Claiming for private treatment of mesothelioma Mesothelioma prognosis Mesothelioma is a cancer for which there is currently no known cure. The prognosis of most mesothelioma patients is generally in the region of 12-24 months, although many will survive for much longer than this. The prognosis is highly dependent upon the stage of the mesothelioma when it is diagnosed. Unfortunately, for many, mesothelioma is often at an advanced stage before a diagnosis is made. Following a diagnosis of mesothelioma, many of our client’s then turn to the availability of treatment and how they may prolong their life and improve their prognosis and symptoms. With symptoms such as chest pain, shortness of breath, weight loss, loss of appetite, sweating and tiredness, treatment resulting in symptom relief is welcomed. It should be noted that there are many different treatment options available to mesothelioma patients including surgery, chemotherapy, radiotherapy and clinical trials and each and every mesothelioma patient should seek professional advice from their treating consultant on the most appropriate form of treatment for their condition. One particular treatment consideration which has become a hot topic in compensation claims for mesothelioma is private treatment of mesothelioma such as immunotherapy. What is Immunotherapy treatment for mesothelioma? Immunotherapy is a treatment designed to help the immune system to fight off disease. The drugs work in different ways, some by making the cancer highly visible to the patient’s own immune system. In other cases the drug will essentially upgrade the immune system to improve its effect against the cancer. The patient’s own immune system then kills the cancer. Immunotherapy is not without its own side effects. Common side effects of immunotherapy include shortness of breath, diarrhoea, rash, fatigue, changes to the liver, loss of appetite and nausea and vomiting. The severity to the side effects will vary between individuals. Mesothelioma patients undergoing immunotherapy are kept under close review and monitored regularly. Blood tests will be undertaken, together with CT scans and the health of the mesothelioma patient will be closely monitored. If necessary, immunotherapy treatment will be withdrawn if it has a detrimental impact on the patient’s health. Clinical trials & Immunotherapy There are a number of clinical trials for mesothelioma which involve immunotherapy treatment. This includes a current trial of defactinib and pembrolizumab for people with solid tumours (FAK-PD1). The availability of clinical trials changes frequently and details of those clinical trials currently available for mesothelioma can be found on the Mesothelioma UK website. Clinical trials are considered to be necessary to add to knowledge about effective treatments for mesothelioma. The recent PROMISE-meso trial concluded that in some patients, immunotherapy treatment may result in similar benefits as chemotherapy and therefore may be a reasonable alternative to chemotherapy for some mesothelioma patients. Further investigation was considered necessary to be able to better understand which patients would benefit most from immunotherapy. Private treatment & Immunotherapy For some patients, clinical trials may not be an option available to them, or they may not be an option which they wish to consider. In cases such as these, the use of private treatment for mesothelioma such as pembrolizumab (Keytruda) or nivolumab (opdivo) may be appropriate. Pembrolizumab and nivolumab have not yet been approved by the National Institute for Health Care and Excellence (“NICE”) in the treatment of mesothelioma patients (although pembrolizumab has been approved for the treatment of other cancers) and therefore this treatment is currently not available as a free treatment on the NHS, unless you are participating in a clinical trial. Mesothelioma patients who do not therefore wish to participate in a clinical trial, but wish to undergo immunotherapy treatment, are therefore in a position where they can only do so by way of private mesothelioma treatment. Private immunotherapy treatment can be funded by private medical insurance, by the individual mesothelioma patient or through a successful compensation claim. How can we help to fund private treatment for mesothelioma? When we talk about funding private treatment for mesothelioma, we must be clear that this is not necessarily limited to immunotherapy treatment. We have successfully agreed settlements funding private chemotherapy and radiotherapy treatment and alternative holistic treatments, where appropriate. Our asbestos team are committed to helping change the futures of mesothelioma patients by continuing to research the disease and striving to improve management of symptoms. We have successfully recovered the cost of immunotherapy treatment as a part of mesothelioma claims and will continue to push the boundaries to improve compensation in mesothelioma claims. Charities such as Mesothelioma UK are strong advocates of ongoing trials and improvements on symptom management for mesothelioma patients and the Boyes Turner asbestos claims team support their efforts with annual sponsorship and fundraising. In my recent case on behalf of Brian, the Court ordered that his pembrolizumab treatment should be funded by the insurers of the company responsible for having negligently exposed him to asbestos. The insurers also funded a consultation to consider private radiotherapy treatment. Brian’s settlement allows him to recover the cost of any other private mesothelioma treatment which is recommended to improve his symptoms and prognosis. In the event that the insurers do not agree to fund any treatment, Brian has the option to return to Court to enforce his Order for funding. When talking about the funding for his immunotherapy treatment and his compensation claim Brian said: “Your success in gaining a fair settlement in compensation and reimbursement of past and future treatment costs and expenses has provided a more secure future for my wife and myself and securing future treatment costs is absolutely fantastic. The generous early interim payments were a God-send, enabling me to make an early start and subsequent continuation on the course of Keytruda. Had that money not been available it is unlikely that I would have been able to begin treatment. The inclusion of past and future treatment costs have given back my full and fair compensation which will help greatly in whatever future life I have to enjoy. You have been very professional and courteous dealing with me and brought my claim to a very successful conclusion” In addition to funding treatment already underway, where our mesothelioma clients are not yet undergoing private mesothelioma treatment, we always consider the possibility that they may wish to undergo private treatment at some future point. We have reached quick settlements for our mesothelioma clients with orders that they can at any time request that the costs of their immunotherapy treatment be funded by the insurers. In Laura Magson's recentcase on behalf of Darren she negotiated a settlement which includes an Order protecting Darren’s future position with regards to any future treatment with an indemnity for future immunotherapy costs. At Boyes Turner we work hard to ensure that as many of our mesothelioma clients as possible receive lifetime settlements and frequently negotiate settlements which allow our clients the option of future funding for private mesothelioma treatment. Advice on treatment of mesothelioma There are a number of options available for NHS funded and private treatment for mesothelioma and it can be difficult for clients to navigate their way through all of the options. We work closely with our client’s treating consultants and Lung Cancer Nurse Specialists to assess the most appropriate way forward for each mesothelioma client. In addition to working with our mesothelioma client’s treating consultants, we also work closely with mesothelioma charity Mesothelioma UK. Mesothelioma UK has a Free National Helpline number (0800 169 2409). A nursing expert is available Monday-Friday 8.30-4.30 to offer advice and support.