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Adding insult to injury
By RACHEL GRUNWELL
27 February 2005 - Dying Aucklander Victor Angell is calling for ACC to be more sensitive after it mailed his "estate" a compensation cheque to settle his asbestos claim.
Angell is among more than 100 asbestos-related claimants who, it was revealed last week, could cost ACC about $150-400 million in payments over the next decade.
About 17 families have received around $100,000 from ACC since a law change in 2002 enabling payouts over asbestos-related diseases.
But all have been warned to put the money aside in case ACC overturns a landmark court case on these payments and wants the cash back.
ACC accepted last year that Angell, 69, has mesothelioma (a cancer of the lung lining) as a result of dealing with asbestos as a carpenter from 1951 to 1972. He recalls spraying asbestos in firebreaks in Auckland buildings without wearing masks as it was not then known what effects the substance could have.
He has been awarded the maximum ACC sum payable of $104,109.06.
Angell received a part of this payment, $87,023.38, last week, addressed to his "estate", which was upsetting.
"They're already writing me off," said Angell, whose wife Juanita has received a verbal apology after complaining, but still wants a formal written apology.
"I found it very distressing. I felt sick," said Juanita Angell, adding the situation was made worse because her husband was dying. However, he has lived a month past doctors' predictions due to successful chemotherapy. Angell was fit and healthy until the middle of last year, when the disease finally took a hold and made him short of breath, unable to eat and weak. He has since regained strength and some weight, but the cancer could become aggressive at any time.
He said he would spend the compensation paying off the mortgage so his wife did not have to worry about money when he died.
ACC spokesman Fraser Folster said the February 11 ACC letter addressed "to the Estate of Mr Victor Angell" was "deeply regretted" and ACC had apologised.
"ACC works very hard to maintain a high level of customer service . . . any slip in this service is regretted," he said.
But Folster said of the claims that ACC has settled, Angell was one of only two claimants alive at the time of payment.
"The ACC staff member incorrectly assumed that this was also an estate claim. The staff member has been admonished and will undergo further training," he said.
Meanwhile, Victor Angell's friend Shirley Dawson, 67, has also had trouble with ACC correspondence. Her husband Robert died of the same disease three months ago and she has just received the full compensation payout - in a letter calling her by her Mangere street address.
"ACC has to learn to treat people as human beings and not a number," said a tearful Shirley Dawson. She said the ACC payout could not compensate the loss of losing her much-loved husband.
ACC said it needed authorisation from Dawson to comment on her case.
Diagnoses of lung cancer are rising
By Tara Parker-Pope, The Wall Street Journal
August 16, 2005 - Lung cancer has always been viewed as a disease of smokers, or even ex-smokers. But now, doctors say the deadly cancer may be showing up more often in patients who never smoked at all.
The disease is still a far bigger worry for smokers and former smokers, but there's good reason to take a closer look at so-called never-smokers with lung cancer. Recently, researchers discovered that female never-smokers are far more likely to respond to the new targeted therapies for lung cancer -- Iressa and Tarceva.
Understanding the genetic differences between lung cancers in never-smokers and those who have smoked could ultimately lead to better treatments for both groups, notes Bruce E. Johnson, director of thoracic oncology at Dana-Farber Cancer Institute. Dana-Farber is conducting a study of the targeted drug Tarceva as a first-line treatment in female lung-cancer patients who never smoked.
The fact that never-smokers are also at risk for lung cancer was highlighted last week when Dana Reeve, the widow of actor Christopher Reeve, announced she was undergoing treatment for lung cancer. Ms. Reeve never smoked.
The hard data on never-smokers are sketchy. But doctors who treat lung-cancer patients say they believe the number of never-smokers with the disease is growing. "There's no question in my clinic, week to week, month to month, there are more never-smokers," says Scott J. Swanson, chief of thoracic surgery at Mount Sinai School of Medicine in New York.
Right now, doctors say about 15 percent of patients diagnosed with lung cancer each year fall into the category of never-smokers -- that amounts to about 28,500 people.
Nobody really knows why lung cancer appears to be increasing in never-smokers. One theory is that baby boomers may have been exposed to large amounts of second-hand smoke by parents and grandparents who smoked at home. But doctors may not think of lung-cancer risk when treating patients who never smoked, and may attribute symptoms like chronic cough to other causes. Lung-cancer experts say doctors and nurses need to be more vigilant in taking a patient's personal smoke-related history, including whether they come from families with smokers.
Many cases of lung cancer in never-smokers are detected by accident. That was the case for Cynthia Kneibert, a 65-year-old psychotherapist from Sedalia, Mo., who underwent a routine chest X-ray to prepare for hip-replacement surgery. After finding a mass in her lung, doctors removed part of her lung and Ms. Kneibert is now undergoing chemotherapy.
Ms. Kneibert, who exercised regularly and considered herself the picture of health, was stunned that she had lung cancer, sending her and her husband on a search for what might have caused it. Except for a few experimental puffs as a teenager, Ms. Kneibert never smoked. But her father did. "I remember riding in cars as a little child with the windows up and the car filled with smoke," she says.
Also, Ms. Kneibert lives in an area known to have high levels of radon. Radon is a naturally occurring radioactive, invisible, odorless gas. It can accumulate in enclosed areas, such as homes and underground mines, and it's known to increase risk for lung cancer.
Ms. Kneibert learned her basement had a level of seven picocuries of radon per liter of air. Research has shown that lung-cancer risk increases at residential concentrations of about three picocuries. But Ms. Kneibert spent little time in her basement, so it isn't clear whether she really had much radon exposure.
Most never-smoking patients will never know for sure whether the cancer was caused by a combination of passive smoke, radon or some other environmental exposure -- or whether, for them, lung cancer was genetically determined, says Derek Raghavan, chairman of Cleveland Clinic's Taussig Cancer Center. Family history can put you at higher risk, but scientists are also discovering that some people carry certain genetic mutations that may play a role.
Doctors do know that lung cancers in patients who never smoked are genetically different from those in smokers and former smokers. Never-smokers' tumors are more likely to carry the genetic signature that targeted therapies like Iressa are designed to attack.
Women never-smokers may also be at higher risk than men never-smokers. Part of the reason may simply be that there is a greater pool of women who have never smoked than men. But recent research has also shown that the mechanism by which the body repairs cell damage doesn't seem to work as well in women as in men, perhaps making them more vulnerable to cell damage from environmental factors. In addition, researchers are studying whether hormonal factors play a role in lung cancer.
Some studies support the idea that using special CT scans to screen smokers and former smokers can lower the death rate from lung cancer, but even less is known about how or whether to screen people who have never smoked. "Perhaps we should do a one-time screening of nonsmoking women at the age of 40 -- that's a question we need to study," says Claudia Henschke, radiology professor at New York-Presbyterian/Weill Cornell Medical Center.
Patients, regardless of smoking history, should always talk to a doctor about a persistent or unusual cough. And make sure your doctor knows if you have a family history of lung cancer, or you have been exposed to high levels of passive smoke, asbestos or other environmental risks. Finally, check out www.epa.gov/radon to learn more about radon and whether your home should be tested.