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Mesothelioma and Asbestos: Looking for Answers – and Hope
Despite the knowledge that asbestos is the sole known cause of the rare but very aggressive cancer mesothelioma, a ban in the United States on the source of the problem — the production and use of asbestos in all its forms everywhere — continues to elude us. While more than 60 countries have outlawed the importation and use of asbestos outright, the U.S. is not one of them, and with an uptick in asbestos product and raw fiber importations into this country as of August of 2018, it doesn’t look like a ban will be coming here anytime soon.
So is there anything to be hopeful about? In fact, while mesothelioma is still a horrific and deadly cancer, there is encouraging news. Significant strides have been made toward finding a cure for mesothelioma in coming years. For instance, in 2016, Congress passed the 21st Century Cures Act, which was signed into law by then President Barack Obama. This $6.3 billion bill was approved by an overwhelming 94-5 Senate vote, providing continued funding for the Cancer Moonshot, an initiative headed by the National Cancer Advisory Board to accelerate the fight against cancers of all kinds, including mesothelioma.
Every year since 2011, funding for research on mesothelioma has been provided by the Department of Defense in its Defense Appropriations Act. That the funding comes from the DoD is significant because so many mesothelioma patients were exposed to asbestos during their military service to our country. In 2016, $1.9 million in DoD grant money went directly to researchers at the University of Hawaii’s thoracic oncology department for their study of high-mobility group box 1 (HMGB1) proteins as biomarkers used in mesothelioma detection. The Defense Appropriations bill continues to earmark substantial funding, upwards of $282 million, for cancer research, with more than $12 million dedicated to mesothelioma and lung cancer research, specifically. In Fiscal Year 2018, the Defense Appropriations Act provided $80 million to the DoD Peer Reviewed Cancer Research Program. The Congressionally directed topic areas include a mandate for research on mesothelioma.
In addition to increased funding for mesothelioma research, new guidelines were developed in 2016 by the National Comprehensive Cancer Network (NCCN), a consortium of dozens of the biggest cancer centers in the United States, to recommend that unresectable pleural mesothelioma (mesothelioma which cannot be surgically removed) should always be treated with the monoclonal antibody bevacizumad in addition to chemotherapy drugs pemetrexed and cisplatin because studies have shown that bevacizumad makes pemetrexed and cisplatin so much more effective against tumor growth. Hailed as the first significant change to mesothelioma care standards since 2004, scientific advancements in treating mesothelioma seem to be producing potentially effective treatments at a frenetic pace – all of which bodes well for those suffering from this devastating malignancy.
That’s not to say that more cannot be done. Despite the fact that asbestos has not been widely available in new construction materials or other merchandise for several decades, this Group One rated carcinogen is still being imported to the United States and used in products which are sold to the public and employed in industrial processes. In addition, asbestos exists in many buildings constructed before 1980 and in the pipes which form our public water and sewer infrastructure, where workers performing demolition or remodeling in a variety of trades can easily inhale or ingest its toxic fibers.
Given that the number of years between a person’s first exposure to asbestos and his or her diagnosis of mesothelioma cancer, known as a latency period, can extend from ten to 71 years, the majority of people alive today are thought to have been exposed to asbestos before 1980. Experts predicted that deaths from mesothelioma would peak at about 3,060 per year in the United States until 2005, after which the number would start to decline. But a decrease in the number of deaths from mesothelioma in this country has not occurred.
Instead, between 1999 and 2015, 45,221 deaths from malignant mesothelioma were recorded in the United States alone. Despite the extreme rarity of the disease, there were 118 more deaths from mesothelioma in this country in 2015 than in 1999. And while the number of people dying from mesothelioma in America who are older than 85 had been expected to rise as the population thought to be most widely exposed to asbestos ages, scientists were surprised to discover that people younger than 55 are also dying of mesothelioma at alarming rates.
A 2017 report, published in the Morbidity and Mortality Weekly Report by the leading national public health institute of the United States, the Center For Disease Control and Prevention (CDC), concluded that the “annual number of malignant mesothelioma deaths remains substantial”. The report pointed out the need for further restrictions on the importation of asbestos, as well as more careful monitoring during the demolition and remodeling of older buildings which were likely constructed with asbestos-containing materials.
Our nation and the world are at a pivotal moment in history with regard to defining asbestos as the horrific killer it is and enacting legislation worldwide to ban its use outright. A cure for mesothelioma is desperately needed in order to bring a halt to the devastating loss of life that continues to be caused by this microscopic menace. Researchers seem to be on the threshold of developing a treatment that will make a death sentence of mesothelioma a thing of the past. We can only hope that the pace of medical advances continues unabated.
There is much to be thankful for as we reflect upon the significant progress that has been made in getting asbestos out of most products available for consumer purchase and in the workplace today. Tremendous strides are being made right now in improving length and quality of life for patients with malignant mesothelioma. We have come so far, and there is still so much more to do.