Honorable senators, Ladies and gentlemen,

I am proud to be an advocate for patients afflicted with asbestos related cancers, and I am proud to represent a small cadre of intensely devoted physicians, researchers, and nurses who, behind the scenes, with far too little resources are trying to gain insight into the management of this disease.

This disease, mesothelioma, is on the run.

Since its discovery in the 1950s when it was found to be associated with asbestos, mesothelioma has had the benefit of staying under the radar, afflicting only 3000 or so individuals in the United States, and befuddling any attempts to understand how and when it will occur.

It has defied early detection just enough to frustrate the most skilled clinicians such that the unfortunates who eventually manifest the disease are mainly in advanced stages with horrific symptoms of pain, shortness of breath, and weight loss.

This frustration has been fed by the diseases resistance to standard therapies including chemotherapy, radiation therapy and surgery, and up until recently this frustration has led to the propagation of nihilism by the medical community when confronted with such patients.

There is nothing more dangerous to medical research than nihilism since it is an excuse for disregard.

Moreover, as a society, we use further excuses when confronted with this disease by citing that the peak incidence is approaching and because of our asbestos abatement programs, the disease will decline and disappear rapidly after 2020.

I am not an epidemiologist. I am a surgeon, but I will go on record as saying that we are fooling ourselves, and doing an incredible injustice to many of our neighbors if we think that mesothelioma and asbestos related cancers are going to go away.

Look to the west, and we are confronted with a new hotspot in Libby, Montana, a situation so critical that a public health crises outcry necessitated the development of the center for asbestos related diseases in that city.

Yet the influence of the mines in Montana and other Western states is creeping into my community: Vermiculite, contaminated with asbestos, has been processed in plants in my state, and has been used as insulation in hundreds of thousands of houses where I live, as well as in potting soils.

These hotspots are not confined to the United States; in the Latrobe valley of Australia close to Melbourne, a mesothelioma epidemic is emerging. Where will the next hotspot turn up the developing nations?

Ladies and gentlemen, mesothelioma is still laughing at us but it is starting to look over its shoulder.

The disease still has many secrets which it only begrudgingly gives to clinicians and investigators, however, the clinicians and investigators across the United States who treat patients with this disease have one weapon against this nightmare which mesothelioma never counted on: steadfastness of purpose in destroying the nihilism which protects this disease from discovery.

This steadfastness has resulted from a unity of purpose with formal yet collegial collaborative teams which have formed to either study the reasons why this disease develops, how to detect this disease earlier, or how to more effectively destroy this disease.

The days of disjointed, individual efforts for this disease by individual institutions has been replaced by private advocacy foundations such as the Mesothelioma Applied Research Foundation (www.marf.org) and other mesothelioma advocacy groups which not only serve as a patient resource, but also to help fund the newest ideas for the management of this disease.

The only way in which mesothelioma can be harnessed is with an approach which is independent of politics, independent of physician or legal self gain, and which is with interactive discourse among Centers of Excellence which have devoted their energies to this killer.

Because of these interactions, collaborations across this country between clinics and universities, hospitals and industry . . . collaborations unheard of ten years ago . . . are focusing on using the newest technologies of genomics and proteomics to find this disease earlier, expose its Achilles heel, and enthusiastically design new molecules which can rapidly be put into large trials for these patients who so desperately want to hear we have something exciting for you to consider.

There is no doubt we are making progress and the focus on early detection of high risk asbestos exposed individuals will help us define markers in the blood that will alert us that a cohort patients deserve closer scrutiny.

We are making progress in figuring out how this complicated tumor grows, invades, and even starts and we are learning that there are other factors which work with asbestos to potentiate mesothelioma.

We are making progress with treatment, especially with new compounds like Alimta which can shrink mesothelioma 2-3 times better than our old therapies.

Progress, however, requires funding. Believe it or not, this aspect is also improving and federal agencies like the Early Detection Research Network of the National Cancer Institute are interested in this disease. The funding however, remains absolutely insufficient to set up the type of collaborative approaches that already exist with lung cancer, breast cancer, prostate cancer, and colon cancer. Funding must come from diverse sources not only the federal government but from the department of defense, industrial sources and philanthropy. Mesothelioma patients themselves are some of the greatest donators in order to move the field forward, and serve as an incredible example of compassion in the face of adversity.

The medical, legal, industrial, and governmental community must now join as a team to promote programs which will lessen the anxiety for individuals at high risk for asbestos related cancers, by focusing on early detection, prevention strategies, and innovative treatments. I encourage our elected officials to study the model proposed by MARF for the creation of a Mesothelioma Research and Treatment Program.

This starts with education of the lay and medical community about this continuing health menace. This education will eliminate the ignorance which has perpetuated the nihilism regarding these diseases, and allow us to set the standards for the investigation and care for asbestos related diseases which will serve as a model for other nations.

Thank you.

Dr. Harvey Pass

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• Senator Holds Press Conference with Victims of Asbestos-Related Illness, Medical Experts, Fellow Senators  (3/26/04)

• Murray, Senators, Doctors, and Victims Urge Congress to Protect Americans from Deadly Asbestos (3/26/04)