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Posts by: Steven Kazan

Mesothelioma and Exercise: What Patients Should Know About Physical Activity

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man on exercise machineFor people with malignant pleural mesothelioma (MPM), life after treatment can be very different. Things like diet, rest and daily activities usually change to accommodate a person’s new health status. But that doesn’t mean that everything from your old life has to fall away. Certain things, like regular exercise, can still be an important part of your weekly schedule.

At Kazan, McClain, Lyons, Greenwood and Harley, we know. We’ve spent almost 40 years helping people with MPM understand their legal and medical options. While we always recommend that patients talk to their doctor about physical activity, we do know that moderate, low-impact exercise can help improve quality of life for some people with mesothelioma.

In fact, two new studies have proven it.

Moderate activity boosts QoL

The pair of reports, both published in an August issue of the journal The Cochrane Library, essentially said the same thing. (And they should – they’re written by the same people.) For individuals with cancer, exercise can help improve their quality of life (QoL).

Each paper comes in the form of a literature review, combining the results of as many as 56 prior trials involving more than 4,800 people with cancer. The authors found that, overall, physical activity boosted a number of QoL indicators.

After six months of exercise-based interventions, participants exhibited improvements in:

  • Overall QoL
  • Body image
  • Self-esteem
  • Emotional wellness
  • Sexual activity
  • Pain levels
  • Fatigue
  • Anxiety levels
  • Physical mobility
  • Social interactions

Researchers said that “together, these reviews suggest that exercise may provide quality of life benefits for people who are undergoing or have undergone treatment for cancer.”

But be cautious

While life with mesothelioma does not necessarily have to be taken lying down, it’s important to be judicious with physical activity. Patients who have just received treatments must take several weeks (or, in many cases, months) to fully recover. Once a doctor clears you for exercise, start slow.

The Mayo Clinic recommends beginning with relaxation exercises, in which you slowly tense and then release different muscle groups. After that, MPM patients may gradually work their way up to yoga, tai chi, hiking or slow jogging.

In all cases, patients should have someone on hand to help moderate their level of activity and to assist in case they begin feeling dizzy or faint. Remember to warm up beforehand, cool down afterward and drink fluids throughout.

And again, as the American Cancer Society emphasizes, only engage in exercise after being cleared by your cancer team.

Related articles:

Nutritional Information for Mesothelioma or Lung Cancer Patients

Strategies for Coping with a Mesothelioma Diagnosis

Mesothelioma Support Services and Groups: Benefits and How to Find Them

 

Asbestos Issue Rising to the Forefront in Brazil

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Like a number of countries around the world, Brazil is currently in the midst of tackling a major public health issue that has continued to pose a serious risk to its citizens for years: asbestos.

Brazil has been one of the countries at the forefront of the asbestos issue since the Global Asbestos Congress was held in the nation in 2000. A number of Brazil’s major states – including Sao Paulo, Rio de Janeiro and Rio Grande do Sul have already moved to ban the carcinogenic substance, while similar legislation is circulating in other regions of the country as well.

According to Laurie Kazan-Allen, Coordinator for International Ban Asbestos Secretariat (IBAS), while the asbestos lobbyists in Brazil have taken a serious hit, resistance to the ban is still pretty prevalent throughout the country. Wealthy asbestos backers have pushed for the status quo, which supports the “controlled use of asbestos,” according to Kazan-Allen.

Asbestos hearings headed to Brazilian Supreme Court

August marks an important month for the fate of asbestos in Brazil. Kazan-Allen notes that the Brazilian Supreme Court is set to take on the issue, hearing from local and international experts ranging from supporters of the ban to industry backers.

Last week, an agenda was set for the initial round of hearings on the asbestos issue, with more than 35 speakers scheduled to testify on the issue, including some of the world’s most notorious asbestos supporters. Scientific experts from Italy, Brazil and the U.S. are also scheduled to appear during the court hearings.

As Kazan-Allen notes, the international importance of the court hearings can be seen in the fact that the end-of-the-month proceedings will be translated into English.

Despite scientific evidence, asbestos issue rolls on

Though many states in Brazil have banned the substance, the fact that asbestos industry supporters still have a voice is alarming considering the plethora of evidence pointing to the serious risks caused by exposure to the carcinogenic material.

The dangers of asbestos have been seen as far back as the days of Pliny the Elder, the Roman philosopher who noticed that slaves who worked with asbestos appeared to suffer a “sickness of the lungs.”

Fast forward to 2012, and it has been well-documented that asbestos exposure can lead to the development of asbestosis, lung cancer and malignant mesothelioma. All told, the World Health Organization estimates that such asbestos-related diseases kill approximately 107,000 people around the world each year.

Award-Winning Study Shows that Mesothelioma Tissue Tests are Improving

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family making medical decisionsBecause malignant pleural mesothelioma (MPM) is such a tough disease to treat, it’s easy to feel like there’s little or nothing that patients have going for them. Fortunately, this isn’t true. At Kazan, McClain, Lyons, Greenwood and Harley, we make it our business to see that MPM patients have an advocate, someone who helps them learn their complete legal and medical rights. Making fully informed decisions about care and treatment is essential for people with mesothelioma.

Meanwhile, from the clinical end, researchers are making exciting new finds practically every month, many of which directly affect mesothelioma patients and their families.

Consider an award-winning presentation given at this year’s British Thoracic Oncology Group Conference. In it, researchers announced that diagnostic tissue tests for mesothelioma are getting better and better.

The ‘changing face of mesothelioma diagnosis’

Delivered by a team of British doctors from the Glenfield Hospital in Leicester, the poster session won one of the conference’s runner-up prizes, out of a field of 200 entries.

So, what did they say?

The team addressed the “changing face of mesothelioma diagnosis,” concluding that it is shifting toward earlier, more thorough diagnoses. Even though it may seem like cases of MPM have been confirmed in the same manner for the last 30 or 40 years, researchers said that’s not the case. In fact, in just the past decade, the diagnostics that oncologists use for MPM have undergone a seismic shift.

The authors proved as much by analyzing every case of mesothelioma reported in Leicester, England, between 2000 and 2010. The results of some basic number crunching indicated a major change in the ways oncologists find MPM.

Over a decade, histology makes a big leap

To start, researchers noted that nearly all cases of mesothelioma are now confirmed histologically – that is, under a microscope. Their data showed that while in 2000 just three-quarters of cases involved doctors examining cell samples up close, by 2010 that figure had jumped to 96 percent.

Likewise, the proportion of cases diagnosed during post mortem exams plummeted from 34 percent to just 4 percent.

What do these changes mean? Basically, more cases are being confirmed in a thorough manner, while fewer are dying before diagnosis.

The team also noted that the kinds of diagnostic tests being used are shifting:

  • In the first half of the decade, CT-guided biopsies were used to confirm diagnoses in just 6 percent of cases. By the end of the decade, 36 percent of MPM patients were undergoing this test.
  • Medical thorascopy also had a meteoric rise in Leicester. The team noted that this less invasive form of biopsying leaped from being totally unused to contributing to more than one-third of all diagnoses.
  • Meanwhile, invasive surgical biopsies declined from 43 percent to 20 percent.

“Pre-mortem histological diagnostic confirmation has significantly increased in the past five years compared to the previous five years and is now achieved in [more than] 95 percent of our patients,” the group concluded. “This is due to increased use of CT-guided pleural biopsy and medical thoracoscopy.”

What does this mean for patients?

There are several positive findings in this study. The first is that, by using tissue sampling and microscopic cell staining, doctors are diagnosing more cases of MPM during patients’ lifetimes, making people with mesothelioma more likely to get a solid prognosis and have access to proper treatments and palliative care.

The poster session also indicated that histological staining can adequately confirm the presence of MPM, sparing many patients the experience of undergoing an invasive diagnostic surgery.

Finally, it’s nice to know that the methods doctors use to diagnose mesothelioma are getting more sophisticated all the time.

San Francisco-Based Bechtel Group in Hot Water over Asbestos Issue in Australia

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engineerSan Francisco, California-based Bechtel Group, the largest construction and engineering company in the U.S., has run into trouble related to asbestos in the Australian state of Queensland.

According to the Australian Broadcasting Corporation, the Electrical Trades Union (ETU) says it could take Bechtel to federal court over a wage dispute in which some workers refused to complete a project until asbestos testing was completed.

The dispute, which is taking place on Queensland’s Curtis Island near Gladstone, stems from pre-built electrical switch rooms that were imported by Bechtel from Indonesia. Testing has indicated that the rooms contain white asbestos, which is a banned import in Australia, according to the news source.

Peter Ong, an official with the ETU, told the media outlet that after a Fair Work Australia hearing did not resolve the issue, the union is considering taking the matter to federal court.

“The current agreement that covers the projects being built at Curtis Island is a WorkChoices agreement, so it was made in 2009,” Ong explained. “That agreement doesn’t allow for arbitration, so it doesn’t allow for the commissioners to actually make a call or make a judgment on it unless both parties agree to arbitration.”

Bechtel’s asbestos issues continue

Bechtel, which was founded in 1898, has a long history with asbestos, particularly during World War II during work on shipyards. The company has also been the subject of asbestos lawsuits from individuals who were exposed on the job, making it all the more troubling that the carcinogenic substance has become an issue for Bechtel once again.

The issue is particularly disconcerting considering the well-documented risks of asbestos exposure. According to World Health Organization estimates, asbestos-related illnesses such as lung cancer, asbestosis and malignant mesothelioma are responsible for the deaths of approximately 107,000 individuals around the world each year.

Ong, the union official helping to lead the charge in the Bechtel case, told the Australian Broadcasting Corporation that the fact that the industrial giant has not admitted to poorly handling the situation and not properly compensated workers is more than troubling.

“Now that’s not happening all, that’s left up to our side of things … to take it to the Federal Court,” Ong explained.

Asbestos Victim Shares His Mesothelioma Lawsuit Experience

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Dr. Ron Gersten I have told hundreds of asbestos victims about the process of a mesothelioma lawsuit, yet nothing can prepare a client for the experience like the following excerpt. Thanks to Kazan Law client, Dr. Ron Gersten, for sharing his story in his book, Where the Mountain Takes Me, which he wrote with Gerry Mandel after his mesothelioma diagnosis in June of 2008.

The Courtyard by Marriott became the scene for a critical confrontation between the plaintiff Dr. Ron Gersten and a long list of defendants. The attorneys at Kazan Law sensed they had a strong case. They tried to cover every base, even bases that Ron was unaware of–his entire history, his grades in college, his affiliations and friends. Anything that might pertain to his condition, as remote as it might be, was examined inside and out.

Kazan’s team of investigators probed into every aspect of his case, from the companies responsible for the products and their lack of safety at the site, to the use of the asbestos in the products themselves. Thousands of pages of information were reviewed and potential witnesses contacted. The resources of this experienced law firm had been cranked into overdrive to move into the deposition quickly and effectively.

This phase of the hearings promised to put tremendous pressure on Ron. His sense of detail, his memory of events long past, his specific job functions, who, where and what the projects were, what kind of materials were used and who specified them—Kazan was a tremendous help.

Ron entered the room at the Marriott where fourteen attorneys were prepared to begin the deposition. Kazan Law partner Gordon Greenwood helped Ron to a chair. The process began after opening formalities. Ron’s lead attorney was a beautiful blonde woman with a perky attitude. More important, she was one hell of a lawyer. Her name was Andrea Huston and she ran the meeting with an iron fist.

The deposition lasted four days. Ron was in pain much of the time, and coughed frequently, a persistent attempt to clear his air passages. When he appeared to be tiring, Andrea halted the proceedings with a no-nonsense “Dr. Gersten is not in shape to continue. We will take a break.”

At the end of the four days, Ron went home and waited. He kept his cell phone near him throughout the day and night. They had sued fourteen entities. Gordon called occasionally to reassure him. Andrea kept him informed of where things stood. Ron’s wife, Martha, waited as breathlessly as Ron.

Andrea called one day not long after. “Good news, Ron. We’ve just settled one of the cases.” She told Ron a number and he almost dropped the phone. He had never seen that number before, not with a dollar sign attached to it anyway. Little by little, thirteen out of fourteen settled.

The size of the final awards ensured that all medical costs and living expenses for Ron and Martha would be taken care of.

Plan to Fully Ban Asbestos in Taiwan Underway

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TaiwanThe Environmental Protection Administration (EPA) in Taiwan has published a timeline for the complete ban of asbestos in the country, according to a recent release.

Though most uses of asbestos are already banned in Taiwan, the EPA noted that some uses are still permitted, meaning a total elimination is still necessary. As a result, the EPA has established guidelines for the implementation of specific phases of the asbestos ban.

The schedule adopted by the EPA was reportedly designed to give industry groups a specific deadline to curtail, and ultimately, eliminate the use of the carcinogenic substance. Once the plan is fully adopted, Taiwan would join a growing list of countries that have decided to ban asbestos.

The plan

The deadline for the first phase of the plan has already come and gone, as on August 1, the use of asbestos in manufacturing “extruded cement composite hollow panels and construction sealants” was banned.

The next phase, which will be adopted on February 1, 2013, calls for the prohibition of asbestos in the manufacturing of roof tiles, according to the EPA. Asbestos can be found in roof tiles across the globe, as the material was once prized for its resistance to fire and utility as an insulator.

The final step in the EPA’s plan to fully ban asbestos in Taiwan will be implemented on July 1, 2018, when the carcinogenic substance will no longer be allowed in the manufacturing of brake linings, the administration said in its release.

In setting these deadlines, the EPA noted that the phasing out of asbestos use in the manufacturing of such products will lower the overall amount of the carcinogen in the country and, as a result, reduce the prevalence of asbestos-related illnesses, which include lung cancer, asbestosis and malignant mesothelioma, a rare form of cancer.

Asbestos illnesses remain a major concern

Taiwan’s efforts to ban asbestos are crucial, particularly as the World Health Organization estimates that approximately 107,000 people die each year as a result of asbestos-related diseases.

The phase-out plan also sends a strong message to the rest of the world, particularly given the recent news from Canada, where an asbestos mine is scheduled to be revitalized as a result of a government loan.

International Groups Join Forces Against Quebec Asbestos Mine Reopening

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Quebec government buildingThough investors in the Jeffrey asbestos mine in Asbestos, Quebec, may be celebrating the Quebec government’s recent decision to offer a $58 million loan to revitalize the mine, their cheers have been somewhat muted as a result of international criticism.

While supporters and asbestos industry lobbyists have hailed the decision, saying it will provide a significant economic boost, scientists and health groups have pointed to the significant dangers the mining of asbestos will bring to the forefront. Quebec has also been blasted for exporting the carcinogenic substance to developing countries while restricting its use at home.

According to Laurie Kazan-Allen, Coordinator for International Ban Asbestos Secretariat (IBAS), one troubling aspect of the revitalization of the mine is that one key financier, Ulan Marketing Co. Ltd, is an asbestos conglomerate from Thailand. Despite the fact that the Thai government opted to ban asbestos last year, this commitment by Ulan demonstrates the effort of industry groups to reverse the restriction on asbestos.

The Montreal Gazette reports Ulan has provided $14 million to assist the project, while businessman Baljit Chadha and Jeffrey Mine president Bernard Coulombe have put down another $11 million total. That $25 million was required in order for the government to provide a guarantee on the $58 million loan, according to the news provider.

Overseas criticism grows louder

Opposition to the reopening of the Jeffrey mine can be seen across the globe. The British Parliament has denounced the decision by the Quebec government, while publications in Britain, Australia and India have also railed against the actions, according to Kazan-Allen.

In countries like Japan, India and Indonesia, protests have been held in front of Canadian embassies, while officials from other countries – including Korea and the Philippines – have sent letters to Canadian authorities asking them to cease the mining and exportation of asbestos.

Developing countries like these often bear the brunt of such actions by the Canadian government, as they import the asbestos despite the known risks. According to the World Health Organization, asbestos-related diseases such as lung cancer, asbestosis and malignant mesothelioma – a rare cancer that attacks the tissues surrounding many of the body’s inner organs – kill approximately 107,000 people around the world each year.

History of Punitive Damages and Our Civil Justice System

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Western civilization has held society members responsible for what they do and and the damage they cause for some 4,000 years. As early as the Book of Exodus, in addition to awarding damages to compensate people injured by the careless or malicious acts of others, the Bible also recognized that it was important to impose punitive-type damages to punish intentionally wrongful acts that interfered with society’s most important activities in a society that depended on agriculture and farming as its primary means for support and sustenance.

Please join me in my sixth and final short talk in a series of videos devoted to understanding the  Bible as the basis for our civil justice system’s compensation of those who are hurt by the act of others, and the evolution of punitive damages to punish those who deserve it, as reflected in today’s American law.

Related posts:

Introduction to the History and Evolution of Law

History of Personal Injury Law and Our Civil Justice System

History of Civil Liability and Compensatory Damages

History of Construction Law and Our Civil Justice System

History of Product Liability Law

International Health Officials Release Statement Calling for Asbestos Ban

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Globe importantA new statement released by a number of organizations and supported by more than 150 health groups and scientists in twenty countries is calling on the complete and total ban of asbestos mining, use and exportation.

The statement comes amid controversy over the Quebec government’s decision to extend a loan to help revitalize the Jeffrey asbestos mine in the town of Asbestos. Critics of the move have pointed to Canada’s seemingly contradictory policies of restricting asbestos use at home while continuing to export the carcinogenic material to developing countries.
“Continued use of asbestos will lead to a public health disaster of asbestos-related illness and premature death for decades to come, repeating the epidemic we are witnessing today in industrialized countries that used asbestos in the past,” Dr. Stanley Weiss, chair of the Joint Policy Committee of the Societies of Epidemiology (JPC-SE), said in a statement.

Weiss pointed to the “irrefutable scientific evidence of harm to human health resulting from exposure to all forms of asbestos,” which includes the development of illnesses such as lung cancer, asbestosis and malignant mesothelioma, a rare form of cancer.

Dr. Robert Hiatt, a representative of the American College of Epidemiology, added in the statement that the health groups were calling on countries such as Canada, Russia, Brazil and Kazakhstan to stop mining and exporting the dangerous material, and assist their mining communities with this shift.

Evidence of asbestos dangers seen around the world

The statement, which is 25 pages, posits that in addition to dangers posed by the exportation of asbestos to developing countries, mining nations are also endangering their own citizens. One look at the community of Libby, Montana, offers evidence to this assertion, as 400 people in the area have been killed by asbestos-related diseases and another 1,700 have been sickened as a result of the operations of the W.R. Grace and Company vermiculite operations.

In the statement, the health organizations criticize asbestos industry groups over what they believe has been intimidation tactics designed to suppress the thoughts of scientists.

Despite any attempts, however, the evidence is clear. The World Health Organization estimates that asbestos-related diseases claim the lives of approximately 107,000 individuals each year.

Landmark Study Implicates Enzyme in Respiratory Cancers Like Mesothelioma

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medical researchersIn the world of experimental, targeted mesothelioma treatments, scientists have thousands of potential targets to work with. Literally – since, according to Shayne Cox Gad’s Handbook of Pharmaceutical Biotechnology, the human body contains at least 3,000 unique enzymes and 40,000 discrete proteins. While some of these molecules have nothing to do with malignant growth, others have been tied to the genesis of specific cancers.

CK2-alpha is one such enzyme. In a landmark study published in the journal PLoS ONE, researchers from the Thoracic Oncology Laboratory at the University of California, San Francisco (UCSF) became the first team to link CK2-alpha to a cellular signalling pathway that can cause respiratory cancers if uncontrolled.

This knowledge may contribute to better treatments for malignant pleural mesothelioma (MPM).

The first domino to fall

According to the report, CK2-alpha is responsible for “switching on” at least 300 separate proteins in the human body. Hence, this enzyme is so important for the delicate balance of cell growth and death that (researchers reasoned) CK2-alpha could easily lead to cancers if it went haywire.

The team explained that, in a number of malignancies, CK2-alpha levels are higher than normal. In fact, cancers that have very high CK2-alpha concentrations often have poorer prognoses.

Why? Well, without being sure, a number of oncologists have suspected that this enzyme can set off a cascade of cellular effects that cause uncontrolled growth.

To do so, overactive CK2-alpha seems to work through the Hedgehog (Hh) family of proteins – namely, the Indian, Desert and Sonic Hedgehog trio. (And yes, the latter is named for a video game character.) Hh proteins control organ development and stem cell growth. When CK2-alpha levels jump – possibly due to asbestos exposure – the enzyme probably cranks up the activity of the Hh proteins, leading to the creation of cancerous stem cells.

At least, that was the theory. Now, the UCSF team has essentially proved it.

Establishing it three separate ways

In cementing CK2-alpha’s role as an Hh destabilizer and respiratory cancer generator, the group went about it in three distinct ways:

  1. They analyzed 100 separate cancer tissues and established that the levels of CK2-alpha often match those of Gli1, a protein that, to put it crudely, does the Hh proteins’ dirty work.
  2. The team used chemicals to shut off CK2-alpha activity in cancer cells. This resulted in lower levels of Gli1. It also led to lower levels of cancer stem cells in the tissue.
  3. The UCSF group tried the opposite, cranking up CK2-alpha production. This led, as they suspected, to an overabundance of Gli1.

Researchers concluded that CK2-alpha may be a novel target for respiratory cancer treatments.

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