Following are some interesting and informative articles on research and other issues regarding asbestos.
Promise of Lung Cures in Stem Cell
By Robyn Riley
A break through in stem cell research promises a cure for lung diseases that kills tens of thousands of Australians – and millions around the world every year. Melbourne scientists at the National Stem Cell Centre have turned human embryonic stem cells into lung cells. The development is a step towards coaxing damaged lungs to repair themselves. The technique could yield cures for cystic fibrosis, mesothelioma, emphysema, chronic bronchitis and, eventually lung cancer. Research leader Richard Mollard said the discovery was a big step forward. He said it was the first time lung cells had been successfully grown. Dr. Mollard, 37 said although it was too soon to start human clinical trials, early results were promising. “It certainly looks like we are heading in the right direction,” he said “This is an exciting step forward and the potential has been realised.” lung diseases cost Australia more than $2 billion a year to treat. The United States spends more than $24 billion a year treating the diseases.
“Lung Diseases is highly underestimated as a killer,” Dr Mollard said. There is no cure for Cystic Fibrosis, a genetic disease that cost Australia $500 million a year to treat. Dr Mollard said the break through meant that people with lung diseases may be offered pioneering stem cell therapy as a treatment and potential cure within a few years; however, a cure for lung cancer would take longer. “Lung Cancer is a very different disease,” Dr Mollard said, however, eventually we may even be able to replace cells damaged by cancer.
Asbestos Compensation Under Attack
By Thady Blundell, Turner Freeman Lawyers
Compensation entitlements for those with asbestos disease in Queensland have been maintained in recent years, largely through efforts of the Society to lobby for decent beneftis. However, very recently compensation for dependents of those who pass away from asbestos related disease have in large part been abolished. The WorkCover Queensland legislation was amended as of 1 January 2008 so that dependents of any person who died on or after that date of an asbestos disease and who had previously received lump sum compensation from WorkCover are no longer eligible for futher dependency benefits that have been available for years. These benefits were abolished with no corresponding increased benefits to workers or other persons with asbestos disease.
The abolition of these dependency benefits was done without any consultation with the Society and the Society is now taking steps to lobby to have these benefits restored. This is an example of why it is important to have a strong Society with large membership and resources to be able to effectively lobby government and represent those with asbestos disease. An update on the campaign will be provided in the next newsletter.
Alimta is not always free
By Thady Blundell, Turner Freeman Lawyers
With much fanfare prior to Christmas, Alimta was added to the PBS scheme. Alimta of course is the main chemotherapy drug for the treatment of mesothelioma. When this announcement was made there was never any suggestion that there were any strings attached to the listing of Alimta. However, recent experience has demonstrated that Alimta is only on the PBS free list when used in combination with a particular drug - cisplatin. This is a fairly toxic drug and discussions with oncologists have revealed that another drug, carboplatin - a less toxic drug, is often the preferred drug to use in combination with Alimta. However, the free listing of Alimta is only when it is used in conjunction with cisplatin. The reason for this is apparently because the original trial of Alimta was done with cisplatin, not with carboplatin.
Because of the benefits of using Alimta with carboplatin over cisplatin the Society is going to lobby to have Alimta included on the free list when used in conjunction with carboplatin.
It is therefore very important from a cost perspective that persons who are undertaking Alimta chemotherapy treatment be careful to check which drug is being used in combination with the Alimta.
Article by Professor Tess Crammond
My interest in asbestos related disease dates back to 1970, when a patient was referred for relief of pain associated with mesothelioma. This was achieved with the interruption of pain pathways by an open operation - a cordotomy - and the patient had no pain till his inevitable death. The open procedure necessitated an incision - over the spine of the upper chest so the patient had pain on the movement of the arms for several weeks.
While cordotomy relieved his pain he still experienced shortness of breath, lethargy and fatigue which we did our best to relieve. Then in the 1980's the use of a percutaneous technique was possible with minimal side effects and with the assistance of Dr Gordon Stuart 400 patients with cancer have been helped. The most common malignancies responsible for the pain were carcinoma of the lung and mesothelioma.
Rightly, patients with mesothelioma and lung cancer consequent on asbestos related disease deserve the best possible pain relief and control of other distressing symptoms such as shortness of breath, fatigue and lethargy, while research continues into development of disease modifying treatment.
To the families and carers of the 72 members of Queensland Asbestos Related Disease Support Society who died from these malignancies in the past 12 months, I offer my personal condolences and those of the members of the Multidisciplinary Pain Centre at Royal Brisbane Hospital. You will take your comfort from the support you gave them and the security given by those they loved and who loved them.
But what of those with pleural plaques and pleural fibrosis whose pain has been ignored - with derogatory statements like "pleural plaques do not cause pain". Their pain can be so unpleasant and so severe that responsible experienced thoracic physicians investigated them for lung cancer. Others present with chest pain radiating to the arm so they require assessment by a cardiologist to exclude coronary artery disease. It is very significant that very frequently the onset of the pain predates the diagnosis of pleural plaques. In May, at the Annual Scientific Meeting of the Australian & New Zealand College of Anaesthetists in Adelaide, a paper was presented giving the results of the assessment of 43 of more than 100 patients with beign asbestos related pleural disease with whom I have been associated. The review of the remainder is in progress.
In my address to the Ecumenical Service at St Stephens Cathedral in 1996, I emphasised this very important fact - that pain so often predates the diagnosis of the pleural plaques. Patients do not complain of pain just because they are told they have pleural plaques.
Patients with what is euphemistically called benign asbestos related pleural disease - and there is nothing benign about unrelieved pain - have a lot of living to do, yet they have to face life not only with ongoing pain but at times with night sweats, fatigue and the emotional impact of the prospect of developing mesothelioma, lung cancer and asbestosis.
As well as persistent pain they have to accept that this pain is extraordinarily diffficult to terat. At best, it is only partially responsive to the potent pain relieving drugs - the opiods or narcotics as they are known. The ability of these patients to continue in the workforce is compromised as well as their ordinary activities of daily living and recreational pursuits.
The lag time for the development of pleural plaques is unpredictable and recent studies at video assisted thoracoscopy - key hole surgery where the thoracic surgeon looks into the chest - revealed that pleural plaques are always far more extensive than what is shown on even the most sophisticated CT scans.
The aim of my research is to obtain objective evidence of the relationship between the distribution of the patients pain, and its nature and the location of the plaques relative to the intercostal nerves and the diaphragm. It will consist of 2 parts - the patients history of the exposure to asbestos, the time lag to the development of symptoms, particularly pain, the physical examination, the results of lung function tests and imaging.
The second part of this research requires the cooperation of pathologists, thoracic physicians and surgeons, as well as Pain Medicine Specialists and more importantly patients who are prepared to consent to a limited autopsy to provide crucial evidence. Some members of the Society have already given unsolicited advanced directives so that this objective evidence can be provided to the unbelievers who state that pleural plaques do not cause pain. It will show too that the patients need ongoing support for control of the pain, the cause of which cannot be reversed and for which, at present, there is no definitive treatment.
The staff of the Multidisciplinary Pain Centre will provide this support and optimum pain relief as the research continues to determine the mechanism of the pain - and its physical and emotional impact on the patients.
Again my thanks to the Society and the Trustees and John Gordon Wright Foundation for this grant - it will be put to good use.