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The Asbestos Answer
By Marshall Manson
March 4, 2005 - Of all the selfish exploitation schemes that greedy trial lawyers have perpetrated on our justice system, their abuse of asbestos litigation is certainly the worst. Use of asbestos essentially ended more than 30 years ago, yet trial lawyers are still soliciting and bringing countless claims, many of which are frivolous or downright fraudulent. They are clogging the courts and driving good businesses - many of which had little or nothing to do with asbestos - into bankruptcy.

To be sure, there are real victims of asbestos, and the extent of their suffering is hard to comprehend. About 2,000 people each year develop the hideous lung disease mesothelioma, a form of cancer that causes unbearable pain. It has only one known cause: asbestos exposure. No one would doubt for a moment that these victims deserve justice. But thanks to the trial lawyers, legitimate victims of mesothelioma are having a harder and harder time getting it.

You see, many years ago, trial lawyers saw a gold mine in mesothelioma claims. The problem was that there weren't enough actual victims. So they started bringing lawsuits on behalf of people who might someday get the disease. Over time, asbestos claims became an industry as lawyers set up "mass screenings" anywhere they could park a mobile X-ray and woo potential plaintiffs with the promise of an easy settlement. After assembling a suitably huge group of plaintiffs, the trial lawyers filed their lawsuits and tried to strong arm the defendants into settling. Most defendants and their issuers usually obliged in order to avoid costly court battles.

Today, asbestos claims from people who do not have any kind of cancer make up 89 percent of all claims filed, according to a RAND Institute study. RAND also reports that more than 300,000 claims are now pending. Meanwhile, the real victims - those actually afflicted with mesothelioma - are receiving only a tiny fraction of the awards and having to wait years for justice because so many frivolous and dubious asbestos complaints are clogging the courts.

At the same time, asbestos claims are driving company after company out of business. Nearly one hundred companies have been forced into bankruptcy as a direct result of asbestos liabilities. As many as 60,000 jobs have been lost, with hundreds of thousands more projected to disappear in the coming years. The bankruptcies are also jeopardizing retirees' pension and 401(k) benefits. And the problems are getting worse.

Having driven nearly all of the asbestos manufacturers out of business, trial lawyers turned to other deep pockets. There are now more than 8,400 companies defending against asbestos claims, many of them small businesses. Nearly all these employers never made or installed asbestos. But they have money, so the trial lawyers have put them on the hook.

No one - except the trial lawyers - doubts that asbestos litigation has become a crisis that cries out for a solution. Fortunately, there is now a proposal before Congress to create a fund with money from businesses and insurers, not taxpayers, large enough to handle current and future complaints. Such a fund will ensure swift justice for the real victims and provide certainty for companies now facing an endless number of asbestos claims and the infinite payouts that accompany them.

The fund will also mean an end to the wasteful trial lawyer gravy train. Since claimants would only need to show that they are sick with an asbestos-related disease in order to collect from the fund, they won't even need to hire an attorney in order to obtain compensation. At the same time, the fund plan includes medical and exposure criteria to eliminate the fraud that plagues the current system and ensure that money goes to actual victims. The fund will also guarantee that there is money available down the road for those victims who don't yet know that they are sick.

Best of all, victims won't need to prove that a particular defendant caused their illness. That will end the complexities and lengthy delays that have become common in the current system. Victims will be able to collect their compensation fast, and the trial lawyers' asbestos jackpot will finally be eliminated.


Advanced therapies improve the odds for lung cancer patients

by Michael Flynn, STAFF WRITER

August 16, 2005 - ASHEVILLE - Since being diagnosed with lung cancer in May 2003, Fairview's Liz Becker-Reems, 62, has undergone three surgeries plus chemotherapy and radiation treatments.

"I should have probably died six months after having (the first) surgery," said Becker-Reems. "I think I'm doing pretty good."

Lung cancer is the No. 1 form of cancer that kills both men and women, with an estimated 173,700 new cases of lung cancer and 160,440 deaths from the disease in the United States last year, according to the American Lung Association. In Buncombe County, about 150 cases of lung cancer were diagnosed in 2001.

But new drugs that target tumors, advances in radiation and chemotherapy and better combined therapies are all improving survival rates, said Dr. Michael Messino, an oncologist with Cancer Care of WNC. "People are living longer with lung cancer after diagnosis," he said.

Chemotherapy given to patients after surgery can improve their survival rate, physicians said, and newer anti-nausea drugs and antibiotic use is making chemotherapy more tolerable.

Publicity surrounding the diagnoses of Peter Jennings and Dana Reeve has also brought more attention to the disease.

"These two people are going to make awareness of lung cancer more prevalent," said Messino, who added his patients have noted Reeve's nonsmoking status and relative youth. "That's been a surprise for a lot of people," he said.

Overall, the rate of lung cancer cases in the United States appears to be dropping among white and African-American men, while it continues to rise among both white and African-American women.

Becker-Reems said her cancer, though locally advanced, is currently inactive. Although doctors haven't pinpointed the cause of her condition, Becker-Reems said she smoked for a few years in college but quit about 40 years ago. "I thought I didn't have anything to worry about," she said.

Messino said that for former smokers the risk of lung cancer drops significantly several years after quitting, but never equals the lower risk for people who never smoked.

And with smokers having about 20 times more risk of developing lung cancer than nonsmokers, cessation remains a top priority for physicians, Messino said.

Scans and early detection
Early detection remains a critical lung cancer survival tool, and advances in imaging technology can produce clearer pictures for diagnostic purposes.

A study of nearly 50,000 current and former smokers is under way to better understand how - or if - X-rays and more detailed spiral CT scans are useful for detecting lung cancer.

Results from the National Lung Cancer Screening Trial won't be available for several years, but already some people are asking their doctors for a CT scan.

There are risks. Anywhere from 25 percent to 60 percent of current or former smokers have some kind of abnormality that a CT scan would find. These abnormalities could be scar tissue, areas of inflammation or other conditions that aren't lung cancer but can look like it. The test might also find small tumors that would never be life threatening.

"You can pick up very small lesions that may be nothing," Messino said.

To examine these abnormalities, doctors remove a small piece of lung tissue. With this procedure, patients risk infection or other complications. Doctors might have to perform open lung surgery, which carries even more risk.

"The main risk in my view of screening is you can hurt the patient by trying to find out what's wrong when they really don't have cancer," says Dr. F. Anthony Greco, medical director of the Sarah Cannon Research Institute. "And this is not rare." He and others generally don't recommend it for former or current smokers.

Targeted drugs
In addition to early detection, new patients have access to an experimental drug called Avastin, one of two main types of so-called targeted therapies. Avastin prevents the growth of blood vessels that feed tumors, so tumors essentially starve to death.

Dr. Alan Sandler, associate professor of medicine at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., is leading a study of nearly 900 patients that compares combined treatment with the drug and chemotherapy versus chemotherapy alone.

Sandler presented preliminary results of his study at a meeting of the American Society of Clinical Oncology in Orlando, Fla. The study found that patients with the most common type of lung cancer lived an average of 12.5 months with the drug compared to an average of 10.2 months without it.

"This the first time that an agent that targets new blood vessel development has shown a survival benefit in lung cancer," Sandler says.

Patients enrolled in the study had relatively advanced lung cancer, and Sandler expects the drug might be used with earlier stage disease with better results.

While Avastin targets blood vessel growth, new drugs Iressa and Tarceva target a protein that's mutated in some cancer patients. The U.S. Food and Drug Administration approved Iressa in 2003 based on preliminary data for use in lung cancer patients who have tried two chemotherapy treatments without success.

Although preliminary data suggests a benefit for Iressa, more recent data found no statistically significant benefit. In June, the FDA told doctors that the medicine should be used only in cancer patients who already take it with good results. The agency does not want new patients to be given Iressa because a large study did not show that the drug made people live longer.

The FDA continues to approve Tarceva, which a study found to have increased average survival from 4.7 months to 6.7 months.

Sameh Fahmy and others at The Tennessean contributed to this report

Contact Flynn at 232-2936 or mlflynn@citizen-times.com.

On the Web

www.quitnet.com, QuitNet, a quit smoking site.

www.cancer.org, American Cancer Society

www.lungusa.org, American Lung Association

www.peoplelivingwithcancer.org, American Society of Clinical Oncology

www.lungcanceralliance.org, Lung Cancer Alliance

www.lungcanceronline.org, Lung Cancer Institute

www.cancer.gov, National Cancer Institute

Disease takes an emotional, social toll
The emotional and social effects of cancer can be the most difficult issues survivors face, patients and health professionals said.

"Initially I was in shock, and definitely depressed," said lung cancer patient Liz Becker-Reems of Fairview about her diagnosis. "I felt like it was a death sentence."

About half of the more than 1,000 cancer survivors connected to the Lance Armstrong Foundation surveyed by Dr. Steven Wolff, chairman of internal medicine at Meharry Medical College in Nashville, Tenn., said that emotional issues are more of burden than the disease itself.

Among the survey's findings were 70 percent of respondents had suffered depression and 49 percent said they had non-medical cancer needs not being met, including emotional distress, financial problems and sexuality concerns.

Jeanne Keesler, a licensed clinical social worker with Cancer Care of WNC, said cancer's emotional impact can be most devastating once the initial flurry of treatments ends.

"When you get the diagnoses, you get on the roller coaster immediately," she said about the tests, scans, therapies and surgeries. "You just go from one thing to the next."

To help address an ensuing let down, Keesler encourages patients to tap into support systems provided by family, friends, health professionals and other groups.

Like many survivors, Becker-Reems said she was inspired by Lance Armstrong's achievements, and she drew strength from several closer sources, including her son, Jack Becker, who moved back from Salt Lake City, and the purchase of a new puppy.

"I tried to become young," she said. "You couldn't just dissolve into your illness."

-Michael Flynn

Lung cancer risk factors
- Tobacco use; smokers have 20 times more risk of developing lung cancer than nonsmokers.

- Second-hand smoke.

- Exposure to radon, asbestos and certain industrial substances, such as arsenic.

- Radiation exposure from occupational, medical and environmental sources.

- Air pollution.

- Tuberculosis.

Though all of the above factors are known to cause lung cancer, nearly nine in 10 cases can be attributed to tobacco use or exposure.

Radon accounts for about 10 percent of cases. Air pollution is though to be the cause of 1 percent to 2 percent of cases. Occupational exposure to substances is 9 percent to 15 percent, and lung cancer can be ascribed to more than one cause.

-Gannett News Service, American Lung Association

Survival rates
New advances in treatment offer hope that people diagnosed with lung cancer will be able to live longer. Still, the percentage of patients alive five years after diagnosis is significantly lower than many other cancers.

Five-year survival rate:

- Pancreas, 4 percent
- Lung, 15 percent
- Ovary, 44 percent
- Colorectal, 63 percent
- Cervix, 73 percent
- Breast, 88 percent
- Melanoma, 91 percent
- Prostate, 99 percent

Source: American Cancer Society, Cancer Facts and Figures 2005

Contact Michael Flynn at 828-232-2935 or via e-mail at mlflynn@ashevill.gannett.com.

 


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