| The economic, legal and political aspects of asbestos receive great national attention. At least 60 major companies formerly involved with asbestos have declared bankruptcy, with rippling economic consequences. Asbestos liability has been among the largest of all litigation areas, and billions of dollars have changed hands. Congress has focused for more than six years on exempting defendant companies from further liability and financially “compensating” the individuals and families afflicted with asbestos disease. Major sectors of our society, including the largest Fortune 500 corporations in America, insurance companies, unions, veterans groups, consumer groups, and trial lawyers have spent millions lobbying for or against this legislation. But in all this, the Meso Foundation is the only organization calling on the federal government to focus on the most fundamental aspect of the problem, curing the disease itself. We believe the human tragedy of meso is more significant than any of its legal, political or economic aspects, and must be addressed most urgently. The Foundation is uniting the meso community into a force for advocacy, raising awareness of the need for research to develop effective treatments, and calling on the federal government to partner in this urgent effort. We are making progress:
* National Cancer Institute funding for meso research, though still very low, has been increasing substantially the past two years.
* At the end of 2005, we obtained from Congress the first appropriation ever for meso research. Congress appropriated $1 million to the National Institute for Occupational Safety and Health (NIOSH) to begin a national mesothelioma registry and tissue bank. In 2006, Congress has appropriated another $1 million to NIOSH to continue the registry and tissue bank.
* In 2006 we also succeeded in persuading Congress to make meso researchers eligible to compete for grants from a $45 million per year fund administered by the Department of Defense. This is only the second time in U.S. history that legislation has specifically provided for meso research funding. |
THE TRAGIC FACTS
Malignant mesothelioma (meso) is the story of Americans who worked hard to build and defend this country. For 50 years, America's industrial and building trades workers, Navy personnel and many others were exposed to asbestos. The so-called "miracle mineral" was common in the workplace and on Navy ships and in shipyards. When workers brought the asbestos fibers home each night in their clothes and hair, their families were exposed also. Approximately three thousand Americans each year or more now develop meso, a malignant tumor that -- after a latency period of ten to fifty years -- aggressively invades the linings of the lungs, abdomen, heart or testicles. Millions more Americans are being put at risk today, because of all of the asbestos that remains present in occupational settings; in buildings such as homes, offices and schools; and in a wide variety of products. The incidence of meso still has not peaked in the U.S., and is also growing to epidemic proportions in other parts the world. The tragedy of 9/11 demonstrates the continued, long-term threat of mesothelioma. Estimates of the amount of asbestos released around Manhattan range as high as 1,000 tons. The impact pulverized this asbestos into tiny, microscopic fibers to which the firefighters, rescue workers and other heroes of 9/11 were exposed. In the weeks and months following workers, residents and school children in the area continued to be exposed. After meso’s long latency period, the risk of cancer among those most heavily exposed could reach as high as one in ten. Thus, even if asbestos were banned today, and it absolutely should be, the meso epidemic would continue for decades and cry out urgently for development of better treatments. An Orphan Disease
Meso was identified in the medical literature by the late 1940’s. However, for decades the need for research to develop effective treatments for meso patients was ignored, obscured by the legal, economic and political aspects of asbestos. For the most recent years for which there are figures, 2000 through 2003, the National Cancer Institute’s annual investment in clinical meso research was less than $2 million. This is only approximately one twentieth of one percent of the NCI’s annual budget; while the NCI is investing as much as 16 times more, per death, on other cancers. Cancer | Annual NCI Research Funding | Annual Mortality | Research Funding Factor (per Mortality) Relative to Mesothelioma | Breast | $548,700,000 | 40,200 | 11.87 | Prostate | $305,200,000 | 28,900 | 9.18 | Leukemia (all) | $200,900,000 | 21,900 | 7.98 | Cervical | $79,000,000 | 4,100 | 16.76 | Hodgkin disease | $16,500,000 | 1,300 | 11.04 | Mesothelioma | $2,847,000 | 2,476 | 1.00 | Since 1992, Congress has directed $3.75 billion to research on various diseases through the Department of Defense Congressionally Directed Medical Research Program. But none of this has been invested in meso research, even though one third of today’s meso patients were exposed to asbestos while serving our nation’s defense on U.S. navy ships and shipyards. Calling for a National Commitment
The Meso Foundation is active in Washington, D.C., calling on the federal government to partner with the Foundation in funding the research necessary to develop effective treatments. This should include NCI funding of meso research at levels proportionate to other cancers. It should also include designated federal funding for meso research, given the involvement of the federal government, especially the Department of Defense, with asbestos, and the high toll of the disease among military veterans. The Meso Foundation’s scientific experts have developed a proposal for a National Mesothelioma Research and Treatment Program, a comprehensive $30 million/year plan by which the federal government could most effectively promote development of improved treatments through research funding. For the full proposal please click here. Better Treatments Are Within Reach
Our optimism that with such a national investment, dramatically improved treatments for meso could be developed is not just wishful thinking. Alimta (pemetrexed) – the first FDA-approved drug developed specifically for meso – demonstrates the potential. The Alimta/Cisplatin combination achieved a 46% response rate compared to 20% for the Cisplatin only arm. The Meso Foundation has now funded two exciting studies for how to further improve the effectiveness of Alimta. The development of SMRP and other meso biomarkers is incredibly exciting. The Meso Foundation is funding research by Dr. Brad Black in Libby itself to further validate this marker. New genomic and proteomic technologies are enabling investigators to understand the molecular biology of meso, and this is attracting intense research interest because of the potential to develop targeted therapies. Two Meso Foundation-funded researchers just got their work in this area featured on the cover of the American Journal of Pathology. In fact, specific features of meso should make it particularly amenable to treatment. Anti-angiogenesis is generating great excitement across cancers generally, and meso should be particularly vulnerable to this approach. Meso patients have the highest VEGF levels of any patients with solid tumors. As another example, Dr. Steven Albelda at the University of Pennsylvania believes meso is a particularly good candidate for gene thereapy because at least until late stage it tends not to metastasize and to be confined to one region/cavity, it is accessible in that the thoracic cavity can be easily catheterized; and meso shows evidence of immune responsiveness. The brilliance and dedication of the researchers around the world who are working on meso, and the progress they are making, give great optimism. Meso Foundation researchers have been funded to look at novel therapeutics (targeting HDAC’s, AKT, receptor tyrosine kinases, IAPs, and immune modulatory molecules), develop new diagnostics or biomarkers (tumor specific cell-surface antigens, mesothelin, osteopontin), and better understand mechanisms of tumor formation. Competition for Meso Foundation funds is very intense and these researchers represent some of the top researchers in cancer biology and radiology. The entire field of meso research is beginning to move forward very quickly. The Resources Are Available
Thus, we are confident that with a national investment, we can dramatically improve treatments for meso and end suffering. So, what is holding back this investment? Ironically, it is not a question of resources. Huge resources are available to improve treatments for meso, just has been done for so many other diseases in the past decade. It is a question of the will to commit the resources. The funds consumed in the U.S. by asbestos litigation from its inception in the 1960’s through year-end 2002 are calculated at $70 billion. Of this, $21 billion went to defense attorneys, $19 billion went to plaintiffs’ attorneys, and $30 billion was the net “compensation” to plaintiffs themselves. The predicted final cost of asbestos litigation in the U.S is $250 billion. Of the many companies that have filed for bankruptcy because of asbestos liability, at least six are valued at more than $1 billion each. The “Asbestos Trust Fund” bill the Senate has been considering for several years now would set aside $140 billion over the next 30 years. But with trivial exceptions this huge fund is only to intended to “compensate” people after they’re already sick or dead. Only one fifth of one percent is allocated to medical research to actually reduce the toll of suffering in the first place. In 2003 and 2004, 21 companies spent $27.9 million lobbying in favor of this legislation. One need not take a position on the legislation itself in order to recognize that huge amounts of money are being spent regarding a bill that only trivially addresses the fundamental human problem. So the numbers prove that vast resources are available and being consumed by the economic and legal sides of asbestos. Only a minority of these resources even make it to the injured patients and families themselves, as compensation. But because of the lack of effective treatments currently, meso is almost always rapidly fatal. “Compensation” is a cruel travesty. Future victims would be much better served if some of these resources were put to better use developing life-saving treatments for the disease.
|
PALLIATIVE THERAPIES: may also be used which entail draining excess fluid from the patient through the use of a needle and suction. To prevent further fluid accumulation drugs may be fed through a tube into the patient following the fluid drainage. 
