Creating Marital Property
Lawyers.comsm
So you are thinking about getting married and you are wondering about the effect of marriage on your property. What property remains yours after marriage and what property belongs to both you and your spouse?
Property which you own before marriage is considered your separate property or non-marital property after you get married. In order to keep the property as separate property, you should keep it titled in your name. If the property is a bank account, you should not put funds owned by you and your spouse, which is marital property, into the same account. If the property is a house, you should not spend marital money on the house's upkeep. Conversely, if you want to convert your separate property into marital property, then you should have the property re-titled in both your name and your spouse's name.
State Law and Married Couples' Property
Generally, state law treats the property of married couples in two ways. Some states have separate property and community property, and these states are called community property states or jurisdictions. Other states have non-marital property and marital property, which are known as equitable distribution states or jurisdictions. Of the 50 states, as well as the District of Columbia and Puerto Rico, there are nine community property states and forty-three equitable distribution states.
The differences between community property states and equitable distribution states are important should a couple divorce. The laws vary from state to state, and the differences are sometimes based on whether the state is a community property state or an equitable distribution state. However, all states share some common principles when it comes to property owned by spouses.
Separate Property or Community Property?
Property which you own before your marriage is considered separate property in a community property state and non-marital property in an equitable distribution state. Property purchased by you or your spouse with funds earned during your marriage or through your or your spouse's labor is considered community property or marital property. The classification of separate or non-marital property is important because if there is a divorce, the separate property of each spouse is usually awarded to him or her, and community or marital property is divided between the spouses.
Property Owned before Marriage
If you want to remain the sole owner of your separate property after you get married, you must keep your separate property separate. Remember that the classification of property can change. Whether your property remains classified as separate property depends on how you use and manage it. You should keep the property titled in your name, and you should not use marital money to make payments on the property or to maintain it. You cannot spend your time maintaining the property either, as your labor is marital property and will change the classification of the property. Also, if you use separate property to buy a house for yourself and your spouse, the new property will probably be classified as marital property.
Other assets that you might want to keep as your separate property in case of divorce are bank accounts and investment accounts. These accounts can increase in value with minimal participation by you, and they can be easily kept as separate property. These funds should be titled in your name, and you should not put marital funds into the same account. If you happen to combine your funds with marital funds, you might be able to retain your separate property in case of a divorce if you can trace the origin of the funds. So, keep track of the source of any additions to the accounts.
Other Property
Social Security benefits are considered separate property. State law is preempted or displaced by federal law for marital property distribution of Social Security benefits (Old Age, Survivor, and Disability Insurance).
The monetary award received in a personal injury lawsuit can be considered separate property or marital property, depending on whether you live in a community property state or an equitable distribution state.
Another asset that is considered separate property is an inheritance. If you inherit money or property from a parent, sibling or other relative, that is considered to be your separate property. If you keep a financial account or title to the property in your name, you don't spend marital funds or use your labor in increasing its value and maintaining it, and you don't use the inheritance to do something to benefit you and your spouse as a married couple, such as buying a home and living there, the inheritance will still be separate property if your marriage ends in divorce.
Questions for Your Attorney
* How do I keep my property as separate property after I get married?
* Can I spend my time renovating my property after marriage and keep the property as separate
sabato 5 luglio 2008
treatment of mesothelioma
Multimodal treatment of mesothelioma
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
Doctors specializing in mesothelioma treatment frequently adopt a multimodal approach: they treat a patient with a combination of therapies. Due to the relative lack of effectiveness of single-modality treatment in affecting patient survival, the multimodal combination of treatments holds more promise for survival of malignant mesothelioma patients. For an over view of single-mode and multimodal treatment regimens, see the abstract of "Treatment of Malignant Mesothelioma" by M.T. Jaklitsch, S.C. Grondin, and D.J. Sugarbaker and published in the World Journal of Surgery in 2001.
The December 1999 issue of the medical journal, Chest, published a clinical case presentation that illustrates a fairly typical multimodal treatment. The patient was a 52-year-old man with an early diagnosis of Stage I pleural mesothelioma. Doctors performed a pleurectomy (i.e. surgery) and then delivered intrapleural doses of chemotherapy drugs. Then he received additional localized radiation and chemotherapy. Two years after the surgery he did not show evidence of the tumor.
The author concluded that "Aggressive trimodality therapy for mesothelioma is presented as a successful treatment option." (R. Buono - "Mesothelioma Clinical Presentation", Chest 1999; 116:444S-445S)
In recent years, there has been some progress made in the management of malignant mesothelioma, particularly in the area of combination of agents and treatment methods used. More details can be found in this interview with mesothelioma medical expert, Dr. Nicholas Vogelzang: "New Directions for the Treatment of Mesothelioma: An Expert Interview" (Oncology 6(1), 2003).
The following discussion of mesothelioma treatments is organized into separate sections (surgery, photodynamic therapy, radiation, etc.) so that each component of a combination of treatments (multimodality therapy) can be better understood.
Further Information:
"Multimodality Treatments for Mesothelioma?" by W. Eberhardt, (27th Annual congress of the European Society for Medical Oncology).
Two presentations evaluating multimodal treatment of mesothelioma were part of the program of the 37th Annual Meeting of the American Society of Clinical Oncology, May 12-15, 2001 (San Francisco). The first study, by M. Keohan, et al., used an agressive regimen for their phase II study of trimodal therapy for peritoneal mesothelioma. The second study, by J.V. Juturi, et al., investigated intracavitary paclitaxel in a multimodality management of malignant pleural mesothelioma; two earlier cooperative group studies using this treatment method yielded response rates of 0% and 9%, respectively, in patients with mesothelioma. For information about obtaining ASCO asbstracts, check their webpage.
A.M. Boylan - "Mesothelioma: new concepts in diagnosis and management" in Current Opinion in Pulmonary Medicine, March 2000; 6(2):157-163. An interesting discussion about the difficulties of diagnosing mesothelioma; the controversies about staging mesothelioma; and whether the improved survival rates of some new treatments indicate that these treatments are more effective or are explained by patient selection.
D. H. Sterman, MD, et. al. - "Advances in the Treatment of Malignant Pleural Mesothelioma" in Chest 1999; 116:504-520; (see abstract) This article discusses the roles of chemotherapy, radiotherapy, surgery and combined modality approaches in the treatment of pleural mesotheliomas. Promising new avenues may modify the therapeutic nihilism that is rampant among clinicians dealing with mesothelioma.
Types of Mesothelioma Treatment:
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
Doctors specializing in mesothelioma treatment frequently adopt a multimodal approach: they treat a patient with a combination of therapies. Due to the relative lack of effectiveness of single-modality treatment in affecting patient survival, the multimodal combination of treatments holds more promise for survival of malignant mesothelioma patients. For an over view of single-mode and multimodal treatment regimens, see the abstract of "Treatment of Malignant Mesothelioma" by M.T. Jaklitsch, S.C. Grondin, and D.J. Sugarbaker and published in the World Journal of Surgery in 2001.
The December 1999 issue of the medical journal, Chest, published a clinical case presentation that illustrates a fairly typical multimodal treatment. The patient was a 52-year-old man with an early diagnosis of Stage I pleural mesothelioma. Doctors performed a pleurectomy (i.e. surgery) and then delivered intrapleural doses of chemotherapy drugs. Then he received additional localized radiation and chemotherapy. Two years after the surgery he did not show evidence of the tumor.
The author concluded that "Aggressive trimodality therapy for mesothelioma is presented as a successful treatment option." (R. Buono - "Mesothelioma Clinical Presentation", Chest 1999; 116:444S-445S)
In recent years, there has been some progress made in the management of malignant mesothelioma, particularly in the area of combination of agents and treatment methods used. More details can be found in this interview with mesothelioma medical expert, Dr. Nicholas Vogelzang: "New Directions for the Treatment of Mesothelioma: An Expert Interview" (Oncology 6(1), 2003).
The following discussion of mesothelioma treatments is organized into separate sections (surgery, photodynamic therapy, radiation, etc.) so that each component of a combination of treatments (multimodality therapy) can be better understood.
Further Information:
"Multimodality Treatments for Mesothelioma?" by W. Eberhardt, (27th Annual congress of the European Society for Medical Oncology).
Two presentations evaluating multimodal treatment of mesothelioma were part of the program of the 37th Annual Meeting of the American Society of Clinical Oncology, May 12-15, 2001 (San Francisco). The first study, by M. Keohan, et al., used an agressive regimen for their phase II study of trimodal therapy for peritoneal mesothelioma. The second study, by J.V. Juturi, et al., investigated intracavitary paclitaxel in a multimodality management of malignant pleural mesothelioma; two earlier cooperative group studies using this treatment method yielded response rates of 0% and 9%, respectively, in patients with mesothelioma. For information about obtaining ASCO asbstracts, check their webpage.
A.M. Boylan - "Mesothelioma: new concepts in diagnosis and management" in Current Opinion in Pulmonary Medicine, March 2000; 6(2):157-163. An interesting discussion about the difficulties of diagnosing mesothelioma; the controversies about staging mesothelioma; and whether the improved survival rates of some new treatments indicate that these treatments are more effective or are explained by patient selection.
D. H. Sterman, MD, et. al. - "Advances in the Treatment of Malignant Pleural Mesothelioma" in Chest 1999; 116:504-520; (see abstract) This article discusses the roles of chemotherapy, radiotherapy, surgery and combined modality approaches in the treatment of pleural mesotheliomas. Promising new avenues may modify the therapeutic nihilism that is rampant among clinicians dealing with mesothelioma.
Types of Mesothelioma Treatment:
Pleural mesothelioma
Pleural mesothelioma
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
Pleural mesothelioma is of two kinds: (1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous.)
Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, however, are very serious. Fortunately, they are rare - about two thousand people are diagnosed with mesothelioma in the U.S. each year.
The remainder of this section is about diffuse malignant pleural mesothelioma.
Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.
Mesothelioma is sometimes diagnosed by coincidence, before there are any symptoms. For instance, tumors have been discovered through routine chest x-rays. However, when symptoms occur, they may include shortness of breath, weakness, weight loss, loss of appetite, chest pains, lower back pains, persistent coughing, difficulty in swallowing, alone or in combination. An initial medical examination often shows a pleural effusion, which means an accumulation of fluid in the pleural space - the area between the lungs and the chest wall.
The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan. This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.
The actual diagnosis usually requires obtaining a piece of tissue through a biopsy. This could be a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope.) If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube. This is a hospital procedure that requires anesthesia, but is not usually painful. The tissue sample is tested by a pathologist.
Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and much experience in understanding them.
The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.
The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.
Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.
There is as yet no known cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The Firm has represented many clients who lived for five to ten years after diagnosis, most of them in good health for a majority of those years. Some mesothelioma victims succumb within a few months; the average survival time is about a year.
The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously. Many people are treated with a combination of therapies, sometimes known as multimodal therapy.
Specific types of treatment include:
* » Chemotherapy and other drug-based therapies
* » Radiation therapy
* » Surgery and
* » Intra-operative photodynamic therapy.
There are also experimental treatments like gene therapy and immunotherapy, angiogenesis inhibitors, and clinical trials for various new treatments and combinations of treatments.
Treatments that reduce pain and improve lung function, are becoming more successful (although they cannot cure mesothelioma.) Pain control medications have become easier to administer. Debulking is a surgical process of removing a substantial part of the tumor and reducing the pleural thickening; this can provide significant relief. X-ray therapy has also been successfully used to control the tumor and the pain associated with it for a while.
Types of Mesothelioma:
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
Pleural mesothelioma is of two kinds: (1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous.)
Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, however, are very serious. Fortunately, they are rare - about two thousand people are diagnosed with mesothelioma in the U.S. each year.
The remainder of this section is about diffuse malignant pleural mesothelioma.
Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.
Mesothelioma is sometimes diagnosed by coincidence, before there are any symptoms. For instance, tumors have been discovered through routine chest x-rays. However, when symptoms occur, they may include shortness of breath, weakness, weight loss, loss of appetite, chest pains, lower back pains, persistent coughing, difficulty in swallowing, alone or in combination. An initial medical examination often shows a pleural effusion, which means an accumulation of fluid in the pleural space - the area between the lungs and the chest wall.
The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan. This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.
The actual diagnosis usually requires obtaining a piece of tissue through a biopsy. This could be a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope.) If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube. This is a hospital procedure that requires anesthesia, but is not usually painful. The tissue sample is tested by a pathologist.
Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and much experience in understanding them.
The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.
The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.
Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.
There is as yet no known cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The Firm has represented many clients who lived for five to ten years after diagnosis, most of them in good health for a majority of those years. Some mesothelioma victims succumb within a few months; the average survival time is about a year.
The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously. Many people are treated with a combination of therapies, sometimes known as multimodal therapy.
Specific types of treatment include:
* » Chemotherapy and other drug-based therapies
* » Radiation therapy
* » Surgery and
* » Intra-operative photodynamic therapy.
There are also experimental treatments like gene therapy and immunotherapy, angiogenesis inhibitors, and clinical trials for various new treatments and combinations of treatments.
Treatments that reduce pain and improve lung function, are becoming more successful (although they cannot cure mesothelioma.) Pain control medications have become easier to administer. Debulking is a surgical process of removing a substantial part of the tumor and reducing the pleural thickening; this can provide significant relief. X-ray therapy has also been successfully used to control the tumor and the pain associated with it for a while.
Types of Mesothelioma:
Mesothelioma Treatment
Mesothelioma Treatment Options:
Patient Medical Research & Pain Management
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
1) Keep up an open dialogue with your doctor
It is natural to want to understand as much as possible about a disease and its treatments, particularly when the disease is as rare as malignant mesothelioma. The Internet has opened up a wealth of information on mesothelioma, however, it is still important to keep in mind that your doctor is your FIRST and (hopefully) BEST resource for understanding and dealing with this disease.
This does not mean that you shouldn't explore resources and treatments on your own; a good doctor wants informed patients who are interested in discussing every available option. Only a trained physician, however, can help you understand each treatment and evaluate how it fits in with your particular circumstances, including the stage of your disease.
There are valuable research and support resources available via the Internet which can assist you in your efforts to gain medical knowlege as you begin your interaction with your doctor. To begin, there is an online resource that tutors on how to use the Internet to research a lung cancer diagnosis. This tutorial also cautions you as a researcher to be mindful of the limitations of Internet-based research and to learn how to evaluate the information that you do find. Another useful tool to assist in being an informed patient is The Cancer Patient's Workbook: Everything You Need to Stay Organized and Informed, (DK Books, 2001). This workbook hopes to help the patient better understand their situation so they may deal with and fight their disease from an informed position. This interactive guide helps patients cope and also explains how to receive the best treatment possible.
2) Explore the American Cancer Society's Cancer Resource Center
This community-based organization claims its mission is "eliminating cancer as a major health problem...through research, education, advocacy, and service." As a non-governmental organization, the American Cancer Society is the largest source of private funds earmarked for cancer research. The ACS website is a very good place for you to investigate ongoing research and treatment options, as well as find extensive links to help further direct your medical research.
If you suspect that you might have mesothelioma, there are several methods which can help to detect the presence of this disease.
While you may find some answers on this particular site, the ACS advises you to remember that as you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that's on your mind, no matter how small it might seem.
3) Explore the National Cancer Institute's PDQ
The National Cancer Institute provides a computer service called PDQ to give up-to-date information on cancer issues for patients, their families, doctors, and other healthcare professionals. Detailed information on detection, diagnosis, treatment, support groups, clinical trials and treatments is reviewed and updated each month by oncology experts. Each topic is discussed in two tracks, one for patients and one for healthcare professionals.
You might want to visit the information written for patients first, in order to get a clear understanding of the issues discussed in layman's terms. For more detailed information, you can then explore the physician's track.
By going to NCI's CancerNet, you can research the PDQ informational summaries for malignant mesothelioma; these summaries are written for both patient or professional readers. You will also find a useful overview on researching, treating, and coping with malignant mesothelioma.
You will find links to other treatment specific PDQ pages throughout this website.
4) Explore MEDLINE
Published by the National Library of Medicine, MEDLINE is a comprehensive index of medical citations and abstracts dating back to 1966. In the past, this database was available only to students, doctors or by subscription. However, there are now several Internet resources which offer free MEDLINE access, including PubMed and MedlinePlus. Use of both services is free, although you must initially fill out a member registration form.
An additional benefit of these services is access to full-text versions of many of the articles. PubMed publishes a list of MEDLINE journals with links to publisher web sites at: http://www.ncbi.nlm.nih.gov. Access to these articles may require user registration or a small fee, but recent issues are often available free of charge.
These publications and abstracts are not written for the layperson, so make sure you discuss any literature you read with your doctor before making any decisions about them.
Although MEDLINE is the most comprehensive database of medical literatere, the National Cancer Institute also has a free database of cancer-specific abstracts and literature.
5) Contact the Cancer Information Service
The National Cancer Institute offers an informational and educational service known as the Cancer Information Toll-Free Telephone Service (CIS). Information is available in Spanish and English, and is up-to-date and easy to understand. You can get information about recent scientific advances, cancer programs, prevention, early detection, and other topics.
Contact the CIS, toll-free in the United States and Puerto Rico, at 1-800-4-CANCER (1-800-422-6237), Monday through Friday, 9:00 a.m. to 4:30 p.m., your time.
6) Explore OncoLink
The University of Pennsylvania maintains OncoLink, an outstanding resource on the web for information about all types of cancer and related topics. The homepage is http://www.oncolink.com and has information about clinical trials, symptom management, cancer support services, financial issues, book reviews, and many other topics. OncoLink has mesothelioma patient information found under Patient Statement: Malignant Mesothelioma. For a more personal perspective, there is also an article entitled "Thoughts from a Mesothelioma Patient".
Lastly, for a broad resource on the cancer topic and links to specific web sites, consult the Lung Cancer Resources Directory.
If you have questions, need more information, or experience difficulty accessing these sites, please feel free to contact us and we will do our best to help.
Patient Medical Research & Pain Management
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
1) Keep up an open dialogue with your doctor
It is natural to want to understand as much as possible about a disease and its treatments, particularly when the disease is as rare as malignant mesothelioma. The Internet has opened up a wealth of information on mesothelioma, however, it is still important to keep in mind that your doctor is your FIRST and (hopefully) BEST resource for understanding and dealing with this disease.
This does not mean that you shouldn't explore resources and treatments on your own; a good doctor wants informed patients who are interested in discussing every available option. Only a trained physician, however, can help you understand each treatment and evaluate how it fits in with your particular circumstances, including the stage of your disease.
There are valuable research and support resources available via the Internet which can assist you in your efforts to gain medical knowlege as you begin your interaction with your doctor. To begin, there is an online resource that tutors on how to use the Internet to research a lung cancer diagnosis. This tutorial also cautions you as a researcher to be mindful of the limitations of Internet-based research and to learn how to evaluate the information that you do find. Another useful tool to assist in being an informed patient is The Cancer Patient's Workbook: Everything You Need to Stay Organized and Informed, (DK Books, 2001). This workbook hopes to help the patient better understand their situation so they may deal with and fight their disease from an informed position. This interactive guide helps patients cope and also explains how to receive the best treatment possible.
2) Explore the American Cancer Society's Cancer Resource Center
This community-based organization claims its mission is "eliminating cancer as a major health problem...through research, education, advocacy, and service." As a non-governmental organization, the American Cancer Society is the largest source of private funds earmarked for cancer research. The ACS website is a very good place for you to investigate ongoing research and treatment options, as well as find extensive links to help further direct your medical research.
If you suspect that you might have mesothelioma, there are several methods which can help to detect the presence of this disease.
While you may find some answers on this particular site, the ACS advises you to remember that as you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that's on your mind, no matter how small it might seem.
3) Explore the National Cancer Institute's PDQ
The National Cancer Institute provides a computer service called PDQ to give up-to-date information on cancer issues for patients, their families, doctors, and other healthcare professionals. Detailed information on detection, diagnosis, treatment, support groups, clinical trials and treatments is reviewed and updated each month by oncology experts. Each topic is discussed in two tracks, one for patients and one for healthcare professionals.
You might want to visit the information written for patients first, in order to get a clear understanding of the issues discussed in layman's terms. For more detailed information, you can then explore the physician's track.
By going to NCI's CancerNet, you can research the PDQ informational summaries for malignant mesothelioma; these summaries are written for both patient or professional readers. You will also find a useful overview on researching, treating, and coping with malignant mesothelioma.
You will find links to other treatment specific PDQ pages throughout this website.
4) Explore MEDLINE
Published by the National Library of Medicine, MEDLINE is a comprehensive index of medical citations and abstracts dating back to 1966. In the past, this database was available only to students, doctors or by subscription. However, there are now several Internet resources which offer free MEDLINE access, including PubMed and MedlinePlus. Use of both services is free, although you must initially fill out a member registration form.
An additional benefit of these services is access to full-text versions of many of the articles. PubMed publishes a list of MEDLINE journals with links to publisher web sites at: http://www.ncbi.nlm.nih.gov. Access to these articles may require user registration or a small fee, but recent issues are often available free of charge.
These publications and abstracts are not written for the layperson, so make sure you discuss any literature you read with your doctor before making any decisions about them.
Although MEDLINE is the most comprehensive database of medical literatere, the National Cancer Institute also has a free database of cancer-specific abstracts and literature.
5) Contact the Cancer Information Service
The National Cancer Institute offers an informational and educational service known as the Cancer Information Toll-Free Telephone Service (CIS). Information is available in Spanish and English, and is up-to-date and easy to understand. You can get information about recent scientific advances, cancer programs, prevention, early detection, and other topics.
Contact the CIS, toll-free in the United States and Puerto Rico, at 1-800-4-CANCER (1-800-422-6237), Monday through Friday, 9:00 a.m. to 4:30 p.m., your time.
6) Explore OncoLink
The University of Pennsylvania maintains OncoLink, an outstanding resource on the web for information about all types of cancer and related topics. The homepage is http://www.oncolink.com and has information about clinical trials, symptom management, cancer support services, financial issues, book reviews, and many other topics. OncoLink has mesothelioma patient information found under Patient Statement: Malignant Mesothelioma. For a more personal perspective, there is also an article entitled "Thoughts from a Mesothelioma Patient".
Lastly, for a broad resource on the cancer topic and links to specific web sites, consult the Lung Cancer Resources Directory.
If you have questions, need more information, or experience difficulty accessing these sites, please feel free to contact us and we will do our best to help.
Malignant Mesothelioma
Diagnosis for Malignant Mesothelioma Cancer: Screening
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
The National Cancer Institute's definition of screening for cancer is the examination or testing of people for early signs of certain type of cancer even though they have no symptons - this is the best way to achieve a diagnosis as early as possible. Early detection and diagnosis is particularly important for people with historical exposure to asbestos due to the latency period (up to 30 years) before which symptoms of malignant mesothelioma cancer may become apparent.
Early Signs of Mesothelioma Aid Diagnosis:
Recognizing early symptoms of malignant mesothelioma may aid in diagnosis. Symptoms include difficulty in breathing (dyspnea) and/or chest pains, fever, nausea or anemia; other signals are hoarseness, difficulty swallowing (dysphagia), or coughing up blood (hemoptysis). For many suffering from pleural mesothelioma, there may be pain in the chest or lower back. Those people with peritoneal mesothelioma may experience an expanding waist size or abdominal pain resulting from the growth of cancer cells in the abdomen.
Since many of these symptoms are also caused by less serious illnesses, it can be difficult to recognize asbestos-related diseases in the early stages. Due to this difficulty of early diagnosis of asbestos cancer and mesothelioma, the best way to determine your health risk is to consult a doctor for an initial examination, which may include a pulmonary function test (PFT) and x-rays.
Screening Methods to Identify Asbestos-Related Disease:
After a preliminary physical examination, the doctor may need to look inside your chest cavity with a thorascope for accurate diagnosis. During this thoracoscopy procedure, a cut will be made in your chest and a small piece of tissue (biopsy) may removed for examination. While you may feel some pressure, there is usually no pain.
Another special tool that may be used is the peritoneoscope, which allows for examination inside your abdomen. This instrument is inserted into an opening made in the abdomen, and a biopsy specimen may also be taken.
If the presence of fluid is indicated by either of these procedures, the doctor may drain it by inserting a needle into the affected area. Removal of chest fluid is called thoracentesis; removal of abdominal fluid is call paracentesis.
Other screening methods for diagnosis of asbestos-related disease include various imaging tests. In addition to X-rays, methods include magnetic resonance imaging (MRI) or positron emission tomography (PET). A more recent and promising screening method is the computed tomography (CT) scan.
Computed Tomagraphy / CT Scan:
Computed tomagraphy, or spiral CT scan, is a special radiographic technique that produces a clear cross-sectional image that allows a radiologist to see distinct aspects of the lung or pleura that are not readily apparent from the standard X-ray image. Recent studies (CHEST 2002;122:15-20 support the use of annual chest computed tomography (CT scans) exams as a valuable screening tool for people with a high risk of developing lung cancer, including mesothelioma cancer. There does appear to be conflicting assessment as to the cost-effectiveness of CT screening. A 2003 study by Johns Hopkins raises this concern about the cost-effectiveness of CT scans and states, "There is a downside to this, including high costs and possible harm to individuals who may unnecessarily get invasive procedures if the scan detects a benign lung nodule." A more recent study in Chest, 2003:124:614-621 comes to a different conclusion: "A baseline low-dose CT scan for lung cancer screening is potentially highly cost-effective and compares favorably to the cost-effectiveness ratios of other screening programs."
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The National Cancer Institute's definition of screening for cancer is the examination or testing of people for early signs of certain type of cancer even though they have no symptons - this is the best way to achieve a diagnosis as early as possible. Early detection and diagnosis is particularly important for people with historical exposure to asbestos due to the latency period (up to 30 years) before which symptoms of malignant mesothelioma cancer may become apparent.
Early Signs of Mesothelioma Aid Diagnosis:
Recognizing early symptoms of malignant mesothelioma may aid in diagnosis. Symptoms include difficulty in breathing (dyspnea) and/or chest pains, fever, nausea or anemia; other signals are hoarseness, difficulty swallowing (dysphagia), or coughing up blood (hemoptysis). For many suffering from pleural mesothelioma, there may be pain in the chest or lower back. Those people with peritoneal mesothelioma may experience an expanding waist size or abdominal pain resulting from the growth of cancer cells in the abdomen.
Since many of these symptoms are also caused by less serious illnesses, it can be difficult to recognize asbestos-related diseases in the early stages. Due to this difficulty of early diagnosis of asbestos cancer and mesothelioma, the best way to determine your health risk is to consult a doctor for an initial examination, which may include a pulmonary function test (PFT) and x-rays.
Screening Methods to Identify Asbestos-Related Disease:
After a preliminary physical examination, the doctor may need to look inside your chest cavity with a thorascope for accurate diagnosis. During this thoracoscopy procedure, a cut will be made in your chest and a small piece of tissue (biopsy) may removed for examination. While you may feel some pressure, there is usually no pain.
Another special tool that may be used is the peritoneoscope, which allows for examination inside your abdomen. This instrument is inserted into an opening made in the abdomen, and a biopsy specimen may also be taken.
If the presence of fluid is indicated by either of these procedures, the doctor may drain it by inserting a needle into the affected area. Removal of chest fluid is called thoracentesis; removal of abdominal fluid is call paracentesis.
Other screening methods for diagnosis of asbestos-related disease include various imaging tests. In addition to X-rays, methods include magnetic resonance imaging (MRI) or positron emission tomography (PET). A more recent and promising screening method is the computed tomography (CT) scan.
Computed Tomagraphy / CT Scan:
Computed tomagraphy, or spiral CT scan, is a special radiographic technique that produces a clear cross-sectional image that allows a radiologist to see distinct aspects of the lung or pleura that are not readily apparent from the standard X-ray image. Recent studies (CHEST 2002;122:15-20 support the use of annual chest computed tomography (CT scans) exams as a valuable screening tool for people with a high risk of developing lung cancer, including mesothelioma cancer. There does appear to be conflicting assessment as to the cost-effectiveness of CT screening. A 2003 study by Johns Hopkins raises this concern about the cost-effectiveness of CT scans and states, "There is a downside to this, including high costs and possible harm to individuals who may unnecessarily get invasive procedures if the scan detects a benign lung nodule." A more recent study in Chest, 2003:124:614-621 comes to a different conclusion: "A baseline low-dose CT scan for lung cancer screening is potentially highly cost-effective and compares favorably to the cost-effectiveness ratios of other screening programs."
Mesothelioma Types
What happens when we breathe?
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When we take a deep breath, the air goes down the wind-pipe (or trachea) into the middle of the chest. There the trachea divides into two, then four, then eight - and finally, hundreds of thousands of little airways (or bronchi and bronchioles) in each lung. At the end of each airway is a tiny sac (or alveolus.) Healthy lungs have hundreds of millions of these sacs (or alveoli.)
Oak Tree
Oak Tree
An upside-down oak tree provides a good example: The wind-pipe is like the large trunk which divides countless times into branches (airways) and twigs (small airways), until at the end of every twig there is a leaf (alveolus). As the wind blows, the leaves move.
Similarly, the air we inhale moves all the way through the lungs to the alveoli. The oxygen in that deep breath is transported through the walls of the alveoli into the red blood cells in the blood vessels (capillaries) that surround each alveolus.
The heart then pumps the oxygen-rich blood through the body and we are able to do things like run up a hill, throw a ball, or surf the web.
One of the by-products of all this web-surfing and ball-throwing, is the build-up of "exhaust fumes" (carbon dioxide) in the body's cells. Red blood cells pick up the carbon dioxide in place of the oxygen they deliver.
Thus, there are two processes at work as we breathe in and breathe out. Blood vessels transport blood that is rich in carbon dioxide and poor in oxygen to the alveoli. And, in the reverse process, the carbon dioxide goes out through the walls of the alveoli, into the airways, and, as we breathe out, back up the trachea.
The lungs expand and contract as we breathe in and out, whereas our ribs are fairly immobile. The pleura, or lining around the outside of the lungs and inside of the ribs, has some lubricating fluid. It allows the lungs and ribs to slide over each other comfortably. It is easy to imagine that, if the pleura is damaged or inflamed, every breath becomes very painful.
However, when we are healthy, breathing is easy - so easy we don't even think about it
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
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* » In Home
* » Building Materials
When we take a deep breath, the air goes down the wind-pipe (or trachea) into the middle of the chest. There the trachea divides into two, then four, then eight - and finally, hundreds of thousands of little airways (or bronchi and bronchioles) in each lung. At the end of each airway is a tiny sac (or alveolus.) Healthy lungs have hundreds of millions of these sacs (or alveoli.)
Oak Tree
Oak Tree
An upside-down oak tree provides a good example: The wind-pipe is like the large trunk which divides countless times into branches (airways) and twigs (small airways), until at the end of every twig there is a leaf (alveolus). As the wind blows, the leaves move.
Similarly, the air we inhale moves all the way through the lungs to the alveoli. The oxygen in that deep breath is transported through the walls of the alveoli into the red blood cells in the blood vessels (capillaries) that surround each alveolus.
The heart then pumps the oxygen-rich blood through the body and we are able to do things like run up a hill, throw a ball, or surf the web.
One of the by-products of all this web-surfing and ball-throwing, is the build-up of "exhaust fumes" (carbon dioxide) in the body's cells. Red blood cells pick up the carbon dioxide in place of the oxygen they deliver.
Thus, there are two processes at work as we breathe in and breathe out. Blood vessels transport blood that is rich in carbon dioxide and poor in oxygen to the alveoli. And, in the reverse process, the carbon dioxide goes out through the walls of the alveoli, into the airways, and, as we breathe out, back up the trachea.
The lungs expand and contract as we breathe in and out, whereas our ribs are fairly immobile. The pleura, or lining around the outside of the lungs and inside of the ribs, has some lubricating fluid. It allows the lungs and ribs to slide over each other comfortably. It is easy to imagine that, if the pleura is damaged or inflamed, every breath becomes very painful.
However, when we are healthy, breathing is easy - so easy we don't even think about it
ASBESTOS
What is asbestos?
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Asbestos is the name for a group of naturally occurring silicate minerals that can be separated into fibers. The fibers are strong, durable, and resistant to heat and fire. They are also long, thin and flexible, so that they can even be woven into cloth.
Because of these qualities, asbestos has been used in thousands of consumer, industrial, maritime, automotive, scientific and building products. During the twentieth century, some 30 million tons of asbestos were used in industrial sites, homes, schools, shipyards and commercial buildings in the United States.
There are several types of asbestos fibers, of which three have been used for commercial applications: (1) Chrysotile, or white asbestos, comes mainly from Canada, and has been very widely used in the US. It is white-gray in color and found in serpentine rock. (2) Amosite, or brown asbestos, comes from southern Africa. (3) Crocidolite, or blue asbestos, comes from southern Africa and Australia. Amosite and crocidolite are called amphiboles. This term refers to the nature of their geologic formation.
Other asbestos fibers that have not been used commercially are tremolite, actinolite and anthophyllite, although they are sometimes contaminants in asbestos-containing products. It should be noted that there are non-fibrous, or non-asbestiform, variants of tremolite, anthophylite and actinolite, which do not have the adverse health consequences that result from exposure to commercial forms of asbestos.
Here are some additional "Facts About Asbestos".
What are asbestos-containing products?
What is common to many asbestos-containing products is that they were (are) used to contain heat (i.e. thermal insulation.) It is impossible to list all of the products that have, at one time or another, contained asbestos. Some of the more common asbestos-containing products are pipe-covering, insulating cement, insulating block, asbestos cloth, gaskets, packing materials, thermal seals, refractory and boiler insulation materials, transite board, asbestos cement pipe, fireproofing spray, joint compound, vinyl floor tile, ceiling tile, mastics, adhesives, coatings, acoustical textures, duct insulation for heating, ventilation and air conditioning (HVAC) systems, roofing products, insulated electrical wire and panels, and brake and clutch assemblies. Some of these products contained a very high proportion of asbestos, while others contained small amounts.
Why is asbestos still a problem?
Asbestos is still a problem because a great deal of it has been used in the United States and elsewhere, because many asbestos-containing products remain in buildings, ships, industrial facilities and other environments where the fibers can become airborne, and because of the serious human health hazards of inhaling asbestos fibers.
Many Americans believe that use of asbestos in products was banned years ago. The fact is that asbestos-containing products are still being imported and sold in this country, continuing to endanger people who may come in contact with such products. A majority of these products are imported from Canada and Mexico, two countries where asbestos is still used; further, not all imported asbestos-containing products are clearly labeled with proper content information. (Sources: U.S. Geological Survey, Mineral Commodity Summaries 2003, and "Asbestos Strategies")
In an August 2003 report, the EPA's Office of Inspector General reiterates that asbestos is still a product very much around us: a survey in the mid-1980s found that, on average, 20% of all buildings in the United States contain asbestos. Further, this latest report confirms that asbestos containing material is still allowed in pipeline wrap, asbestos-cement corrugated sheet, asbestos-cement flat sheet, roofing felt, millboard, vinyl-asbestos floor tile, asbestos-cement shingle, and roof coatings. (Rept. #2003-P-00012).
A 2004 report by the Environmental Working Group provides a timely evalution of the asbestos-related disease epidemic in America - a "public health tragedy caused by asbestos." This report documents the history of asbestos use and provides analysis and statistics to inform the political debate currently being waged to resolve the problem.
Other pages on this website contain information about:
* » What is Asbestos?
* » Diseases
* » Screening
* » Research
* » Mesothelioma Types
* » Mesothelioma Treatments
* » At Risk
* » In Home
* » Building Materials
Asbestos is the name for a group of naturally occurring silicate minerals that can be separated into fibers. The fibers are strong, durable, and resistant to heat and fire. They are also long, thin and flexible, so that they can even be woven into cloth.
Because of these qualities, asbestos has been used in thousands of consumer, industrial, maritime, automotive, scientific and building products. During the twentieth century, some 30 million tons of asbestos were used in industrial sites, homes, schools, shipyards and commercial buildings in the United States.
There are several types of asbestos fibers, of which three have been used for commercial applications: (1) Chrysotile, or white asbestos, comes mainly from Canada, and has been very widely used in the US. It is white-gray in color and found in serpentine rock. (2) Amosite, or brown asbestos, comes from southern Africa. (3) Crocidolite, or blue asbestos, comes from southern Africa and Australia. Amosite and crocidolite are called amphiboles. This term refers to the nature of their geologic formation.
Other asbestos fibers that have not been used commercially are tremolite, actinolite and anthophyllite, although they are sometimes contaminants in asbestos-containing products. It should be noted that there are non-fibrous, or non-asbestiform, variants of tremolite, anthophylite and actinolite, which do not have the adverse health consequences that result from exposure to commercial forms of asbestos.
Here are some additional "Facts About Asbestos".
What are asbestos-containing products?
What is common to many asbestos-containing products is that they were (are) used to contain heat (i.e. thermal insulation.) It is impossible to list all of the products that have, at one time or another, contained asbestos. Some of the more common asbestos-containing products are pipe-covering, insulating cement, insulating block, asbestos cloth, gaskets, packing materials, thermal seals, refractory and boiler insulation materials, transite board, asbestos cement pipe, fireproofing spray, joint compound, vinyl floor tile, ceiling tile, mastics, adhesives, coatings, acoustical textures, duct insulation for heating, ventilation and air conditioning (HVAC) systems, roofing products, insulated electrical wire and panels, and brake and clutch assemblies. Some of these products contained a very high proportion of asbestos, while others contained small amounts.
Why is asbestos still a problem?
Asbestos is still a problem because a great deal of it has been used in the United States and elsewhere, because many asbestos-containing products remain in buildings, ships, industrial facilities and other environments where the fibers can become airborne, and because of the serious human health hazards of inhaling asbestos fibers.
Many Americans believe that use of asbestos in products was banned years ago. The fact is that asbestos-containing products are still being imported and sold in this country, continuing to endanger people who may come in contact with such products. A majority of these products are imported from Canada and Mexico, two countries where asbestos is still used; further, not all imported asbestos-containing products are clearly labeled with proper content information. (Sources: U.S. Geological Survey, Mineral Commodity Summaries 2003, and "Asbestos Strategies")
In an August 2003 report, the EPA's Office of Inspector General reiterates that asbestos is still a product very much around us: a survey in the mid-1980s found that, on average, 20% of all buildings in the United States contain asbestos. Further, this latest report confirms that asbestos containing material is still allowed in pipeline wrap, asbestos-cement corrugated sheet, asbestos-cement flat sheet, roofing felt, millboard, vinyl-asbestos floor tile, asbestos-cement shingle, and roof coatings. (Rept. #2003-P-00012).
A 2004 report by the Environmental Working Group provides a timely evalution of the asbestos-related disease epidemic in America - a "public health tragedy caused by asbestos." This report documents the history of asbestos use and provides analysis and statistics to inform the political debate currently being waged to resolve the problem.
Other pages on this website contain information about:
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