Mesothelioma Help Cancer News
Eleven Indicted in NY Asbestos Removal Project at Buffalo Housing Project
Three New York inspectors are among nine people and two companies indicted on criminal charges involving illegal asbestos removal at a Buffalo, N.Y. housing complex. Breathing asbestos causes life threatening diseases including mesothelioma and lung cancer so New York and federal laws strictly regulate the handling of asbestos-containing materials.
The 62-page federal indictment, handed down Aug. 4, focuses on work done by two companies that were hired to remove asbestos from the Kensington Heights housing project before its demolition. Johnson Contracting of WNY, Inc., was contracted to remove and dispose of an estimated 63,000 square feet of hazardous asbestos from each of six housing towers in the 17-acre complex. JMD Environmental Inc. was hired as a sub-contractor to monitor the asbestos removal work and do air sampling.
According to the U.S. Department of Justice release, from June 2009 to January 2010, workers for Johnson Contracting overseen by company president Ernest Johnson and supervisor Rai Johnson allegedly illegally stripped asbestos-containing materials at the Kensington Towers in violation of the Clean Air Act. The indictment accuses the company officials of instructing workers to dump asbestos-containing debris down holes cut in the floor and directing workers to leave asbestos in the towers knowing that the buildings were going to be demolished.
During the same time period, the JMD Environmental was supposed to monitor the asbestos removal work and perform air sampling, according to the Justice Department. The indictment alleges that JMD and its employees including supervisor Evan Harnden and three project monitors failed to conduct proper air sampling and created false visual inspection reports by certifying that all asbestos had been removed from the buildings.
Two city of Buffalo building inspectors also were charged with falsely certifying that all asbestos had been removed from the six buildings, when they knew the asbestos had not been removed. Also indicted was an inspector with the New York State Department of Labor Asbestos Control Bureau for allegedly concealing the illegal asbestos removal activities occurring at Kensington Heights.
Each of the 23 charges carries a maximum penalty of five years in prison, a fine of $250,000 or both.
Each year, an estimated 3,000 Americans are diagnosed with mesothelioma, a cancer of the lining of the lung that is a signature disease of asbestos exposure. Many older houses and buildings contain insulation, shingles and other building materials containing asbestos. Asbestos exposure is an occupational hazard for construction and demolition workers and a primary way people are exposed to asbestos today.
Dignity Therapy to Improve Mesothelioma Patients’ Perception of Life
Mesothelioma is a unique and rare form of cancer, typically affecting the lining of the lungs, caused by exposure to asbestos fibers. Usually not diagnosed until symptoms appear, sometimes decades after exposure to asbestos, patients are left with few treatment options as the disease rapidly progresses. The treatments at this point are often palliative and are intended to control pain, stop bleeding, and relieve pressure. Now, according to a study published in The Lancet Oncology, offering dignity therapy, an individualized, short-term psychotherapy, can help improve a patient’s quality of life, increase a sense of dignity and alter the way patients were seen and appreciated by their family.
In the study, investigators from the University of Manitoba, Winnipeg, MB, Canada, randomly assigned dignity therapy, client-centric care or standard palliative care to 165 patients with a life expectancy of less than six months. Focusing on reduction of distress and self-reported end-of-life experiences, the researchers’ goal was to determine whether dignity therapy could mitigate distress or bolster the experience in patients nearing the end of their lives.
While no significant differences were noted in the distress levels before and after completion of the study in the three groups, self-reported spiritual well-being and lessening of sadness or depression were significantly improved in the dignity group compared to the other two groups without dignity therapy. The researchers concluded that the benefits of dignity therapy “in terms of self-reported end-of-life experiences support its clinical application for patients nearing death.”
Oftentimes, mesothelioma patients and their family turn to a hospice program when the patients no longer respond to the prescribed treatment plan, and their primary caregiver needs support caring for their loved one. Hospice is designed to improve the quality of a patient’s last days by offering comfort and dignity, and often allows the patients to remain in their own home surrounded by their loved ones. This approach can be combined with dignity therapy to further support the patient.
Further, in the American Society of Clinical Oncology’s guidelines released in January for care of patients with advanced cancer, they stated that with palliative care “patients with advanced cancer are given the opportunity to die with dignity and peace of mind.” With palliative care, the expectation is that the patient will maintain a good quality of life until the end.
The authors of the study added, “Future research exploring the beneficial effects of dignity therapy will help to unravel the psychological, spiritual, and existential complexities for an individual facing death.”
International Malignant Pleural Mesothelioma Staging Project Underway
By Nancy Meredith
An international collaboration effort is underway to study and improve the current staging system for malignant pleural mesothelioma. Led by the International Association for the Study of Lung Cancer (IASLC), and in collaboration with the International Mesothelioma Interest Group (IMIG), the Prospective Staging Project in Malignant Pleural Mesothelioma was formally initiated at a joint meeting of the IASLC-ISC Mesothelioma Domain and Advisory Committee in September 2010 in Kyoto, Japan, in conjunction with the biennial IMIG meeting.
The current mesothelioma staging system used by the American Joint Committee on Cancer, recognized as the official organization for formulating and publishing systems of classification of cancer, was developed by IMIG in 1995. Their “TNM” staging system is based on the relationship between Tumor size, lymph Node, and Metastasis. This staging system applies to only those tumors that arise from the pleura.
However, now mesothelioma experts believe there are improvements in the diagnosis and treatment of mesothelioma that warrant a revised staging system. Specifically, the IASLC indicates that some of the “T” descriptors in the current staging system are difficult to apply to patients who are managed non-surgically, and the “N” staging is nearly identical to non-small cell lung cancer (NSCLC), even though there are significant differences between the two cancers.
An accurate staging system is critical for determining the prognosis and effective treatment for mesothelioma patients. The treatment options are typically based on the extent of the cancer, which is determined by staging. A localized cancer would be identified as Stage 1, for example, and can involve a surgically removable tumor. Once the cancer cells have spread beyond that original location, and a higher stage level is designated, the mesothelioma is considered advanced and surgery is often no longer an option.
The process of modifying the staging system involves a detailed collection and analysis of mesothelioma patient data and samples leading researchers “to identify and validate additional descriptors for possible inclusion in future revisions to the TNM classification.” The data will be based on subjects that have been diagnosed with malignant pleural mesothelioma after January 1, 2010. The data will be compiled and stored in a secure, web-based, electronic data capture system provided by Cancer Research and Biostatistics (CRAB) in Seattle, Washington.
Some of the primary members of the committee include renowned mesothelioma experts Harvey Pass, M.D., NYU Langone Medical Center, Hedy Kindler, M.D.,University of Chicago and Jeremy Erasmus, M.D., M.D. Anderson Cancer Center.
The project leaders expect to submit recommendations for proposals for change regarding the 8th edition of the TNM classification for the staging of malignant pleural mesothelioma in January 2014. The recommendations will be based on data collected prior to December 31, 2012. The group intends to continue to collect prospective data to inform future revisions of the staging guidelines.
For more information see the IASLC website.
Hawaii Researchers’ Efforts to Crack Mesothelioma Code Aided by $3.5m Gift
Michele Carbone, director of the University of Hawaii Cancer Center and his colleagues, have made a series of recent scientific breakthroughs in understanding the mechanism by which asbestos triggers mesothelioma, an aggressive cancer of the lining of the lung and abdomen.
In recognition of that groundbreaking research, an anonymous donor has given the University of Hawaii Cancer Center a $3.58 million gift to support mesothelioma research, the university announced this month. The gift is the second largest in UH Cancer Center history.
“Mesothelioma is a serious public health problem,” said Virginia Hinshaw, chancellor of the University of Hawaii Manoa. “We’re proud that Dr. Carbone’s team is leading the world in this area of discovery. This gift validates their efforts and will help them remain at the forefront of thoracic oncology research.”
Closely associated with inhaling airborne asbestos fibers, mesothelioma produces an aggressive type of tumor. The current median survival from diagnosis is just 12 months, creating a need for more effective therapies to extend mesothelioma patients’ lives. Approximately 2,500 to 3,000 people in the U.S. are diagnosed with mesothelioma each year. Most were exposed to asbestos decades before cancer symptoms appeared.
Dr. Carbone and colleagues including Assistant Professor Haining Yang and Adjunct Professor Giovanni Gaudino have studied asbestos-related disease for more than a decade, analyzing how genetics, environmental carcinogens and viral infection interact to cause malignant mesothelioma.
In an article in the Proceedings of the National Academy of Sciences, Carbone and colleagues described how asbestos killed cells through a process called programmed cell necrosis that leads to the release of a protein molecule HMGB1. People exposed to asbestos have elevated levels of the protein in their blood. The protein begins an inflammatory chain reaction in tissue that causes the release of mutagens that promote tumor growth. Cancer often occurs in the presence of chronic inflammation. By interfering with the inflammatory reaction, it may be possible to decrease the occurrence of mesothelioma.
Many of the UH researchers’ findings have been based on work conducted in the villages of Capadoccia, a region of Turkey that has an extraordinarily high rate of mesothelioma deaths. Nearly 50 percent of the region’s residents develop and die of mesothelioma from exposure to eronite, a naturally occurring mineral fiber found in rock formations that is even more toxic than asbestos. Eronite has been used in the U.S. in road paving.
Drs. Carbone and Yang plan to conduct a clinical trial co-sponosored by the U.S. National Cancer Institute in Cappadocia to validate the serum biomarkers they discovered for the early detection of mesothelioma.
Their findings may have applications far beyond the villages of Turkey and lead to new ways to prevent and treat the disease. In the future, treatment approaches aimed at identifying people who are likely to develop mesothelioma based on elevated biomarkers and blocking chronic inflammation could reduce the risk of mesothelioma among workers exposed to asbestos.
“This generous gift is critical to support our efforts to generate discoveries that will aid in the prevention of mesothelioma and the development of new therapies,” Dr. Carbone said in a statement.
NY Medical Center Cited For Asbestos Workplace Safety Violations
One of the primary ways that workers today are exposed to cancer-causing asbestos is during demolition and remodeling activities. A workplace safety investigation at a Brooklyn medical center serves as a cautionary tale of the need to train workers to prevent asbestos exposure.
Many older buildings and houses, constructed before 1980, have asbestos-containing ceiling tiles, floor tiles, insulation, or plumbing. Demolition and remodeling activity can raise clouds of asbestos dust, jeopardizing the health of workers who breathe the microscopic mineral fibers floating in the air. Inhaling asbestos is associated with mesothelioma, an incurable cancer of the lining of the lungs, as well as lung cancer and asbestosis, a chronic scarring of the lung that causes shortness of breath and breathing problems.
Last week, inspectors with the federal Occupational Safety and Health Administration cited the Interfaith Medical Center in Brooklyn, New York with 14 violations of workplace safety and health standards and proposed $48,000 in fines.
Kay Gee, OSHA’s NY area director for Brooklyn, Manhattan and Queens, said that federal work safety standards require that employees whose jobs bring them into contact with asbestos or potential asbestos-containing materials should be trained about the hazards of asbestos and the required safety precautions to protect their health.
According to a U.S. Department of Labor news release, an OSHA inspection found that the medical center failed to provide adequate asbestos training for environmental staff and employees in the engineering department who perform demolition and renovation. Asbestos exposure is an occupational hazard for demolition and renovation workers. In addition, the hospital failed to label properly asbestos-containing insulation and floor tile and allowed the disposal of asbestos-containing materials in the hospital dumpster. The hospital also failed to train trade workers about the hazards or inform outside contractors of the presence of potentially asbestos-containing materials, the inspectors said.
The OSHA inspectors issued citations for 10 serious asbestos violations and proposed a total of $48,000 in fines. A serious violation is defined as one where there is a substantial probability that serious physical harm or death could result from a hazard that an employer knew about or should have known about.
Interfaith Medical Center has 15 business days to comply or contest the findings before the independent OSHA review commission.
Robert Kulick, OSHA’s regional administrator in New York, said creating and maintaining an illness and injury prevention program to identify and eliminate hazards is a means of addressing such workplace hazards.
Approximately 3,000 people in the U.S. are diagnosed with mesothelioma each year. Many are workers and veterans exposed to asbestos in the 1960s, 1970s and 1980s. The symptoms of mesothelioma typically take 20 to 50 years to appear after the initial exposure.
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