Why do People Contract Mesothelioma?

laurie_kazan-allenBy Laurie Kazan-Allen

Mesothelioma is an avoidable disease. If governments had first acted when the asbestos hazard was known, the incidence of this deadly cancer would, by now, be much lower. And yet, despite the evidence documenting the deadly consequences of asbestos exposure, governments turned a blind eye to an industrial sector which was generating thousands of jobs, huge revenue streams and generous political contributions. In some countries, they still do. It is truly staggering to think that since 1920, 194 million tonnes have been used worldwide.

In February 2012, a landmark verdict handed down by an Italian Court found executives guilty for their roles in the asbestos deaths of thousands of Italian citizens; the defendants were sentenced to 16 years in prison and fined millions of euros. This was the first time that corporate decision makers had been held to account for such crimes. In November 2012, French Judge Marie-Odile Bertella-Geffroy arrested Martine Aubry, a senior official in the French Ministry of Social Affairs, over asbestos allegations. The Magistrate, whose caseload focuses on health-related issues, has charged Aubry with “involuntary manslaughter and causing bodily harm by negligence” due to the government’s failure to implement a 1983 European Union directive designed to improve the safety of asbestos workers. Two other officials are being investigated by the Judge as are asbestos industry personnel.

It is long past time for us to ask why asbestos was used despite all that was known and who made the decisions which allowed the lives of so many innocent people to be jeopardized.  People, especially those whose lives have been impacted by mesothelioma, deserve to know what dynamics were at work that created the climate in which the use of asbestos flourished. The French Magistrate is right to question politicians and civil servants as well as asbestos lobbyists and executives. We would do well to follow her example.

About Laurie Kazan-Allen

Ms. Laurie Kazan-Allen has been researching, writing and campaigning on asbestos issues for more than twenty years. The British Asbestos Newsletter, the quarterly publication she founded in 1990, is widely regarded as one of the most authoritative contemporary sources of information by the UK community of asbestos activists. In collaboration with international colleagues, in 1999 she established The International Ban Asbestos Secretariat (IBAS). As the IBAS Coordinator she has organized and/or participated in asbestos events on six continents, amongst the most recent of which was an asbestos hearing at the European Parliament.

As an adviser to the UK All Party Parliamentary Asbestos Sub-Group, Ms. Kazan-Allen helps organize the annual Parliamentary asbestos seminar. Kazan-Allen has written prolifically about asbestos issues in 85+ issues of the British Asbestos Newsletter and in IBAS publications such as Eternit and the Great Asbestos Trial, Report on the Asian Asbestos Conference 2009, India’s Asbestos Time Bomb and Killing the Future – Asbestos Use in Asia. These and other texts can be accessed on the websites: www.britishasbestosnewsletter.org and www.ibasecretariat.org

On March 25, 2012, Ms. Kazan-Allen became the first non-Australian to receive the prestigious Emeritus Professor Eric G. Saint Memorial Award at a ceremony held in Perth, Western Australia.

Meso Foundation Clinical Trial Consortium for Faster Advancement of Mesothelioma Research

by Lee M. Krug, MD

At the International Mesothelioma Interest Group Meeting in Boston, a group of investigators convened at a Clinical Trials Design Workshop to discuss the challenges of conducting trials in this disease. The rarity of mesothelioma poses various issues with regards to proper study design, accrual, and interest by pharmaceutical companies. One theme that emerged from that workshop was the need to establish a clinical trials consortium. This concept has been quite successful with other rare cancers such as pediatric tumors and sarcoma. I propose that the Meso Foundation would provide the optimal mechanism to initiate such a consortium for mesothelioma trials.

The Meso Foundation Trials Consortium (MFTC) would offer the following advantages:

  • It would provide scientific input to ensure that the trials are scientifically sound. The investigators involved in the Consortium best understand the biologic underpinnings of the disease. They would have important insight into the optimal design of the trials. Trials could be prioritized based on scientific merit and promise. This would ensure that valuable resources would not be wasted on trials unlikely to be successful.
  • It would establish an international network of participating institutions with the highest volume of mesothelioma patients. This would have drastic effects on speeding accrual to complete trials in a timely fashion. The vorinostat phase III trial took over 5 years to complete enrollment, despite enlisting 125 institutions in 23 countries. The majority of those sites enrolled only 1 or 2 patients over that time. Typically, pharmaceutical companies hire Contract Research Organizations (CROs) who identify sites to conduct trials and collect the data. CROs do not know which institutions will have the appropriate patients for the trial.
  • It would offer a referral mechanism to boost accrual. Patients look to the Meso Foundation as the primary source for medical advice, so they could be steered toward institutions that are participating in the designated studies.

Of course, the Meso Foundation does not have the resources to conduct clinical trials itself. The funding will initially need to come from the pharmaceutical industry. The process would work as such: Pharmaceutical companies interested in conducting large trials in mesothelioma would formulate an agreement to work with the Meso Foundation. Their protocols would be reviewed by a subcommittee of the Science Advisory Board who would provide feedback on the design and technical aspects. The Meso Foundation would solicit key institutions with strong research programs and high patient volumes to open the trial at their sites. Patients would be preferentially referred to these studies for participation. Once the success of this mechanism has been established, other companies will surely look to the Foundation for assistance. Ultimately, investigator-initiated trials could even be considered.

This year, more pharmaceutical companies than ever are planning clinical trials for patients with mesothelioma. This heightens the urgency to develop this consortium. As a research community, we cannot wait any longer. Let’s work together to make this happen.

Lee M. Krug, MD, is an Associate Attending Physician in the Division of Thoracic Oncology, Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York, NY. Dr. Krug is also the Director of the Mesothelioma Program at Memorial Sloan-Kettering Cancer Center and Chair of the Science Advisory Board of the Mesothelioma Applied Research Foundation.

The End of Canada’s Asbestos Reign of Terror?

by Laurie Kazan-Allen 

Closing in CanadaCanadian asbestos has poisoned American citizens for over one hundred years.[1] According to the United States Geological Survey from 1900: “The United States was the largest market for exported Canadian (asbestos) fiber.” It is therefore not unreasonable to suggest that the majority of asbestos-related disease in the U.S. was caused by exposure to Canadian asbestos.  Members of the Meso Foundation community have a particular interest in the operations of the Canadian asbestos mining industry. They know full well the tragic reality of mesothelioma and remain determined to see an end to the epidemic caused by occupational, domestic and environmental exposures. The news that Quebec’s support for this toxic industry has been withdrawn has been warmly welcomed by Meso Foundation’s executive director, Mary Hesdorffer, Nurse Practitioner, who said: “We are ecstatic to see the Canadian government acknowledge the overwhelming evidence that mesothelioma is caused by exposure to asbestos and put an end to asbestos mining in Quebec. ”  We expect that malignant mesothelioma will continue to increase in the developing world and the pressure is on the Foundation to fund the necessary research for prevention, early detection and more effective treatment strategies for those exposed to asbestos who go on to develop malignant mesothelioma.

Mary is not alone. All over the world ban asbestos campaigners have been watching developments in Canada very closely. For decades Canadian asbestos stakeholders, with financial and political support from the governments in Ottawa and Quebec, have orchestrated the global campaign to whitewash the image of asbestos. “Asbestos,” they said “could be used safely under controlled conditions;” the fact that these “controlled conditions” did not exist in Canada, the U.S., India or Thailand is a fact they omitted from the glossy brochures they produced and the evidence they provided. When the Environmental Protection Agency (EPA) tried to implement a ban on asbestos in the U.S. in the mid-1980s, it was largely as a result of political pressure and legal action by Canadian vested interests that the ban was overturned. As a result, the use of asbestos remains legal in the U.S.

A review of recent developments in Canada is encouraging. In 2011, asbestos production in Canada ceased when the sole operational chrysotile (white) asbestos mine was exhausted. Plans to develop new open-pit mining facilities in Quebec had run into a financial snag; the private consortium backing the scheme could not attract investors. The Government of Quebec stepped in with a promise of a $58 million loan guarantee for the project. This support was condemned by citizens, doctors and public health professionals inside Quebec as well as campaigners outside the Province. On June 29, 2012, Quebec Premier Jean Charest announced that the $58 million loan guarantee had become an outright loan and that the agreement had now been signed. Some weeks later, Pauline Marois, who was engaged in a fierce campaign for the Premiership of Quebec, announced that her party would revoke the asbestos loan if they won the election. On September 4, the Parti Québécois won and Charest’s Liberals lost. As the new Premier, Marois confirmed her intention to revoke the loan and use the money to help the asbestos mining regions diversify their economy. Within days, the Canadian federal government also announced it was turning its back on the asbestos industry. Without such powerful allies, the future of the industry appears doomed but considering the years of twists and turns there have been, it would be unwise to be too sure too soon. For the moment, we hold our breath while we wait to see whether finally, after so many deaths and so much heartache, this truly is the end for Canada’s asbestos industry.


[1] Virta R. U.S. Geological Survey: Worldwide Asbestos Supply and Consumption Trends from 1900 to 2000. U.S. Department of the Interior.

About Laurie Kazan-Allen

Ms. Laurie Kazan-Allen has been researching, writing and campaigning on asbestos issues for more than twenty years. The British Asbestos Newsletter, the quarterly publication she founded in 1990, is widely regarded as one of the most authoritative contemporary sources of information by the UK community of asbestos activists. In collaboration with international colleagues, in 1999 she established The International Ban Asbestos Secretariat (IBAS). As the IBAS Coordinator she has organized and/or participated in asbestos events on six continents, amongst the most recent of which was the 2011 meeting in India of the Asian Ban Asbestos Network and the 2011 seminar: “Asbestos-Still a Killer” in the European Parliament. As an adviser to the UK All Party Parliamentary Asbestos Sub-Group, Ms. Kazan-Allen helps organize the annual Parliamentary asbestos seminar. Kazan-Allen has written prolifically about asbestos issues in 80+ issues of the British Asbestos Newsletter and in IBAS publications such as Eternit and the Great Asbestos Trial, Report on the Asian Asbestos Conference 2009India’s Asbestos Time Bomb and Killing the Future – Asbestos Use in Asia. These and other texts can be accessed on the websites: www.britishasbestosnewsletter.org and www.ibasecretariat.org On March 25, 2012, Ms. Kazan-Allen became the first non-Australian to receive the prestigious Emeritus Professor Eric G. Saint Memorial Award at a ceremony held in Perth, Western Australia.

GUEST POST: An ASCO Update from Dr. Lee M. Krug, MD

The Meso Foundation is happy to present this special guest blogpost from Lee M. Krug, MD, Associate Attending Physician in the Division of Thoracic Oncology, Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York, New York and Director of the Mesothelioma Program at Memorial Sloan-Kettering Cancer Center. Dr. Krug has investigated multimodality approaches for patients with early stage malignant pleural mesothelioma, has led a multicenter U.S. trial of induction chemotherapy before extrapleural pneumonectomy, and has a current study testing the feasibility of chemotherapy followed by pleural radiation. Dr. Krug also has a strong interest in novel therapeutics for patients with more advanced disease, and is the principal investigator of an international, phase III trial of a histone deacetylase inhibitor, vorinostat. Dr. Krug led the committee for the National Comprehensive Cancer Network (NCCN) that established treatment guidelines for mesothelioma, and is currently the chairman of the Scientific Advisory Board and serves on the Board of Directors at the Meso Foundation.

The Annual Meeting of the American Society for Clinical Oncology (ASCO) was held in Chicago, IL from June 1-5, 2012. This is the largest meeting in oncology each year with over 25,000 attendees from all over the world. Several abstracts of interest to mesothelioma were presented, so I thought I would summarize the results of a few of the most interesting:

Randomized Phase II Trial of Pemetrexed/Cisplatin with or without CBP501 in Patients with Advanced Malignant Pleural Mesothelioma: CBP501 is a novel compound that enhances the ability of cisplatin to damage cancer cells. In this international trial, patients received treatment with standard chemotherapy (pemetrexed and cisplatin), or they received it in combination with CBP501. 63 patients participated in total; 40 were in the group with CBP501. The only additional side effect of CBP501 seemed to be a rash that occurred during the infusion. Forty percent of the patients who received chemotherapy plus CBP501 had tumor shrinkage as compared to 17% of the patients who received chemotherapy alone. The average time before the cancer grew back was 5.9 months in the CBP501 arm, and 4.7 months in the other arm. Although the patients who received chemotherapy alone fared less well than expected, the results seemed encouraging. Another similar trial with CBP501 has also been conducted in lung cancer and until those results become available later this year, plans for future trials are unclear. Continue reading “GUEST POST: An ASCO Update from Dr. Lee M. Krug, MD” »

If you can walk the walk you can talk the talk… at your own pace.

Bonnie at a press conference for the MODDERN Cures Act. Bonnie is on the far right, her Congressman Leonard Lance is third from the right.


It was a really difficult decision for me to stop working due to mesothelioma.  I loved my job but I was so sick, I would sit around in pajamas most days feeling sorry for myself, having my own pity party.  I needed to work on something besides my own daily medical battle.  I couldn’t just sit around and do nothing anymore.  I decided I was going to try to get Meso  Awareness Day Sept 26 passed in NJ  I had no idea about politics or rules, or what legislative people to see or how to contact them.  My friend June told me to make an appointment and she would come with us (I got my husband involved too).  I realized I could do this on the days I felt good.  I consulted with June on how to get the attention of my politicians. I can hear her mantra, “call them, write letters, call them again, send them emails, make sure they know you. Go to the politician’s home offices when they are not in the capital on both state and federal level and tell them your story about dealing with mesothelioma, stand on their doorstep if you need to get their attention.”

Our first stop was a NJ state senator’s office. My husband, our daughter, June and myself met with his aides as constituents (his voters) and put our cards on the table and so did they.  We spoke on mesothelioma and asbestos and finally reached a deal to get the stalled bill out of the committee and onto a floor vote. (Note here that I didn’t know what a constituent was, a committee or a floor vote, I was totally politically ignorant).

I got my meso information and asbestos patter down to 15 minutes, and started contacting all the representatives I could, and visiting those from my district, and some out of my district.  I got to know their aides and their names, I called to update them or just to say “hi” so they would remember me. We would go to speak to any politician at any state, or town fair as they were shaking people’s hands.  I had decided we would be tenacious.  I found out about deadlines and the way to find out timeframes for a bill to be introduced and acted on.  If we didn’t find out on our own what those dates were, we lost the ability to get the bill introduced or voted on at each level and had to start all over again during the next election year, contacting the many layers of Democrats and Republican levels of aides to get a bill noticed and passed.

Maybe that’s why our government is failing, so many aides, so many levels, so many people to contact about a bill.

A girlfriend who was a Rotary member asked us to speak at a monthly meeting. We found other Rotary members we knew and asked if they were interested in having us speak to their group.  I met a Rotary member at our tiny town fair and told him about mesothelioma and on asbestos dangers and facts, and got another speaking engagement.  I was on a roll and started emailing those program chairs to speak.  I try to space them out for when I feel well in between multitudes of doctor appointments.  I start up conversations in the grocery store while in line, or any other place and find people are amazed, that mesothelioma is not just a word on the television and that asbestos is still imported into the USA.  During September I go to every business in town with posters for Mesothelioma Awareness Day (MAD) and speak to every store owner about it. We drop off MAD posters to all our district politicians. We set up a table at our little township’s Veteran’s Day parade. Thank goodness it was overcast, as I can’t take heat and sun. The weather is what stops me from setting up tables at every fair. My numerous illnesses prevent me from holding events.  But I can talk.

By meeting so many people we were able to work with our state Work Environment Council, a terrific nonprofit that has helped us spread the word.  Then this past December I was told I was being honored by this organization along with some pretty impressive people. After the awards speech, leaders of every major union in our state came up to me, everyone had tears in their eyes from what I had to say.  Not only did all these leaders learn about our dealings with mesothelioma to bring back to their groups, but our state teachers unions took notice and helped me tell every educator in NJ about mesothelioma.  I have come to realize we all have a part in teaching others about mesothelioma and asbestos.  The more people know the closer we get to people acting on these subjects, and hopefully enable more research.

One sentence leads to another, one meeting leads to another, one person leads to another, one story…your story told by you, your spouse, and your friend can make all the difference in educating others.  If you are home, all you have to do is pick up the phone and call to make that first appointment, send a group email to all your friends to make an appointment with their politicians.  After all, it’s about talking the talk that makes the difference to show everyone that we have walked that walk, and we don’t want others to have to do that.