Asbestos Lung Cancer.

Asbestos lung cancer is a rare type of lung cancer, which is the most common cause of cancer death in the United States. An estimated 4,800 deaths a year are linked to asbestos lung cancer, a number that represents about 4 percent of all U.S. fatalities connected to lung cancer. The overwhelming majority of other deaths - about 90 percent - are linked to smoking.

Medical researchers first made a probable causal relationship between exposure to asbestos and lung cancer in 1935. Seven years later, a member of the National Cancer Institute confirmed asbestos as a cause of lung cancer. Study after study continued to show the cause-effect relationship of asbestos and lung cancer. By 1986, the Occupational Safety and Health Administration (OSHA) proclaimed lung cancer as the greatest risk for Americans who worked with asbestos.

Like mesothelioma, another asbestos-related cancer, lung cancer associated with asbestos is typically diagnosed at a late stage of development because of the long latency period of development and the onset of symptoms.

Similarities and Differences of Mesothelioma and Asbestos Lung Cancer: Mesothelioma and asbestos lung cancer are similar in that they can take decades to develop yet only months to spread to distant organs. And they have similar diagnostic procedures and treatment techniques. But the diseases differ in physical characteristics and non-asbestos risk factors.

How Asbestos Causes Lung Cancer

Fast Fact One study, published in the British Journal of Cancer, concluded that asbestos killed twice as many people through lung cancer than through mesothelioma.

A naturally occurring mineral found in homes, the workplace or the environment, asbestos has been mined and used for commercial purposes in North America since the late 1800s. It is now highly regulated and a number of countries (and U.S. government agencies) classify it as a human carcinogen. When someone disturbs an asbestos-containing product, they release the microscopic fibers into the air. If inhaled, these thin fibers can become trapped in the lungs. Over long periods of time, they can accumulate and cause inflammation, scarring and other critical health problems. In some cases, the fibers can even trigger the development of lung cancer.

Researchers report that the duration and concentration of asbestos exposure plays a role in the risk of developing lung cancer. The Helsinki Criteria states that the risk for lung cancer increases as much as 4 percent with each year of exposure. The Occupational Safety and Health Administration (OSHA) has demonstrated a clear association between the concentration of asbestos exposure and the risk of lung cancer, finding that the higher the concentration of asbestos fibers, the higher the risk of lung cancer.

The implications of asbestos exposure are not apparent immediately following exposure. When asbestos fibers are first inhaled, they can become lodged in the lining of the lungs. The size of asbestos fibers affects where they become lodged, having implications on whether lung cancer or mesothelioma develops. Researchers discovered that 3mm fibers are more likely to become lodged in the lining of the lungs, whereas 5mm fibers (1/5 inch) tend to lodge in the lung tissue and increase the risk of developing lung cancer.

After many years, sometimes decades, these fibers cause enough irritation and cellular damage to generate tumor formation. Whether someone develops lung cancer, mesothelioma or asbestosis will depend on a person's health, genetics, habits like smoking, and the duration and concentration of exposure.

Occupational Exposures

Workers in certain trades and professions, most of them industrial, carry elevated risks of developing asbestos-related lung cancer. Shipyards, which have notoriously poor safety records, exposed workers to widespread asbestos until the mid-1970s. Many employees rarely wore necessary protective gear, and nearly all shipyard workers placed themselves at risk for lung cancer, asbestosis and mesothelioma.

But shipyards workers are hardy the only trade considered high risk for asbestos lung cancer. Any occupation in which people are in a confined area where asbestos is present - or where asbestos dust is circulated - is dangerous.

Those occupations include:

• Auto mechanics
• Construction workers
• Insulation installer
• Roofers
• Tilers
• Plumbers

• Paper mill workers
• Textile workers
• Sheet metal workers
• Toll collectors
• Linotype technicians

Prognosis and Survival Rates

The prognosis and survival rate for someone with asbestos lung cancer differs by type and subtype of the disease and also by the stage at which the cancer is found. Overall, though, the median survival for a limited stage small cell patient, with combination chemotherapy, is 16 to 22 months. For patients with extensive stage cancer, the median survival is nine to 11 months with the same treatment.

The prognosis and survival rate for someone with asbestos lung cancer differs by type and subtype of the disease and also by the stage at which the cancer is found. Overall, though, the median survival for a limited stage small cell patient, with combination chemotherapy, is 16 to 22 months. For patients with extensive stage cancer, the median survival is nine to 11 months with the same treatment.

A 2008 review of medical literature found that adenocarcinoma is almost always associated with longer survival times. A 2011 study agreed with these findings, reporting that adenocarcinoma patients lived a median of 8.4 months while all other NSCLC patients lived a median of 8.1 months. While the difference is small, researchers believe it to be significant.

Diagnosed with Asbestos-Related Lung Cancer?

The treatment you might need for your cancer depends greatly on the type of cancer you have. Although asbestos lung cancer doctors often treat more than one form of the disease, clinical trials are develop around specific disease types and circumstances. You may qualify for one of those clinical trials because of your specific disease.

Asbestos Exposure and Cancer Risk.

1. What is asbestos?

   
   Asbestos is the name given to a group of minerals that occur naturally in the environment as bundles of fibers that can be separated into thin, durable threads. These fibers are resistant to heat, fire, and chemicals and do not conduct electricity. For these reasons, asbestos has been used widely in many industries.
   Chemically, asbestos minerals are silicate compounds, meaning they contain atoms of silicon and oxygen in their molecular structure.
   Asbestos minerals are divided into two major groups: Serpentine asbestos and amphibole asbestos. Serpentine asbestos includes the mineral chrysotile, which has long, curly fibers that can be woven. Chrysotile asbestos is the form that has been used most widely in commercial applications. Amphibole asbestos includes the minerals actinolite, tremolite, anthophyllite, crocidolite, and amosite. Amphibole asbestos has straight, needle-like fibers that are more brittle than those of serpentine asbestos and are more limited in their ability to be fabricated.
   

2. How is asbestos used?

   
   Asbestos has been mined and used commercially in North America since the late 1800s. Its use increased greatly during World War II. Since then, asbestos has been used in many industries. For example, the building and construction industries have used it for strengthening cement and plastics as well as for insulation, roofing, fireproofing, and sound absorption. The shipbuilding industry has used asbestos to insulate boilers, steam pipes, and hot water pipes. The automotive industry uses asbestos in vehicle brake shoes and clutch pads. Asbestos has also been used in ceiling and floor tiles; paints, coatings, and adhesives; and plastics. In addition, asbestos has been found in vermiculite-containing garden products and some talc-containing crayons.
   In the late 1970s, the U.S. Consumer Product Safety Commission (CPSC) banned the use of asbestos in wallboard patching compounds and gas fireplaces because the asbestos fibers in these products could be released into the environment during use. In addition, manufacturers of electric hairdryers voluntarily stopped using asbestos in their products in 1979. In 1989, the U.S. Environmental Protection Agency (EPA) banned all new uses of asbestos; however, uses developed before 1989 are still allowed. The EPA also established regulations that require school systems to inspect buildings for the presence of damaged asbestos and to eliminate or reduce asbestos exposure to occupants by removing the asbestos or encasing it.
   In June 2000, the CPSC concluded that the risk of children’s exposure to asbestos fibers in crayons was extremely low. However, U.S. manufacturers of these crayons agreed to eliminate talc from their products.
   In August 2000, the EPA conducted a series of tests to evaluate the risk for consumers of adverse health effects associated with exposure to asbestos-contaminated vermiculite. The EPA concluded that exposure to asbestos from some vermiculite products poses only a minimal health risk. The EPA recommended that consumers reduce the low risk associated with the occasional use of vermiculite during gardening activities by limiting the amount of dust produced during vermiculite use. Specifically, the EPA suggested that consumers use vermiculite outdoors or in a well-ventilated area; keep vermiculite damp while using it; avoid bringing dust from vermiculite into the home on clothing; and use premixed potting soil, which is less likely to generate dust.
   The regulations described above and other actions, coupled with widespread public concern about the health hazards of asbestos, have resulted in a significant annual decline in the U.S. use of asbestos. Domestic consumption of asbestos amounted to about 803,000 metric tons in 1973, but it had dropped to about 2,400 metric tons by 2005.
   

3. What are the health hazards of exposure to asbestos?

   
   People may be exposed to asbestos in their workplace, their communities, or their homes. If products containing asbestos are disturbed, tiny asbestos fibers are released into the air. When asbestos fibers are breathed in, they may get trapped in the lungs and remain there for a long time. Over time, these fibers can accumulate and cause scarring and inflammation, which can affect breathing and lead to serious health problems.
   Asbestos has been classified as a known human carcinogen (a substance that causes cancer) by the U.S. Department of Health and Human Services, the EPA, and the International Agency for Research on Cancer. Studies have shown that exposure to asbestos may increase the risk of lung cancer and mesothelioma (a relatively rare cancer of the thin membranes that line the chest and abdomen). Although rare, mesothelioma is the most common form of cancer associated with asbestos exposure. In addition to lung cancer and mesothelioma, some studies have suggested an association between asbestos exposure and gastrointestinal and colorectalcancers, as well as an elevated risk for cancers of the throat, kidney, esophagus, andgallbladder. However, the evidence is inconclusive.
   Asbestos exposure may also increase the risk of asbestosis (an inflammatory condition affecting the lungs that can cause shortness of breath, coughing, and permanent lung damage) and other nonmalignant lung and pleural disorders, including pleural plaques (changes in the membranes surrounding the lung), pleural thickening, and benign pleural effusions (abnormal collections offluid between the thin layers of tissue lining the lungs and the wall of the chest cavity). Although pleural plaques are not precursors to lung cancer, evidence suggests that people with pleural disease caused by exposure to asbestos may be at increased risk for lung cancer.
   

4. Who is at risk for an asbestos-related disease?

   
   Everyone is exposed to asbestos at some time during their life. Low levels of asbestos are present in the air, water, and soil. However, most people do not become ill from their exposure. People who become ill from asbestos are usually those who are exposed to it on a regular basis, most often in a job where they work directly with the material or through substantial environmental contact.
   Since the early 1940s, millions of American workers have been exposed to asbestos. Health hazards from asbestos fibers have been recognized in workers exposed in the shipbuilding trades, asbestos mining and milling, manufacturing of asbestos textiles and other asbestos products, insulation work in the construction and building trades, and a variety of other trades. Demolition workers, drywall removers, asbestos removal workers, firefighters, and automobile workers also may be exposed to asbestos fibers. Studies evaluating the cancer risk experienced by automobile mechanics exposed to asbestos through brake repair are limited, but the overall evidence suggests there is no safe level of asbestos exposure. As a result of Government regulations and improved work practices, today’s workers (those without previous exposure) are likely to face smaller risks than did those exposed in the past.
   Individuals involved in the rescue, recovery, and cleanup at the site of the September 11, 2001, attacks on the World Trade Center (WTC) in New York City are another group at risk of developing an asbestos-related disease. Because asbestos was used in the construction of the North Tower of the WTC, when the building was attacked, hundreds of tons of asbestos were released into the atmosphere. Those at greatest risk include firefighters, police officers, paramedics, construction workers, and volunteers who worked in the rubble at Ground Zero. Others at risk include residents in close proximity to the WTC towers and those who attended schools nearby. These individuals will need to be followed to determine the long-term health consequences of their exposure.
   One study found that nearly 70 percent of WTC rescue and recovery workers suffered new or worsened respiratory symptoms while performing work at the WTC site. The study describes the results of the WTC Worker and Volunteer Medical Screening Program, which was established to identify and characterize possible WTC-related health effects in responders. The study found that about 28 percent of those tested had abnormal lung function tests, and 61 percent of those without previous health problems developed respiratory symptoms. However, it is important to note that these symptoms may be related to exposure to debris components other than asbestos.
   Although it is clear that the health risks from asbestos exposure increase with heavier exposure and longer exposure time, investigators have found asbestos-related diseases in individuals with only brief exposures. Generally, those who develop asbestos-related diseases show no signs of illness for a long time after their first exposure. It can take from 10 to 40 years or more for symptoms of an asbestos-related condition to appear.
   There is some evidence that family members of workers heavily exposed to asbestos face an increased risk of developing mesothelioma. This risk is thought to result from exposure to asbestos fibers brought into the home on the shoes, clothing, skin, and hair of workers. To decrease these exposures, Federal law regulates workplace practices to limit the possibility of asbestos being brought home in this way. Some employees may be required to shower and change their clothes before they leave work, store their street clothes in a separate area of the workplace, or wash their work clothes at home separately from other clothes.
   Cases of mesothelioma have also been seen in individuals without occupational asbestos exposure who live close to asbestos mines.
   

5. What factors affect the risk of developing an asbestos-related disease?

   
   Several factors can help to determine how asbestos exposure affects an individual, including:
   
   • Dose (how much asbestos an individual was exposed to).
   • Duration (how long an individual was exposed).
   • Size, shape, and chemical makeup of the asbestos fibers.
   • Source of the exposure.
   • Individual risk factors, such as smoking and pre-existing lung disease.
   Although all forms of asbestos are considered hazardous, different types of asbestos fibers may be associated with different health risks. For example, the results of several studies suggest that amphibole forms of asbestos may be more harmful than chrysotile, particularly for mesothelioma risk, because they tend to stay in the lungs for a longer period of time.
   

6. How does smoking affect risk?

   
   Many studies have shown that the combination of smoking and asbestos exposure is particularly hazardous. Smokers who are also exposed to asbestos have a risk of developing lung cancer that is greater than the individual risks from asbestos and smoking added together. There is evidence that quitting smoking will reduce the risk of lung cancer among asbestos-exposed workers. Smoking combined with asbestos exposure does not appear to increase the risk of mesothelioma. However, people who were exposed to asbestos on the job at any time during their life or who suspect they may have been exposed should not smoke. 
   

7. How are asbestos-related diseases detected?

   
   Individuals who have been exposed (or suspect they have been exposed) to asbestos fibers on the job, through the environment, or at home via a family contact should inform their doctor about their exposure history and whether or not they experience any symptoms. The symptoms of asbestos-related diseases may not become apparent for many decades after the exposure. It is particularly important to check with a doctor if any of the following symptoms develop:
   
   • Shortness of breath, wheezing, or hoarseness.
   • A persistent cough that gets worse over time.
   • Blood in the sputum (fluid) coughed up from the lungs.
   • Pain or tightening in the chest.
   • Difficulty swallowing.
   • Swelling of the neck or face.
   • Loss of appetite.
   • Weight loss.
   • Fatigue or anemia.
   A thorough physical examination, including a chest x-ray and lung function tests, may be recommended. The chest x-ray is currently the most common tool used to detect asbestos-related diseases. However, it is important to note that chest x-rays cannot detect asbestos fibers in the lungs, but they can help identify any early signs of lung disease resulting from asbestos exposure.
   Studies have shown that computed tomography (CT) (a series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an x-ray machine) may be more effective than conventional chest x-rays at detecting asbestos-related lung abnormalities in individuals who have been exposed to asbestos.
   A lung biopsy, which detects microscopic asbestos fibers in pieces of lung tissue removed bysurgery, is the most reliable test to confirm the presence of asbestos-related abnormalities. Abronchoscopy is a less invasive test than a biopsy and detects asbestos fibers in material that is rinsed out of the lungs. It is important to note that these tests cannot determine how much asbestos an individual may have been exposed to or whether disease will develop. Asbestos fibers can also be detected in urine, mucus, or feces, but these tests are not reliable for determining how much asbestos may be in an individual’s lungs.
   

8. How can workers protect themselves from asbestos exposure?

   
   The Occupational Safety and Health Administration (OSHA) is a component of the U.S. Department of Labor (DOL) and is the Federal agency responsible for health and safety regulations in maritime, construction, manufacturing, and service workplaces. OSHA established regulations dealing with asbestos exposure on the job, specifically in construction work, shipyards, and general industry, that employers are required to follow. In addition, the Mine Safety and Health Administration (MSHA), another component of the DOL, enforces regulations related to mine safety. Workers should use all protective equipment provided by their employers and follow recommended workplace practices and safety procedures. For example, National Institute for Occupational Safety and Health (NIOSH)-approved respirators that fit properly should be worn by workers when required.
   Workers who are concerned about asbestos exposure in the workplace should discuss the situation with other employees, their employee health and safety representative, and their employers. If necessary, OSHA can provide more information or make an inspection. Regional offices of OSHA are listed in the “United States Government” section of a telephone directory’s blue pages (under “Department of Labor”). Information about regional offices can also be found on OSHA’s website.
   
   The National Institute for Occupational Safety and Health (NIOSH), which is part of the Centers for Disease Control and Prevention (CDC), is another Federal agency that is concerned with asbestos exposure in the workplace. NIOSH conducts asbestos-related research, evaluates work sites for possible health hazards, and makes exposure control recommendations. In addition, NIOSH distributes publications on the health effects of asbestos exposure and can suggest additional sources of information.
   
   

9. What programs are available to help individuals with asbestos-related diseases?

   
   Some people with asbestos-related illness may be eligible for Medicare coverage. Information about benefits is available from Medicare’s Regional Offices, located in 10 major cities across the United States and serving specific geographic areas. The Regional Offices serve as the agency’s initial point of contact for beneficiaries, health care providers, state and local governments, and the general public. General information about Medicare is available by calling toll-free 1–800–633–4227 (1–800–MEDICARE) or by visiting the Medicare website.
   People with occupational asbestos-related diseases also may qualify for financial help, including medical payments, under state workers’ compensation laws. Because eligibility requirements vary from state to state, workers employed by private companies or by state and local government agencies should contact their state workers’ compensation board. Contact information for state workers’ compensation officials may be found in the blue pages of a local telephone directory or on the DOL website.
   If exposure occurred during employment with a Federal agency, medical expenses and other compensation may be covered by the Federal Employees’ Compensation Program, which is administered by the DOL, Employment Standards Administration’s Office of Workers’ Compensation Programs. This program provides workers’ compensation benefits to Federal (civilian) employees for employment-related injuries and diseases. Benefits include wage replacement, payment for medical care, and, where necessary, medical and vocationalrehabilitation assistance in returning to work. Benefits may also be provided to dependents if the injury or disease causes the employee’s death. The program has 12 district offices nationwide.
   In addition, the Longshore and Harbor Workers’ Compensation Program provides benefits to longshoremen, harbor workers, other maritime workers, and other classes of private industry workers who are injured during the course of employment or suffer from diseases caused or worsened by conditions of employment. Information about eligibility and how to file a claim for benefits under either of these programs.
   Eligible veterans may receive health care at a Department of Veterans Affairs (VA) Medical Center for an asbestos-related disease. Veterans can receive treatment for service-connected and nonservice-connected medical conditions. Information about eligibility and benefits is available from the VA Health Benefits Service Center at 1–877–222–8387 (1–877–222–VETS) or on the VA website.
   

10. Is there Federal legislation to help victims of asbestos-related diseases?

    
    No Federal legislation has been enacted to compensate victims of asbestos-related diseases or to protect people from asbestos exposure. However, a bill called the Fairness in Asbestos Injury Resolution Act, or FAIR Act, has been introduced in Congress several times. This bill would create a national trust fund to compensate victims suffering from asbestos-related diseases. The proposed trust fund would be administered by the DOL, outside of the courts, through a claims process in which all individuals with certain medical symptoms and evidence of asbestos-related disease would be compensated. Funding for the trust would come from insurance companies and companies that mined, manufactured, and sold asbestos or asbestos products. Under the bill, individuals affected by asbestos exposure would no longer be able to pursue awards for damages in any Federal or state court.
    

11. What other organizations offer information related to asbestos exposure?

    
    The organizations listed below can provide more information about asbestos exposure.
    The Agency for Toxic Substances and Disease Registry (ATSDR) is the principal Federal agency responsible for evaluating the human health effects of exposure to hazardous substances. This agency works in close collaboration with local, state, and other Federal agencies, with tribal governments, and with communities and local health care providers to help prevent or reduce harmful human health effects from exposure to hazardous substances. The ATSDR provides information about asbestos and where to find occupational and environmental health clinics.
    The U.S. Environmental Protection Agency (EPA) regulates the general public’s exposure to asbestos in buildings, drinking water, and the environment. The EPA offers a Toxic Substances Control Act (TSCA) Hotline and an Asbestos Ombudsman. The TSCA Hotline provides technical assistance and information about asbestos programs implemented under the TSCA, which include the Asbestos School Hazard Abatement Act and the Asbestos Hazard Emergency Response Act. The Asbestos Ombudsman focuses on asbestos in schools and handles questions and complaints. Both the TSCA Hotline and the Asbestos Ombudsman can provide publications on a number of topics, particularly on controlling asbestos exposure in schools and other buildings. The Ombudsman operates a toll-free hotline for small businesses, trade associations, and others seeking free, confidential help.
    The EPA website includes a list of EPA state asbestos contacts. In addition, EPA’s Asbestos page provides links to information about asbestos and its health effects, including suggestions for homeowners who suspect asbestos in their homes, and laws and regulations applicable to asbestos.
    The U.S. Consumer Product Safety Commission (CPSC) is responsible for protecting the public from unreasonable risks of serious injury or death from more than 15,000 types of consumer products, including asbestos, under the agency’s jurisdiction. The CPSC maintains a toll-free 24-hour hotline where callers can obtain product safety and other agency information and report unsafe products. In addition, CPSC publications provide guidelines for repairing and removing asbestos, and general information about asbestos in the home. 

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What Are Asbestos-Related Lung Diseases?

Asbestos-related lung diseases are diseases caused by exposure to asbestos (as-BES-tos) fibers. Asbestos is a mineral that, in the past, was widely used in many industries.

Asbestos is made up of tiny fibers that can escape into the air. When breathed in, these fibers can stay in your lungs for a long time. If the fibers build up in your lungs, they can lead to:

• Pleural plaque. In this condition, the tissue around the lungs and diaphragm (the muscle below your lungs) thickens and hardens. This tissue is called the pleura. Pleural plaque usually causes no symptoms. Rarely, as the pleura thickens, it can trap and compress part of the lung. This may show up as a mass on an x-ray image.
• Pleural effusion. In this condition, excess fluid builds up in the pleural space. The pleural space is the area between the lungs and the chest wall.
• Asbestosis (as-bes-TOE-sis). In this condition, the lung tissue becomes scarred. People who have asbestosis are at greater risk for lung cancer, especially if they smoke.
• Lung cancer. This type of cancer forms in the lung tissue, usually in the cells lining the air passages.
• Mesothelioma (MEZ-o-thee-lee-O-ma). This disease is cancer of the pleura.

Asbestos also can cause cancer in the lining of the abdominal cavity. This lining is known as the peritoneum (PER-ih-to-NE-um).

Overview

Until the 1970s, asbestos was widely used in many industries in the United States. For example, it was used to insulate pipes, boilers, and ships; make brakes; strengthen cement; and fireproof many items, such as drywall.

People who worked around asbestos during that time are at risk for asbestos-related lung diseases. People at highest risk include:

• Unprotected workers who made, installed, or removed products containing asbestos. People who worked near others who did these jobs also are at risk.
• Family members of workers who were exposed to asbestos. Family members may have breathed in asbestos fibers that workers brought home on their clothes, shoes, or bodies.
• People who live in areas with large deposits of asbestos in the soil. This risk is limited to areas where the deposits were disturbed and asbestos fibers got into the air.

Asbestos fibers also can be released into the air when older buildings containing asbestos-made products are destroyed. Removing these products during building renovations also can release asbestos fibers into the air.

Generally, being around asbestos-made products isn’t a danger as long as the asbestos is enclosed. This prevents the fibers from getting into the air.

People in the United States are less likely to have asbestos-related lung diseases now because the mineral is no longer widely used.

The use of asbestos is heavily restricted, and rules and standards are now in place to protect workers and others from asbestos exposure. Asbestos is found in only a few new products, such as gaskets used in brakes.

However, many countries do not yet restrict asbestos use. People in those countries are still exposed to the mineral.

Outlook

The outlook for people who have asbestos-related lung diseases can vary. It will depend on which disease a person has and how much it has damaged the lungs.

No treatments can reverse the effects of asbestos on your lungs. However, treatments may help relieve symptoms, slow the progress of the disease, and prevent complications.

If you've been exposed to asbestos, let your doctor know. He or she can watch you for signs of asbestos-related problems and start treatment early, if needed. Early treatment may help prevent or delay complications.

Quitting smoking and making other lifestyle changes may help people who are at high risk for asbestos-related lung diseases. These lifestyle changes may prevent more serious diseases, such as cancer.

Mesothelioma Cancer.

Mesothelioma is an aggressive cancer affecting the membrane lining of the lungs and abdomen. Malignant mesothelioma is the most serious of all asbestos-related diseases. The primary cause and risk factor for mesothelioma is exposure to asbestos.

Making a correct mesothelioma diagnosis is particularly difficult for doctors because the disease often presents with symptoms that mimic other common ailments. There is no known cure for mesothelioma, but treatments such as surgery and chemotherapy have helped to improve the typical mesothelioma prognosis.

Pleural mesothelioma (affecting the lung’s protective lining in the chest cavity) represents about three quarters of all mesothelioma incidence. Peritoneal mesothelioma, which affects the abdominal cavity, and pericardial mesothelioma, which affects the cardiac cavity, comprise the remainder.

There are three recognized mesothelioma cell-types. Between 50 and 70% of all mesotheliomas are of the epithelial variety. While prognosis is generally poor, it is considered less aggressive than sarcomatoid mesothelioma and biphasic mesothelioma, which comprise the remainder of cell type diagnoses.

The cavities within the body encompassing the chest, abdomen, and heart are surround by a membrane of cells known as the mesothelium. Mesothelial cells assist in general organ functions. The mesothelium is particularly important to organs that are commonly in motion, such as expansion or contraction of the lungs, stomach, or heart. Lubrication from the mesothelial cells allows free range of motion within the body. The mesothelium of the chest, abdomen, and cardiac cavity are called the pleura, the peritoneum, and the pericardium, respectively. Each of these groupings of mesothelial cells is extremely critical to the functions of the body structures which they encompass.

Malignancies (cancerous tumors) occurring within the mesothelial membranes are known as malignant mesothelioma, or simply mesothelioma. Benign tumors of the mesothelium are known to occur, but are much more rare than malignant mesothelial tumors.

While tumors of the mesothelium were first recognized in the late 18th century, it was not until the middle of the 20th century that this particular cancer was studied and examined with more detail. It was at this time when suspicions of the cancer’s causal relationship with asbestos exposure became more substantiated. A joint research venture through the Department of Thoracic Surgery at the University of the Witswater and Johannesburg General Hospital in South Africa provided the most compelling evidence of the nexus between asbestos exposure and the development of pleural mesothelioma.

Incidence of mesothelioma is still quite rare, with only 2,500-3000 diagnoses in the United States each year. There was a spike in reported diagnoses between 1970 and 1984, which has been attributed to the latency period between diagnosis and the height of industrial exposures, which occurred roughly 40-60 years prior to this time. Exposure was common in nearly all industries but was particularly common in the WWII-era military industrial cycle, including Navy Shipyards.

Although this cancer is much more common in men over the age of 60 (largely attributed to the industrial exposures within male-dominated industries), mesothelioma in women and children has been described as well. Mesothelioma causes for diagnosis in women and children are mainly attributed to secondary exposure to asbestos, as it was not uncommon for men to bring asbestos back into the home on their body or clothing if proper cleaning facilities were not available on site.

Mesothelioma is diagnosed through a comprehensive combination of biopsy and imaging scans.

Mesothelioma can be a difficult malignancy to diagnose because the symptoms of the disease closely resemble other respiratory conditions, and because the pathology can be very difficult to distinguish from adenocarcinoma of the lung. For this reason, misdiagnosis is not uncommon in mesothelioma patients. Symptoms of mesothelioma include chest pain, chronic cough, effusions of the chest and abdomen, and the presence of blood in lung fluid.

Diagnostic surgeries, including a biopsy, will typically be required to determine the type of malignant cells that are present in the body. Typically a body imaging scan, including a magnetic resonance image (MRI), computer topography (CT scan), and/or positron emission tomography (PET), will be required to determine the extent and location of the disease.

While mesothelioma is typically advanced at diagnosis, treatment options are available.

Mesothelioma, while certainly an aggressive disease, is a manageable malignancy. While there is no cure for the cancer, mesothelioma treatment options may potentially include surgery, chemotherapy, and radiation therapy. A combination of Alimta® and Cisplatin is currently the only FDA approved chemotherapy regimen, though several clinical trials are currently in progress utilizing other drugs including Gemcitabine and Onconase, that may lead to new treatment options that provide a benefit for patients.

Radiation therapy is also utilized, but typically in conjunction with other treatment methods like surgery and chemotherapy. Surgical resection of mesothelioma is possible in early-stage-diagnosed patients. Diagnostic and palliative procedures such as thoracentesis and pleurodesis are also commonly performed in patients with malignant mesothelioma in order to minimize cancer-related symptoms.

Alternative therapies have also been used effectively by many mesothelioma patients to assist in managing symptoms of the disease and conventional treatments.

Mesothelioma is caused by exposure to asbestos.

Mesothelioma is primarily caused by exposure to asbestos, though cases have been documented in children or other individuals with no asbestos history. Asbestos is a microscopic and naturally occurring mineral that lodges in the pleural lining of the lungs and the peritoneal lining of the abdominal cavity. In most cases, several years will pass (up to 60) before mesothelioma develops in those who had been exposed to asbestos.

Asbestos and Mesothelioma Lawsuits: What to Expect.

If you've been exposed to asbestos and been diagnosed with mesothelioma, you may ask, "If I file a lawsuit can I expect to recover significant money damages?" The answer is usually "yes." People who discover they are suffering from mesothelioma due to working with asbestos (or, if they are deceased, their spouse) have an excellent chance of achieving substantial money damages, either from the company that manufactured or installed the asbestos, or from an insurance company or asbestos victims' trust fund that has assumed liability for the company. And this is true even if the original manufacturer has long since sold out, closed down, or even gone bankrupt, thanks to the formation of asbestos victims' trust funds.

How Long Do I Have to Sue?

Mesothelioma tends to develop 10 to 40 years after exposure to asbestos. State laws called statutes of limitations usually give people one to five years (depending on the state) from the diagnosis or discovery of mesothelioma to file a lawsuit. But it's important to act promptly, because in a few states, including California, Tennessee, and Louisiana, the statue of limitations is only one year from diagnosis.

If a mesothelioma victim has already died, his or her spouse and other heirs typically have one to three years from the date of death to file a wrongful death action, which can also result in the recovery of substantial money damages.

Mesothelioma victims can't file or join in class actions lawsuits because each person's medical history and prognosis is different, so mesothelioma cases must be filed individually.

How Long Does an Asbestos or Mesothelioma Case Take?

Most asbestos cases are settled before they ever get to a jury (meaning the parties agree outside of court to the amount of money damages the mesothelioma victim will get). If you have gathered all the facts about your medical condition and employment history, and your lawyer runs an efficient office, and there is an easily identifiable payment source -- such as an insurance company or an asbestos victims' trust fund -- you may get your money in less than a year from the date your lawsuit is filed. But in other situations, where the amount of money damages depends on going to trial (or at least threatening to do so), it can take two years or more. Fortunately, the court rules in many states recognize that mesothelioma victims have a short life expectancy and as a result, fast track their lawsuits.

How Much Can I Recover?

The dollar amount you are likely to receive as compensation for developing mesothelioma is hard to estimate. Some cases result in settlements or jury awards in the millions, while similar ones settle for comparatively little. This is because over the years, many companies that manufactured or installed asbestos have closed down or gone bankrupt, which in turn has resulted in courts' requiring that large funds be set aside to compensate future victims. Some of these funds are still large enough to pay out all claims at full value, but others have been depleted to the point that far less is available, so settlement amounts must be rationed.

In addition to the size of the asbestos victims' compensation fund available for payment, each victim's particular mesothelioma illness and how it has affected their life is important to arriving at a cash settlement or jury verdict. The dollar amount of wages lost due to the illness, the cost of medical expenses, and, usually most important, the degree of the victim's pain and suffering are all key factors in putting a dollar value on a particular case.

A third factor in estimating how much money damages you'll recover is time. When cases are settled relatively quickly, the amount recovered tends to be significantly less than if your lawyer waits to present your case to a trial jury. But preparing and conducting a jury trial may take several years, whereas settlements can often be arranged in a year or less. For this reason, many seriously ill plaintiffs prefer a relatively quick settlement, and this is especially true when they learn that some lawyers charge substantially more when a case goes to trial.

All of this being said, many mesothelioma cases result in settlement or awards in the range of $1 million to $5 million or more, but when attorneys' fees, court costs, and medical expenses are subtracted, victims often end up with around two-thirds of these amounts.

Can I Get Disability Because of Mesothelioma?

The most common types of mesothelioma qualify for expedited disability benefits from the Social Security Administration.

How Do I Pay My Lawyer?

All mesothelioma cases are handled on a contingency fee arrangement. This means your lawyer charges you no fees up front, but instead receives a percentage of the eventual settlement or money damages you receive as the result of a court judgment, plus any expenses (for things like depositions, copying, and postage) that you agree to pay as part of a written fee agreement. A typical contingency fee is 25% to 40% of money damages you recover. The exact amount depends on several factors, including whether a victims' trust fund places a cap on contingency fees (some allow no more than 25%), whether you settle out of court or go to trial, how much the lawyer wants your case (if the attorney believes your case is certain to win a big settlement or court judgment, you are in a much better bargaining position than if you are likely to receive a lower amount), and how hard you bargain before signing a fee agreement.

How Do I Find a Mesothelioma Lawyer?

Nolo provides a personalized lawyer directory that includes lawyers who specialize in personal injury and mesothelioma cases. Information about each lawyer's experience, education, and fees, and (perhaps most importantly) the lawyer's general philosophy of practicing law is available. 

How to Hire a Mesothelioma or Asbestos Lawyer.

Mesothelioma is a disease caused by exposure to asbestos. Mesothelioma victims almost always win money damages if they sue, but the cases can be complicated and a mesothelioma lawyer is usually needed to identify the parties who are liable for the asbestos exposure (asbestos manufacturers, insurance companies, or asbestos victims' trust funds) and begin the lawsuit or settlement process. Because mesothelioma cases are a specialized legal niche it's important to understand how mesothelioma lawyers operate and how to hire a good one. 

The Legal Background

People who find out that they are suffering from mesothelioma (often as a result of working with asbestos) usually have an excellent chance of recovering substantial money damages -- either from the company that manufactured or installed the asbestos, or from an asbestos victims' trust fund. But these cases can get complex, especially from a medical standpoint, since mesothelioma often shows up 10 to 40 years after exposure to asbestos. Having an experienced attorney on your side -- especially one with a record of success in mesothelioma cases -- can make all the difference. 

Finding the right mesothelioma lawyer can be key to your case, but it can also take time and effort. If you are not feeling well, make sure you get help from a consumer savvy relative or friend. As discussed below, you'll get the best results if you do careful research as to a lawyer's qualifications and track record and then interview several. You also may need to bargain as to the amount of the contingency fee and other costs.

Ways to Find the Right Mesothelioma Lawyer

Ask former colleagues. If you have been diagnosed with mesothelioma, chances are good that people who you worked with at the time of your exposure also suffer from it and may have already hired a lawyer and filed a lawsuit. If they have achieved a good result through a lawyer they like and respect, this is one good place to start.

Check Nolo's online Lawyer Directory. Some attorneys featured in Nolo's lawyer directory handle mesothelioma cases (full disclosure: lawyers pay a fee to list with Nolo). These attorneys have filled out a detailed profile containing valuable information about their schooling, professional background, legal specialties, and personal attitudes. While there are also a number of other legal directories, we believe Nolo's provides the most consumer friendly information.

Investigate lawyers online. Because mesothelioma cases can be so profitable, many law firms spend big dollars on Internet ads and websites. Just Google mesothelioma lawyer and you'll find a long list. Click on a few ads or websites and you'll see that everyone claims to be the best of the best. How do you cut through all this hype to focus on a short list of hopefully excellent mesothelioma lawyers? We recommend that you carefully read the legal information each lawyer provides. In our experience lawyers who provide well-written, in-depth information demonstrate a superior sensitivity to client needs. By the same token, we distrust lawyers who say little more than "I can get you millions pronto -- trust me."

How to Choose the Right Mesothelioma Lawyer

Check a lawyer's references. A good mesothelioma lawyer should be able to provide you with the name and contact information of a few satisfied clients. Of course, the lawyer will have to get the permission of the client, but this can usually be arranged. Although you'll only be given the names of very satisfied clients, it can still be very helpful to talk to someone who has worked with the lawyer you are considering in a mesothelioma case.

Interview the lawyers. Once you develop a short list of mesothelioma lawyers, contact their offices (again, get help if you are very ill). Request a case evaluation and, if possible, arrange a personal interview. Ask who exactly will manage your case (often a case manager, who is a non-lawyer in larger firms). Find out who you can call or email if you have questions, and how long it will take to get back to you. Anticipating these questions, many law firms will give you a written overview of what to expect. Especially if it's detailed and guarantees that all calls and emails will be returned in 24 hours, this is a good sign.

Negotiate fees with the lawyer. Mesothelioma lawyers charge a contingency fee for their legal representation, plus additional costs to prepare your case. One good approach is to contact several lawyers, making it clear that you'll take your time before signing a fee agreement. Your goal is to find a good quality lawyer who will represent you for 25% to 30% of your recovery, instead of 33% to 40%. But keep in mind that mesothelioma cases can be very complex. If you find an attorney who comes well-recommended and has a lot of experience (and a record of success) representing mesothelioma clients, a few percentage points on a contingency fee probably shouldn't dictate whether or not you hire that attorney.

Find out how are costs handled. A good attorney will deduct costs (things like filing fees and expert witnesses' compensation) off the top of any settlement or award, before the money is divided and the attorney takes their agreed-upon percentage. That way you and the attorney share payment of the costs. And a good attorney will give you receipts showing that all costs incurred were specific to your case -- meaning you're not being saddled with part of the bill for the firm's general operating expenses.

Mesothelioma Law Firm.

What is Mesothelioma?

Mesothelioma is a rare form of cancer that occurs in the mesothelium –– a thin layer of tissue that covers most of our internal organs. In most cases, the tissue surrounding the lungs is affected. However, cases have been reported in which other body organs are affected with this condition. This form of cancer is very aggressive and often proves fatal if it is malignant Mesothelioma.

Know the Risk Factors

Although several materials can possibly cause this disease, mesothelioma is primarily attributed to exposure to asbestos as reported by the Agency for Toxic Substances and Disease Registry of the CDC. Furthermore, Asbestos has been classified by the US Environmental Protection Agency (EPA) as a human carcinogen.

According to the CDC (Center for Disease Control and Prevention), exposure to asbestos increases the risk of developing malignant Mesothelioma. The latency period for the disease is reported to be around 20 to 40 years. So exposure to asbestos can go unnoticed for decades. Hence, mesothelioma cases are diagnosed years after the first exposure to asbestos occurs. In a study conducted by the CDC's National Institute for Occupational Safety and Health (NIOSH), annual multiple-cause-of-death records were analyzed for the period from 1999 to 2005. It was found that a total of 18,068 deaths were reported because of malignant Mesothelioma.

Who should be concerned?

Asbestos is imported into the United States and was even mined in the country during the 20th century. In the US, the use of asbestos peaked in 1973 when it amounted to 803,000 metric tons before declining to 1,700 metric tons in 2007. Industrial workers employed in settings such as manufacturing, construction and shipbuilding prior to 1980s are the ones who are at most risk, as federal safety regulation was not in place at the that time. Exposure continues to occur today because of the demolition of buildings in which asbestos was used during construction.

Steps to Take in Case Of Asbestos-Exposure Related Mesothelioma

After taking into consideration several research findings, exposure to asbestos has been singled out as the main cause of Mesothelioma in most cases. This exposure affects individuals differently. Several factors are involved, including concentration, frequency and duration of exposure as well as the shape, size and chemical makeup of the fibers that determine your chances of contracting Mesothelioma.

It is natural to feel concerned about Mesothelioma if you have experienced chronic exposure to asbestos. Doctors recommend that such people should get regular CT scans or chest x-rays. They must also get lung function tests as these tests can detect problems caused by asbestos fibers. If any problems are detected, you should obtain a professional Mesothelioma diagnosis. In the unfortunate event of being diagnosed with Mesothelioma, you have the grounds for filing a lawsuit. A Mesothelioma law suit can help you claim compensation for the additional costs borne in dealing with this disease as well as for the resulting emotional distress and trauma.

Why choose a Mesothelioma Law firm

The dangers associated with asbestos exposure have been known to the Asbestos manufacturers for decades. Victims of the disease rightly feel that they should have been warned about these dangers and so undue hardships both for the victims and their families could have been avoided. Treatment plans are often tailored to the patient’s needs so the medical expenses incurred because of the disease vary from person to person and are often considerable.

If you feel that you or a loved one has developed mesothelioma and have also been exposed to asbestos fibers during their lives, you will typically be eligible for filing a lawsuit and claim compensation for any treatment related expenses, as well as for the pain and suffering caused by this disease. The litigation process involved is quite complex. So it is better to hire the services of a Mesothelioma law firm that has the time as well as the resources to tackle investigations specific to your case.

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Breast Cancer: Everything You Need to Know!

What is Breast Cancer?

Breast cancer develops from the uncontrolled growth of abnormal cells in the breast tissue. These growing cells form a tumor in the breast, which can sometimes be felt as a lump. There are several types of breast cancer, but the most common type is ductal carcinoma, which arises in the milk ducts (the passages through which milk flows toward the nipple). A small percentage of breast cancers develop in the lobules (small glands in which milk is produced) and are called lobular carcinoma.

Ductal and lobular cancers are further classified by whether the cancer cells have spread to other parts of the body. If the breast cancer cells are confined within the milk ducts or lobules, it is called noninvasive or in situ cancer. When the cancer has grown into surrounding tissue or spread to other parts of the body, it is called invasive or infiltrating cancer. About 80 percent of all breast cancers are invasive ductal carcinomas (IDC).

What Causes Breast Cancer?

The precise cause of breast cancer is unknown; it is most likely due to a combination of genetic and environmental factors. Some women who exhibit many of the risk factors of breast cancer never contract the disease, while some who manifest none of the risk factors may succumb to it.

There does appear to be a link between breast cancer and the hormone estrogen. It's possible that the more that a woman is exposed to estrogen, the greater risk she has of breast cancer at some point. Researchers are investigating events in a woman's life, such as her age of first and last menstruation, her age at childbirth and whether she breastfed or underwent hormone therapy, as these events all affect the estrogen levels in the body.

The two most important risk factors to doctors right now are a woman's family history of breast cancer and her age. A woman with a blood relative who had breast cancer is two to three times more likely to develop the disease herself, while women who are older than 60 have a greater risk than younger women.

What Are the Risk Factors for Breast Cancer?

There are some risk factors for breast cancer that are within your control, while there are others that are out of your hands.

Risk factors include:

• Gender -- Women are much more susceptible to breast cancer than men.
• Age -- Older women are at greater risk than younger women.
• Family history of breast cancer -- If a blood relative, such as a mother or a sister, has had breast cancer, then the likelihood increases that other women in the family will have breast cancer.
• Inherited genes -- Some women carry the BRCA1 and BRCA2 genes, which increase the risk of breast cancer.
• Personal history of breast cancer -- If a woman has had breast cancer before, she may have it again in the other breast.
• Obesity -- Obese and overweight women are at a greater risk of breast cancer.
• Alcohol use -- Excessive alcohol consumption may increase the risk of breast cancer.
• Estrogen-containing medicines -- Women who undergo hormone therapy after menopause may have an increased risk of breast cancer, as well as many women who take oral contraceptives containing estrogen. Ask your doctor before beginning any type of medication that includes estrogen.
• Age at menstruation, menopause and childbirth -- Menstruating at an early age has been linked with an increased risk of breast cancer, as has beginning menopause at an older age. Women who give birth for the first time after the age of 35 may also be more susceptible.

How is Breast Cancer Detected?

Breast cancer can develop for quite a while without any visible symptoms. As the cancer progresses, these symptoms may become apparent:

• A lump or thickening in the breast or under the arm
• A change in the size or shape of the breast
• Discharge from the nipple or tenderness of the nipple
• A change in the color or texture of the skin of the breast or nipple (such as dimpling, puckering, scaliness or new creases)
• A scaly, thickened or inward-turning nipple

See your doctor if you experience any of these symptoms. Your doctor may then order a mammogram, or an X-ray of the breast. In the United States, the government recommends that women over the age of 50 get a mammogram every two years; women who exhibit many of the risk factors listed on the last page should consult their doctors about when to start getting regular mammograms. Mammograms are often how doctors detect abnormalities in the breast, though they may also use tools such as breast ultrasound,breast magnetic resonance imaging (MRI) or biopsies.

How is Breast Cancer Treated?

Breast cancers are divided into different groups, called stages, based on the size of the tumor, whether it is invasive or noninvasive, and whether it has spread through the lymph nodes to other parts of the body. Stage 0 cancer indicates a small, noninvasive tumor, while Stage IV is the highest stage, indicating cancer has spread. To determine whether the cancer is invasive and has spread outside the breast, a surgeon removes one or more lymph nodes and examines them for cancer cells.

The course of treatment depends on the stage of the cancer, the woman's age and her general state of health. Treatment options include:

• Lumpectomy, or surgical removal of the tumor
• Partial mastectomy, which is removal of the tumor and some surrounding tissue
• Total mastectomy, or removal of the entire breast, leaving the underarm lymph nodes
• Modified radical mastectomy, which includes removal of the entire breast, some of the underarm lymph nodes and one of the smaller chest muscles
• Chemotherapy, which uses drugs to destroy cancerous cells. Chemotherapy may be used before or after surgery.
• Radiation uses beams of energy to kill cancerous cells.
• Hormonal therapy may be used for certain types of breast cancer that are sensitive to estrogen and progesterone. Tests can determine if the cells will respond to hormones.
• Targeted drugs, which include Avastin and Herceptin

After enduring a scary diagnosis and a strenuous treatment, it can be frustrating to learn that you still have to be on guard for a recurrence of the cancer. Still, the odds are with you -- 70 percent of women live more than five years after receiving their initial diagnosis, while half survive more than 10 years.