Dr. Giovanni Gaudino is an Italian biochemist and molecular biologist who researches the molecular mechanisms of asbestos and its relationship to the development of mesothelioma.  Attorney Gary Galiher had the privilege of interviewing this humble and dedicated scientist.  His interview appears on our website in a series.  This is the fourth video in the series.

Well known approaches to cancer treatment include surgery, radiation therapy, chemotherapy, immunotherapy, and chemicals.  All of these conventional therapies have been and are still being used to treat mesothelioma.  While some of these approaches have been successful with other solid tumors, unfortunately, this has not been the case with mesothelioma.

“All these agents can kill cells. . . .  Unfortunately, this is not true for mesothelioma, because, as I say, it is a very resistant tumor to … conventional therapy.  So, because of that, we try to find … new therapeutic approaches.” – Giovanni Gaudino

One of these important new approaches is aimed at overcoming chemoresistance and interfering with cell survival.

Overcoming Chemoresistance

Scientists like Dr. Gaudino have been studying how mesothelioma cells develop; in other words, what has gone awry in the normal cell life of growing, maturing and then dying off.  Dr. Gaudino points out that the growth signals that lead to cancer cell proliferation and neoplastic transformation are the result of a series of biochemical reactions that start at the cell’s surface and move down in a multi-step process called “receptor downstream signaling.”  This continues until the signals reach the nucleus of the cell and their final destination, which is the DNA.  The DNA is the “port master” of all that is going on in the cell.  The “big button” on the top of the cell membrane is called the “Receptor Tyrosine Kinases.”  It mediates the process by which cells become resistant to cell apoptosis, or what is known as “programmed cell death.”  Apoptosis is a normal process of getting rid of old cells.  In an average adult human, 50 to 70 billion cells die every day as a result of apoptosis.  In patients with mesothelioma as well as other cancers, there is insufficient apoptosis, and there is cell proliferation of abnormal cells.

“So the rationale of our work was that the Receptor Tyrosine Kinases, which is the big button that you see on top of the handle of the cell membrane, can be a good target, and by inhibiting [the] receptor downstream signaling . . . we could get rid of the tumor chemoresistance.” – Giovanni Gaudino

The purpose of the drugs used to target this button, then, would be to interfere with cancer cell survival and chemoresistance.

Cell Survival

There are many different molecules involved in cell survival and apoptosis.  These molecules are on the surface of the cell, in the interior of the cell, and in the nucleus.  These molecules all have names so that they can be identified.  Thus, if someone is exposed to asbestos, this toxic exposure combines with genetic factors and many other different reactions.  These different reactions are all pathways that determine cell survival and the transformation of normal tissue to tumor cells which results in cancer, in this instance, malignant mesothelioma.

“And, cell survival is a very important step for a cancer, because if [a] cell can survive despite all the DNA mutations, the DNA damage they suffer, it means they have a good chance to become tumor cells and to .. [become] cancer.” – Giovanni Gaudino

Lung cancer, like asbestosis and mesothelioma, can be caused by exposure to asbestos.  Many who suffer from lung cancer and mesothelioma have to undergo invasive procedures when being diagnosed.  However, new procedures are being developed to test for lung cancer and may help trigger the development of similar tests for other cancers.

Promising New Lung Cancer Detection Test

Steven Dubinett, M.D., is the senior author of a study presented at the American Association for Cancer Research – International Association for the Study of Lung Cancer’s (AACR-IASLC) joint conference in California that may change current diagnostic procedures.

Dr. Dubinett is the director of the Lung Cancer Research Program at the Jonsson Comprehensive Cancer Center at the David Geffen School of Medicine, University of California, Los Angeles (UCLA).  He stated that approximately one in every 500 x-rays shows a lung nodule of “indeterminate significance.”  When that occurs, a physician will order a biopsy or insert a scope into the lungs for further review.  However, Dr. Dubinett says that new research has discovered and assembled 40 biomarkers made up of proteins that can be used to detect lung cancer.  A biomarker or biological marker, is a substance in the blood that can be detected and measured with blood tests.  In this case, the biomarkers being tested are the proteins believed to contribute to lung cancer, or the proteins that change when cancer exists.

Status Of New Detection Test

The new procedure, however, is still in the developmental stages.  It will likely take years before it is clinically available.  If successful, the tests will also likely be able to detect lung cancer in early stages.  As with many other illnesses, early detection can help raise survival rates significantly.

Through clinical trials and research, clinicians and researchers will continue to gain a better understanding of how cancer develops, and new procedures will continue to be developed to help provide better care for those who suffer from these diseases.

We Support Research To Find Better Detection And Treatment For Cancer Patients

Galiher DeRobertis Ono is committed to supporting research to help find a cure and better treatment for lung cancer, mesothelioma and asbestosis.  For over 30 years, our law firm has helped our clients and their families obtain compensation for asbestos-related diseases.  We know a diagnosis like lung cancer can be devastating, and we know from our clients how uncomfortable and stressful diagnostic and treatment procedures can be.

Through our legal work, we collaborate with cancer researchers and institutions, and we are very encouraged by their efforts to develop new detection methods and treatments, and to eventually find a cure for these terrible diseases.

USS New York

The destruction of the World Trade Centers on September 11, 2001, left behind not only an indelible mark on the hearts and minds of all Americans, but also thousands of tons of construction debris.  But in an act that symbolizes the resiliency of Americans, seven and a half tons of the steel debris from Ground Zero were melted down to make the bow of one of the Navy’s newest ships, the USS New York LPD-21.  This landing platform dock was commissioned last November on the USS Intrepid Sea, Air and Space Museum Pier.

Although State names are ordinarily reserved for submarines, naming the Navy’s new surface ship the USS New York is only fitting.  “This new class of ships will project American power into the far corners of the Earth and support the cause of freedom . . . and will be a fitting tribute to the people of the Empire State,” announced the Secretary of the Navy in September of 2002.  The new ship will honor the victims and heroes of the September 11th attack.

The USS New York made her maiden voyage from New Orleans to New York in October.  Upon her arrival in New York City in early November she paused in front of the World Trade Center site and fired a 21-gun salute to the people of her namesake city and state.

Asbestos Use on Navy Battleships

Among the crowd gathered to celebrate the ship’s commissioning were families of  September 11th victims, first responders to the September 11th attacks, and sailors who had been aboard a former Navy battleship carrying the same name, the USS New York BB-34.  This battleship served in both World Wars and earned three battle stars in World  World II.  Ironically, her keel was laid on September 11, 1911, 90 years to the day the World Trade Centers were attacked.  But there is another connection between the first responders to the World Trade Center disaster and the crew of the battleship USS New York.  Both were exposed to asbestos dust from the  insulation used in the construction of the twin towers and this Navy warship.

World War II vintage battleships contained literally tons of asbestos insulating products.  Asbestos had been used to insulate the machinery and piping throughout every battleship.  The crewmen who served on the  USS New York, including those who attended the commissioning of the Navy’s newest ship, were exposed throughout their service to the asbestos dust generated from this massive amount of asbestos insulation.  Each time this asbestos insulation was disturbed, removed, and replaced during routine operations and maintenance, millions of hazardous asbestos fibers were released into the air.

Asbestos Insulation Sprayed on World Trade Towers

The World Trade Center attacks on September 11th caused the greatest environmental catastrophe in New York City history.  Over 400 tons of asbestos fibers were used in the construction of the World Trade Center and were released into the air when the towers collapsed.  During the construction that began in 1966, the steel beams were heavily coated with a slurry mix of asbestos and cement sprayed on as fireproofing material.  Although the City of New York banned the use of spray-on asbestos in 1971, hundreds of tons of this cancer-causing product had already become part of these towers.  The first responders who raced to the World Trade Center to help the victims of this tragedy were exposed to the airborne asbestos that was released when the towers collapsed.  Many of the people who escaped the towers and those in the vicinity also experienced bystander exposure to this asbestos dust.

At Risk Because of Past Exposure to Asbestos

As they witnessed the historic commissioning of the Navy’s newest ship honoring the victims of the tragic 9/11 attack, the crewmen of the battleship USS New York and the first responders to the World Trade Center were faced with an insidious danger that binds them again.  Both remain at risk of developing asbestosis, lung cancer, and mesothelioma, a rare and fatal cancer, because of their past asbestos exposure.

One of the most significant problems in the treatment of malignant mesothelioma is that the tumor can be resistant to many traditional forms of chemotherapy drugs.  This drug resistance varies from patient to patient.  Hence, weeks and even months of chemotherapy treatment could be wasted on a patient with malignant mesothelioma if that person’s tumor is particularly resistant to the type of drug being administered.

The International Mesothelioma Program (IMP) at Brigham and Women’s Hospital in Boston, Massachusetts is developing a new treatment aid that may assist physicians in prescribing the most appropriate form of chemotherapy for their mesothelioma patients.  This tool is called the Extreme Drug Resistance (EDR) assay.

Extreme Drug Resistance (EDR) Assay

To do an EDR assay, physicians at Brigham and Women’s Hospital remove a mesothelioma tumor fragment during surgery (extrapleural pneumonectomy or pleurectomy/decortication) and send it to the laboratory of Oncotech, Inc. in Tustin, California.  The cultured tumor is then tested against various chemotherapy drugs that are commonly prescribed for malignant mesothelioma.   Brigham and Women’s Hospital has Oncotech expose the tumor to Cisplatin, Gemcitabine, a combination of Cisplatin and Gemcitabine, and Vinorelbine.  As of now, Alimta, which is a drug frequently used to treat mesothelioma, cannot be used in the EDR assay, but the technical problems associated with Alimta in this test are being worked out, according to Dr. William Richards, Operations Director of the Brigham and Women’s Hospital Tissue and Blood Repository.

Oncotech then determines whether the mesothelioma tumor for that particular patient is resistant to each of the chemotherapy drugs or the combination of drugs.  If the EDR assay shows that a cultured tumor is extremely resistant to a particular drug, then there is a 99 percent probability that the tumor in the patient will also be resistant to that drug or drug combination.

Next Step: Clinical Trial Testing

According to Dr. Gavin Gordon, co-director at the Brigham and Women’s Hospital Thoracic Surgery Oncology Laboratory, the EDR assay for malignant mesothelioma must still be tested in a clinical trial for it to be approved as part of the treatment protocol.  There are case reports where the predictive value of the EDR assay has shown a very high correlation between the in vitro test and actual drug resistance in the patient.

In a published case report from the Kobe University Graduate School of Medicine in Japan, physicians used a test similar to the EDR assay called the collagen gel droplet embedded culture-drug sensitivity test (CD-DST) to identify the correct treatment for malignant pleural mesothelioma in a 63 year old woman.  The CD-DST test showed that the patient’s tumor was particularly sensitive in vitro to Gemcitabine and Vinorelbine.  Based on this result, her physicians selected these chemotherapy agents for her treatment.

The EDR assay test could be an invaluable tool in the treatment of malignant pleural mesothelioma and peritoneal mesothelioma, diseases that have shown a wide variability in response to different chemotherapy agents.

Dr. Giovanni Gaudino

The law firm Galiher DeRobertis Ono congratulates the Cancer Research Center of Hawaii (CRCH) for appointing a leading European mesothelioma expert, Dr. Giovanni Gaudino, as a Professor of Research.   Cancer center director Dr. Michele Carbone, also a world renowned mesothelioma scientist, is excited about the arrival of Dr. Gaudino at the Center, one of 65 National Cancer Institute (NCI) designated institutions in our country.

Dr. Gaudino is a molecular biologist who studies how mesothelial cells become malignant and give rise to mesothelioma, a very aggressive cancer caused by asbestos exposure.  His decision to bring his research to the U.S. is especially noteworthy because it gives much hope for developing new treatment therapies for mesothelioma patients in the United States.  According to Dr. Carbone, Dr. Gaudino has applied his basic scientific findings to the development of some promising new treatments for mesothelioma that are currently being tested in clinical trials in Europe.  Dr. Carbone  says that he is “very happy that Giovanni will join CRCH” and he is “looking forward to working with him and with Dr. Haining Yang, Dr. Morris and the other mesothelioma experts at the Cancer Research Center.”

CRCH receives more federal grant funding for mesothelioma research than any other research institution in the U.S.  The addition of Dr. Gaudino makes Carbone’s research team stronger.  Together they “will find new ways to prevent and treat this terrible cancer,” says Dr. Carbone.

Born in Saronno in northern Italy, Giovanni Gaudino earned his M.S. (U.S. equivalent) in Biological Sciences and his Ph.D. (U.S. equivalent) in biochemistry from the University of Torino in northern Italy.  Before accepting this position at the Cancer Research Center of Hawaii, Dr. Gaudino was a full professor of molecular biology in the School of Pharmacy and DISCAFF at the University of Piemonte Orientale  ”A. Avogadro” in Novara, Italy.

Gaudino has been involved in a promising clinical trial in Italy involving the use of the combination drug therapy of Gleevec and Gemcitabine on mesothelioma patients. Attorney Gary Galiher commented that he was very excited about Dr. Gaudino’s appointment, both as a huge positive step for the Cancer Research Center of Hawaii, and more importantly for the progress it portends for mesothelioma treatment in our country.

The University of Hawaii’s new President, M.R.C. Greenwood has hit the ground running by placing the development of the new facility for the Cancer Research Center of Hawaii (CRCH) on the fast track.  President Greenwood has been holding weekly meetings with the Center’s Director, Dr. Michele Carbone and Brian Minaai, UH Associate Vice President of Capital Improvements and others.  Those involved in the project say that President Greenwood has given a new meaning to “fast track.”

The University of Hawaii hopes to be “turning dirt” this summer with an exciting groundbreaking for this National Cancer Institute (NCI) designated research center.  The site of the new facility will be adjacent to the University of Hawaii’s John A. Burns School of Medicine (JABSOM) in Kakaako with a breathtaking view of the Pacific Ocean.  State funding of $20 million a year through the cigarette tax is more imperative than ever to develop this cancer center for the people of Hawaii.  Director Michele Carbone, M.D. told state legislators in an informational session that the Cancer Research Center of Hawaii can serve as the bridge between the east and the west, as it is located in the middle of the Pacific Ocean.  This cancer center’s position is unique nationally and internationally.

Cancer Center Actively Involved in Mesothelioma Research

Dr Carbone & Gary Galiher watching a presentation on mesothelioma research

For over three decades, Galiher DeRobertis Ono has represented clients with mesothelioma, lung cancer and asbestosis.  Our law firm has helped many workers and their families obtain compensation for asbestos-related diseases and has always supported research that is aimed at finding better treatment and a cure for these devastating illnesses caused by asbestos exposure.

The Cancer Research Center of Hawaii is a leader in mesothelioma research and receives more federal grant funding for mesothelioma research than any other research institution in the United States.  Drs. Michele Carbone,  Haining Yang, Giovanni Gaudino and others are doing cutting edge research to understand how mesothelioma develops in the human body.  The new facility being built will positively impact the lives of U.S. Veterans and civilian workers who suffer from diseases like mesothelioma as a result of their asbestos exposure at job sites like Pearl Harbor Naval Shipyard.

Recent Progress in Kakaako Facility Development

Three local firms have already been selected to design and move the project forward.  In its request for proposals for the cancer center project, the University of Hawaii required that the companies involved had prior experience creating research centers in Hawaii.

Kobayashi Group, a residential and commercial land developer, has been selected as the project manager.  Kathy Inouye, COO of the Kobayashi Group, presented compelling testimony in a joint informational session of the State House and Senate Higher Education Committees.  She told how the Kobayashi Group visited several cancer centers on the mainland and attended all day sessions meeting with architects, developers, administrators and researchers so that the Kobayashi Group could develop the best possible cancer center for the community.  In her company’s more than 30 years as a developer in Hawaii, Inouye said she sees this project as probably their most important undertaking, with far-reaching significance to the lives and well-being of the people of our State and beyond.

Wilson Okamoto Corp., who handled planning for the University of Hawaii, John A. Burns School of Medicine, has been chosen to manage the project planning.  Its duties will include acquiring entitlements and planning infrastructure.  Shimokawa + Nakamura will lead the design team and has worked on other projects for the University of Hawaii.

The next steps of the project will be to find a general contractor and hold public meetings.  University of Hawaii President M.R.C. Greenwood says she hopes the completed cancer center will be open by 2013.

Galiher DeRobertis Ono is Committed to Supporting Cancer Research

Gary Galiher at the Cancer Research Center of Hawaii

Through our legal work, Galiher DeRobertis Ono collaborates with cancer researchers and institutions, like the Cancer Research Center of Hawaii.  Attorney Gary Galiher says he is “elated about the advent of the new cancer research facility because this promises more and better research for the many mesothelioma clients and their families who I’ve come to know over the years.”  We are very encouraged by their efforts to develop better treatments for lung cancer, mesothelioma and asbestosis and are committed to supporting their research efforts.

Dr. Giovanni Gaudino is an Italian biochemist and molecular biologist who researches the molecular mechanisms of asbestos and its relationship to the development of mesothelioma. In addition to his laboratory research in Italy, Dr. Gaudino conducts mesothelioma research in the United States as a visiting scholar at the Cancer Research Center of Hawaii (CRCH). Currently, Dr. Gaudino is conducting a clinical trial in Italy on mesothelioma patients using Gemcitabine in combination with a different drug, Imatanib Mesylate (trade name Gleevec).  Attorney Gary Galiher had the privilege of interviewing this humble and dedicated scientist. His interview will appear on our website in a series. This is the third video in the series.

Gleevec: A New Role for a Classic Drug

“So we started in this direction and we used … Gleevec and we observed, of course, Gleevec was blocking all the targets we identified . . . .”
– Giovanni Gaudino

Touted by some doctors as one of the most impressive drugs in 20 years when it first came into use in 2001, Gleevec is well known as a successful drug for the treatment of some forms of leukemia and gastrointestinal tumors.  Gleevec is the brand name; the chemical name is imatinib mesylate.  Imatinib mesylate is a specific inhibitor of the receptor tyrosine kinase (the “big button” described earlier) called PDGFRB.  This receptor is widely expressed in most mesotheliomas and is one of the molecules critical to inducing chemoresistance.  With the discovery of the importance of these receptors, it was thought that Gleevec, a classic drug, could be used to inhibit these receptors and thus overcome the tumor cells’ chemoresistance and allow conventional chemotherapeutic drugs to work better.  Gleevec blocked all the identified targets. In lay terms, Gleevec kills abnormal cells and has very little effect on the normal cells.  When it was first used in the treatment of chronic myeloid leukemia (CML), the use of Gleevec was a medical breakthrough.  The primary investigator responsible for the leukemia research at the time dreamed of the day when Gleevec would be effectively used to fight other cancers.  This repurposing of existing, approved drugs such as Gleevec helps to bring new treatment therapies to patients more quickly and efficiently.

The next step for Dr. Gaudino’s research project was to test Gleevec with different chemotherapeutic drugs to see if this specific inhibitor could be used in combination with standard chemotherapeutic drugs to impair tumor resistance.

The Animal Experimental Model

“We moved to [an] animal experimental model, and we used … quite a peculiar model.  We exploited the so-called genetic engineering.  We modified human mesothelioma cells by introducing a foreign gene – a gene coming from a fish – which induce luminescence on these cells.  So these cells basically were emitting lights.”
– Giovanni Gaudino

Gleevec and its combination with other drugs had to first be tested on animals.  In preparation for animal testing, Dr. Gaudino and his team created a very special model.  By the use of genetic engineering, they modified human mesothelioma cells by introducing a foreign gene, a gene from a fish, which caused the cells to emit light.  This enabled the researchers to follow the growth or reduction of the tumor in the live animals by the use of imaging, in the same way a physician uses CT scans or other imaging techniques to see what is going on inside his patient.  So they injected special mice, called SCID mice, with the modified human mesothelioma cells and were able to observe the formation of the tumors by the use of imaging.

Gleevec and Gemcitabine: A New Combination

Next the cancer researchers treated the animals by infusing the tumors with Gleevec combined with different chemotherapeutic drugs, and they found that Gleevec and Gemcitabine were a successful combination.

“It’s quite clear that the treatment … with the two drugs, Gemcitabine and Gleevec . . . reduce a lot of the size of the tumors . . . .  And also, increase quite remarkably the survival of the mice. … [T]he pictures of the mice, I think, are quite convincing because you can see that the right mouse is doing much better than the left one.”
– Giovanni Gaudino

Gleevec & Gemcitabine (Click image to zoom)

Gemcitabine is an old and very well known drug. Gemcitabine is commonly called by its brand name Gemzar.  Gemcitabine has been approved by the FDA since 1996 and is used to treat some lung cancers and pancreatic and ovarian cancers. Dr. Gaudino’s research team knew that Gemcitabine alone was not effective on mice, neither was it effective on mesothelioma patients. But it became quite clear that the combination of Gemcitabine and Gleevec resulted in the reduction in the size of the tumors, which they could measure through imaging, and it also increased, “quite remarkably,” the survival of the mice.

From Mice to Patients: From Pilot Study to Phase II Clinical Trial

The next step, of course, was to move from animal studies to patients.  According to Dr. Gaudino who is involved in bench research, the network the scientists have established is very useful and important, because the results of their work will be published in scientific journals and this will “catch the interest of our clinician colleagues.”

Pilot Study with Gleevec and Gemcitabine (Click image to zoom)

So they started with what is known as a “pilot study” with the combination of Gleevec and Gemzar.  A pilot study comes before the real clinical trial and is usually done on a limited number of patients.  In this case there were 21 patients who had not responded to first-line conventional therapies.  The results were very encouraging: In six patients there was no progression of the disease (stable disease); in one patient there was a complete disappearance of the cancer (complete response); in eight patients there was incomplete reduction of the tumor (partial response); and in six patients, the disease didn’t stop and unfortunately the cancer continued to grow (progression).  Some patients respond better than others and some do not respond at all, which is common in clinical trials.

“And, you know, you may argue that this is not a big deal, just to stop the cancer – you won’t get rid of the cancer.  But for mesothelioma, which is so aggressive, this is a very good result.  We got also one complete response, which means complete disappearance of the cancer.”
– Giovanni Gaudino

This pilot study was followed by a phase II second line clinical trial, which is ongoing and is being validated by the National Cancer Institute (NCI).   It is expected that the results of this study will be coming out in the next few months.  Dr. Gaudino and his team are very optimistic that this therapy will lead to a longer survival.  For mesothelioma patients, the research being done by Dr. Gaudino offers a great deal of hope and promise for longer survival rates and eventually a cure for mesothelioma.

Toxic asbestos insulating products are no longer used in the construction of U.S. Navy or commercial ships, but the hazards of asbestos live on.  Hundreds of Navy and commercial ships built in the United States prior to the mid 1970s incorporated toxic substances, including polychlorinated biphenyls (PCBs), lead, and asbestos, that must be carefully handled when these ships are dismantled for scrap recycling at the end of their useful lives.

The stakes are high in the ship breaking industry.  A single ship can be worth $5 million in scrap steal and there are the many subsidiary businesses that thrive on the dismantling of the various parts of the ship, including its furniture, fittings and machinery.  There was a substantial ship breaking business in the U.S., but strict regulations regarding the disposal of hazardous substances have lead some ship owners to circumvent these requirements and send their ships to foreign ship breaking yards.

Reportedly half of the ships from around the world that need to be dismantled end up in Alang, a town in the state of Gujarat, India, known as the center of India’s ship breaking industry.  Significant controversy has surrounded the Alang yards related to the hazardous working conditions, the poor living conditions, and the environmental impact related to the ship breaking industry.  Nevertheless ship owners continue to go to extremes to have their ships dismantled there.

SS Independence Laden With Toxic Materials Reaches Alang

SS Independence in Hawaii

One of the most recent instances involves a well-known luxury liner, the SS Independence that was built in 1951 at the Bethlehem Quincy Shipyard in Massachusetts.  She operated for many decades as a cruise ship and spent the last part of her life sailing in the Hawaiian Islands.  After her owners declared bankruptcy in 2001, she was moth balled in San Francisco Bay at Pier 70.  In February 2008, however, she was towed away amid speculation that she was headed to Alang, India to be dismantled.

Environmental groups that keep a watchful eye on old ships containing hazardous materials did not let this situation go unnoticed.  Claims were made by the Basel Action Network (BAN), an organization that campaigns against the illicit movement of hazardous waste, that this ship never should have been allowed to leave San Francisco because the export of the PCB-ladened ship was illegal under the Toxic Substances Control Act (TSCA).  The 18,500 ton former luxury liner reportedly had 210 tons of PCBs and 250 tons of asbestos as part of its construction materials.

Notwithstanding intervention by the Environmental Protection Agency, the ship ultimately reached Alang under a new name, SS Platinum II.  Claims were made that the ship had reached Alang with a falsified flag and ship registry.  In response to complaints concerning the presence of hazardous materials, the SS Platinum has been left anchored in the harbor while investigations continue to look into into the toxic substances aboard.  Recent reports indicate, however, that the SS Platinum may be allowed into Alang for dismantling, contributing further the hazards associated with the disposal of toxic materials.

High Incidence of Asbestosis in Alang

Although ship breaking may provide much needed jobs in India, these monetary gains come at a very high cost to both workers and the environment.  In South Asia, workers dismantle ships with hand tools and without strict regulations in place to prevent their exposure to hazardous substances, including asbestos.

According to attorney Gary Galiher, who has handled cases involving asbestos-related diseases for over 30 years, the impact is predictable and devastating:

Given the quantities of asbestos incorporated into these ships when they were built, these unprotected workers are being exposed to high quantities of asbestos dust.  We know this will lead to asbestos-related diseases, including asbestosis, lung cancer, and mesothelioma, a rare and fatal lung cancer.  It is a travesty that the western industrial world is exporting the hazards of asbestos to other countries that have yet to put into place the needed protections to ensure workers do not become sick.

A 2006 report by a panel appointed by India’s Supreme Court confirmed what attorney Gary Galiher predicts.  They found that one in six workers at Alang had signs and symptoms of asbestosis, a scarring of the lungs caused by breathing asbestos.  Although the Supreme Court’s report called for reforms in working conditions at Alang, the work at this ship breaking yard goes on.  Shipowners continue to export their asbestos hazards to India and to expose uninformed and unprotected workers to this deadly hazard.

Virginia class submarine

The United States Pacific Fleet Commander Submarine Force announced on January 6, 2010, that Pearl Harbor Naval Station will be the homeport of the Navy’s newest submarine – the USS North Carolina SSN-777.  The USS North Carolina is one of only six Virginia class nuclear attack submarines in the Navy’s Fleet.  The USS North Carolina will join two other Virginia class submarines:  the USS Hawaii SSN-776, and USS Texas SSN-775.  This will make Pearl Harbor homeport to three of the six currently commissioned Virginia class submarines.

The Virginia class is the submarine of the 21st Century.  It is a nuclear powered submarine with unlimited range, armed with Tomahawk cruise missiles and MK-48 torpedoes.  It boasts a complement of 134 officers and crew.  The Virginia class is replacing the Seawolf class which was itself designed to replace the Los Angeles class nuclear submarine (of which 17 of the 62 total have now been decommissioned).  In fact, the famous USS Los Angeles is scheduled to arrive in Los Angeles Harbor tomorrow for a public decommissioning event this Saturday, January 23rd in San Pedro, CA.  Incidentally, the Los Angeles class submarine was featured in the popular novel, The Hunt for Red October by Tom Clancy, which was made into a movie starring Sean Connery.

The Virginia class submarines are being constructed by General Dynamics Electric Boat in Groton, Connecticut and Northrop Grumman Shipbuilding in Newport News, Virginia at a rate of one per year.  From 2011 to 2013, the Navy is expected to increase the annual construction to two per year for economies of scale cost savings.

The Virginia Class Submarines

The Virginia class submarines commissioned to date with their respective homeports are:

• USS Virginia SSN-774, Groton, Connecticut
• USS Texas SSN-775, Pearl Harbor Naval Station, Hawaii
• USS Hawaii SSN-776, Pearl Harbor Naval Station, Hawaii
• USS North Carolina SSN-777, Pearl Harbor Naval Station, Hawaii
• USS New Hampshire SSN-778, Groton, Connecticut

The USS New Mexico SSN-779 is scheduled to be commissioned on March 27, 2010.  Its homeport is yet to be announced.  Other Virginia class submarines in construction are:

• USS Missouri SSN-780
• USS California SSN-781
• USS Mississippi SSN-782
• USS Minnesota SSN-783
• USS North Dakota SSN-784
• USS John Warner SSN-785

These submarines are scheduled to be completed between 2011 and 2015.   An additional six unnamed subs designated “Block III” began construction in 2009.   This will bring the total number of Virginia class submarines to 18.

Pearl Harbor Historically Homeport to Many Navy Submarines

Pearl Harbor has historically been the homeport to a high percentage of the Navy’s submarine fleet.  This is due to Pearl Harbor’s strategic location and the importance submarine warfare first demonstrated in World War II.  Pearl Harbor Naval Shipyard is also one of the few nuclear submarine repair facilities in the United States.

The law firm of Galiher DeRobertis Ono has represented former active duty submariners (both diesel and nuclear submarine service) as well as shipyard workers who were involved in the original construction or repair of diesel and nuclear submarines.  Our clients were exposed to asbestos dust from both direct hands-on exposure (for example, shipyard workers such as marine machinists and machinist mates) and also from bystander exposure such as stewards and cooks assigned to the submarines.  As a result, many of these men developed asbestos-related diseases such as mesothelioma, lung cancer, and asbestosis.

Even a retired Navy captain who had been in charge of construction of nuclear submarines at Hunters Point Naval Shipyard in San Francisco, California was a client of Galiher DeRobertis Ono.  He  developed mesothelioma from his bystander exposure to deadly asbestos dust during the construction process.  Our submariner clients served in a variety of shipyards, including Pearl Harbor Naval Shipyard, Puget Sound Naval Shipyard in Bremerton, Washington, San Diego Naval Station, Hunters Point Naval Shipyard, California, Mare Island Naval Shipyard, California, Newport News Shipyard and Virginia Dry Dock in Virginia and Groton, Connecticut.

For over 30 years, Galiher DeRobertis Ono has represented clients who have been diagnosed with mesothelioma, lung cancer, asbestosis and other asbestos-related diseases.  When our clients are being treated for complex illnesses such as mesothelioma, they are treated by a team of medical professionals that may include a pulmonologist, pathologist, primary care physician, surgeon, and oncologist.  More often than not, these specialists work in separate facilities and do not have immediate access to records from other members of the medical team.

Health Care Professionals Need Faster Access to Necessary Records

Effective communication between members of a medical team is critically important, especially when treating a rare disease like mesothelioma.  When battling cancer or other illnesses, health care professionals need to be able to access necessary medical records quickly and efficiently.  It can be frustrating for both patients and their medical team members who are forced to wait or to go through the tedious process of requesting medical records.  Fortunately, the health care industry is now developing new procedures that are designed to avoid those frustrating delays by using electronic medical records.

Technology and the Future of Health Care

On January 6, 2010, Kaiser Permanente and the Department of Veterans Affairs, two of the largest health care organizations in the country, implemented a program that will allow them to share a patient’s medical records electronically.  This program will facilitate the exchange of medical data between Kaiser Permanente’s “HealthConnect” system and the VA’s “Veterans Affairs Health Information Systems and Technology Architect” or VistA system.  This will give medical professionals secure and instant access to information which could dramatically improve the quality of health care, and in the long run should lower cost.

This program represents the collaboration of two giants in health care services.  The Veterans Health Administration (VHA) became the largest single medical system in 2003.  Almost a quarter of the population is potentially eligible for these benefits, which are available to veterans as well as their family members or survivors.  In 2009, the budget for the VA health system was close to $90 billion.  Almost 280,000 VA employees work at medical facilities and benefit offices to coordinate the delivery of these services.  Because of the number of patients it serves, the VA became one of the first entities to develop a system-wide electronic health record system that it calls “VistA.”

On the civilian side, Kaiser Permanente’s “HealthConnect” represents one of the largest employer-developed electronic health records system in the country.  Over 8.6 million people are connected to their medical team and the latest medical information.  Every day over 90,000 users access this system.  There are 80,000 new users going on-line each month to utilize this system.

The exchange of medical records between two entities the size of the VA and Kaiser Permanente will help to eliminate the pitfalls of incomplete and unreadable records and lead to the delivery of higher quality care.  If this collaboration is successful, it is likely that many other health care organizations will follow the procedure of creating electronic medical records.  Better access to a patient’s medical history will lead to better care for mesothelioma patients who are being treated by a large team of specialists.