Month: March 2009

Galiher DeRobertis & Waxman has represented clients with mesothelioma and lung cancer resulting from asbestos exposure for the past 30 years.   Some of our clients have participated in clinical trials that test new combinations of surgery, radiation and chemotherapy drugs.  Our clients also have benefited from the advances and new discoveries made through the study of other types of cancer.
Researchers are always looking for new ways to battle cancer.  We know that new approaches, research, and discoveries related to all types of cancer can play an important role in finding better treatments, and eventually a cure for mesothelioma and lung cancer.  The chemotherapy drug Cisplatin, for example, was used against various types of cancer since the 1970s.  However, clinicians eventually combined Cisplatin with Alimta and found that it was an effective treatment against mesothelioma.  Mesothelioma patients lived as much as 30% longer when treated with this combination, and it was made possible by the discoveries and advances made against other forms of cancer.

For years Mina Bissell, Ph.D., of the Lawrence Berkeley National Laboratory and others have pushed hard to emphasize the point that studying and understanding the cellular environment of cancer is as important as understanding gene mutations and alterations.  Which for the most part, has received the majority of researchers’ attention thus far.  As a result of their efforts, many researchers are now looking to study a tumor’s environment.  Scientists increasingly believe the interaction between cancer cells and the surrounding cells and tissue may reveal important information for eventually finding ways to prevent cancer.

Normal Cells May Be Responsible for Allowing Cancer to Escape

Autopsies often find tumors in people who die from something other than cancer.  However, these tumors go unnoticed because they were not causing noticeable symptoms.  Researchers believe that the tumor’s environment may play a big role in helping to keep these tumors in check.

Researchers are looking at normal cells to possibly explain why a tumor becomes lethal, rather than focusing solely on the tumor itself.  Researchers are also looking at factors that may affect normal cells such as aging and chronic liver inflammation that can change the normal architecture of cells or cause them to crumble.  The idea is that cancer may spread and become lethal because normal cells allow cancer cells to escape and thrive.

How a Cancer’s Environment Responds May Fuel Its Growth

In addition to allowing cancer cells to escape and spread, a tumor’s environment also plays a big role in fueling its growth.  Studies are now underway to show how cancer cells are able to signal surrounding cells (or cell signaling pathways) in a way that promotes cancer growth.  Genentech, a biotechnology company that is part of the Roche Group, is currently testing a new drug to interrupt this type of signaling.  The theory is that some tumors cannot successfully spread without the cooperation of the surrounding cells, so some types of cancer may be successfully treated by focusing on the cancer’s environment.

Focus on Cancer’s Environment Causes Researchers to Also Look Elsewhere

Many new studies have begun to focus on cancer growth factors that were previously dismissed.  For example, researchers are looking at the relationship between injuries and cancer growth.  There are many reports that cancer becomes more aggressive after surgery or some other traumatic injury, and researchers like Dr. Bissell are still developing evidence to support or disprove these theories.

Obviously, research in these areas will continue to help researchers better understand cancer.  These new approaches have not yet led to any cures, but researchers and scientists are hopeful, even though success may be years away.

We Support Research To Find Better Treatments For Cancer Patients

Galiher DeRobertis & Waxman is committed to supporting research to help find a cure and better treatment for lung cancer, mesothelioma and asbestosis.  Our law firm has helped many clients and their families obtain compensation for asbestos-related illnesses.

Through our legal work, we also collaborate with cancer researchers and institutions.  We are very encouraged by their efforts to develop better treatments, and we support researchers who are finding new approaches to fight cancer and other terrible diseases.

Today, cancer is the leading cause of death worldwide.  It is estimated that the number of cancer deaths around the world is expected to rise by 45 percent between 2007 to 2030.  However, experts now claim that as many as 40 percent of cancers could be prevented by protecting against infections and by making lifestyle changes.

Experts Give Ways To Prevent Cancer

A report by the International Union Against Cancer (UICC), a non-governmental organization based in Geneva, highlighted infections that can possibly lead to cancer.  The report accentuated the importance of vaccines and lifestyle changes.

David Hill, the President of the International Union Against Cancer, stated that we now have the knowledge to prevent approximately 40 percent of cancers, but tragically, we are not using it.

International Union Against Cancer Urges Government And Policymakers To Take Action Now

The International Union Against Cancer emphasized the importance of using the vaccines that we now have for human papillomavirus (HPV), which can lead to cervical cancer, and hepatitis B, which can lead to liver disease and cancer, as well as other illnesses that can be prevented with vaccines.

Other diseases that can also lead to cancer such as human immunodeficiency virus (HIV), hepatitis C and Epstein Barr have no vaccines.  However, the International Union Against Cancer has made a call to policymakers to educate their communities so that preventive measures can be taken and simple changes in lifestyle can be made.  Simple changes that would be of benefit include smoking ceasation, alcohol intake limitation, and sun exposure reduction.

As part of an effort to better educate communities and have governments and policymakers take preventive measures, the International Union Against Cancer launched their “Cancer Can Be Prevented Too” campaign on World Cancer Day, February 4, 2010.

Adequate Warnings Could Have Prevented High Incidence of Mesothelioma

Today, we are grateful that many experts are focusing on prevention and education as well as better treatments and cures for all types of cancers.  For more than 30 years, the Galiher law firm has been successfully representing clients who have contracted mesothelioma, a deadly form of cancer caused by exposure to asbestos, that could have been prevented if adequate warnings had been given and safety measures taken.  We know that exposure to asbestos is the cause of mesothelioma, and that many asbestos-related illnesses could have been prevented if civilian shipyard workers and military personnel on U.S. Navy ships and submarines had been adequately warned of the dangers of asbestos.  However, our clients were not provided with the information they needed to take necessary precautions to protect themselves.

In addition, others who lived near asbestos factories or mines were never educated as to the dangers of asbestos and never had the opportunity to take precautionary measure to protect themselves, and as a result, many have suffered from asbestos-related illnesses.  Due to bystander exposure and environmental exposure,  many unwary people have contracted and suffered from asbestos-related diseases.  Unfortunately, the asbestos manufacturers knew of the hazards of asbestos but concealed their knowledge and continued to sell their products, resulting in an ongoing tragedy of people being diagnosed with mesothelioma and lung cancer.

Malignant mesothelioma is a rare disease in the general population.  About one person per million contracts this aggressive cancer, which is caused by exposure to asbestos products.  By way of comparison, about 215,000 people were diagnosed with lung cancer in 2009 versus about 3,000 who were diagnosed with mesothelioma.  As a result, the ability for research scientists to rapidly gather data about the disease is limited by the number of patients seen by the researcher’s facility.  Fortunately, the International Mesothelioma Program (IMP) at the Brigham and Women’s Hospital in Boston has helped to solve this problem and advance research in this area because of its extensive tumor bank and patient registry.

International Mesothelioma Program Shares Tissue Samples to Advance Research

The International Mesothelioma Program, under the leadership of Dr. David Sugarbaker, sees approximately 300 mesothelioma patients for consultation each year.  Last year, over 160 of these patients also underwent surgery.  The IMP maintains a patient data registry as well as a tumor bank of all patients who are seen at Brigham and Women’s Hospital for mesothelioma treatment.  Because the International Mesothelioma Program works collaboratively with the Dana-Farber Cancer Institute, mesothelioma patients treated at any of these facilities become part of this important patient data registry.  If surgery is performed, their pathology material is preserved in the International Mesothelioma Program’s tumor bank as well.

There is significant research underway at the International Mesothelioma Program using the tissue samples and the data from the patient registry.  However, the IMP also recognizes the importance of advancing  mesothelioma research in other hospitals and cancer institutes.  Accordingly, the IMP readily shares the information in the patient data registry and the tissue samples from the mesothelioma tumor bank with researchers at other cancer centers to advance the study of the development of mesothelioma and how to treat this disease.

One such researcher is Dr. V. Courtney Broaddus, a professor of medicine at the University of California at San Francisco.  Dr. Broaddus is studying the role played by other cells such as immune cells around the mesothelioma cells.  She studies macrophages to understand the role they play in assisting the mesothelioma tumor’s growth.  To do this research, the IMP sends tumor tissue to Dr. Broaddus via Federal Express from tumors that are resected from patients.  After the overnight flight from Boston to San Francisco, the tumor cells are still alive when they arrive.  Dr. Broaddus commented that this just shows how tough and hardy these mesothelioma cells are.  She grows these cells in vitro to observe the growth of the macrophages.  Growing these cell lines also enables her to test various treatments on mesothelioma cells.

Research Comparing Surgical Results Based On Patient Age

Although the International Mesothelioma Program was officially formed in 2002,  a patient data registry has been maintained for many years because patients have been treated at the Brigham and Women’s Hospital for mesothelioma since the 1980s.  The database has 400 fields, so all kinds of information has been captured and recorded for 2,000 patients.

One example of the type of research that has been conducted involves a study done by Dr. Andrea Wolfe of the IMP and Brigham and Women’s Hospital.  Dr. Wolfe compared the outcomes for mesothelioma patients having either an extrapleural pneumonectomy or a pleurectomy with decortication and were 65 years old and older.  She found that older patients fared less well immediately after the extrapleural pneumonectomy, but in terms of longer term outcomes of those who survived the surgery, both surgeries produced similar results.  She was able to do this research retrospectively looking back at 227 patients who were in the patient data registry.

Attorneys Recognize Valuable Resource for Mesothelioma Research

Attorney Richard DeRobertis, who has successfully represented hundreds of mesothelioma clients, remarked that the IMP’s patient data registry and tumor bank are, “an incredibly valuable resource for scientists so they can do cutting edge research that will eventually lead to a cure for this devastating disease.”   While DeRobertis and his law firm Galiher DeRobertis & Waxman have been able to obtain fair compensation for their mesothelioma clients and their families, the untold suffering caused by mesothelioma can only be addressed by medical research being done by Dr. Sugarbaker, the IMP and other scientists.

Lung cancer, like asbestosis and mesothelioma, can be caused by exposure to asbestos.  Many who suffer from lung cancer and mesothelioma have to undergo invasive procedures when being diagnosed.  However, new procedures are being developed to test for lung cancer and may help trigger the development of similar tests for other cancers.

Promising New Lung Cancer Detection Test

Steven Dubinett, M.D., is the senior author of a study presented at the American Association for Cancer Research – International Association for the Study of Lung Cancer’s (AACR-IASLC) joint conference in California that may change current diagnostic procedures.

Dr. Dubinett is the director of the Lung Cancer Research Program at the Jonsson Comprehensive Cancer Center at the David Geffen School of Medicine, University of California, Los Angeles (UCLA).  He stated that approximately one in every 500 x-rays shows a lung nodule of “indeterminate significance.”  When that occurs, a physician will order a biopsy or insert a scope into the lungs for further review.  However, Dr. Dubinett says that new research has discovered and assembled 40 biomarkers made up of proteins that can be used to detect lung cancer.  A biomarker or biological marker, is a substance in the blood that can be detected and measured with blood tests.  In this case, the biomarkers being tested are the proteins believed to contribute to lung cancer, or the proteins that change when cancer exists.

Status Of New Detection Test

The new procedure, however, is still in the developmental stages.  It will likely take years before it is clinically available.  If successful, the tests will also likely be able to detect lung cancer in early stages.  As with many other illnesses, early detection can help raise survival rates significantly.

Through clinical trials and research, clinicians and researchers will continue to gain a better understanding of how cancer develops, and new procedures will continue to be developed to help provide better care for those who suffer from these diseases.

We Support Research To Find Better Detection And Treatment For Cancer Patients

Galiher DeRobertis & Waxman is committed to supporting research to help find a cure and better treatment for lung cancer, mesothelioma and asbestosis.  For over 30 years, our law firm has helped our clients and their families obtain compensation for asbestos-related diseases.  We know a diagnosis like lung cancer can be devastating, and we know from our clients how uncomfortable and stressful diagnostic and treatment procedures can be.

Through our legal work, we collaborate with cancer researchers and institutions, and we are very encouraged by their efforts to develop new detection methods and treatments, and to eventually find a cure for these terrible diseases.

In a recent survey, the American Pain Foundation, a non-profit organization dedicated to promoting research for effective pain management, found that a majority of cancer patients experience severe pain even when using pain medications.  As a result, the American Pain Foundation has turned its attention to raising awareness and research into what is known as “breakthrough cancer pain,” which is the sudden and unexpected flare-up of severe pain that can occur even if the patient is on pain relief medication.

The American Pain Foundation’s goal is to improve the quality of life for those in pain by providing information, raising awareness, and promoting research to increase effective pain management.  Breakthrough cancer pain can wake cancer patients from their sleep and affect their ability to do certain activities including routine everyday activities.  Many have also reported that breakthrough pain has raised their daily medical expenses and caused increased visits to the doctor.

In response to the results of its recent survey, the American Pain Foundation will feature papers on the topic in their quarterly news letter.  The organization will also host a web-based seminar, provide tips on pain management, have a roundtable discussion with leading medical experts, and have a dedicated online chat.

Galiher DeRobertis & Waxman Is Committed To Better Care For Cancer Patients

For over 30 years, Galiher DeRobertis & Waxman has represented clients with mesothelioma, lung cancer, asbestosis, and other illnesses that result from asbestos exposure.  We have worked with the families of our clients during difficult times, and as a result of our experience, we are very aware of the emotional, financial and physical impact of these diseases.   We have collaborated with world-renowned researchers, scientists and medical experts.  We have seen the evolution of cancer care over the years, and we are very encouraged by the progress we have made.

We are told by many of our clients’ families that the hardest part is seeing their loved one in pain.  Thankfully, further research continues in clinical trials, laboratories, and hospitals, and the focus on treatment continues to broaden into new areas that aim to provide patients with better comprehensive care.  The research by the American Pain Foundation is one important step toward helping patients better tolerate their medical treatments, thereby improving their quality of life.

The fact that asbestos exposure can cause malignant mesothelioma and other asbestos-related diseases is well established.  However, despite years of research, the actual mechanisms by which asbestos fibers cause disease on a cellular level remain unclear.  The International Mesothelioma Program (IMP) research team at the Brigham and Women’s Hospital in Boston continues to investigate the role of asbestos in the development of mesothelioma.  They hope these studies will improve mesothelioma patient treatment and recovery leading to the ultimate goal of finding a cure for this deadly tumor.

Focusing on Asbestos Fibers

Researchers such as John Godleski, M.D. at the International Mesothelioma Program want to answer three basic questions about asbestos in the body and its relationship to mesothelioma.  They want to know what kinds of asbestos fiber are present, how much is there and where those fibers are located.  Using various scientific equipment and innovative techniques including confocal microscopy, chemiluminescence on in vivo or live tissue, and scanning electron microscopy, they are able to answer some of these questions.

Confocal microscopy captures images that are cross-sections of tissue samples.  These two-dimensional slices can be combined to create a three-dimensional volume or model which helps researchers visualize the precise locations of the asbestos fibers in the tissue.  Knowing where the asbestos fibers are located is key to understanding the mechanism of translocation, which is the way asbestos fibers deposited in the lungs are transported to the pleura or lining in the lungs and abdomen.

The amount of reactive oxygenation species or ROS present in a tissue sample can be measured using in vivo chemiluminescence techniques.  High levels of ROS can damage DNA and may be linked to the development of cancers such as mesothelioma.  The IMP research team uses chemiluminescence to determine the timing and location of this important process.

Lastly, when asbestos fibers are identified accurately, the amount of asbestos fibers or fiber burden can be estimated with electron microscopes.  The type of fiber may be compared with the patient’s asbestos exposure history to correlate certain fiber types with the development of mesothelioma.

Possible Implications for Mesothelioma Treatment and Prognosis

One approach to prevent the development of mesothelioma is to try to block, disrupt or alter the process of translocation of asbestos fibers from the lungs to the pleura.  As noted earlier, in vivo chemiluminescence can identify susceptible regions like the lymphatic system involved in the translocation process.  This information could be used to slow down the movement or allow removal of the fibers before they are able to develop mesothelioma in the pleura.

The IMP investigators observed that pleural malignant mesothelioma patients with lower asbestos burdens have a higher survival rate than those patients with the highest burdens.  They discovered an association between asbestos fiber burden and degree of tumor suppressor gene silencing.  Higher asbestos burden corresponded to an increase in epigenetic silencing of tumor suppressor genes in mesothelioma.  This may explain why patients with lower asbestos fiber burden are predicted to have better clinical outcomes.

Need for Asbestos Research Remains

The use of asbestos through the 1980s and later in the United States and long latency means that mesothelioma will affect a significant number of exposed individuals for the foreseeable future.  Ilana Waxman, managing partner of Galiher DeRobertis & Waxman, a law firm that has represented mesothelioma patients for more than 30 years, agrees with the International Mesothelioma Program researchers that “additional studies of the role of asbestos in the development of mesothelioma are necessary and will help improve treatment and prognosis of this deadly cancer.”

Because mesothelioma is a relatively rare form of cancer, it is often difficult to diagnose and treat.  Fortunately, researchers all over the country are working hard to improve our understanding of the disease in order to develop better treatments, and ultimately a cure for this terrible disease.

At the Mesothelioma Program at M. D. Anderson Cancer Center at the University of Texas, a team of multidisciplinary scientists and physicians have made significant strides in developing more accurate methods of surgical staging for malignant pleural mesothelioma.  “Staging” is the medical term for the process of determining the extent to which a tumor has spread through the body.

Proper Staging of Mesothelioma Essential to Treatment

M. D. Anderson’s team of more than 30 physicians have worked together to develop an innovative surgical staging process that helps them properly assess and describe the extent of the disease.  This is crucially important, because mesothelioma must be properly staged before a patient begins treatment in order to provide the most effective therapy.  For example, surgical procedures such as extrapleural pneumonectomy (EPP) are can be very effective for a patient in the early stages, but are generally not recommended for patients in the later stages.

Initially, staging is usually done through radiographic imaging, such as a CT scan, an MRI, and/or a PET scan.  Doctors may also use serum mesothelin blood tests to measure certain proteins that are secreted by mesothelioma tumors.  These tests may also be confirmed by biopsy or thoracentesis.

Surgical Staging Also Required Before Surgery

However, these methods are not entirely accurate.  As a result, all patients who undergo surgery at M. D. Anderson also undergo a thorough surgical staging to ensure the mesothelioma has not spread to the lymph glands or abdomen.  This is done through a minimally invasive laparoscopic procedure, usually on an outpatient basis.

According to Dr. Anne Tsao, Director of the Mesothelioma Program, this surgical staging is crucially important to make sure that the patient is a viable candidate for surgery.  Dr. Tsao explained that, “the reason why it’s so hard to treat is often times people have more extensive disease than what we initially realize from the radiographic imaging.  So here at M. D. Anderson before we make the patient undergo a very large surgical procedure, we have to do a smaller surgery that stages the patient to be sure that they’re a correct candidate for that surgery.”

Attorneys Recognize Important Strides Toward Improved Treatment

Galiher DeRobertis & Waxman has a 30 year history of representing clients with mesothelioma.  Our attorneys and staff have seen firsthand the devastating effect of this disease on patients and their families.  Attorney Richard DeRobertis says, “We salute the physicians and researchers at M. D. Anderson who are making important strides toward improving the treatments for mesothelioma and giving patients real hope for a cure.”