Tuesday, 1 May 2007
What is a Mesothelioma Claim?
Mesothelioma Claim
A mesothelioma claim is the lawsuit that is filed on behalf of an individual who has developed mesothelioma as a result of harmful exposure to asbestos. A mesothelioma claim is filed against the party who is responsible for the victim's exposure to asbestos. Mesothelioma claim defendants can be government organizations, manufacturers, employers, asbestos removal professionals, or any other party whose negligence contributed to harmful asbestos exposure.
At least six hundred thousand Mesothelioma claims have been filed in the United States alone. A mesothelioma claim can be filed by the victim or their loved ones in the event that mesothelioma has already claimed that person's life. A mesothelioma claim can help a victim or their loved ones to receive compensation for their losses including medical expenses, loss of income or earning potential, disability, and psychological suffering.
When considering a mesothelioma claim, there are some important things to consider. This first aspect to a mesothelioma claim is the statute of limitations that applies to the filing of a mesothelioma claim. Each state may have their own statute of limitations which restricts the amount of time a victim has to file a mesothelioma claim. Usually a statute of limitation begins at the point at which a person develops the injury. Because mesothelioma can remain dormant and asymptomatic for decades, the statute of limitations may begin at the point of diagnosis rather than the time of exposure. The statute of limitations for a mesothelioma claim can vary based on a number of factors, and therefore it is important to discover the laws applicable to your case.
To have a successful mesothelioma case, you must also be able to prove the exact source of the asbestos exposure, the party who is responsible for that exposure, and the exact damages that were suffered as a result of that asbestos exposure. A trained and experienced mesothelioma claim legal expert can help to determine these factors and develop a strong case to protect and maximize a victim's rights.
Because there have been so many mesothelioma claims filed in the United States, the federal government has considered the development of an asbestos compensation fund. If this fund is created, victims of mesothelioma would no longer have the legal option to file a mesothelioma claim. Instead these victims would be eligible for compensation of their losses through this fund if they meet specific requirements. Critics of this asbestos fund legislation worry that many victims of mesothelioma will not be able to receive adequate compensation for their injuries under this law.
Under existing law, it is possible for a victim to file a mesothelioma claim to seek compensation for the damages they have suffered at the hands of those who failed to prevent harmful asbestos exposure. To learn more about your rights and options in a mesothelioma claim, please contact us to confer with a qualified and experienced mesothelioma attorney in your area.
For more information about mesothelioma claims, please Contact a Mesothelioma Attorney to learn your legal rights!
A mesothelioma claim is the lawsuit that is filed on behalf of an individual who has developed mesothelioma as a result of harmful exposure to asbestos. A mesothelioma claim is filed against the party who is responsible for the victim's exposure to asbestos. Mesothelioma claim defendants can be government organizations, manufacturers, employers, asbestos removal professionals, or any other party whose negligence contributed to harmful asbestos exposure.
At least six hundred thousand Mesothelioma claims have been filed in the United States alone. A mesothelioma claim can be filed by the victim or their loved ones in the event that mesothelioma has already claimed that person's life. A mesothelioma claim can help a victim or their loved ones to receive compensation for their losses including medical expenses, loss of income or earning potential, disability, and psychological suffering.
When considering a mesothelioma claim, there are some important things to consider. This first aspect to a mesothelioma claim is the statute of limitations that applies to the filing of a mesothelioma claim. Each state may have their own statute of limitations which restricts the amount of time a victim has to file a mesothelioma claim. Usually a statute of limitation begins at the point at which a person develops the injury. Because mesothelioma can remain dormant and asymptomatic for decades, the statute of limitations may begin at the point of diagnosis rather than the time of exposure. The statute of limitations for a mesothelioma claim can vary based on a number of factors, and therefore it is important to discover the laws applicable to your case.
To have a successful mesothelioma case, you must also be able to prove the exact source of the asbestos exposure, the party who is responsible for that exposure, and the exact damages that were suffered as a result of that asbestos exposure. A trained and experienced mesothelioma claim legal expert can help to determine these factors and develop a strong case to protect and maximize a victim's rights.
Because there have been so many mesothelioma claims filed in the United States, the federal government has considered the development of an asbestos compensation fund. If this fund is created, victims of mesothelioma would no longer have the legal option to file a mesothelioma claim. Instead these victims would be eligible for compensation of their losses through this fund if they meet specific requirements. Critics of this asbestos fund legislation worry that many victims of mesothelioma will not be able to receive adequate compensation for their injuries under this law.
Under existing law, it is possible for a victim to file a mesothelioma claim to seek compensation for the damages they have suffered at the hands of those who failed to prevent harmful asbestos exposure. To learn more about your rights and options in a mesothelioma claim, please contact us to confer with a qualified and experienced mesothelioma attorney in your area.
For more information about mesothelioma claims, please Contact a Mesothelioma Attorney to learn your legal rights!
what is Mesothelioma?
Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos.[1] In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking [2].
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* chest wall pain
* pleural effusion, or fluid surrounding the lung
* shortness of breath
* fatigue or anemia
* wheezing, hoarseness, or cough
* blood in the sputum (fluid) coughed up
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* abdominal pain
* ascites, or an abnormal buildup of fluid in the abdomen
* a mass in the abdomen
* problems with bowel function
* weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* blood clots in the veins, which may cause thrombophlebitis
* disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
* jaundice, or yellowing of the eyes and skin
* low blood sugar level
* pleural effusion
* pulmonary emboli, or blood clots in the arteries of the lungs
* severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
[edit] Diagnosis
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.[3]
Pathophysiology
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).[4] However, there is now evidence that smaller particles may be more dangerous than the larger fibers.[1][2] They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.[3]
Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
* Neurofibromatosis type 2 at 22q12
* P16INK4A
* P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
* Inactivation of tumor suppressor genes
* Activation of oncogenes
* Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
* Activation of DNA repair enzymes, which may be prone to error
* Activation of telomerase
* Prevention of apoptosis
Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.
Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
[edit] Epidemiology
[edit] Incidence
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence is approximately one per 1,000,000. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.[5] It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States [4]. Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
[edit] Risk factors
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.[6]
[edit] Exposure
Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
Exposure to asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.
The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure.
Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
[edit] Treatment
Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
[edit] Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing with a 5 year survival rate of less than 10%. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.
[edit] Radiation
Wikibooks
Wikibooks has a book on the topic of
Radiation Oncology/Lung/Mesothelioma
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy and is often times given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. [7] Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
[edit] Chemotherapy
In February 2004, the Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.
[edit] Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
[edit] Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.[7] The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.
[edit] Prevention & Expectations
What can be done to prevent the disease? Since the 1970s, the Environmental Protection Agency and the Occupational Safety and Health Administration have regulated the asbestos industry in the U.S. In the past, asbestos was used as a fire retardant and an insulator. Other products are now used in its place. The controversy involving exposure to different forms of asbestos continues.
There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.
Removal is taking place in schools and other public buildings throughout the U.S. The hope is that these measures will greatly reduce the occurrence of this cancer.
What are the long-term effects of the disease? A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted example.
What are the risks to others? Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.
[edit] Notable people with mesothelioma
Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.
Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the US Marines as a young adult -- asbestos was then commonly used to insulate ships' piping -- or because of its use as an insulating material in car racing suits.[8]
United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.
After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind including the song Keep me in your heart which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.
Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote the "The Median Isn't the Message," [5] for Discover magazine, in which he argued that statistics such as median survival are just useful abstractions, not destiny. Gould lived for another twenty years eventually succumbing to metastatic adenocarcinoma of the lung, not mesothelioma.
Author Paul Kraus was diagnosed in June 1997 with peritoneal mesothelioma. He declined surgery, chemotherapy, and radiation, and later wrote about the various lifestyle changes and alternative modalities he has used to successfully manage his cancer.
[edit] Legal issues
Main article: asbestos and the law
The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars. The amounts and method of allocating compensation have been the source of many court cases, and government attempts at resolution of existing and future cases.
[edit] History
The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos.[9] The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker.[10] The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.
In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.
Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.
By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking [2].
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* chest wall pain
* pleural effusion, or fluid surrounding the lung
* shortness of breath
* fatigue or anemia
* wheezing, hoarseness, or cough
* blood in the sputum (fluid) coughed up
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* abdominal pain
* ascites, or an abnormal buildup of fluid in the abdomen
* a mass in the abdomen
* problems with bowel function
* weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* blood clots in the veins, which may cause thrombophlebitis
* disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
* jaundice, or yellowing of the eyes and skin
* low blood sugar level
* pleural effusion
* pulmonary emboli, or blood clots in the arteries of the lungs
* severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
[edit] Diagnosis
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.[3]
Pathophysiology
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).[4] However, there is now evidence that smaller particles may be more dangerous than the larger fibers.[1][2] They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.[3]
Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
* Neurofibromatosis type 2 at 22q12
* P16INK4A
* P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
* Inactivation of tumor suppressor genes
* Activation of oncogenes
* Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
* Activation of DNA repair enzymes, which may be prone to error
* Activation of telomerase
* Prevention of apoptosis
Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.
Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
[edit] Epidemiology
[edit] Incidence
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence is approximately one per 1,000,000. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.[5] It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States [4]. Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
[edit] Risk factors
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.[6]
[edit] Exposure
Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
Exposure to asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.
The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure.
Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
[edit] Treatment
Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
[edit] Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing with a 5 year survival rate of less than 10%. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.
[edit] Radiation
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Radiation Oncology/Lung/Mesothelioma
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy and is often times given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. [7] Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
[edit] Chemotherapy
In February 2004, the Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.
[edit] Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
[edit] Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.[7] The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.
[edit] Prevention & Expectations
What can be done to prevent the disease? Since the 1970s, the Environmental Protection Agency and the Occupational Safety and Health Administration have regulated the asbestos industry in the U.S. In the past, asbestos was used as a fire retardant and an insulator. Other products are now used in its place. The controversy involving exposure to different forms of asbestos continues.
There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.
Removal is taking place in schools and other public buildings throughout the U.S. The hope is that these measures will greatly reduce the occurrence of this cancer.
What are the long-term effects of the disease? A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted example.
What are the risks to others? Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.
[edit] Notable people with mesothelioma
Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.
Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the US Marines as a young adult -- asbestos was then commonly used to insulate ships' piping -- or because of its use as an insulating material in car racing suits.[8]
United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.
After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind including the song Keep me in your heart which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.
Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote the "The Median Isn't the Message," [5] for Discover magazine, in which he argued that statistics such as median survival are just useful abstractions, not destiny. Gould lived for another twenty years eventually succumbing to metastatic adenocarcinoma of the lung, not mesothelioma.
Author Paul Kraus was diagnosed in June 1997 with peritoneal mesothelioma. He declined surgery, chemotherapy, and radiation, and later wrote about the various lifestyle changes and alternative modalities he has used to successfully manage his cancer.
[edit] Legal issues
Main article: asbestos and the law
The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars. The amounts and method of allocating compensation have been the source of many court cases, and government attempts at resolution of existing and future cases.
[edit] History
The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos.[9] The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker.[10] The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.
In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.
Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.
By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.
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what is a lawyer?
Lawyers interpret the law through actions and words for the protection of an individual, a business concern or an idea. They must be widely versed in a great many areas: the law, economics, history, human motivation and behavior, and the practicalities of day to day living. The education of lawyers never ends because they must constantly be abreast of information which may be of use to the client.
As our society grows in complexity, the lawyer's role grows as well. No longer is it possible for one single lawyer to handle every aspect of every client's legal needs. Although well informed as to the tax implications of stock market transactions, a lawyer may not know enough to cover adequately the client's requirements for divorce proceedings, for instance. For this reason, the vast majority of today's lawyers are specifying the types of clients and cases which they will serve. It is important to understand, however, that even though the legal profession itself is specializing, the law school and prelegal education remain general in nature. Any specialization you choose to follow must take place after you graduate from law school, pass the bar examination, and enter the professional world. The type you choose to practice may depend upon employment conditions when you begin, your personal interest and background, the amount of money you want to earn, the area of the country in which you want to live, etc. If you enjoy working with numbers or have a great concern for the welfare of society, you're a natural for some particular legal specialties; see descriptions below.
So how can you know if you'll like being a lawyer? The practice of law includes so many alternatives that it is difficult to generalize at all. Many lawyers in large corporate firms concentrate their efforts in mastering one particular area of specialization within the law, e.g. the intricacies of tax law. These attorneys often serve primarily as advisors to corporate clients, rarely being involved with taking a case to court. Litigation lawyers, on the other hand, prepare and present cases in court or negotiate to settle the case before the scheduled court appearance. Practicing law in a small town or with a small community-based firm often means taking whatever cases walk through the door. This kind of practice tends to focus more on the daily legal needs of individuals - drawing up wills or deeds, filing for divorces, getting someone out of jail on bond, settling personal damage suits in court - rather than the more technical and specialized needs of corporate clients. Success is often due more to the quality of your personal interactions and persuasiveness than to your intellectual capabilities.
Although various kinds of legal practice are different in many ways, there are some common links. First of all, clients come to lawyers with a certain set of facts - the specific details of their experience. They come seeking a remedy. Your task as the attorney is to use your skills and understanding of the law to support their cases. Clients tend not to concern themselves with theory although you may think cases pose some interesting issues. They want you to take the facts - their facts - and weave the details into a case to support their position. Your success as a lawyer is determined by the extent to which you serve the best interests of your clients. Your satisfaction in a legal career is also in part determined by the extent to which you like the interests and clients you serve.
It is impossible to list and explain all of the various types of law practiced in the United States today. The following descriptions cover the legal fields most widely known and available to beginning lawyers. Most law schools have very sophisticated methods with which to assist you in finding appropriate employment opportunities. Your law school placement office will be able to give you more complete information when you need it. The following descriptions are presented only to give you an idea of what some types of lawyers do. You should also be aware that some of the descriptions given here may fit other titles as it is often difficult to differentiate between types of law which may overlap a great deal, i.e. what is entitled comparative law here may be considered international law by some. You must also realize that the descriptions are only brief summaries and do not cover everything that the lawyer working in that specialty does.
Comparative Law A lawyer who chooses this specialty must have a good working knowledge of the laws, society, and government of at least one country other than the United States. This usually means that the lawyer has attended both college and law school in the United States as well as a formal educational institution in the foreign country with whose affairs s/he will eventually work. The comparative lawyer works with international relations in trade and commerce, travel, government business, and many other areas depending upon the breadth of his/her knowledge and the needs of his/her employer. The field of comparative law is one in which there is a great deal of opportunity for advancement and challenging work. Comparative lawyers may find their employment with business firms, with government organizations, or with any person or group which deals with countries other than the United States.
Environmental Law One of the newest entries in the legal world, environmental law requires a concern for the nation's resources, knowledge of where the resources are, what they are used for, how and why they may be endangered or exploited, and whose job it is to protect them. Environmental lawyers may work alone or in and for groups whose job it is to prosecute offenders and remedy the offending situation. On the other side of the coin, environmental lawyers may represent the "offenders" to prove why the exploitation is not bad or is not what it seems to be. Finally, they may mediate between concerned groups and help generate arrangements which will benefit the country, the consumers, and the corporation.
Patent Law Patent Law is the only legal specialty officially recognized by the American Bar Association. It is also one of the few areas of legal practice which requires a specific educational background usually in the natural sciences, mathematics, or engineering. This background is required because the work a patent lawyer does is to see that no one has already patented a client's idea and that no one "borrows" the client's idea after it has been patented. To do this the lawyer must thoroughly understand the client's idea and be able to ascertain whether differences occur in similar ideas or if, indeed, the idea has already been used or is being "borrowed". Patent lawyers are usually employed by large firms whose research teams may constantly be coming up with new ideas to be protected, or by large law firms where they handle individual clients and companies who seek the advice of the lawyer. Sometimes patent lawyers enter private practice and work as representatives to individuals and companies.
Poverty Law and Legal Services A general title for a great number of legal opportunities, poverty law and legal services offers a lawyer the chance to represent and protect those in our society who may not have the money or the knowledge to help themselves. Many law schools are now offering third year students and occasionally second year students the option of working with poverty law clients as part of an internship or clinical program. If your law school offers this as an elective, it is not only an excellent method of acquainting yourself with the real "meat" of this particular type of law practice, it is also a fine introduction into the legal world itself as it shows the student the kind of knowledge s/he will be called upon to utilize every day. In addition, it serves as a respite from what may become academic tedium during the later years of law school. Poverty law and legal services encompass positions such as the district attorney and public defenders in city governments, legal aid work, and government groups such as VISTA and the Peace Corps which have recently introduced legal work into their programs of assistance. If you are considering this type of law, do not expect to make a lot of money, expect to be very busy, and realize that your services will be sought by many and may be appreciated by only a few. For the vast majority of the lawyers who enter this type of law, the clients' appreciation when it occurs is the finest reward.
Tax Law A tax lawyer assists people or businesses in the computation and payment of taxes of all kinds: income, property, estate, etc. A good background in statistics, mathematics and/or business as well as a genuine enjoyment of working with numbers are basic necessities for the tax lawyer. LLM degrees (the Master of Law Letters degree which follows the JD or LLB degree) can be received in tax law in a number of law school graduate divisions around the country. This is one of the specific areas in which the LLM degree is most frequently pursued. Tax law is a growing field because of the increasing complexity of the financial status of the United States and its private citizens. If you satisfy the requirements of the field, your work in private practice or as a corporation tax lawyer can be a lucrative career.
Corporate Law The corporate lawyer deals with the entirety of a corporation's activities from settling tax, employment, or labor problems, to setting up mergers between and among corporations and arranging stock options. Generally, a corporate lawyer is one of a team of lawyers, each handling or assisting in the handling of only one of the activities areas. A corporate lawyer, therefore, may be any one of the preceding types of lawyers and also be a corporate lawyer. For instance, an environmental lawyer may be employed by Kodak and still retain both titles of environmental and corporate lawyer; one does not preclude the other. Corporate law opportunities are unlimited and offer continually broadening horizons commensurate with the growth of the corporation.
Criminal Law Criminal Law involves just what the label implies: persons accused of crimes. Lawyers who specialize in criminal law may work on either side of the adversary process -- defense or prosecution. Those who defend the accused may work in private practice or in a public defender's office. Those who work for the prosecution side will generally be employed by the government, e.g. in District Attorneys' offices, etc. At the higher levels of government (e.g. the Federal Justice Department), criminal lawyers will often find themselves defending the accused, because their role will be to argue cases that are being appealed on constitutional grounds.
As previously stated, there are many more types of law from which to choose; what you choose will depend upon your present interests and your interests as they develop in law school. There is no reason to make your decision now as to what type of law you will practice; the legal profession changes constantly and you may find your own interests changing as you become exposed to more and more information.
As our society grows in complexity, the lawyer's role grows as well. No longer is it possible for one single lawyer to handle every aspect of every client's legal needs. Although well informed as to the tax implications of stock market transactions, a lawyer may not know enough to cover adequately the client's requirements for divorce proceedings, for instance. For this reason, the vast majority of today's lawyers are specifying the types of clients and cases which they will serve. It is important to understand, however, that even though the legal profession itself is specializing, the law school and prelegal education remain general in nature. Any specialization you choose to follow must take place after you graduate from law school, pass the bar examination, and enter the professional world. The type you choose to practice may depend upon employment conditions when you begin, your personal interest and background, the amount of money you want to earn, the area of the country in which you want to live, etc. If you enjoy working with numbers or have a great concern for the welfare of society, you're a natural for some particular legal specialties; see descriptions below.
So how can you know if you'll like being a lawyer? The practice of law includes so many alternatives that it is difficult to generalize at all. Many lawyers in large corporate firms concentrate their efforts in mastering one particular area of specialization within the law, e.g. the intricacies of tax law. These attorneys often serve primarily as advisors to corporate clients, rarely being involved with taking a case to court. Litigation lawyers, on the other hand, prepare and present cases in court or negotiate to settle the case before the scheduled court appearance. Practicing law in a small town or with a small community-based firm often means taking whatever cases walk through the door. This kind of practice tends to focus more on the daily legal needs of individuals - drawing up wills or deeds, filing for divorces, getting someone out of jail on bond, settling personal damage suits in court - rather than the more technical and specialized needs of corporate clients. Success is often due more to the quality of your personal interactions and persuasiveness than to your intellectual capabilities.
Although various kinds of legal practice are different in many ways, there are some common links. First of all, clients come to lawyers with a certain set of facts - the specific details of their experience. They come seeking a remedy. Your task as the attorney is to use your skills and understanding of the law to support their cases. Clients tend not to concern themselves with theory although you may think cases pose some interesting issues. They want you to take the facts - their facts - and weave the details into a case to support their position. Your success as a lawyer is determined by the extent to which you serve the best interests of your clients. Your satisfaction in a legal career is also in part determined by the extent to which you like the interests and clients you serve.
It is impossible to list and explain all of the various types of law practiced in the United States today. The following descriptions cover the legal fields most widely known and available to beginning lawyers. Most law schools have very sophisticated methods with which to assist you in finding appropriate employment opportunities. Your law school placement office will be able to give you more complete information when you need it. The following descriptions are presented only to give you an idea of what some types of lawyers do. You should also be aware that some of the descriptions given here may fit other titles as it is often difficult to differentiate between types of law which may overlap a great deal, i.e. what is entitled comparative law here may be considered international law by some. You must also realize that the descriptions are only brief summaries and do not cover everything that the lawyer working in that specialty does.
Comparative Law A lawyer who chooses this specialty must have a good working knowledge of the laws, society, and government of at least one country other than the United States. This usually means that the lawyer has attended both college and law school in the United States as well as a formal educational institution in the foreign country with whose affairs s/he will eventually work. The comparative lawyer works with international relations in trade and commerce, travel, government business, and many other areas depending upon the breadth of his/her knowledge and the needs of his/her employer. The field of comparative law is one in which there is a great deal of opportunity for advancement and challenging work. Comparative lawyers may find their employment with business firms, with government organizations, or with any person or group which deals with countries other than the United States.
Environmental Law One of the newest entries in the legal world, environmental law requires a concern for the nation's resources, knowledge of where the resources are, what they are used for, how and why they may be endangered or exploited, and whose job it is to protect them. Environmental lawyers may work alone or in and for groups whose job it is to prosecute offenders and remedy the offending situation. On the other side of the coin, environmental lawyers may represent the "offenders" to prove why the exploitation is not bad or is not what it seems to be. Finally, they may mediate between concerned groups and help generate arrangements which will benefit the country, the consumers, and the corporation.
Patent Law Patent Law is the only legal specialty officially recognized by the American Bar Association. It is also one of the few areas of legal practice which requires a specific educational background usually in the natural sciences, mathematics, or engineering. This background is required because the work a patent lawyer does is to see that no one has already patented a client's idea and that no one "borrows" the client's idea after it has been patented. To do this the lawyer must thoroughly understand the client's idea and be able to ascertain whether differences occur in similar ideas or if, indeed, the idea has already been used or is being "borrowed". Patent lawyers are usually employed by large firms whose research teams may constantly be coming up with new ideas to be protected, or by large law firms where they handle individual clients and companies who seek the advice of the lawyer. Sometimes patent lawyers enter private practice and work as representatives to individuals and companies.
Poverty Law and Legal Services A general title for a great number of legal opportunities, poverty law and legal services offers a lawyer the chance to represent and protect those in our society who may not have the money or the knowledge to help themselves. Many law schools are now offering third year students and occasionally second year students the option of working with poverty law clients as part of an internship or clinical program. If your law school offers this as an elective, it is not only an excellent method of acquainting yourself with the real "meat" of this particular type of law practice, it is also a fine introduction into the legal world itself as it shows the student the kind of knowledge s/he will be called upon to utilize every day. In addition, it serves as a respite from what may become academic tedium during the later years of law school. Poverty law and legal services encompass positions such as the district attorney and public defenders in city governments, legal aid work, and government groups such as VISTA and the Peace Corps which have recently introduced legal work into their programs of assistance. If you are considering this type of law, do not expect to make a lot of money, expect to be very busy, and realize that your services will be sought by many and may be appreciated by only a few. For the vast majority of the lawyers who enter this type of law, the clients' appreciation when it occurs is the finest reward.
Tax Law A tax lawyer assists people or businesses in the computation and payment of taxes of all kinds: income, property, estate, etc. A good background in statistics, mathematics and/or business as well as a genuine enjoyment of working with numbers are basic necessities for the tax lawyer. LLM degrees (the Master of Law Letters degree which follows the JD or LLB degree) can be received in tax law in a number of law school graduate divisions around the country. This is one of the specific areas in which the LLM degree is most frequently pursued. Tax law is a growing field because of the increasing complexity of the financial status of the United States and its private citizens. If you satisfy the requirements of the field, your work in private practice or as a corporation tax lawyer can be a lucrative career.
Corporate Law The corporate lawyer deals with the entirety of a corporation's activities from settling tax, employment, or labor problems, to setting up mergers between and among corporations and arranging stock options. Generally, a corporate lawyer is one of a team of lawyers, each handling or assisting in the handling of only one of the activities areas. A corporate lawyer, therefore, may be any one of the preceding types of lawyers and also be a corporate lawyer. For instance, an environmental lawyer may be employed by Kodak and still retain both titles of environmental and corporate lawyer; one does not preclude the other. Corporate law opportunities are unlimited and offer continually broadening horizons commensurate with the growth of the corporation.
Criminal Law Criminal Law involves just what the label implies: persons accused of crimes. Lawyers who specialize in criminal law may work on either side of the adversary process -- defense or prosecution. Those who defend the accused may work in private practice or in a public defender's office. Those who work for the prosecution side will generally be employed by the government, e.g. in District Attorneys' offices, etc. At the higher levels of government (e.g. the Federal Justice Department), criminal lawyers will often find themselves defending the accused, because their role will be to argue cases that are being appealed on constitutional grounds.
As previously stated, there are many more types of law from which to choose; what you choose will depend upon your present interests and your interests as they develop in law school. There is no reason to make your decision now as to what type of law you will practice; the legal profession changes constantly and you may find your own interests changing as you become exposed to more and more information.
What Do Auto Accident Lawyers Do?
Auto accident attorneys are ready and available to help you with your car accident lawsuit claim. Chances are you will be involved in at least one car accident in your lifetime, and you'll probably be injured at least once in your lifetime due to a car accident. If you are injured in a car accident, contact a LawInfo Lead Counsel qualified car accident attorney today!
A car accident attorney can help "level the playing field" by providing car accident victims with information regarding the practical and legal aspects of personal injury law and car accident claims. For a review of your claim, please contact a car accident attorney now.
Car accidents are the leading cause of injury and death for drivers under the age of 34 years, and the number of people over the age of 34 years injured and killed in car accidents is also alarmingly high. Over 40,000 people are killed in approximately five million motor vehicle collisions and other car accidents annually, many involving teen car accidents. In 2002 alone, nearly 43,000 people died in highway accidents nationwide. That equates to over 115 fatalities per day.
In almost all auto accidents, at least one injury is involved, which is why car accidents are one of the top personal injury claims filed in civil courts these days. The economic costs of personal injuries and property damage sustained in car accidents is staggering—over $150 billion per year. What does all this mean to you? It means that all drivers, including you, are likely to get in at least one car accident in their lifetime. They also indicate that you probably will sustain an injury, and if you are injured you will need an experienced car accident attorney to assist you with your personal injury claim.
What Should You Do If You Have a Car Accident?
The first thing you should do if you are able to move is to make sure you and your passengers (if any) are OK. Move as far off the roadway as possible, but stay at the scene of the auto accident. Warn oncoming traffic by activating your hazard warning lights or setting flares.
Exchange vital information with other drivers involved in the car accident.
Write down the name, address, phone number and license numbers for all drivers and witnesses. Ask for the insurance companies and policy numbers for drivers involved in the car accident. Be sure to note makes, models, colors and descriptions of all vehicles involved, and take down the plate numbers, as well.
Call the police to report the accident if damage exceeds $500 or if any injuries may be involved.
If the damages exceed $500 and/or an injury could be involved, call the police and have them take a report. The majority of accidents require a police report because they seldom involve damages less than $500 and the chances of injury are very high, even they may not be immediately apparent. Neck and back injuries are notorious for cropping up days and even months after the accident occurred.
Interview all witnesses and record their comments.
Interview all witnesses and record their comments either at the scene of the accident or as soon as possible afterwards. It is important to do these interviews as quickly as possible because witnesses' memories tend to fade with time and the information you get may not be as valuable to you. Information gathered immediately or very soon after the accident will be much more accurate than any recalled at some later date.
Photograph the accident scene and notate traffic light color (if applicable)
If you happen to have a camera, try to photograph the scene prior to moving the vehicles (only if safe to do so). Be sure to note what color the traffic light was was (if applicable). Remember to write everything down immediately or as close to the time of the accident as you can. You should also keep in mind that anything you say to anyone following the accident will be admissible and is not considered hearsay, so it is important that the information you provide is as accurate as possible.
Seek medical attention for your injuries as quickly as possible.
If treatment is delayed, the other driver may argue that it was not his or her negligent driving that caused your injury, but rather something that occurred between the time of the accident and your visit to the doctor. Then, contact an experienced and reputable car accident lawyer as quickly as possible because there are time limits involved in filing any car accident personal injury claims. Any delays could affect your entitlement to a lawsuit claim.
Get a copy of the police report.
Get a copy of the police report. They are typically available about 10 business days after the car accident occurred. Review the police report to be sure that it generally coincides with your recollection of the accident. Even if it doesn't you will need it for your claim. An car accident attorney will be able to provide advise if the report does not coincide with your recollection.
Although all vehicles must obey traffic safety laws, they are not treated the same under law. Some vehicles are not considered as motor vehicles, and are subject to different laws than those that are. This could affect your rights as an injured person. For example, if you are injured in an accident involving a bus, trolley or train, your rights as an injured person are affected because busses and trolleys are governed by different laws in your state, and trains are regulated by federal law. This is why it is imperative to contact an car accident attorney as quickly as possible after the accident has occurred. An experienced car accident attorney will be able to determine what medical benefits you will be entitled to and also if any immunities will be granted to municipal owners.
If you have been seriously injured in an car accident you should contact an Car Accident Attorney who can evaluate your case and help you protect your legal rights as soon as you can. Because there are typically statutes of limitations (time limits) involved with filing a lawsuit claim, you should contact an auto accident attorney immediately after receiving care for your injury.
A car accident attorney can help "level the playing field" by providing car accident victims with information regarding the practical and legal aspects of personal injury law and car accident claims. For a review of your claim, please contact a car accident attorney now.
Car accidents are the leading cause of injury and death for drivers under the age of 34 years, and the number of people over the age of 34 years injured and killed in car accidents is also alarmingly high. Over 40,000 people are killed in approximately five million motor vehicle collisions and other car accidents annually, many involving teen car accidents. In 2002 alone, nearly 43,000 people died in highway accidents nationwide. That equates to over 115 fatalities per day.
In almost all auto accidents, at least one injury is involved, which is why car accidents are one of the top personal injury claims filed in civil courts these days. The economic costs of personal injuries and property damage sustained in car accidents is staggering—over $150 billion per year. What does all this mean to you? It means that all drivers, including you, are likely to get in at least one car accident in their lifetime. They also indicate that you probably will sustain an injury, and if you are injured you will need an experienced car accident attorney to assist you with your personal injury claim.
What Should You Do If You Have a Car Accident?
The first thing you should do if you are able to move is to make sure you and your passengers (if any) are OK. Move as far off the roadway as possible, but stay at the scene of the auto accident. Warn oncoming traffic by activating your hazard warning lights or setting flares.
Exchange vital information with other drivers involved in the car accident.
Write down the name, address, phone number and license numbers for all drivers and witnesses. Ask for the insurance companies and policy numbers for drivers involved in the car accident. Be sure to note makes, models, colors and descriptions of all vehicles involved, and take down the plate numbers, as well.
Call the police to report the accident if damage exceeds $500 or if any injuries may be involved.
If the damages exceed $500 and/or an injury could be involved, call the police and have them take a report. The majority of accidents require a police report because they seldom involve damages less than $500 and the chances of injury are very high, even they may not be immediately apparent. Neck and back injuries are notorious for cropping up days and even months after the accident occurred.
Interview all witnesses and record their comments.
Interview all witnesses and record their comments either at the scene of the accident or as soon as possible afterwards. It is important to do these interviews as quickly as possible because witnesses' memories tend to fade with time and the information you get may not be as valuable to you. Information gathered immediately or very soon after the accident will be much more accurate than any recalled at some later date.
Photograph the accident scene and notate traffic light color (if applicable)
If you happen to have a camera, try to photograph the scene prior to moving the vehicles (only if safe to do so). Be sure to note what color the traffic light was was (if applicable). Remember to write everything down immediately or as close to the time of the accident as you can. You should also keep in mind that anything you say to anyone following the accident will be admissible and is not considered hearsay, so it is important that the information you provide is as accurate as possible.
Seek medical attention for your injuries as quickly as possible.
If treatment is delayed, the other driver may argue that it was not his or her negligent driving that caused your injury, but rather something that occurred between the time of the accident and your visit to the doctor. Then, contact an experienced and reputable car accident lawyer as quickly as possible because there are time limits involved in filing any car accident personal injury claims. Any delays could affect your entitlement to a lawsuit claim.
Get a copy of the police report.
Get a copy of the police report. They are typically available about 10 business days after the car accident occurred. Review the police report to be sure that it generally coincides with your recollection of the accident. Even if it doesn't you will need it for your claim. An car accident attorney will be able to provide advise if the report does not coincide with your recollection.
Although all vehicles must obey traffic safety laws, they are not treated the same under law. Some vehicles are not considered as motor vehicles, and are subject to different laws than those that are. This could affect your rights as an injured person. For example, if you are injured in an accident involving a bus, trolley or train, your rights as an injured person are affected because busses and trolleys are governed by different laws in your state, and trains are regulated by federal law. This is why it is imperative to contact an car accident attorney as quickly as possible after the accident has occurred. An experienced car accident attorney will be able to determine what medical benefits you will be entitled to and also if any immunities will be granted to municipal owners.
If you have been seriously injured in an car accident you should contact an Car Accident Attorney who can evaluate your case and help you protect your legal rights as soon as you can. Because there are typically statutes of limitations (time limits) involved with filing a lawsuit claim, you should contact an auto accident attorney immediately after receiving care for your injury.
What is a Tax Attorney?
When a taxpayer has problems with the Internal Revenue Service, or the state department of revenue, he may be able to solve it himself. However, with the intricacies of U.S. tax law being what they are, the taxpayer may find himself better served in hiring a tax attorney.
A tax attorney specializes in working with taxpayers to solve their problems with the IRS or state revenue department. In fact, they generally focus only on tax issues and relief. A tax attorney can help a taxpayer in trouble make it through an audit, have fines reduced, liens removed, and can navigate through the minefield of small business and self-employment tax issues.
Many small business owners consider their tax attorney to be as vital as their accountant. This is because a good tax attorney can help head off tax problems before they even begin. He or she can see potential trouble spots for a business and can advise the owner how to avoid them.
U.S. tax law is not only labyrinthine in structure, it also changes nearly every year. Thus, a good tax attorney will keep up with the latest changes and can advise clients accordingly. A tax attorney may also be helpful when setting up trust funds, stock portfolios and the like, so a taxpayer doesn't run into unexpected surprises on April 15.
A person looking for a tax attorney shouldn't call the first one listed in the phone book. He should look around, ask friends, or even his personal attorney (if he has one) to recommend a good tax specialist. As a prospective client, the taxpayer should look for a tax attorney with extensive experience in dealing with the IRS, in debt management cases, and in working with real live taxpayers. He should also ask the attorney for references. The taxpayer should also make certain his tax attorney is a member of the American Bar Association and the state bar association. A client should also make sure he knows what his attorney's rates are, and make arrangements for payment early on in the consultation process.
If a taxpayer finds himself in over his head where the IRS is concerned, he should certainly consult a tax attorney. Tax fines tend to snowball, and it is always in the taxpayer's best interests to get problems solved while they are still relatively small ones. Waiting until the last minute to see a tax attorney could be extremely costly, and might result in jail time for the taxpayer, as well as higher legal fees.
Money invested in the services of a tax attorney can be considered a wise investment for a taxpayer.
A tax attorney specializes in working with taxpayers to solve their problems with the IRS or state revenue department. In fact, they generally focus only on tax issues and relief. A tax attorney can help a taxpayer in trouble make it through an audit, have fines reduced, liens removed, and can navigate through the minefield of small business and self-employment tax issues.
Many small business owners consider their tax attorney to be as vital as their accountant. This is because a good tax attorney can help head off tax problems before they even begin. He or she can see potential trouble spots for a business and can advise the owner how to avoid them.
U.S. tax law is not only labyrinthine in structure, it also changes nearly every year. Thus, a good tax attorney will keep up with the latest changes and can advise clients accordingly. A tax attorney may also be helpful when setting up trust funds, stock portfolios and the like, so a taxpayer doesn't run into unexpected surprises on April 15.
A person looking for a tax attorney shouldn't call the first one listed in the phone book. He should look around, ask friends, or even his personal attorney (if he has one) to recommend a good tax specialist. As a prospective client, the taxpayer should look for a tax attorney with extensive experience in dealing with the IRS, in debt management cases, and in working with real live taxpayers. He should also ask the attorney for references. The taxpayer should also make certain his tax attorney is a member of the American Bar Association and the state bar association. A client should also make sure he knows what his attorney's rates are, and make arrangements for payment early on in the consultation process.
If a taxpayer finds himself in over his head where the IRS is concerned, he should certainly consult a tax attorney. Tax fines tend to snowball, and it is always in the taxpayer's best interests to get problems solved while they are still relatively small ones. Waiting until the last minute to see a tax attorney could be extremely costly, and might result in jail time for the taxpayer, as well as higher legal fees.
Money invested in the services of a tax attorney can be considered a wise investment for a taxpayer.
What is Mesothelioma?
Mesothelioma is a cancer of the mesothelium, the protective sac that covers and protects most internal organs of the body. The mesothelium has two layers, one, which covers the organ, and a second, which forms a sac around it. The mesothelium has different names depending on the location in the body. The pleura is the mesothelial tissue surrounding the lungs and lining the chest cavity. mesothelioma cancerThe peritoneum covers most of the organs in the abdominal cavity (where abdominal mesothelioma occurs), while the pericardium covers and protects the heart.
The mesothelium produces a lubricating fluid that allows organs within it to move and glide easily. For example, the fluid allows the lungs to breathe and the heart to expand and contract.
Like other forms of cancer, mesothelioma occurs when cells become abnormal and divide or grow out of control. In mesothelioma, the helpful lubricating fluid is over-produced. This excess fluid encases the organs with a thick layer of tumor tissue, described as similar to a rind type of layer. In advanced cases of heart and wallmesothelioma, cells metastasize, or grow and invade other organs and spread to other areas of the body.
The majority of individuals suffering from mesothelioma have cancer in the lining of the lung. Sometimes, mesothelioma occurs in the lining of the abdominal cavity (peritoneal mesothelioma) or in the lining of the heart (pericardial mesothelioma).
The mesothelium produces a lubricating fluid that allows organs within it to move and glide easily. For example, the fluid allows the lungs to breathe and the heart to expand and contract.
Like other forms of cancer, mesothelioma occurs when cells become abnormal and divide or grow out of control. In mesothelioma, the helpful lubricating fluid is over-produced. This excess fluid encases the organs with a thick layer of tumor tissue, described as similar to a rind type of layer. In advanced cases of heart and wallmesothelioma, cells metastasize, or grow and invade other organs and spread to other areas of the body.
The majority of individuals suffering from mesothelioma have cancer in the lining of the lung. Sometimes, mesothelioma occurs in the lining of the abdominal cavity (peritoneal mesothelioma) or in the lining of the heart (pericardial mesothelioma).
Mesothelioma Lawyers
Mesothelioma is a very rare malignancy in the general population, but found quite commonly in asbestos-exposed individuals. In fact, asbestos is the only known confirmed cause of mesothelioma in the United States. Mesothelioma is a cancer of the lining of the lung, known as the pleura, (pleural mesothelioma) or the lining of the abdominal cavity, known as the peritoneum (peritoneal mesothelioma).
Mesothelioma is a very serious condition which usually first develops many years after a person was first exposed to asbestos. The time it takes for mesothelioma to develop following first exposure to asbestos, known as the latency period, can be from ten to fifty years. People exposed to asbestos, including people who worked at a summer job involving intensive asbestos exposure while they were in their teens or in school, may be shocked to learn many years later that the mesothelioma they developed came from a fleeting, short term exposure to asbestos. That is why an extensive occupational and asbestos exposure history is explored with each potential client suffering with mesothelioma to discover the source of their disease.
Mesothelioma Symptoms
The first symptoms of pleural mesothelioma include one or more of the following: shortness of breath, chest or pleural pain (such as experienced with pleuritis), cough, weakness and a loss of weight or appetite. Often, pleural mesothelioma is accompanied by the accumulation of pleural fluid which can cause significant discomfort and chest pain. That fluid can be removed and analyzed by a physician for malignant cells.
Peritoneal mesothelioma may cause loss of weight or appetite as well as severe cramps or diarrhea.
Mesothelioma Diagnosis
Mesothelioma can be detected and diagnosed by a variety of techniques including CAT Scan and/or chest x-ray, cytology (which is examination of fluid removed from the pleural space) or pathology (which is examination of tissue removed by surgery). The most effective and certain way to diagnose mesothelioma is through a biopsy of pleural tissue. Not surprisingly, the more tissue that can be examined, the more definite the diagnosis can be. A transbronchial biopsy, taken through a tube inserted down the throat, will not require surgery but will also result in a very small tissue sample which may or may not be able to confirm a diagnosis. A more invasive surgical procedure, while less physically desirable, will provide more tissue and greater chance for confirming the diagnosis.
Mesothelioma Treatment
There is presently no known cure for mesothelioma, although a number of treatments have been developed and attempted to help contain the spread of the disease and thus the longevity of the mesothelioma victim.
Mesothelioma is a very serious condition which usually first develops many years after a person was first exposed to asbestos. The time it takes for mesothelioma to develop following first exposure to asbestos, known as the latency period, can be from ten to fifty years. People exposed to asbestos, including people who worked at a summer job involving intensive asbestos exposure while they were in their teens or in school, may be shocked to learn many years later that the mesothelioma they developed came from a fleeting, short term exposure to asbestos. That is why an extensive occupational and asbestos exposure history is explored with each potential client suffering with mesothelioma to discover the source of their disease.
Mesothelioma Symptoms
The first symptoms of pleural mesothelioma include one or more of the following: shortness of breath, chest or pleural pain (such as experienced with pleuritis), cough, weakness and a loss of weight or appetite. Often, pleural mesothelioma is accompanied by the accumulation of pleural fluid which can cause significant discomfort and chest pain. That fluid can be removed and analyzed by a physician for malignant cells.
Peritoneal mesothelioma may cause loss of weight or appetite as well as severe cramps or diarrhea.
Mesothelioma Diagnosis
Mesothelioma can be detected and diagnosed by a variety of techniques including CAT Scan and/or chest x-ray, cytology (which is examination of fluid removed from the pleural space) or pathology (which is examination of tissue removed by surgery). The most effective and certain way to diagnose mesothelioma is through a biopsy of pleural tissue. Not surprisingly, the more tissue that can be examined, the more definite the diagnosis can be. A transbronchial biopsy, taken through a tube inserted down the throat, will not require surgery but will also result in a very small tissue sample which may or may not be able to confirm a diagnosis. A more invasive surgical procedure, while less physically desirable, will provide more tissue and greater chance for confirming the diagnosis.
Mesothelioma Treatment
There is presently no known cure for mesothelioma, although a number of treatments have been developed and attempted to help contain the spread of the disease and thus the longevity of the mesothelioma victim.
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