented investigations of this lethal disease. More Information
Survival
Survival of malignant pleural mesothelioma cases in the Tuscan Mesothelioma Register, 1988-2000: a population-based study. Eur J Cancer Prev. 2005 June
This study analyzed survival of Tuscan residents ( Italy , 3.5 million population) diagnosed by histological examination with malignant pleural mesothelioma (MPM) during the period 1988-2000, and recorded in the Tuscan Malignant Mesothelioma Register.Therapeutic information was available for patients of the period 1997-2000. There was no significant difference in survival between treated versus untreated patients. More Information
Treatments
A phase II study evaluating the cisplatin and epirubicin combination in patients with unresectable malignant pleural mesothelioma. Lung Cancer. 2005 Oct
Few chemotherapeutic agents have demonstrated their efficacy in malignant mesothelioma. The cisplatin plus doxorubicin combination has one of the highest response rates. Epirubicin is an anthracyclin, analogous to doxorubicin, with a different toxicologic pattern. As there are no data on the activity of the combination cisplatin plus epirubicin in malignant mesothelioma, the European Lung Cancer Working Party (ELCWP) designed a phase II study with response rate as primary objective.Median survival was 13.3 months. More Information
Limited efficacy of imatinib mesylate in malignant mesothelioma: A phase II trial. Lung Cancer. 2005 Oct
Twenty-five patients with histologically proven malignant mesothelioma participated in a trial of imatinib mesylate (Glivec) with a starting dose of 400mg per day taken orally, up to a maximal dose of 800mg. No responses were observed in the patient group, while three patients showed prolonged (>6 months) stabilization of disease. The median survival time was 398 days (range 88-840); the median time to progression was 63 days (range 29-275). Side effects of the medication were mild and included edema, nausea, constipation and diarrhea. We conclude that further investigation with monotherapy imatinib in mesothelioma is not warranted. More Information
Bowel Complications in 203 Cases of Peritoneal Surface Malignancies Treated With Peritonectomy and Closed-Technique Intraperitoneal Hyperthermic Perfusion. Ann Surg Oncol. 2005 Sep 21
Peritonectomy and intraperitoneal hyperthermic perfusion (IPHP) are increasingly used in the management of carcinomatosis of various sites of origin. We analyzed the risk factors for bowel complications with primary anastomoses and the closed technique for IPHP.Bowel complications are not increased when primary unprotected anastomoses are performed during peritonectomy and IPHP when the closed technique is used. Male sex, duration of the procedure, and no previous systemic chemotherapy are independent unfavorable risk factors. More Information
A median sternotomy approach to right extrapleural pneumonectomy for mesothelioma. Ann Thorac Surg. 2005 Sep
We assessed the feasibility of a median sternotomy approach as an alternative to thoracotomy in right-sided resections. Over a 15-month period, this approach was attempted in 10 cases. In 7 of them, the entire procedure was completed without additional thoracotomy access. There were no postoperative deaths in this group. At median follow-up of 8 months, we have not encountered tumor progression in the scars. More Information
Radiation recall dermatitis with pemetrexed. Lung Cancer. 2005 Aug 16
Pemetrexed has recently been approved for use in combination with cisplatin as first-line chemotherapy for malignant pleural mesothelioma (MPM). Radiation therapy is frequently administered to the thoracic orifices and no data are available about the interactions between radiotherapy and pemetrexed. We report the first case of radiation recall dermatitis occurring after pemetrexed chemotherapy in a patient with MPM previously treated with radiation therapy to the thoracoscopy and drainage orificies.Pemetrexed could also act as a radiosensitizing agent that should be used with care for several weeks after radiotherapy. More Information
Gene therapy of mesothelioma. Expert Opin Biol Ther. 2005 Aug
Despite improved diagnostic skills and new chemotherapeutic regimens, malignant mesothelioma (MM) remains a pathological disease with survival expectations after diagnosis remaining < href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16050782&query_hl=1" target="_blank">More Information
Triplet chemotherapy with cisplatin, gemcitabine and vinorelbine for malignant pleural mesothelioma. Jpn J Clin Oncol. 2005 Aug
We investigated the use of triplet combination chemotherapy with cisplatin (CDDP), gemcitabine (GEM) and vinorelbine (VNR) for the treatment of Japanese patients with MPM [malignant pleural mesothelioma].The median survival time and survival rate at 2 years for all patients were 11 months and 50%, respectively. More Information
Hemithoracic radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma. Int J Radiat Oncol Biol Phys. 2005 Jul 28
Pleurectomy/decortication with adjuvant radiotherapy (RT) is not an effective treatment option for patients with MPM. Our results imply that residual disease cannot be eradicated with external RT with or without brachytherapy and that a more extensive surgery followed by external RT might be required to improve local control and overall survival. More Information
Photodynamic therapy as an adjunct to surgery for malignant pleural mesothelioma. Lung Cancer. 2005 July
Malignant pleural mesothelioma (MPM) is increasingly observed in industrial countries. Despite concerted efforts and combined treatments including surgery, chemotherapy and irradiation patients eventually succumb from relentless local progression of the disease. Recent publications have demonstrated an improved response rate with the cytostatic agent pemetrexed which will be tested in a neoadjuvant setting followed by surgery. However, effective tumor control requires new loco-regional treatment modalities, eventually in combination with neoadjuvant chemotherapy. Intraoperative photodynamic therapy (PDT) of the chest cavity has been proposed as an attractive treatment concept for MPM since a selective treatment of the tumor bed following resection has the potential to improve local tumor control.Refinements of PDT for mesothelioma will depend on a more detailed understanding of the pathways for preferential sensitizer accumulation within the tumor as well as on synergistic effects between PDT and chemotherapeutic agents. More Information
Women
Malignant peritoneal mesothelioma in women: a study of 75 cases with emphasis on their morphologic spectrum and differential diagnosis. Am J Clin Pathol. 2005 May
Seventy-five malignant mesotheliomas of the peritoneum in women were reviewed to highlight their morphologic spectrum. The patients ranged from 17 to 92 (mean, 47.4) years of age. The clinical presentation was usually abdominal or pelvic pain, abdominal swelling (sometimes due to ascites), or a pelvic mass.Many tumors had foci that, viewed in isolation, resembled so-called well-differentiated papillary mesothelioma, and accordingly that diagnosis should be made cautiously.The varied morphology of peritoneal malignant mesotheliomas may raise a broad differential diagnosis, but in most cases the resemblance to other tumors is limited. Histochemistry, immunohistochemistry, and electron microscopy may provide important aid, particularly when tissue is limited, but should be needed only occasionally. More Information
MESOTHELIOMA NEWS
Dramatic Increase of Asbestos-Related Deaths in Canada
December 12, 2006 - A recently released study, Five Deaths a Day: Workplace Fatalities in Canada, 1993-2005, found that workplace fatalities in Canada are climbing, and that most of the increase is caused by asbestos exposure. In 2004, there were a total of 958 workplace-related fatalities in Canada. That number increased to 1,097 in 2005. Of the 2005 total of 1,097 workplace-related fatalities, 557 were caused by occupational disease. Three hundred forty of the occupational disease fatalities were asbestos-related.
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Chrysler Ordered to Pay $20 Million to Mesothelioma Victim
November 22, 2006 - A New York jury ordered DaimlerChrysler AG to pay $20 Million to a 73-year-old, former brake repairman. The jury ruled that DaimlerChrysler acted with reckless disregard, making DaimlerChrysler liable for 80% of a total verdict of $25 Million. The victim was diagnosed with mesothelioma approximately two years ago. DaimlerChrysler stated after the trial that they will appeal the verdict. The jury also found that General Motors and Ford Motor Company were each 10% liable for the mesothelioma victim's injuries. Both companies previously settled with the plaintiff for undisclosed amounts.
The plaintiff worked with auto brake linings that contained asbestos from 1960 to 1981. The brake linings were made by the defendant corporations.