January 21, 2005
The Honorable Arlen Specter
Chairman, Senate Judiciary Committee
711 Hart Building
Washington, D.C. 20510
Re: Solution to Asbestos Public Health Crisis
Dear Senator Specter:
As you have acknowledged, asbestos disease in this country is a public
health crisis. We the undersigned are doctors and scientists who have
expertise in the diagnosis, causation, prevention and treatment of malignant
mesothelioma, the signature cancer for asbestos exposure. Mesothelioma
is painful tumor with a dismal prognosis, and our mission is to increase
the funding of the medical research that will, we believe, eventually
solve the problem.
On January 11, 2005, Billy Speicher, a mesothelioma patient, implored his
government to help find a cure. We were pleased that in response you acknowledged
that asbestos disease is more than a litigation crisis and that the government
should play a leadership role in funding medical research. You indicated
that you, as a member of the Labor-HHS subcommittee, would look into how
much of the National Cancer Institute's nearly $5 billion budget is
earmarked for basic and applied research on mesothelioma.
We also looked into this question, and here is what we found. From 2000
to 2003, the NCI spent on average $2.1 million per year on grants which
use the word "mesothelioma" in their abstract. This amount is
far less than .1% of the NCI's 2004 budget. Unlike other cancers,
the NCI does not even have a formal budget for mesothelioma research,
nor does it solicit grants relating to the treatment or cure of mesothelioma.
Mesothelioma kills between 3,000 and 4,000 Americans annually (the exact
number is unknown since this country does not have a nationwide registry
unlike many others). Cervical cancer, which has a similar mortality profile
(viz., about 4,100 deaths per year), in 2003 received $71.3 million from
the NCI. To put those numbers into perspective, the NCI allocated $17,340
for each cervical cancer death, but only $933 per mesothelioma death.
Clearly, mesothelioma is under-funded when compared to other cancers.
Of the patients diagnosed with mesothelioma every year, approximately 32%
were exposed to asbestos while serving in the U.S. Navy or while working
in U.S. Navy shipyards. However, neither the Department of Defense nor
the Department of Veterans Affairs has a program for the detection, prevention,
treatment or cure for mesothelioma. Meanwhile, Congress has since 1992
appropriated over $3.4 billion to the DOD for Congressionally Directed
Medical Research Programs (CDMRPs). A substantial portion of those billions
has been targeted for breast, ovarian and prostate cancer research --
cancers that are not specific to military service. Mesothelioma, on the
other hand, is clearly a service-connected injury for veterans who worked
with and around asbestos.
We believe the Federal Government must take the lead in solving the national
tragedy of mesothelioma. Mesothelioma has been a known occupational cancer
for over 50 years. Billions of dollars have been consumed by asbestos
litigation, most of which has been absorbed by transaction costs. Thousands
of veterans and civilians have already died as a result of asbestos diseases,
and the mortality rate for asbestos cancers is expected to climb over
the next 10 years, as millions of tons of asbestos remain in place in
schools, buildings, homes and workplaces throughout the country, subjecting
millions of Americans to an increased risk of cancer. The asbestos epidemic
will continue to haunt us for decades, unless we take long overdue curative action.
In 2002, MARF proposed a comprehensive $140 million mesothelioma research
and treatment program, which is 0.1% of the projected value of the $140
billion federal asbestos trust fund you are endorsing. The program addresses the
public health program at all levels: prevention, early detection, education,
treatment and cure. The program would foster collaboration between public
and private researchers, create nationwide treatment networks, promote
and fund innovative research, attract top scientific and medical talent,
and provide meaningful treatment options. In particular, the program would:
Establish a competitive peer review grant program;
Fund Ten (10) Centers of Mesothelioma Research/Treatment Excellence ($2.5M
per year for five (5) years);
Fund the Admiral Elmo Zumwalt Registry and Clinical Database;
Fund the Congressman Bruce Vento Blood & Tissue Bank; and
Target Research Priorities, which include:
- Biomarkers for early detection and prediction of recurrence;
- Biological therapies (immunotherapy, gene therapy, novel chemotherapeutic
- Strategies for prevention (inhibit pathways transforming normal to malignant
- Pain Management (mesothelioma is an extremely aggressive and painful tumor).
The current version of the FAIR bill incorporates only a portion of MARF's
proposal. Unfortunately, the need to fund medical research has always
been drowned out by the often shrill debate over who pays and how much.
Because asbestos disease is a public health crisis, and because the U.S.
Government must play a leadership role in solving the health problem,
we believe present and future asbestos disease patients are best served
by a direct appropriation for a CDMRP for mesothelioma. The need to alleviate
the suffering, extend survival, prevent needless death and create hope
should not be tied to the fortunes of an asbestos litigation reform bill,
which historically has failed to resonate with the American people in
general and asbestos victims in particular. Compensating victims does
not in itself solve the health crisis, and the two issues should be treated
The U.S. Government has a role and so does industry, which for years mined,
milled and processed the once ubiquitous mineral fiber. As you have said
repeatedly, since 2000, over 40 former asbestos companies have sought
reorganization under Chapter 11 of the Bankruptcy Code. Experts project
that the aggregate value of all pending asbestos debtors' settlement
trusts will exceed $65 billion (this number does not include the value
of the 10-15 existing Chapter 11 asbestos debtor trusts). A substantial
portion of the future trusts will be siphoned off by management fees.
Yet none of that money is required to be set aside for peer-reviewed competitive
research grants to help alleviate the suffering of current claimants or
extend the lives of future claimants. We implore Congress to amend the
Bankruptcy Code to mandate that a reasonable percentage of existing and
future asbestos settlement trusts be allocated to a medical research trust,
which will target and fund meritorious research programs designed to detect,
prevent, treat and cure asbestos cancers. The former asbestos companies
will walk away from the bankruptcy courts, cleansed of their tort liabilities,
and leave behind a legacy of 27 million Americans with dangerous levels
of carcinogenic asbestos fibers in their lungs, fibers which one day may
generate lung cancer or mesothelioma, for which the median survival at
present is 12.3 months for those patients fortunate enough to qualify
We believe we can find the Achilles heel in mesothelioma. Even with limited
funding, we have been able to make meaningful improvements in the survival
of mesothelioma patients. But to declare victory against this terrible
tumor which has exacted such a heavy toll on Navy veterans, and which
over the next 15 years will likely rear its ugly head in the lung and
abdominal linings of the brave men and women who responded to the 9/11
terrorist attack at Ground Zero, we cannot continue to rely on private
donations alone. We need the resources and the commitment of the U.S.
Government. The Government has the awesome power to replace despair with
hope, nihilism with optimism, defeatism with a can-do spirit, and rhetoric
We appreciate your efforts to help our patients survive the ravages of
a tumor that does not respect rank, power, age, sex, fame or political
affiliations. We would be pleased to meet with you and your staff to articulate
the details underlying MARF's proposals.
Steven Albelda, M.D.
Vice Chief and Director, Lung Research
University of Pennsylvania
Raphael Bueno, M.D.
Division of Thoracic Surgery
Brigham & Womens Hospital
Robert B. Cameron, M.D.
Associate Professor of Clinical Surgery
UCLA Medical Center
Los Angeles, California
Steve Hahn, M.D.
Department of Radiation Oncology
Michael Harbut, M.D.
Center for Occupational and
Royal Oak, Michigan
Hedy Lee Kindler, M.D.
University of Chicago Medical Center
Section of Hematology/Oncology
Ulf Jungnelius, M.D
Oncology Clinical Development
New London, Connecticut
Dan Miller, M.D.
Surgical Director, Thoracic Oncology
Winship Cancer Institute
Harvey Pass, M.D.
Professor of Surgery and Oncology
Karmanos Cancer Institute
Lary A. Robinson, M.D.
Director, Div. of Cardiovascular &
H. Lee Moffitt Cancer Center &
Victor Roggli, M.D.
Professor of Pathology, Duke University
and Virginia Medical Centers
Durham VA Medical Center
Durham, North Carolina
W. Roy Smythe, M.D.
Professor & Chairman
Texas A&M Univ. Health Sciences Ctr.
Scott & White Hospital and Clinic
Department of Surgery
Daniel Sterman, M.D.*
Director, Interventional Pulmonology Program
Clinical Director, Thoracic Oncology Gene
Associate Professor of Medicine in Surgery
University of Pennsylvania Medical Center
Joseph R. Testa, M.D.
Fox Chase Cancer Center
Eric Vallieres, M.D
Swedish Cancer Institute
Claire Verschraegen, M.D.
Director of Experimental Therapeutics
Cancer Research and Treatment Center
University of New Mexico
Albuquerque, New Mexico
Nicholas J. Vogelzang, M.D.
Director, Nevada Cancer Institute
Las Vegas, Nevada
Bret Williams, M.D.
Hillsborough, North Carolina
* President, International Mesothelioma Interest Group, http://www.imig.org.
The International Mesothelioma Interest Group (IMIG) is a multinational
scientific organization composed of researchers, clinicians and others
dedicated to research into the causes and cures for Malignant Mesothelioma.
||Senate Judiciary Committee:
Sen. Saxby Chambliss (R-GA)
Sen. John Cornyn (R-TX)
Sen. Larry Craig (R-ID)
Sen. Mike DeWine (R- OH)
Sen. Lindsey Graham (R-SC)
Sen. Charles E. Grassley (R-IA)
Sen. Jon Kyl (R-AZ)
Sen. Jeff Sessions (R-AL)
Sen. Patrick J. Leahy, Ranking Democratic Member, VT
Sen. Joseph R. Biden, Jr. (D-DE)
Sen. Richard J. Durbin (D-IL)
Sen. Russell D. Feingold (D-WI)
Sen. Dianne Feinstein (D-CA)
Sen. Edward M. Kennedy (D-MA)
Sen. Herbert Kohl (D-WI)
Sen. Charles E. Schumer (D-NY)
Sen. Harry Reid (D-NV)
Sen. Patty Murray (D-WA)