Combination Of Asbestos And Cigarettes Together With Underlying Asbestosis Significantly Increases One’s Risk Of Developing Lung Cancer Later In Life

A recently released study sought to determine the extent to which the combination of asbestos exposure and cigarette smoking serves to act “synergistically” so as to multiply the odds that one will develop lung cancer, especially when the person has already developed asbestosis.

This study is the subject of “Asbestos, Asbestosis, Smoking and Lung Cancer: New Findings from the North American Insulator Cohort”, which was published online in April 2013 by the American Journal of Respiratory and Critical Care Medicine medical journal

An April 12, 2013 report found at the ScienceDaily web site, “Asbestos Exposure, Asbestosis, and Smoking Combined Greatly Increase Lung Cancer Risk”, does a good job of summarizing this asbestos lung cancer study, as well as adding some commentary from the lead author.

As for the findings, from the April 2013 ScienceDaily report:

Among non-smokers, asbestos exposure increased the rate of dying from lung cancer 5.2-fold, while the combination of smoking and asbestos exposure increased the death rate more than 28-fold. Asbestosis increased the risk of developing lung cancer among asbestos-exposed subjects in both smokers and non-smokers, with the death rate from lung cancer increasing 36.8-fold among asbestos-exposed smokers with asbestosis.

Among insulators who quit smoking, lung cancer morality dropped in the 10 years following smoking cessation from 177 deaths per 10,000 among current smokers to 90 per 10,000 among those who quit. Lung cancer rates among insulators who had stopped smoking more than 30 years earlier were similar to those among insulators who had never smoked.

And here’s how the lead author described this new study’s findings, overall:

“The interactions between asbestos exposure, asbestosis and smoking, and their influence on lung cancer risk are incompletely understood,” said lead author Steven B. Markowitz, MD DrPH, professor of occupational and environmental medicine at the School of Earth & Environmental Sciences at Queens College in New York. “In our study of a large cohort of asbestos-exposed insulators and more than 50,000 non-exposed controls, we found that each individual risk factor was associated with increased risk of developing lung cancer, while the combination of two risk factors further increased the risk and the combination of all three risk factors increased the risk of developing lung cancer almost 37-fold.”

“Our study provides strong evidence that asbestos exposure causes lung cancer through multiple mechanisms,” said Dr. Markowitz. “Importantly, we also show that quitting smoking greatly reduces the increased lung cancer risk seen in this population.”

We will continue to watch the medical journals for study articles that focus on asbestosis, lung cancer, and mesothelioma.


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Identification Of Gene Alterations in Asbestos-Related Cancers Like Non-Small Cell Lung Cancer Shows A Synergistic Effect Of Asbestos And Tobacco Smoke

An article published by the medical journal Mutagenesis in February 2013, “Differential mutation profiles and similar intronic TP53 polymorphisms in asbestos-related lung cancer and pleural mesothelioma” shows the synergistic effect between asbestos exposure and cigarette smoking.

As background,  lung cancer has been shown to be caused by both tobacco smoke and asbestos exposure, as well as other carcinogens. Exposure to both tobacco smoke and asbestos greatly enhances that risk so that the total risk is greater than adding the individual effects (a toxicology effect called synergism). If asbestos exposure increases your chance of getting cancer by 5 times and smoking increases your chance of getting cancer by 12 times, then being exposed to both of them can increase your chances by 60 to 100 times.

From the Absract for this February 2013 Mutagenesis article, which was based on a French study:

Given the interest in defining biomarkers of asbestos exposure and to provide insights into asbestos-related and cell-specific mechanisms of neoplasia, the identification of gene alterations in asbestos-related cancers can help to a better understanding of exposure risk. To understand the aetiology of asbestos-induced malignancies and to increase our knowledge of mesothelial carcinogenesis, we compared genetic alterations in relevant cancer genes between lung cancer, induced by asbestos and tobacco smoke, and malignant pleural mesothelioma (MPM), a cancer related to asbestos, but not to tobacco smoke…. While genetic changes in [non-small cell lung cancer (NSCLC)] are dominated by the effects of tobacco smoke, the increase of transversions in TP53 gene is consistent with a synergistic effect of asbestos. These results may help to define cell-dependent mechanisms of action of asbestos and identify susceptibility factors to asbestos.

Lastly, we want you to know that there is evidence that quitting smoking will reduce the risk of lung cancer among people who have been exposed to asbestos dust, perhaps by as much as half after at least 5 years without smoking tobacco.


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Addition Of Thalidomide Maintenance To First-line Chemotherapy For Patients With Pleural Or Peritoneal Mesothelioma Did Not Help With Disease Progression

 

On April 12, 2013 The Lancet Oncology medical journal published early online this article, “Thalidomide versus active supportive care for maintenance in patients with malignant mesothelioma after first-line chemotherapy (NVALT 5): an open-label, multicentre, randomised phase 3 study”.

From the Abstract of this new medical study article concerning malignant mesothelioma disease progression:

Background
Standard chemotherapy does not lead to long-term survival in patients with malignant pleural mesothelioma. Malignant pleural mesothelioma is strongly dependent on vasculature with high vessel counts and high concentrations of serum vascular growth factors. Thalidomide has shown antiangiogenic activity, and we hypothesised that its use in the maintenance setting could improve outcomes.

Methods
In this open-label, multicentre, randomised phase 3 study, eligible patients had proven malignant pleural or peritoneal mesothelioma and had received a minimum of four cycles of first-line treatment containing at least pemetrexed, with or without cisplatin or carboplatin, and had not progressed on this treatment…. Thalidomide was given for a maximum of 1 year or until unacceptable toxicity….

Interpretation
No benefit was noted in time to progression with the addition of thalidomide maintenance to first-line chemotherapy. Different treatment strategies are needed to improve outcomes in patients with malignant mesothelioma.

This study involved 222 patients during the time period May 2004 to December 2009.

We will continue to watch for medical developments concerning mesothelioma treatments.


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Protect Asbestos Victims: Reasons To Oppose H.R. 982, the Furthering Asbestos Claim Transparency (FACT) Act of 2013

As an asbestos attorney who has been handling mesothelioma, asbestos lung cancer, and asbestosis cases for more than 20 years, I urge you to call or write your elected official in the U.S. House of Representatives in Washington, DC and tell them to oppose H.R. 982, the Furthering Asbestos Claim Transparency (FACT) Act of 2013.

In effect, this House bill is a one-sided attempt to hurt asbestos victims by allowing the asbestos industry to delay and deny accountability so victims die before they are able to receive justice.

To learn how H.R. 982, the FACT Act of 2013, is a misguided piece of legislation, read this insightful piece:  “What “Lies” Beneath the Wall Street Journal Asbestos Article, Myths and Facts Exposed”.

Here are some important points that you may want to include in the email or letter which you send to your respective member of Congress in Washington:

  • The dangers associated with asbestos exposure have been known since the early 1930s.
  • Still the asbestos industry hid the facts, exposed workers and families, and now nearly 10,000 Americans are killed by asbestos diseases every year. This bill does not focus on banning asbestos nor does it look at ways to expedite asbestos cases.
  • This bill, H.R. 982,  instead would require private asbestos bankruptcy trusts to publicly release extensive individual information about asbestos victims and slow down asbestos cases by allowing asbestos defendants to bury the trusts in information requests, no matter how unnecessary or irrelevant. This denies and delays justice for asbestos victims who do not have time on their side.
  • Congress should focus on keeping Americans safe from asbestos exposure and not protecting corporations that deliberately exposed workers and consumers for decades. Oppose H.R. 982!

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NC Senate Bill 429 / House Bill 415: Asbestos Lawsuit Immunity Bills Which Would Benefit ALEC Member Crown Cork & Seal And Possibly Other Companies With Asbestos Liability

North Carolina State Legislators Are Being Led Astray By The American Legislative Exchange Council (ALEC) And Its Successor Asbestos-Related Liability Fairness Act

In North Carolina there is legislation being considered currently that offers immunity to Crown Cork & Seal (and possibly others) for asbestos liability it legally acquired when it bought another manufacturing company, Mundet Asbestos, back in 1963. In effect, this legislation, if it became law, would bailout an out-of-state corporation allowing it to escape responsibility for its business dealings and shift the burden of caring for people in North Carolina with asbestos-related diseases from the legally responsible corporate entity to the NC taxpayers.

North Carolina Senate Bill (SB) 429 filed by Sen. Harry Brown (R-Onslow) and NC House Bill (HB) 415 filed by Rep. Jacqueline Schaffer (R-Mecklenburg), Rep. John Blust (R-Guilford), and Rep. Tom Murry (R-Wake) were filed in late March 2013. These pieces of proposed legislation are identical and based on a model bill created by the American Legislative Exchange Council (ALEC) Successor Asbestos-Related Liability Fairness Act — that 16 states have now passed and which gives virtual immunity to corporations that purchased an asbestos-making company in the past.

This proposed legislation recently filed in North Carolina — and  which has been made law in 16 other states, already — says that if one company purchased another company which had manufactured asbestos-containing products, the parent company is only liable to people who developed an asbestos disease or cancer like mesothelioma due to being exposed to that asbestos product up to the amount the parent paid for the acquired company.

This law would mean that companies like Crown, Cork and Seal (CC&S) would be immune from any and all future asbestos and mesothelioma lawsuits because CC&S has already paid out more in asbestos lawsuits than it paid for Mundet 50 years ago, back in 1963.

It is important to known that the dangers associated with asbestos exposure have been known since the early 1930s. Still the asbestos industry hid the facts, exposed workers and families, and now nearly 10,000 Americans are killed by asbestos diseases every year.

Essentially, CC&S bought an asbestos company and, rather than be stuck with Mundet’s legal liabilities pursuant to well-established tort law, CC&S wants to undo their bad business decision (in hindsight) and go to the state legislatures by means of ALEC to make this happen for them.

Not a bit surprising to me, at least, is the fact that Crown, Cork and Seal (CC&S) is a member of ALEC, according to Source Watch.

States where this asbestos lawsuit immunity law has passed thus far are Alabama, Arizona, Florida, Idaho, Indiana, Michigan, Mississippi, Ohio, Oklahoma, South Carolina, South Dakota, Nebraska, North Dakota ,Texas, Wyoming, and Utah.

As a North Carolina asbestos-mesothelioma attorney, I am opposed to NC SB 429 and NC HB 415 and I urge our state legislators in Raleigh to not join the states above that have the dubious distinction of having been led astray by the American Legislative Exchange Council (ALEC) and its Successor Asbestos-Related Liability Fairness Act.

In order to learn more about why this ALEC asbestos immunity legislation should be defeated in North Carolina, see this Lawyers.com article, “ALEC Puts the Screws to Asbestos Victims”. And thereafter, if you live in North Carolina or you have been affected by an asbestos disease or cancer like mesothelioma, you should contact one or more of the following NC legislators and voice your opposition to NC SB 429 and NC HB 415  – which may be good for ALEC and its corporate members like Crown Cork & Seas (CC&S) but is absolutely no good for the people of North Carolina.

Those North Carolina legislators who are being led astray by the American Legislative Exchange Council (ALEC) and its Successor Asbestos-Related Liability Fairness Act are:

Sen. Harry Brown (R-Onslow);

Rep. Jacqueline Schaffer (R-Mecklenburg);

Rep. John Blust (R-Guilford); and,

Rep. Tom Murry (R-Wake).


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Malignant Peritoneal Mesothelioma Treatment Options And Long-Term Survival Rates Are Examined In New Medical Study Article

Malignant peritoneal mesothelioma (MPM) is a primary cancer that arises diffusely from the mesothelial cells lining the peritoneum.

Cytoreduction surgery (CRS) with intraoperative or perioperative high-dose regional chemotherapy has been established as the preferred approach in selected patients.

Hyperthermic intraoperative peritoneal chemotherapy (HIPEC) is another treatment regimen for patients with peritoneal mesothelioma.

In this new medical study article, “Treatment Factors Associated With Long-Term Survival After Cytoreductive Surgery and Regional Chemotherapy for Patients With Malignant Peritoneal Mesothelioma”, we learn what factors affect survival rates for patients who underwent the CRS surgery and the HIPEC regimen.

From the Abstract:

Conclusion:  Operative CRS with HIPEC is associated with prolonged survival in patients with [malignant peritoneal mesothelioma (MPM)]. Factors associated with survival include age, complete or near complete gross tumor resection, histologic tumor grade, and HIPEC with cisplatin. Cisplatin (versus mitomycin-C) was independently associated with improved survival and demonstrates a salutary effect for HIPEC with cisplatin in the management of patients with [malignant peritoneal mesothelioma (MPM)].

“The median, actuarial overall survival was 38.4 months’, according to the authors of this article published online March 13, 2013 by the Surgery medical journal (Epub Ahead of Print).

When will continue to watch for new articles about mesothelioma survival and treatment options so that we can report significant findings to you here on Asbestos HUB.

If you know of any developments that we should be reporting on, please leave a Comment below or send me an email.


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How Is Localized Malignant Pleural Mesothelioma Different From The More Common Diffuse Form Of Mesothelioma

According to the World Health Organization (WHO), localized malignant mesothelioma of the pleura (LMM) is histologically identical to diffuse malignant mesothelioma but without any evidence of pleural spread, i.e., localized.

There is an impression that localized malignant mesothelioma of the pleura (LMM) may have a better outcome than the more common diffuse form of mesothelioma. Treatments for LLM include different combinations of surgery, chemotherapy, and radiotherapy.

This issue was explored in this November 2012 medical journal article, “What is the survival after surgery for localized malignant pleural mesothelioma?”. From the Abstract:

In order to advise our patients on prognosis, we studied the duration of survival after surgical resection of [localized malignant mesothelioma of the pleura (LMM)]. A total of 150 papers were found, of which 16 represented the best evidence to answer the question…. Some report median survival (range: 11.6–36 months) and others disease-free survival (range: 0 months to 11 years). Median survival to the longest follow-up was 29 months when calculated by pooling data from informative papers using the Kaplan–Meier method. Our review suggests that survival in [localized malignant mesothelioma of the pleura (LMM)] is longer than that generally quoted for the more common diffuse form of malignant mesothelioma. Hence, aggressive treatment of LMM may be reasonable in appropriate patients.

We will continue to monitor the medical journals for reports concerning mesothelioma treatments and survival times.

Increased Risk Of Pleural Mesothelioma Where There Was Asbestos Exposure Together With Mineral Wool And/Or Silica Exposure, Also (i.e., Co-exposure)

The medical journal American Journal of Respiratory and Critical Care Medicine published this article early online on March 7, 2013:   “Pleural Mesothelioma and Occupational Co-exposure to Asbestos, Mineral Wool and Silica”.

From the Abstract for this new medical journal article about mesothelioma:

Rationale: Occupational co-exposure to asbestos and other fibers or particles could modify the carcinogenicity of asbestos with regard to pleural mesothelioma.

Objectives: To estimate associations between pleural mesothelioma and occupational mineral wool [(MW)] and silica exposure and to study the impact of occupational co-exposure on the risk of pleural mesothelioma….

Conclusion: Our results are in favour of an increased risk of pleural mesothelioma for subjects exposed to both asbestos and [mineral wool (MW)] or asbestos and silica.

This March 2013 article was based on a French pooled case-control study.

We will continue to monitor the literature for medical developments concerning mesothelioma (“meso”).


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Amateur Do-It-Yourself (DIY) Home Renovators Exposed To Asbestos Can Develop Mesothelioma, Asbestos Lung Cancer, Or Asbestosis

This March 7, 2013 newspaper article, “Renovators the ‘third wave’ of asbestos victims”, was published in Australia, but the points it makes are valid here in the United States and elsewhere around the world. To get your attention, perhaps, the sub-headline for this article refers to asbestos as the “silent killer”.

The first wave of victims were those exposed as part of the asbestos mining industry, the second wave was the tradesmen who worked with asbestos products in buildings.

“The third wave is home renovators,” Mr Slevin said.

“That’s people pulling up carpet and the underlay, people pulling out bathrooms, doing some of their own under-house work and being exposed.”

It is these people who are adding to the numbers of people being diagnosed with asbestos-related cancer….

“Despite a general sense that the problem’s been fixed after asbestos was banned around 1983.

“Asbestos was a very good building product, it was cheap and had a number of very useful purposes.

“It’s very common in property built, particularly in Western Australia at least, from the mid 1940s to the early 1980s so that means there’s still a lot of asbestos in those properties, domestic and public.”

Home renovators

It’s estimated that two out of three homes built in Australia between World War 2 and the early 1980s still contain asbestos and it’s those houses that are now being renovated or modified to suit new owners.

There is also a new generation of home renovators and tradespeople who were born after asbestos was banned and may not easily recognise the deadly product for what it is….

“So, the bottom line is it’s still around, it’s gone off the radar, people are still being exposed to it and the number of cases of asbestos-related diseases is still going up.

If you or someone you know does DIY home renovations or repairs, be mindful of older products which may contain asbestos during your work.

As this article points out, asbestos is not called the “silent killer” for nothing.


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Making the Diagnosis of Mesothelioma: Leslie Litzky, MD, Pathologist (Video)

Leslie Litzky, MD, discusses the pathology behind the diagnosis of malignant mesothelioma at the 2012 Focus on Mesothelioma Conference.

Her clear and concise explanation is addressed to mesothelioma patients as well as their family so that they can better understand the diagnostic testing process.

(10:51 video on YouTube)


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