Mesothelima Cases Likely Underreported Worldwide

The study is the first to provide a global estimate of unreported mesothelioma cases based on the collective experience of countries with available data on asbestos use and the disease.

For every four to five reported cases of mesothelioma worldwide, at least one case goes unreported, according to a study in the journal Environmental Health Perspectives. This study is the first to provide a global estimate of unreported mesothelioma cases based on the collective experience of countries with available data on asbestos use and the disease.
Malignant mesothelioma is caused almost exclusively by exposure to asbestos. The disease is difficult to diagnose until it is far advanced, and the prognosis is usually poor. The study’s authors used numbers of mesothelioma deaths as a proxy for numbers of cases, because mesothelioma patients usually die shortly after diagnosis. Also, in many countries, deaths in general tend to be more uniformly and accurately reported than diagnoses.
The authors assessed the relationship between country-level asbestos use from 1920 through 1970 and mesothelioma deaths reported between 1994 and 2008. Cumulative asbestos use in 89 countries, which accounted for more than 82 percent of the global population in the year 2000, totaled more than 65 million metric tons during 1920–1970. The United States, Russia, United Kingdom, Germany, and Japan led the group in asbestos use, defined as production plus import minus export. For the 56 countries also reporting mesothelioma data, there were approximately 174,300 such deaths during 1994–2008.

Mesothelioma typically develops 20–50 years after exposure to asbestos. Accordingly, a country’s cumulative use of asbestos in prior decades was found to clearly and reliably predict numbers of recent mesothelioma deaths in the countries reporting mortality data. When the authors extrapolated this finding to the 33 countries not reporting mesothelioma data, they estimated 38,900 additional cases may have occurred in these countries during that same 15-year period.

“Our most important finding is the magnitude of unreported mesothelioma in countries that use asbestos at substantial levels but report no cases of the disease,” says study co-author Ken Takahashi of the University of Occupational and Environmental Health in Japan. Such countries include Russia, Kazakstan, China, and India, which rank in the top 15 countries for cumulative asbestos use.
Takahashi says any country that uses asbestos is certain to have cases of mesothelioma. He notes the study’s estimates may be conservative because both asbestos use and mesothelioma may be underreported in the countries used as the basis for their estimates.
The authors propose that every country ban the mining, use, and export of asbestos because, Takahashi says, mesothelioma can be prevented by eliminating exposure to asbestos. They also propose that developed countries share experience and technology to help developing countries better diagnose, report, and manage mesothelioma cases.

Proteins May Hold Key to Mesothelioma Susceptibility

Altered cellular proteins may reveal clues as to why some people exposed to asbestos get mesothelioma, while others don’t. That is the conclusion of new research conducted in China.

Asbestos has long been known to cause mesothelioma, but the mechanisms by which it does so remain largely a mystery. For instance, scientists have been at a loss to say why some people can work around asbestos for years with no ill effects, while others with the same level of exposure contract malignant mesothelioma. Understanding why this happens may not only help predict who is at higher risk, but may also give doctors new targets for treatments.

Now, research from China is shedding new light on the subject. The researchers focused their attention on cellular proteins, the command ‘signals’ that direct most cellular activity. To conduct the study, the team looked at samples of three kinds of cells: healthy mesothelial cells, healthy mesothelial cells that were exposed to crocidolite asbestos in the lab, and malignant mesothelioma cells. A multiplex immunoblot-based assay test was used to measure the expression levels of 112 different proteins and phosphoproteins in each of the samples.

The levels of 16 proteins and phosophoproteins were altered (7 were decreased, 9 were increased) in the benign mesothelial cells after they were treated with crocidolite asbestos in the lab. Most of the effected proteins were those that involve DNA damage repair and cell cycle regulation. In the malignant mesothelioma cells, 21 proteins were found to be altered (5 were decreased, 16 were increased). The researchers report “substantial overlap” between the proteins affected in the asbestos-treated cell and the mesothelioma cells.

Reporting in the international medical journal Mutation Research, the Chinese scientists conclude that asbestos exposure “has extensive affects on regulatory pathways and networks” and that these altered proteins may be used in the future to indentify people who are at high risk for developing mesothelioma. Medical treatments that target the levels of these key proteins might also be a way to control mesothelioma, which is notoriously difficult to treat with standard therapeutic modalities.
Sources:
Wang, H et al, “Crocidolite asbestos-induced signal pathway dysregulation in mesothelioma cells”, May 6, 2011, Mutation Research. Epub ahead of print.

For more information go to http://www.survivingmesothelioma.com/

Thanks A Million

Chris Knighton

It is so good to hear that the Mick Knighton Mesothelioma Research Fund has raised one million pound for research. All the money we raise goes to this fund which all goes directly to research into Mesothelioma. Well done to Chris Knighton and to everyone who has donated to this charity.
AFTER Mick Knighton died of asbestos-related cancer in 2001, his wife Chris vowed to raise £100,000 in her husband’s name because that was the average amount of compensation paid to mesothelioma sufferers.
But now, ten years after setting up the Mick Knighton Mesothelioma Research Fund, she is celebrating having collected ten times the amount she set out to raise.“It’s just amazing that we’ve reached £1m, and the fact this is Mick’s tenth anniversary year makes it even more special,” said Chris, of Wallsend. Mick was diagnosed with mesothelioma after returning from holiday with a chest infection.Chris said: “We were told there was no treatment, no cure and no hope.” Just eight months later, Mick, pictured, died.“Throughout Mick’s illness, we had both become increasingly aware of how little is known about mesothelioma and the vital need for more research into the disease,” said Chris. Mick had been exposed to asbestos while in the Navy. As a gunner, he was issued with anti-inflammable gauntlets and hoods, and the gun turret he manned was lined with asbestos. “Many of our donations are given by people who themselves have lost loved ones to the disease, and I’m so grateful for their support,” said Chris. “£1m is fantastic, but it’s what we’ve been able to do with it that’s important.” So far, the charity has funded four major research studies of mesothelioma, and the Rotary Club of Monkseaton Centenary this week presented Chris with a community service award for her fundraising efforts. “Our first study was into Alimta, the only licensed chemotherapy drug to help treat the disease,” she said. “Although not a cure, it may bring a better quality of life for longer to some.
“The next two studies are looking into treating mesothelioma by stem cells. Although in the early stages, the results so far have been encouraging. “The latest study is a new approach into starving the mesothelioma cells of the nutrients they need to survive.” The charity has also set up mesothelioma self-help and friendship groups in both North and South Tyneside to give sufferers and their families an opportunity to meet other people in similar circumstances. “My next challenge is to raise enough money to set up the first mesothelioma tissue and blood bank, which will have a major impact on research into the disease,” said Chris. The fund is holding a memorial service on Friday, July 1, at 11am at St Nicholas’s Cathedral in Newcastle.
Chris said: “The service is for all who have lost their lives to asbestos-related disease, and mesothelioma in particular, and will be followed by a sponsored dove release in their memory. “The service forms part of Action Mesothelioma Day, an annual event to raise awareness of mesothelioma.”
The service will be followed by a seminar at 1.30pm. To book a place at the seminar or make a donation, call (0191) 263 7386 or e-mail c.knighton@mkmrf.org.uk
To learn more about mesothelioma or the Mick Knighton Mesothelioma Research Fund, visit www.mickknightonmesorf.org

Bernie Brighton Marathon 2011

Well done to Bernie Barnaville for completing the Brighton Marathon and running it for our charity, he raised over six hundred pounds for his efforts, it was a huge commitment and we are very proud of him for doing it on behalf of the charity.

Don't forget our sponsored walk on Sunday 29th May, (details below)

Renal Cancer Drug Can Be Used as New Treatment For Mesothelioma

Thursday, May 12th, 2011

In a study published in the May issue of the Journal of Thoracic Oncology, temsirolimus, a drug that is used to treat kidney cancer, has shown positive results when treating pleural mesothelioma cells. Temsirolimus is a kinase inhibitor, which blocks the growth of mammalian target of rapamycin (mTOR) proteins. These proteins are found in mesothelioma cells.

Malignant mesothelioma, an uncommon form of cancer that develops in the lining of the vital organs in the body, is directly linked to asbestos exposure. Because of the long latency period associated with the cancer, it is frequently not diagnosed until the late stages of the disease.

Temsirolimus had a strong growth-stopping effect on all mesothelioma cells. However, cisplatin, a commonly used chemotherapy drug for mesothelioma treatment, displayed hypersensitivity against temsirolimus. Because of this, researchers in the study believe temsirolimus can be used in combination with other current chemotherapeutic treatments as a second-line treatment.

Professor Walter Berger of the Institute of Cancer Research at the Medical University of Vienna, a researcher on the project, stated, “Malignant mesothelioma is a severe human malignancy characterized by a very bad prognosis, with a mean patient survival of less than one year. This unacceptable situation is mainly caused by late diagnosis combined with a distinct resistance to all forms of systemic therapy available so far.”

Professor Berger commented further on the results of the study saying, “In our preclinical study, published in the JTO, we were able to demonstrate that the inhibition of the major oncogene mTOR is activate against human mesothelioma especially after development of chemotherapy resistance both in vitro and in vivo. These results suggest the initiation of clinical trials involving mTOR inhibitors as novel anti-mesothelioma strategy.”

Charity Sponsored Walk Sunday 29th May

We are again doing a sponsored walk this year to raise the much needed funds for research. The walk will be from Holywell to the Southern Water plant along the seafront, and will start at 11.00am then afterwards at Eastourne United Football Club for a barbeque a raffle and a few well earned drinks.

Anyone who wants to take part please contact me 01323 649220 or email millietalula@supanet.com or chris@nimaprint.co.ukl and I will send you out a sponsor form and all the details.

The theme of the walk is to "Be A Little Angel & Walk For Charity" so we would like to see wings, halo's and any other angelic things you can think of to wear.

Thanks for all your support and we look forward to seeing you there.

Brighton Marathon 2011

Bernie Barnaville is running the Brighton marathon in aid of our charity on Sunday 11th April 2011, it is a gruelling 26 miles, so think he is wonderful to take this on.

He has set up a donation and information site www.justgivine.com/bernie-barnaville and also has sponsor packs available, so please give him your support.

All the money you raise goes directly to Mesothlioma & Asbestos research so every penny is needed to find a cure.

The opening of the UK Centre for Medical Research and Inovation planned for London in 2011 will hopefully concentrate some of it research on asbestos exposure and subsequent diseases, it's new chief executive Sir Paul Nurse is a renown specialist in cancer research and cell biology.

Experimental Drug

Study Recruiting Mesothelioma Patients for Testing of Experimental Drug
Oct 26, 2010

A Phase II clinical trial, sponsored by the National Cancer Institute (NCI), is recruiting mesthelioma patients to test an experimental drug intended to block proteins that aid the growth of cancer cells. It will measure drug safety, patient response and survival rates.

Both men and women age 18 and older will be included in the trial. Patients must have undergone standard chemotherapy that has not been effective in halting their cancer. Patients may be diagnosed with either pleural mesothelioma or peritoneal mesothelioma. Both cancers are linked to asbestos exposure, and can take twenty, thirty years or more to develop after the initial exposure.

Estimated enrollment for the study is 55 patients and it will be conducted at the National Institute of Health Clinical Center in Bethesda, MD USA.

The trial is expected to be complete by April 2012.

EL Trigger Litigation Judgement

The Court of Appeal gave its long awaited judgment in the EL Trigger Litigation on 8 October 2010. It had been hoped that this hugely anticipated judgment would bring certainty to the question of which insurer should meet a mesothelioma claim resulting from historic asbestos exposure. What has emerged however is a very complex outcome. The decision, covering more than 160 pages, has almost as many permutations as there were parties to the case.

The background
· Bolton v MMI set the scene in 2006. It was a public liability (PL) case in which it was held that a mesothelioma victim sustains injury for the first time when the tumour starts to develop, 10 years before the manifestation of symptoms.
· Four insurers (Builders Accident, Independent, Excess and Municipal Mutual) had employers liability (EL) policies which were worded in a very similar way to the PL policy in Bolton and which responded if the injury was sustained or contracted during the term of the policy. Those insurers then started to decline EL claims on the Bolton principle.
· Until 2006 insurers had always taken the view that EL policies responded on a causation basis (i.e. if exposure occurred during the life of the policy), and the adoption of the ‘Boltonite’ approach had the effect of shifting insurer responsibility from exposure to the time when the tumour started to develop. This led to vast “black holes” in insurance cover.
· Strikingly, even if the tumour developed during the currency of the policy, claimants who were ex-employees at the time would not on the Boltonites’ argument be covered. This issued weighed particularly heavily on Burton J at first instance. Having considered the overwhelming evidence that until Bolton, the market (including the four insurers) used the verbs ‘cause’, ‘contract’ and ‘sustain’ interchangeably, he concluded that the four insurers’ policies should respond on a traditional causation basis.
The Boltonites appealed.

The Court of Appeal judgment
The Court of Appeal judges took divergent approaches. However, the following principles emerge:
· Where the wording used is “sustained”, the policy which responds is the one in force when the tumour starts to develop.
· Where the wording used is “contracted” (that is synonymous with the word “caused”) then the policy in force at the time of exposure responds.
The lack of unity means each judge’s reasoning needs to be considered in turn.

Rix LJ
· A disease is contracted (within the meaning of the policy) when it is caused.
· Mesothelioma is not sustained on inhalation. Although this frustrates the commercial purpose of the policies (to provide both cover for employers and security for employees), there is no ambiguity in the wording sufficient to justify an alternative interpretation.
· Policies which began after the Employers’ Liability Compulsory Insurance Act 1969, (which came into force in January 1972), respond if the mesothelioma was caused during the life of the policy. This is because such policies are deemed to comply with the Act.

Burnton LJ
· Insurers were entitled to depart from their previous practice of indemnifying and paying mesothelioma claims on a causation basis as the aetiology of mesothelioma became better understood.
· Considered the court was bound by Bolton. Policies with a “sustained” wording would only respond at the date when the tumour starts to develop. By contrast, policies with a “contracted” wording would respond if in force at exposure.

Smith LJ
· The policies should be interpreted according to the understanding of the parties at the time they were entered into. Until Bolton v MMI it was not appreciated that a mesothelioma victim “sustains” injury only when the tumour starts to develop.
· Considered she was not bound by Bolton as that decision related to public liability cases only.

Unfinished business?
This is an extraordinary judgment. Such was the lack of consensus that the leading judgment (Rix LJ) has a seven paragraph postscript responding to the other judgments.
Crucially, Rix LJ considered the court bound by Bolton; had this not been the case he would have preferred to hold that where a victim develops mesothelioma there is actionable injury from the date of inhalation, because liability is created when an employer has materially contributed to the risk. Having not been allowed to arrive at his preferred solution, Rix LJ acknowledged that his decision led to “an unfortunate conclusion”.

For the market, this lack of certainty is deeply troubling. Public authorities will now have to make provision for exposure prior to 1974 (due to the MMI wording), and private sector businesses will have to meet claims if they have a pre-1972 ‘sustained’ policy.

Both defendants and insurers will, by virtue of the joint and several liability provisions in section 3 of the Compensation Act, become liable for an increasing burden of mesothelioma claims as they will now need to fill the insurance “black holes” which result from the vindication of the Boltonites’ position on EL policies written on a ‘sustained’ basis.

Further appeals to the Supreme Court are inevitable. Until that time, the judgment means that some claimants who have no solvent employer to sue may go uncompensated.

Court Date Friday 8th October 2010

El Trigger Litigation

The verdict in the trigger litigation appeal is due to be handed down on Friday at the Royal Court Of Justice London. If the case is won by the victims & families of those exposed to asbestos negligently by their employers it will force insurance companies to finally pay the compensation they have been fighting to hold onto for the last few years. Below is a short outline of the case and why it spent so long in the courts.

Cases were heard together to resolve an important dispute over the relevant ‘trigger’ under various employers’ liability insurance policies which applied to employers of those who suffered and died from mesothelioma. The EL Trigger trial focused on what had to happen during the period of insurance when the insuring clause of a policy stipulated either that an injury must be "sustained” or that a disease must be "contracted” during the period of insurance. The insurers will argue on appeal that the relevant ‘trigger’ under the policies is not the exposure to asbestos, but the development, many years later, of mesothelioma

The hearing has hinged on which policy was key - the one at the time of exposure or when a worker becomes ill. Employers take out liability insurance to insure them against the cost of legal action by staff injured at work.

But a group of insurance firms had questioned which policy should be enacted. They argued during the nine-week hearing that the policy in place at the time the cancer develops was the one that a compensation claim should be brought against rather than the policy that was in place when the worker was employed by the firm.

They said this was common-sense as victims could have worked for several employers where they were exposed to asbestos. However, this stance was challenged by families, employers and one insurance firm. Solicitors representing the families involved in the case said this would make it harder to secure compensation.

One of the key problems is that many modern-day insurance schemes have exemptions for asbestos. That then only leaves the employer for the victims to go after, but as the disease takes so long to develop many of the firms have ceased to exist.