About the Author
Roger G. Worthington is a plaintiff's advocate who represents mesothelioma
patients and their families. He is also the founder of The Mesothelioma
Applied Research Foundation (MARF), whose mission, in cooperation with
all interested parties, is to eradicate mesothelioma as a life-ending
disease. See www.marf.org.
Mesothelioma is now a household word in this country.
Increasingly common television ads flash the word in large block letters
to bring new cases to plaintiffs' firms. New Yorkers worry that the
attack on the Twin Towers, which released untold tons of asbestos into
the air, will raise the 9/11 death toll 15 years or more later with a
ripple of mesotheliomas. Manufacturing and industry lobbyists, long stymied
in their efforts to obtain asbestos tort reform legislation, increasingly
trumpet the argument that lawsuits by unimpaired claimants should be stemmed
and an increasingly limited supply of funds safeguarded to compensate
the most serious cases, most notably, mesothelioma claims.
Lawyers, lobbyists, and doctors will gravely describe the cancer as "incurable."
And by doing so, without investing a fraction of the billions of dollars
that have been spent on litigation since the 1960s in a cure, we as a
nation may be sealing the fate of all present and future mesothelioma
patients. The disease will remain incurable if we lack the will and resolve
to appropriate the money to find a cure, just as we have done with many
other forms of cancer.
Admiral Elmo Zumwalt
Diagnosed October, 1999
Deceased January 2, 2000
We must change the doom and gloom. And we can. Two asbestos bills will
soon be introduced in Congress, one dealing with tort reform and the other
with banning asbestos. (The latter also provides for minimal funding for
mesothelioma treatment at specified centers, and an unspecified amount
for funding research). We need to ensure that the final bill that reaches
the President's desk contains language that finally begins to fix
the root of the asbestos cancer problem by funding basic and applied research.
Every year, approximately 2,500 Americans are diagnosed with malignant
mesothelioma (MM). The cancer has been known in this country since the
late 1940s. The number of mesothelioma cases in the United States is expected
to peak in the next 10 to 15 years and is not expected to retreat to background
levels of incidence in the U.S. until 2025.
MM is invariably fatal with no known confirmed cure. Death can occur suddenly
from complications, opportunistic infections or unexpected rapid tumor
progression. Those who try surgical resection of the tumor face terrible
and prolonged post-surgical pain and a months-long recovery in which they
are virtually homebound and unable to work. With the surgery, expensive
pain medications, chemotherapy and/or radiation therapy, a patient's
medical expenses will commonly exceed $200,000, and can consume a life's savings.
Most patients will die of symptoms of local disease. With pleural MM, the
increasing tumor bulk replaces the effusive component, causing progressive
respiratory compromise. The unrelenting chest pain requiring narcotics
leads to an inability to eat and occasionally dysphagia from tumor compression
of the esophagus. Direct involvement of the pericardium can lead to pericardial
effusion or myocardial dysfunction with arrhythmias.
1954-1973 Machinist Mate
Diagnosed October, 2000
Deceased December 1, 2002
The first lawsuits against the asbestos companies were filed in the 1960s.
The government began regulating the use of asbestos in 1972, and banned
asbestos from several thermal and refractory insulation products in 1973.
The EPA attempted to ban most of the asbestos products remaining in 1989,
but the ban was overturned in court in 1991, and the former Bush Administration
did not appeal.
Over the years, about $56 billion dollars have changed hands - from the
asbestos companies and their insurers, to the lawyers and their experts,
and finally to the victims and their families
With the number of mesothelioma cases in the U.S. expected to increase
for the next 10 to 15 years, the Rand Institute for Civil Justice projects
asbestos litigation will ultimately cost corporate America between $200
billion and $275 billion. Despite those staggering numbers, there is at
present no mandate imposed by the courts or Congress to divert a nickel
to eradicating the source of the misery in the first place.
A Hazard of Government Service.
Many MM patients belong to what's been reverently described as "The
Greatest Generation," exposed to asbestos while defending our borders
and maintaining our fleet. Others were exposed when they got up and went
to work each day to make our steel and build our refineries, powerhouses,
skyscrapers, schools and churches.
Roughly 30 percent of the MM patients diagnosed in the United States served
in the U.S. Navy, Merchant Marines, or as civilians in Navy shipyards,
and it is beyond cavil that they suffer a "service-connected"
disease and disability.
1960-1963 Boiler Tender
Diagnosed February, 2000
Deceased May 13, 2000
What action to remedy the curse of mesothelioma has the Federal Government
taken? The Department of Veterans Affairs does not have any meaningful
treatment protocol. Neither the National Cancer Institute (NCI) nor the
Department of Defense (DOD) has any research programs designed to find
a cure or a standard of care.
In 2001, the NCI, the single largest provider of cancer research money
with a budget of more than $3 billion, allocated just over $1.6 million
for research on mesothelioma, mainly for clinical trials. This is a small
fraction of what most other cancers received, even when adjusted by number
of fatalities (See Figure 1).
Besides the NCI, another major source of cancer research funding is the
DOD. In 1992, thanks to a $25 million congressional appropriation for
breast cancer screening for military women and family members, the DOD
created the Breast Cancer Research Program (BCRP). In 2000, Congress appropriated
another $175 million to this laudable program, and the same amount in
2001. From 1992 to 2001, Congress has appropriated more than $1.2 billion
to fund peer-reviewed breast cancer research through the BCRP.
Similarly, the DOD supports a Prostate Cancer Research Program (PCRP),
which was established in 1997 with a $45 million congressional appropriation.
By 2001, Congress had earmarked $310 million to fund peer-reviewed prostate
cancer research through the PCRP.
Time for Congress to Put a Spotlight on Need for Cure.
Congress has an historic opportunity to correct past mistakes and help
MM patients and their families. In early 2003, Congress is expected to
consider two important bills, one dealing with compensation, and the other
calling for a complete ban on asbestos.
The compensation bill has sparked widespread public interest. This "tort
reform" bill would allow only MM, cancer and seriously-impaired asbestos
claimants to file lawsuits, and force the "unimpaired" claimants
onto a waiting list providing exit to the tort system only if they become
seriously injured. The bill responds to the rash of bankruptcy filings
over the past few years. Most agree these bankruptcies were caused by
the explosion in claims filed by a relative handful of law firms on behalf
of people with asbestos exposure who are not yet sick, and likely never
will be sick. The bill is designed to keep afloat the remaining defendant
companies so they can compensate those with the most grievous injuries.
Over the last year, a mounting number of prominent American newspapers
published editorials on what the Supreme Court called the "elephantine
mass" of asbestos litigation. In the first two months of 2002, lobbyists
for the insurers reported spending $2 million to curry favor in Congress
for the asbestos tort reform bill, an amount roughly 25 percent greater
than the entire NCI budget for MM research in 2001. Add this to the untold
millions spent in the years before by lobbyists for the National Association
of Manufacturers, the American Insurance Association, the American Trial
Lawyers Association and others pushing for and against laws limiting asbestos
litigation. In the next few months millions more will be spent by lobbyists
on all sides of the debate.
Before, no one lobbied for spending a small portion of the billions of
dollars asbestos litigation will consume towards basic and applied research
for expanding MM's treatment options, or a cure. Because of a sense
of nihilism regarding the incurability of MM, and because of our complacency
and timidity in committing to a cure for the disease, its incurability
has become a fait accompli.
Now, at last, the tide is turning.
1951-1955 Boiler Tender
Diagnosed November, 2000
Deceased February 27, 2001
The Ban Asbestos in America Act, which was introduced in June by Senator
Patty Murray (D-WA), is a giant and long overdue step in the right direction
in funding MM research at the federal level. The Act contains three important
"first step" provisions which would (1) for the first time ever,
compel the National Insitute of Health to fund research on asbestos-related
cancers, (2) fund a registry for mesothelioma incidence, and (3) allocate
about $4 million per year for the next few years for MM treatment programs
at seven renowned cancer centers. As the Act's title indicates, the
bill would ban all commercial uses of asbestos -something most Americans
thought had already happened years ago.
After years of neglect, just getting Congress to talk about the ravages
of this deadly cancer on The Greatest Generation is a victory of sorts.
No matter what side of the fence you may be on over the highly charged
compensation debate, everyone should agree that the time has come for
this country to take seriously its responsibility to fund research on
a cure for MM at a level that is proportionate to other cancers and diseases.
But these are just first steps, and more must be done. To find that Achilles
heel and build a weapon that will knock the tumor out, or at least delay
its progression, we need to design and fund collaborative clinical trials
that bring the best and brightest scientists, geneticists, surgeons and
oncologists together. We need data rather than conjecture, organization
rather than chaos.
We need sufficient funds for peer-reviewed research on basic tumor genesis.
How can we turn off or turn on the right switches at the genetic level
to destroy the immortalized malignant mesothelioma cell? How can we prevent
the tumor from arising in asbestos-exposed populations who are bumping
up against their latency period, a group that includes millions of young adults?
An Epidemic That Will Not Fade Away Needs Action Now.
On October 27, 2000, the Hon. Bruce Vento, who served his country for 24
years in the U.S. Congress, passed away from MM, despite receiving the
best treatment available. Before MM robbed us of this courageous leader,
Congressman Vento pleaded to his colleagues in a videotaped speech
Rep. Bruce Vento
Diagnosed January, 2000
Deceased October 10, 2000
Our great country has not applied its vast resources to curing mesothelioma.
Billions have been spent on the litigation. But a pittance has been spent
on finding a cure. Asbestos companies have done little, though finding
a cure is in their interest. The government hasn't stepped up, perhaps
because we believe that the disease will simply fade away . . .
As Congressman Vento alluded, the disease won't simply "fade away"
with the death of the estimated 27 million members of "The Greatest
Generation" who helped build this country and occupationally inhaled
asbestos every day. Today we are seeing more and more young adults diagnosed
with the deadly disease, children whose only exposure came when they hugged
their asbestos-contaminated fathers when they came home from the shipyard.
And we continue to see a small percentage of young Americans who are diagnosed
without any clear exposure to asbestos at all, except perhaps on an "environmental"
or "bystander" basis at public schools built before 1980.
The odds are we will see firefighters, policemen or other heroes of New
York City's 911 tragedy who were exposed to asbestos at Ground Zero
develop mesothelioma. What hope will we offer them? Who will step up to
honor the sacrifice and public service of heroes like Congressman Vento?
Who will advocate on behalf of the unsung heroes, who have served their
country proudly, but now must hold on and stay alive long enough for their
government to finally take responsibility for their care? Who will fund
the research that will generate the treatments that will grant them the
pride and privilege of attending their grandchildren's high school
graduations? We urge you, as a first step, to support the Ban Asbestos
in America Act. Back in 1971, with the creation of the National Cancer
Act, Congress launched the "War on Cancer." Our chief weapon
was money. Since then, we have invested billions of dollars in fighting
all sorts of cancer, with profound success. But we have not funded mesothelioma
at a level that is proportionate to other cancers.
1961-1965 Fireman, Boiler Tender
Diagnosed April 2002
We urge Congress to take the same kind of action it took with respect to
curing prostate and breast cancer through the DOD. Congress launched the
breast cancer and prostate cancer research programs for $25 million (in
1992 dollars) and $45 million, respectively. Congress should also appropriate
$20 million to create a Mesothelioma Medical Research Program through
the DOD. Further, we ask that Congress appropriate $5 million for the
creation of a mesothelioma registry/database. The Center for Disease Control
(CDC) does not even maintain a registry for mesothelioma as a reportable
disease, although it has been called an "epidemic." Most European
nations have mesothelioma registries.
As Congress considers various reforms to the current asbestos tort litigation,
it should also consider creative solutions to ensure that, of the billions
spent on litigation, a fraction is invested in finding a cure. Mechanisms
include a tax on settlements to be paid by industry and a transfer of
a portion of any punitive damage award that is collected to a trust that
will award grants to meritorious researchers after a rigorous peer review.
All tumors deserve eradication, but mesothelioma is particularly heinous.
Mesothelioma is unmercifully cruel in terms of pain as it wraps around
a lung or other organ and squeezes its victims to death. So many died
deserving so much better, poisoned while serving their country in ships
and shipyards and other places vital to the nation. We can, and we must,