Lawyer Mesothelioma

If you read the last article we posted about asbestos trust funds, you’ll remember the clever hammock analogy used to describe what they are. If you didn’t read it, you can do so here.

Now, the Government Accountability Office (GOA) – a sort of congressional watchdog group that keeps an eye on government spending of taxpayer dollars – has published a report that reveals the somewhat secretive system of asbestos trust fund payouts.

The report looked at 52 asbestos trust funds that have paid out over 3,000,000 claims for a total of about $17.5 billion. The investigation was prompted by the fact that these asbestos trust funds don’t publish details about their activities, yet do make general information available. Attorneys representing asbestos companies or defendants — in asbestos lawsuits filed by mesothelioma victims – raised a stink about the secrecy of the details and implored congress to get involved. The investigation proceeded to determine if, in fact, these asbestos trust funds were keeping details secret.

The investigation revealed only “one trust’s financial report contained claimant names and amounts paid to these individuals.”

The defendants in asbestos lawsuits have been the critics of asbestos trust fund secrecy. They allege that asbestos lawyers and mesothelioma law firms oversee the operation of these asbestos trust funds to prevent them from revealing how much their clients have been paid. This, they further allege, allows some asbestos attorneys to file claims with multiple trusts that could contradict each other.

The GAO report stated that 98% of asbestos trust fund claims go through what is called an expedited review process, which requires a claim form and some documentation that asbestos exposure happened. Perhaps the lawyers representing the asbestos companies want mesothelioma victims to have to go through much more than that to get the compensation they deserve?

According to the report, 65 percent of asbestos trust funds treat claims information as confidential and privileged. Defendants and insurers want the details to be available to them so they can reduce the value of the claims awarded to mesothelioma victims in court.

If you or someone you know has been diagnosed with mesothelioma and suspect it’s due to asbestos exposure, contact a mesothelioma attorneyat Sokolove Law for a free consultation. Also, write to your local congressman about keeping the details of asbestos trust fund settlements confidential and out of the hands of the asbestos companies

Asbestos

In a health study of Taconite Workers in Iron Range, Minnesota, the number of citizens who died of mesothelioma is higher than they reported a year ago – up from 63 to 82. Researchers found the additional nine cases by checking death records of former residents who moved out of state.

The University of Minnesota is responsible for the study, which started in 2008 and will wrap up as early as mid-2012. So far, results indicate that the rate at which residents have contracted mesothelioma is much higher than it should be.

Mesothelioma is a rare and fatal cancer, caused primarily by exposure toasbestos fibers, which often takes 30 years or more after exposure to show up.

Exactly how Iron Range residents have been exposed to asbestos is a mystery. Speculation includes one theory that workers handled asbestos in certain products then carried it home. Another theory is that processing taconite rock (a low-concentrate iron ore that has been mined and processed in Minnesota since the 1950s) releases asbestos fibers from within the rock into the air. The mystery is what provoked the $4.9 million health study, which was approved by state lawmakers in 2008.

Researchers have collected data on people who worked in mining as far back as the 1920’s. So far, the study shows that out of about 46,000 taconite workers who ever worked in the industry, 1,681 developed some sort of lung cancer.

Currently, the results from more than 2,000 air samples taken over the last two years at Minnesota’s six operating taconite plants show safe dust levels. Asbestos levels are extremely low, according to the study. Silica concentration was found to be higher than acceptable in some cases.

Mesothelioma

The International Mesothelioma Program at Brigham and Women’s Hospital and Harvard Medical School in Boston continue to make progress in malignant mesothelioma research. The scientists and doctors involved with the project are looking for information that will lead to better adjuvant therapies for the rare and deadly disease. Adjuvant therapies are treatments given to help boost the effectiveness of other treatments. In the case of malignant mesothelioma, the term “adjuvant therapies” typically refers to treatments that are administered to patients after they have had tumors surgically removed.

In a recent study, scientists used mice to test potential adjuvant therapies. Human mesothelioma cells were introduced into the test mice, allowed to metastasize (to grow), then surgically removed. This procedure turned the mice into workable test subjects for testing ne mesothelioma adjuvant therapies.

One of the therapies researchers studied on the mice was “intracavitary chemotherapy,” which means applying the chemotherapy drug, paclitaxel, into the cavity of the body around the site where the tumor has been removed just prior to closing the incision. The results of this test on the test mice were encouraging.

In a report published in the Annals of Thoracic Surgery, “Paclitaxel-laded Expansile Nanoparticles in a Multimodal Treatment, Model of Malignant Mesothelioma,” the researchers state: “Treatment with [paclitaxel] improved overall survival in the setting of [the surgery], suggesting that [it] merits further evaluation for intracavitary drug delivery following the surgical resection of malignant mesothelioma.” What this means is that this particular adjuvant therapy may be successful in the survival of mesothelioma patients.

Advancements such as these are very important to patients of malignant mesothelioma, as the cancer is serious and fatal.

For those who have been diagnosed with mesothelioma cancer that can be linked to asbestos exposure caused by a product or former employer, you may be entitled to financial compensation. Contact an experiencedmesothelioma attorney to learn more about your rights, and to see if pursuing a mesothelioma settlement is in your best interest.

Mesothelioma

It’s long been suspected that a person’s genetics play a role in determining susceptibility to the development of mesotheliomafollowing exposure to asbestos fibers. The suspicion caused the U.S. Department of Health and Human Services National Institutes of Health (NIH) to fund research that would discover this genetic link. As of August, 2011, the specific gene mutation was not only found, but identified to also trigger other types of cancer.

The culprit is the gene, BAP1. Not a very creative name, is it? Why not name genes after Greek gods and goddesses rather than assigning them boring codes made up of capital letters and numbers? The former would better match the mystical powers genes have to determine so much about a person from appearance to temperament to health and beyond. Anyway, the research showed that people with a mutation on the BAP1 gene are more susceptible to developing both mesothelioma cancer as well as melanoma cancer of the eye.

The upshot is that people who are exposed to asbestos are far more likely to develop mesothelioma if they have this mutation to BAP1. The research was funded by the National Cancer Institute (NCI), part of the National Institutes of Health, and led by scientists at the University of Hawaii Cancer Center in Honolulu, and Fox Chase Cancer Center in Philadelphia. The study results were published in Nature Genetics and reported the outcome of tests within two U.S. families with a high incidence of mesothelioma and other cancers linked with BAP1 mutations.

The study’s co-leader,Dr. Joseph Testa, notes that “it appears likely that other genes, in addition to BAP1, will be found to be associated with elevated risk of mesothelioma.” In the study, every person in the two families who developed mesothelioma or melanoma of the eye did have mutations of the BAP1 gene. The research team went on to look at 26 additional people diagnosed with mesothelioma but with no family history of the disease and found that 25 percent of them also had the BAP1 mutations.

Dr. Michele Carbone, study co-leader and director of the University of Hawaii Cancer Center, says of the results: “Identifying people at greatest risk for developing mesothelioma, especially those exposed to dangerous levels of asbestos worldwide, is a task made easier by virtue of this discovery.”

This concludes our series on the newest science concerning mesothelioma. These findings are exciting and inspiring of hope that future diagnostic and treatment practices will help people with mesothelioma live longer, healthier lives. Hope is the message we choose to focus on this week following National Mesothelioma Awareness Week.

Mesothelioma

Because mesothelioma is typically diagnosed at an advanced stage when treatment options are limited, scientists at Somalogic Inc. set out to find ways to detect it at an earlier stage. The goal of early diagnosis is that patients with mesothelioma might be able to enjoy a better quality of life as the fight the illness.

Dr. Rachel Ostroff, a clinical research director of Somalogic Inc. presented her initial results of this ongoing study at the Fourth AACR International Conference on Molecular Diagnostics in Cancer Therapeutic Development. Her results indicated that with the use of aptamer-based proteomics array technology, biomarkers and protein signatures were identified that are characteristic of cancer at an early stage for both mesothelioma and pancreatic cancers.

Aptamer-based proteomics array technology is fairly new in the world of science, developed and refined over the past ten years or so. Aptamers are nucleic acid molecules that bind to certain proteins and were first discovered about 20 years ago. SomaLogic researchers developed a new breed of aptamers called SOMAmers (Slow Off-rate Modified Aptamers), which can be “programmed” for very specific proteins. What this means is that SOMAmers can identify and count specific proteins, or biomarkers, in complex biological samples, thereby identifying potential or inevitable mesothelioma development in people exposed to asbestos.

Ostroff and her colleagues tested blood from study participants – people diagnosed but not yet treated for cancer — to discover the cancer biomarkers. Once discovered, the same technology could be used to spot these cancers at an early stage, where the potential for effective treatment is much higher than in progressed cases.

The goal was met and the researchers found the biomarkers, which they used to make a “signature” biomarker with extreme accuracy for early detection of each form of cancer. As a byproduct of their intended success, they got a little surprise gift: they found high specificity of correct diagnosis, which means the test will be accurate and not lead to disease-free people undergoing unnecessary treatment.

The study is ongoing and validation testing is underway, according to Dr. Ostroff. The research team hopes to have commercially available diagnostic tests that will ultimately yield clinical benefits for patients.

In the next post of this series, we’ll look at a newly discovered genetic link to mesothelioma and what that means for future treatment options.

Mesothelioma

In honor of National Mesothelioma Awareness Day, we’re launching a three-part blog series highlighting the newest scientific research regarding mesothelioma. New science has emerged in the last two years that may have significant implications for the future treatment ofmalignant mesothelioma. In this series, we will look at three important scientific breakthroughs that have the largest potential to affect the future of mesothelioma treatment.

In early 2010, results of a study were published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine that proved the safety of a possible vaccine for mesothelioma.

In late 2010, Dr. Rachel Ostroff, the clinical research director of Somalogic Inc., presented results of an ongoing study at the Fourth AACR International Conference on Molecular Diagnostics in Cancer Therapeutic Development about new biomarkers she discovered for mesothelioma that would impact early diagnosis and provide insight into new therapies for the disease.

Just last month, NIH-funded research discovered a genetic link to mesothelioma.

History of Mesothelioma and Asbestos Exposure

As far back as the early 1900’s, cases of mesothelioma and lung cancerhave been linked to asbestos exposure. It wasn’t until 1970 with the United States Clean Air Act that the Environmental Protection Agency (EPA) was permitted to start regulating asbestos as a hazardous pollutant. With asbestos being more and more regulated in the United States over the past forty years, the rate of new mesothelioma diagnosesin the U.S. each year has risen steadily in men and sporadically in woman.

Currently in the United States, there are an estimated 2000 to 3000 new cases of mesothelioma diagnosed each year. The increase in incidence may be the result of lag time between asbestos exposure and diagnosis, which can be up to 50 years. For this reason, the number of new mesothelioma diagnoses is expected to continue to rise through the year 2020.

New Science – Mesothelioma Vaccine

The continued increase in the rate of mesothelioma diagnosis and the current lack of treatment options is what inspired researchers at the Erasmus Medical Center in the Netherlands to study new therapies. Immunotherapy, which stimulates the immune system to target and destroy cancer cells, had previously shown promise. Based on this previous research, Dr. Joachim G Aerts, a pulmonary physician at Erasmus Medical Center, set out to create a vaccine for mesothelioma. The vaccine, which uses a patient’s own dendritic cells (DC) with antigen from the patient’s tumor, was able to induce a T-cell response against mesothelioma tumors.

In other words, three out of ten patients with malignant pleural mesothelioma of the epithelial subtype showed signs of tumor regression and four others showed evidence of cytotoxicity against their own tumors after vaccination. There is much more work to be done before results can be irrefutably attributed to the vaccine and side effects can be minimized, but the study showed real promise.

Dr. Aerts says of the study: “We hope that by further development of our method it will be possible to increase survival in patients with mesothelioma and eventually vaccinate persons who have been in contact with asbestos to prevent them from getting asbestos related diseases.”

In the next post of this series, we’ll look at mesothelioma biomarkers and the implications they have for possible future treatments

Mesothelioma

Imagine a hammock that more and more people keep piling into without anybody getting out. The weight would quickly become too burdensome to bear and, sagging with a tangle of limbs and torsos, the rope would break. That’s what companies whose livelihoods were once asbestosdependent are like. With billions paid in asbestos settlements each year, the financial strain of numerous personal injury lawsuits from employees exposed to asbestos is too much for any corporation to hold.

What’s best for both the injured employees seeking compensation as well as the companies themselves is for the hammock to hold, or at least have a safety net in place. That’s why more and more of those companies have filed for Chapter 11 bankruptcies to reorganize their assets and debts as well as put aside money for injured asbestos workers into what are known as asbestos bankruptcy trusts. More and more of these have been established as more and more companies have filed Chapter 11’s over the past two decades.

The only problem with asbestos bankruptcy trusts is that the asbestos workers who are ill from asbestos exposure — whether with asbestosis,mesothelioma, or some other type of asbestos-related cancer — don’t receive what they need and deserve, which is the full value of their settlements. The system was created to make asbestos claims easier to file, often requiring no more than a diagnosis and a form to fill out. Yet, the amount of money that actually makes it to the injured worker is typically less than one third the amount of the settlement, according to a study by the RAND Corporation.

Now, there are around 50 different asbestos bankruptcy trusts paying out billions in asbestos claims each year. However, there are still many solvent companies liable for asbestos exposure injuries. Mesothelioma lawsuits are being filed against these solvent companies as regularly as the spinning of a well-oiled wheel. The companies have lawyers scrambling for ways to limit their liability and avoid taking responsibility for the widespread tragedy of asbestos-related cancer and other illness. To that end, defense lawyers want access to detailed records from asbestos bankruptcy trusts, allowing them to see who is paid how much for what specific illness.

Lately, Republicans in congress are looking at the issue, deciding whether to make changes to these asbestos bankruptcy trusts. As reported by the National Law Journal, asbestos lawyers andmesothelioma attorneys argue that the corporate defense lawyers want this reform only to expose the spokes of that well-oiled wheel so that they can throw in sticks.

There is no telling how soon or in what way Republicans in Congress will act on this issue. Meanwhile, if you have mesothelioma or another asbestos-caused illness, you may have a claim against an existing or future asbestos bankruptcy trust. If you were exposed to multiple asbestos products that were manufactured by different bankrupt companies, you may actually qualify for compensation under several trusts.

Asbestos

Women who take certain over-the-counter painkillers during the early stages of pregnancy are more likely to give birth to infants with rare birth defects, a new study suggests.

The study, which has been published in the American Journal of Obstetrics and Gynecology, shows that women who took painkillers such as naproxen (the drug used in Aleve) or aspirin during pregnancy were three times as likely to have children with birth defects such as amniotic band syndrome (a condition that leads to clubfoot) or anaphthalmiaand microphothalmia (conditions where children are born with abnormally small eyeballs, or no eyeballs at all), Reuters reported.

Additionally, the study found that the use of these painkillers early in one’s pregnancy increased the risk of spina bifida by 60 percent, and that the risk of developing a cleft palate increased from 30 to 80 percent.

In the study, interviews were conducted with 15,000 women who had given birth to babies with birth defects and 5,500 women who had given birth to babies without defects. The interviews included questions about any painkillers they ingested during the first stage of their pregnancies.

According to The Centers for Disease Control and Prevention, anophthalmia and microphthalmia occurs in one out of every 5,300 U.S. births. Amniotic band syndrome is even rarer, occurring in approximately one out of every in 10,000 births.

Co-author of the study Martha Werler noted that although the results do not prove that painkillers are the sole cause of these rare birth defects, they are a warning sign. She also recommended that further research be conducted.

If you or someone you know has a child who has been harmed by painkillers, you may be entitled to compensation. Contact Sokolove Law for a free legal consultation.

Birth Defects

Because mesothelioma is typically diagnosed at an advanced stage when treatment options are limited, scientists at Somalogic Inc. set out to find ways to detect it at an earlier stage. The goal of early diagnosis is that patients with mesothelioma might be able to enjoy a better quality of life as the fight the illness.

Dr. Rachel Ostroff, a clinical research director of Somalogic Inc. presented her initial results of this ongoing study at the Fourth AACR International Conference on Molecular Diagnostics in Cancer Therapeutic Development. Her results indicated that with the use of aptamer-based proteomics array technology, biomarkers and protein signatures were identified that are characteristic of cancer at an early stage for both mesothelioma and pancreatic cancers.

Aptamer-based proteomics array technology is fairly new in the world of science, developed and refined over the past ten years or so. Aptamers are nucleic acid molecules that bind to certain proteins and were first discovered about 20 years ago. SomaLogic researchers developed a new breed of aptamers called SOMAmers (Slow Off-rate Modified Aptamers), which can be “programmed” for very specific proteins. What this means is that SOMAmers can identify and count specific proteins, or biomarkers, in complex biological samples, thereby identifying potential or inevitable mesothelioma development in people exposed to asbestos.

Ostroff and her colleagues tested blood from study participants – people diagnosed but not yet treated for cancer — to discover the cancer biomarkers. Once discovered, the same technology could be used to spot these cancers at an early stage, where the potential for effective treatment is much higher than in progressed cases.

The goal was met and the researchers found the biomarkers, which they used to make a “signature” biomarker with extreme accuracy for early detection of each form of cancer. As a byproduct of their intended success, they got a little surprise gift: they found high specificity of correct diagnosis, which means the test will be accurate and not lead to disease-free people undergoing unnecessary treatment.

The study is ongoing and validation testing is underway, according to Dr. Ostroff. The research team hopes to have commercially available diagnostic tests that will ultimately yield clinical benefits for patients.

In the next post of this series, we’ll look at a newly discovered genetic link to mesothelioma and what that means for future treatment options.

Mesothelioma

Actos Lawsuit News 2/14/2012: Did you take Actos? Please contact us today if you took Actos and later experienced harmful side effects. We will connect you with a lawyer that is experienced in complex litigation that may be able to help you recover monetary damages.

Actos Lawsuit: The urinary bladder is a hollow, balloon-like organ located in the pelvis that collects and stores urine until it is ready to be excreted from the body. Urine is produced in the kidneys and is transported to the bladder through two tube-like structures called ureters. Pressure from the accumulation of urine in the urinary bladder forces the wall of the bladder to contract producing the urge to urinate. The urine is then excreted from the bladder via the urethra (a thin tube that carries urine from the bladder to the outside of the body).

A basic understanding of the terminology used by doctors to describe the various subtypes of bladder tumors is important in order to more fully appreciate the various approaches to treatment, the treatment options, and the prognosis (chances for recovery). Superficial bladder tumors are those that are localized (confined) to the transitional epithelium (urothelium) – the layer of epithelial cells that lines the inside of the bladder wall and is in direct contact with the urine – but have not spread to the deeper layers of the bladder. Additionally, bladder tumors that have invaded the lamina propria but have not invaded the muscularis propria can be considered as superficial. Invasive bladder cancer refers to a bladder tumor that is either invading the muscularis propria – the deeper layer of muscle cells that forms the wall of the bladder – or the perivesical fat located beyond the bladder muscle. This type of tumor is referred to as muscle-invasive bladder cancer. Muscle-invasive bladder cancer carries a higher risk of spreading beyond the bladder (metastases) and must be treated more aggressively than superficial bladder cancer. The term metastatic bladder cancer is used when the cancer cells have spread beyond the bladder to distant sites.

Hematuria – Blood in the urine (hematuria) is often the first warning signal and the most common symptom of bladder cancer. It has been estimated that approximately 80% to 90% of patients with bladder cancer develop hematuria which is often painless. In some cases, sufficient numbers of red blood cells are present to turn the color of the urine to dark brown or red. This is known as gross hematuria and is easily recognized by the patient upon urinating. In other cases, insufficient numbers of red blood cells may be present in the urine to cause any evident changes in the color of the urine but red blood cells can be detected by examining the urine under a microscope. This type of hematuria is called microscopic hematuria and may also indicate the presence of bladder cancer. It is important to note that although hematuria is the most common symptom of bladder cancer.

Actos Lawsuit: More information about your search

Actos Lawsuit: Cystoscopy is an important diagnostic tool that enables the physician to directly examine the urinary tract with an instrument called a cystoscope. During this procedure, which is usually performed by an urologist on an outpatient basis, the cystoscope – a long, flexible lighted tube – is inserted through the urethra (the tube that carries urine from the bladder to the outside of the body) and is advanced into the bladder. The cystoscope enables the doctor to view the bladder and urethra and look for any abnormalities including a tumor, infection, or obstruction. During this procedure, the physician may also remove a small piece of tissue from the bladder (biopsy) and submit the biopsy specimen to the pathology laboratory where it is examined under a microscope for the presence of cancer cells. If you have signs and symptoms suggestive of bladder cancer (hematuria and/or changes in bladder habits), your doctor will recommend a cystoscopy to rule out bladder cancer.

A small piece of bladder tissue (biopsy specim en) is obtained by the urologist during cystoscopy for microscopic evaluation. During the biopsy procedure, muscle tissue must be obtained as it is important to determine the extension of the tumor (how far the tumor has spread) since the treatment of superficial bladder cancer differs from muscle-invasive bladder cancer. The biopsy specimen will then be examined under a microscope by another doctor known as a pathologist.

In general, early diagnosis and treatment significantly improves the prognosis for patients with bladder cancer. A high level of suspicion of bladder cancer should be considered for any patient who presents with gross hematuria and known risk factors for the disease. Once the diagnosis is confirmed, patients are evaluated thoroughly to determine the stage (extent of spread) of the disease. The choice of treatment depends upon a variety of factors including the type of bladder cancer, stage of the disease, the presence of other underlying medical conditions, and the patient’s preferences.

Transurethral resection of the bladder tumor (TURBT) represents the primary treatment modality for superficial bladder cancer. During this procedure, which may be performed either under general or regional anesthesia, the tumor is removed using a cystoscope that is inserted into the bladder via the urethra. After surgical removal of the bladder tumor, any remaining cancer cells can be destroyed with either electrical current (fulguration) or with a high-energy laser.

Actos Lawsuit: Additional Information and Resources

Actos Lawsuit: The term “intravesical therapy” refers to the instillation of a biological agent or a chemotherapy drug directly into the bladder in order to destroy any residual cancer cells. Intravesical therapy is a form of local drug therapy whereby the treatment is targeted directly at the site of the cancer (bladder) as opposed to systemic drug therapy where a drug is injected into a vein or is given orally and travels throughout the circulatory system in order to reach the target organ (e.g., bladder).

The most common type of intravesical therapy for superficial bladder cancer is immunotherapy with Bacillus Calmette-Guerin (BCG). BCG is a vaccine that is sometimes used to vaccinate people against tuberculosis. The rationale for using BCG for the treatment of superficial bladder cancer is to boost the body’s natural immune system to destroy the bladder cancer cells. It is thought that BCG induces regression of the bladder tumor through a non-specific inflammatory reaction at the tumor site. Intravesical therapy with BCG is a form of immunotherapy. Intravesical BCG immunotherapy is the treatment of choice for patients with carcinoma in situ (Stage Tis) where the bladder cancer is limited to the lamina propria of the bladder but has not invaded the surrounding tissue.

Patients who undergo a radical cystectomy for muscle-invasive bladder cancer also require urinary diversion reconstructive surgery to collect and eliminate urine. Urinary diversion, also known as urostomy, is the general term used to describe reconstructive surgical procedures that bypass the normal structures of the urinary system by creating a “diversion” or conduit for the passage of urine through an opening in the abdominal wall called a stoma.

Orthotopic continent diversion – In this type of continent diversion, a new bladder, called a neobladder, is created by the surgeon using a long segment of the small or large bowel that serves as a reservoir to collect and store the urine. One technique involves surgically connecting the neobladder to the urethra which enables the patient to void urine normally. This procedure may be more advantageous for younger patients who may not wish to wear a bag attached to the abdomen for collecting the urine.

Another potential side effect of radical cystectomy in men is nerve damage that results when the neurovascular bundles are not spared during surgery. Nerve damage often results in the loss of the ability to have an erection (erectile dysfunction). Younger men under age 60 have a greater likelihood of regaining erectile function following a radical cystectomy than men over age 60. Patients should discuss with their surgeon the advantages and disadvantages of using nerve-sparing procedures during radical cystectomy.

Actos Lawsuit: News and Information from related Sources

Actos Lawsuit: In women, part of the vagina is also usually surgically removed during a radical cystectomy making sexual intercourse more difficult and painful. Intercourse may be made less painful by using lubricating gels, vaginal moisturizers, or vaginal dilators. Women who undergo radical cystectomy are, however, still capable of achieving sexual climax (orgasm). It is evident that radical cystectomy can have a significant impact on the sexual health of both men and women. Patients should talk openly with their doctor about the potential negative side-effects of radical cystectomy on their sexual well-being and discuss the options that may be available for resuming an active and pleasurable sexual relationship after surgery for bladder cancer.

Over the years, doctors have come to learn that radical cystectomy alone is not sufficient as the sole treatment modality for muscle-invasive bladder cancer because about 50% of patients develop recurrent distant metastasis after undergoing radical cystectomy. More recently, the role of systemic chemotherapy has become better defined in the management of patients with muscle-invasive bladder cancer. Systemic chem otherapy may be administered either before radical cystectomy in order to shrink the bladder tumor ( neoadjuvant chemotherapy) or it may be given following surgery to destroy any residual cancer cells remaining in the body (adjuvant chemotherapy).

An important study published in 2003 in the New England Journal of Medicine (Volume 349; pages 859-866) clearly demonstrated the benefits in terms of significantly prolonged survival among bladder cancer patients receiving neoadjuvant combination systemic chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) as compared to the survival rate for patients treated with radical cystectomy alone. The median survival rate over an 11-year period of patients in this study who were treated with neoadjuvant M-VAC systemic chemotherapy followed by radical cystectomy was 77 months compared to only 46 months for patients treated with radical cystectomy alone. Based on the results of this study, the use of neoadjuvant combination chemotherapy has becom e much more prevalent for the treatment of muscle-invasive bladder cancer.

The data supporting the use of adjuvant chemotherapy for high-risk bladder cancer patients remains controversial. Nevertheless, it is generally accepted that patients with Stage T3 or T4 tumors and/or the presence of cancer in one or more lymph nodes at the time of surgery should receive 4-6 cycles of chemotherapy with either GC (gemcitabine) or M-VAC. Patients should discuss with their physicians the benefits and potential side effects of either neoadjuvant or adjuvant chemotherapy approaches.

Actos Lawsuit: Information and News

Actos Lawsuit: Although radical cystectomy is currently considered as the first-line treatment modality for muscle-invasive bladder cancer, some patients may be either unwilling or, due to other underlying medical conditions, may not be eligible to undergo this surgical procedure. What are the treatment options available to these patients?

In recent years, doctors have developed a combination of three treatment modalities (trimodality therapy or multimodality therapy) consisting of transurethral resection (TUR), radiation therapy, and systemic chemotherapy as a means of eradicating the bladder tumor while, at the same time, preserving the patient’s own bladder. The primary advantages of the trimodality therapy approach is that it enables the patient to keep their own bladder by avoiding the need for a radical cystectomy and, thereby, experience an improved quality of life after treatment for bladder cancer.

Although some studies have reported similar survival rates between trimodality therapy and radical cystectomy for patients with muscle-invasive bladder cancer, some experts have expressed the opinion that the risk of local recurrence of the cancer along with the risk of metastatic disease is higher for patients treated with the trimodality approach as compared to patients undergoing radical cystectomy. For these reasons, radical cystectomy is currently still considered as the standard of care for most patients with muscle-invasive bladder cancer, while trimodality therapy is usually reserved for a small subset of patients who are either unwilling or unable to undergo radical cystectomy or those who may wish to enroll in a clinical trial involving trimodality therapy.

Currently, combination systemic chemotherapy is considered as the first-line treatment for patients with metastatic (Stage IV) bladder cancer. The chemotherapeutic regimen that has been used most commonly since 1990 for metastatic bladder cancer is M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin). The median survival rate for patients with metastatic bladder cancer who are treated with M-VAC is only about one-year, however, a small percentage of patients achieve longer survival.

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Actos Lawsuit