Understanding Mesothelioma: First Steps After a Diagnosis

In this first episode of MESO, attorney Paul Danziger and patient advocate Dave Foster explain the immediate medical and legal steps families should take after a mesothelioma diagnosis, and why acting quickly matters.

Episode summary

In the very first episode of MESO: The Mesothelioma Podcast, host Matthew Bertram is joined by Paul Danziger, founding partner of Danziger & De Llano with more than 30 years of mesothelioma litigation experience, and Dave Foster, Executive Director of patient advocacy with 18 years of experience helping mesothelioma families navigate one of the most difficult diagnoses a family can face. The conversation covers why mesothelioma is so often caught late, only about 3,000 Americans are diagnosed each year, and the average patient sees three doctors before receiving an accurate diagnosis. A key reason is the 20-to-50-year latency period between asbestos exposure and the onset of disease, which catches both patients and families off guard and has important implications for the legal timeline. Paul and Dave walk through what families can do in the critical first 30 days: gathering medical records, understanding how treatment approaches at specialized centers like MD Anderson, Brigham and Women's Hospital, and Moffitt Cancer Center differ from local oncology care, and learning what options, surgery, chemotherapy, and clinical trials, may be available. The guests also discuss how patient advocates help families access asbestos trust funds, VA benefits, and legal compensation, and what some survivors who beat the median prognosis did differently, while noting these outcomes are not typical. Emotional and practical support resources are also addressed.

Key takeaways

Source: Paul Danziger, founding partner, speaking in this episode.

• Mesothelioma is rare, roughly 3,000 Americans are diagnosed each year, and the long latency period between asbestos exposure and diagnosis (20 to 50 years) means many families are caught completely off guard.
• The first 30 days matter: securing medical records and understanding all available options, including surgery, chemotherapy, and clinical trials, can shape the path forward.
• Specialized mesothelioma treatment centers approach the disease differently than local oncologists, and patient advocates can help families identify those resources along with financial options such as asbestos trust funds and VA benefits.
• Families are not alone in this, patient advocacy organizations provide both practical guidance and emotional support throughout the process.

In their words

they call asbestos the silent killer, because it is silent for so long. And then all of a sudden, it comes up and rears its ugly head.

Paul Danziger

Terms explained in this episode

Secondary exposure

Asbestos exposure that occurs not through direct occupational contact but through proximity to someone who worked with asbestos, such as a child hugging a parent in work clothes or a spouse washing asbestos-contaminated overalls.

Mesothelial cells

Cells that form the lining of layers around the lungs, heart, and stomach. Dave Foster explains that asbestos fibers injure this area, causing an abnormal inflammatory reaction that can develop into cancer.

Statute of limitations

A legal deadline referenced in the episode that can affect whether a mesothelioma patient or family qualifies to pursue legal compensation; Dave Foster mentions some people fall outside its scope.

Full transcript

You're listening to Miso, the Mesothelioma podcast, where support, education, and outreach come together for families facing Mesothelioma. Howdy, welcome to Miso, the top Mesothelioma podcast. We are coming together today to start a new podcast because, well, there wasn't anything out there that solved a problem for one of the lawyers that has decided to sponsor the show. Paul Danzinger, welcome to the show.

This is your baby. This was your idea. We've created this show because you didn't see anything out there in the space. Dave Foster, also a co-host of mine, my name is Matthew Bertram, and we are hosting Miso, the Mesothelioma podcast, a story for patient advocates. So gentlemen, welcome to the show. Thank you. Thank you. Paul, thanks for sponsoring us and recognizing this need and probably would be a good idea to kind of start out, tell us a little bit about you and how you got into this.

So we've been working and representing Mesothelioma victims and their families for over 25 years. And one of the things, you know, Mesothelioma is an orphan disease or disease that a lot of people have never heard of, never met anyone who has been diagnosed with the And then all of a sudden they get the terrible, shocking news that they've been diagnosed with Mesothelioma and they don't really know what to do, where to get the best treatment.

What's the survival rate, how to live with Mesothelioma. And so what we wanted to do is we wanted to provide a platform or forum for individuals, family members, if you have someone you love who has been diagnosed with Mesothelioma, that they can get just a little bit more information. And so we can help point them in the right direction because they are things you can do.

There's hope. There are avenues to proceed down, but you've got to have the information. You've got to have the knowledge. And we felt that was really lacking. And so we, with the help of Matt's, we want to try and put together just an informational podcast to help people go in the right direction and not waste any time because time is no one's friend ever.

And so that's where we're here today and that we're very happy to sponsor this podcast. And we think it's a privilege and thank you. Awesome. So, Dave, before we get into it, just could you give us like a quick overview from a medical perspective of what Mesothelioma is and why that's important that people get checked early? Maybe some more details around that.

Well, Mesothelioma is almost exclusively caused by asbestos. And so what happens is people were diagnosed either through their job. They were in the military, the Navy, the Air Force, Air Force mechanic. And in some way, fashion or form, they were exposed to asbestos. They inhaled it. It could also be absorbed through the skin or through your private areas.

And that's kind of another topic in and of itself. But the usage of talc and how that has affected this area of disease. But about 2500 people a year get it. The mesothelial cells are part of the lining of the layers around the lungs, the heart, the stomach. And what happens is one of these asbestos fibers injures that area and the body tries to recover and recovers abnormally.

And it becomes an out of control inflammatory reaction. And unfortunately, in some cases, the body can't heal itself. It develops cancer cells, right? The DNA splits wrong. And then from there on out, nothing good happens. Yeah. I mean, the thing that shocked me as I started to learn about this was something that happened so long ago is now affecting you today.

And so people don't think about it. They've lived their life. And then all of a sudden, almost out of nowhere, they get diagnosed. And then it's like you only have potentially a couple of years to live. I'm very scared. Even I've heard about baby powder being one of the components. Talc, that was one of the components. And baby powder is causing a lot of these cancers.

I mean, Paul, what do people do when they're concerned that they've worked in maybe one of these industries that Dave's talked about? Yeah. That's what really makes this disease so shocking. The exposure happened a decade, two decades, three decades, four, five decades ago. And a lot of the exposure happened when people were young. They got a summer job.

They worked in roofing. They worked at a plant for the summer. They cut asbestos piping. They got exposed to asbestos. And then they went on and did other things. And they weren't exposed for basically decades. But that asbestos fiber had got in those individuals' lungs, had lodged in the lungs. And at some point in the future, metastasizes and becomes mesothelioma.

So they call asbestos the silent killer, because it is silent for so long. And then all of a sudden, it comes up and rears its ugly head. But if you were exposed to asbestos decades ago, there's really nothing you can do. But really, the good news is it's a very, very rare disease. And so if you're worried about getting asbestos, I wouldn't.

You're probably not going to get it. Hundreds of thousands of people, if not millions of people, were exposed over the last couple of decades to asbestos. And it's still relatively a rare disease. However, once you do get, once you have been diagnosed with mesothelioma, that's when you really got to take proactive action to seek out the best treatment, the best facilities, the best doctors, and start dealing with it.

You got to, you're going to have living expense issues. You're going to have medical expenses. And so you need to get help. And you need to get help quickly so you can help pay for that. But in terms of just worrying about symptoms, coughing, those things, you're probably not going to have mesothelioma. And you can really, rest assured, put that to the side.

So Rod and I, or Paul and I, wrote a book about mesothelioma survivors. And two of those five survivors are still going strong, out almost 20 years plus, and doing fine in their thing. So there is hope. You just have, like you said, you have to be, you have to do it quickly and get the right doctor and the right treatment and be aggressive about it.

No, Dave, that's so good to hear. So once someone's diagnosed with mesothelioma or they find out about it, or, well, they think they have it, there's ways to go check, but hey, don't worry, it's not going to be you. Hopefully, right, only a few people a year get it. But I feel like Dan Singer and Deano, dandel.com, they really help you navigate this and help you find the right provider, and they help you find the right medical treatment, and they give you the resources to help you prolong your life and get in the right space at the right time.

I feel like that's something y'all do really well. Could you talk more about that? Let me just say, you know, one of the things that we did very early on in our careers is we realized that we needed a patient advocate. Somebody who would know the mesothelioma treatment centers, know the doctors, be able to get second opinions for our clients, and somebody who'd have a relationship.

So let's assume you're trying to get into MD Anderson Cancer Center. It's a huge facility here in Houston. You gotta go through the bureaucracy. But we wanted somebody who would know the doctors on a personal level, who could reach out to them, had their cell phone, and could get our clients in or make a call. And that person is Dave Foster.

He's the director of patient advocacy. We hired him to do that. He's done a stellar job. People know and love him. And so Dave, I'm gonna let you really address what you do and how you do that. And again, this is, you know, Paul's foresight and allowing, sponsoring me to travel really all over the world to meet these doctors.

So we know everybody at every major medical center in the country, and we've all gone out and we've sat down and talked about what their program's like, what they do. And as Paul said, I have their cell phone number. So if somebody wants into, you know, they need into MD Anderson or, you know, Harvard. All we have to do is make a phone call within a week, typically.

They've done the paperwork. They got our patient in there and they're taking care of them. Ironically, I got a call from my daughter last night and she's now working with one of the leading mesothelioma surgeons in the world. And so he actually sent me a message to my daughter last night saying, what a small world, tell your dad hello.

So that came in last night. But it's a small community of people. There's one organization really internationally that we all work together and go together and people like me, as well as the attorneys, all get together for about five days and just talk about what we're doing and what else we can do to improve the lots of these poor people.

Well, man, I can tell you, like, if something shocking like this happened to me and I knew that the law firm that I was working with had all these connections to help with the medical care and to help stay with me as we progress through the disease, that helps me sleep better at night to know that I'm in good hands with people that have been doing this a long time that really care.

That is something unique from what I understand about the industry that Dan Zinger and Deanna does differently than everyone else. And they really do care. And I feel like using this podcast to help get that information out to people is phenomenal. I know some of the people that we're gonna be interviewing are some of the top people in the world, as well as we have some survivors that we're gonna be interviewing and hear their story and understand that journey.

And I think for anybody that was recently diagnosed that's trying to figure it all out, they need a resource to do that. And we hope that this podcast is gonna be that. Hang on, my lights went off here, sorry. One of the other things Paul has done too is allowed us to help people that not necessarily our clients.

There's a lot of people that we work with that either don't qualify or with other law firms or they just outside the scope of the statute of limitations as far as legal. But we've worked with people and done humanitarian, philanthropic work with these people. So it's been a blessing. So one of the biggest questions I have Paul, maybe you can help answer it for me is I keep hearing about secondary exposure, okay?

And from what I understand that means a spouse could get it from something that a husband's doing, like washing clothes or being near him or like, can you tell me more about that? Yeah, it's kind of like one of those tragic things you hear about and I'll give you kind of experience we've had with many of our clients.

We have a say a young woman who comes in and she's like, I've just been diagnosed with mesothelioma. I never worked with mesothelioma. I wasn't exposed to mesothelioma. I don't know where I got it. And then we do some research and everything she says is correct. But then we start doing a little bit more research, a little bit more in-depth research.

And we find that her father worked in one of the plants, say in Cleveland, Ohio and Oakland, California, whatever it may be. And at the end of the day, he would come home and he'd get out of his overalls and he'd shake the overalls. And his daughter would be up there spending a little bit of time with her father or maybe she'd run into his arms when he came home and she absorbed that dust, that asbestos fibers into her lungs.

And 20, 30, 40 years later, that's not metastasizing. So that's a kind of secondary hand exposure that children, wives who wash their husband's clothes or overalls got. And it's just, no one ever saw it. And certainly the father would never think that he was bringing in a poisonous fiber. But unfortunately, the asbestos manufacturers and the companies hid the dangers of asbestos.

And that's why we've got all these people getting sick now. So it's kind of a real tragedy and it's hard to wrap your head around, really is. They could have given warnings and we would have avoided a lot of these problems, but it's just hard to wrap your head around. But we'll move forward. And that actually would be a great podcast in and of itself, just sort of the history of when they found out about this, which was really in 1898, right?

They found out then and then it progressed. And some of these companies said things like, well, they've lived a good life because of our products. They might as well die from it as well. I mean, that's a cold, callous thing to say, which they said, because they wanna continue making money. Dave, I think it's a great idea for a podcast.

One, and two is, can you talk a little bit about that? I feel like the law has been clear and they've set up money that's been set aside for people because of these companies doing reckless things. And people are entitled to compensation and that's pretty clear in the law. Could you maybe talk a little bit more about that?

Well, I don't know that it's necessarily a law that made this happen. There were lawsuits that resulted in money being put aside and then bankruptcies and that sort of thing. And Paul probably could speak to this probably better than I could. But basically, as I said, they knew very early on some of the insurance companies knew through their actuarial data, 1930s, 40s, 50s.

And they used to use memos, right? Not emails. Paul was able to get a lot of these memos and they're absolutely shocking. Don't use the word cancerous. It's a very emotional word. Don't use cancer. I mean, are you kidding me? It's a medical term affecting the lives of these people. So I think that's one of the shocking things.

But a lot of them keep it out. They would do studies but say we want you to understand you're gonna do the study but you cannot publish that data. And so they're intentionally high. Asbestos manufacturers, they knew the product was very dangerous for a long, long time. But they were making a lot of money. And when companies are making a lot of money as they said, they put profit over people and we have to represent the people now.

And that's what we do. And so it's a privilege. I'll tell you one more thing, just anecdotally another thing one of the companies did was they were talking about the lawyers and the marketing people about putting a warning label on this particular product. It was the upside of this is that legally it's kind of required right now for us to do that.

The downside is gonna cost us about two cents per product to do that. So they were worried about those two cents, right? And that's the reason they didn't do it for two pennies. Very, very interesting. It sounds a lot like the tobacco, like what happened with the tobacco. I'm curious about the damages and the impact on people like out of pocket metal expenses, people affecting their work, travel.

Dave, could you speak a little bit more about the life impact that mesothelioma has? And what are things that if someone diagnosed with meso, they should start to consider and how an advocate might help them navigate that path. Well, one of the problems with the diagnosis is that one of the ironies is it's usually healthier people that get this disease that as best as fibers are in their body and the more they move, the more those fibers move around and cut tissues.

So we typically have healthy people that shake off the symptoms they have initially. So by the time they come in, they're stage three or four and this cancer spread enormously. And then the options are surgery, chemo, immunotherapy, but surgery is a great option early on, but it may cost 600 to $800,000 for the surgery. So who's gonna pay for that?

The insurance company is gonna fight it. The chemo, the standard of care is available almost to everybody, but the immunotherapy, which has really been a game changer of the last five, six years, is so expensive. A lot of times insurance companies won't pay for it until they failed chemo. Well, then you're further down the road and you've kicked the problem and it's become the can down the road.

It just became a bigger issue, right? And so it's harder for the immunotherapy to work. So that's just a little taste of that. Maybe we can get a doctor on here and talk about it a little bit more thoroughly. I think we should. So Paul, the question I have is probably people that have found this podcast are still in shock from being diagnosed with it.

And what are the best next steps legally to start to do? How should you be viewing the world if this has happened to you? Like, what is the roadmap that you've seen work the best? Yeah, I think the most important roadmap is you need to get educated and you need to get educated fast. And I think it involves two fundamental steps.

One is you gotta get your medical taken care of. And we always, even though we are lawyers, we always say, let's make sure our clients have the medical side taken care of. So when somebody has just been diagnosed by say a doctor in maybe a smaller city and they not sure what they need to do going forward, we wanna point them and help them get into one of the major mesothelioma treatment centers.

And there are all of them all over the country and they're basically in bigger cities, right? So we'll make sure that they are going to one of the major mesothelioma treatment centers, cancer centers, with one of the specialists who know mesothelioma and know what can be done to help patients who have been diagnosed. So that's the first thing they're gonna do.

And then the second thing is when somebody's considering hiring us to be their law firm, we wanna meet with them. We want to find out where they were exposed, how they were exposed. If they have any coworkers and basically find out who the defendants are or would be in any lawsuit because getting treated for mesothelioma is expensive, even if you have insurance.

If you can't work, that's expensive. And thirdly, let's face it, these asbestos companies made a lot of money off the backs of people who they poisoned basically. And so you and your family are entitled to compensation but we wanna make sure you get that compensation from all the different places you were exposed. So it's important that we speak to you, we work with you as quickly as possible to get both the medical side in place and the financial legal side in place.

And so that's kind of the two tracks that we look at. Now, one of the things that I heard as I've started to learn about this industry is not all law firms are the same. There's a lot of different kinds of things. There's a lot of different kinds of specialties and to have a firm that can help you navigate that path and has been in the industry a long time to make sure that you get the most compensation you're looking for.

I feel like that's really important because I've seen advertising on TV, I've seen it everywhere. It's really overwhelming to know who to go with or how to figure it out. Do you have any tips there? Well, I think it's kind of, whether it's medical or legal, it's the same principle. You don't want to go to a local doctor in a small town.

You want to go to a mesothelioma specialist in a major center. And it's the same thing. You don't want to go with a PI attorney or some attorney locally. You want to find somebody who's done this for 25 plus years. That's what we've done. We've been working with mesothelioma clients for 25 plus years. We've represented, unfortunately, thousands of them.

We've recovered over $2 billion in compensation for our mesothelioma and asbestos clients. And so this is what we do. And this is what we know what to do. And we've been doing it for a long time. We've been successful. And we care about our clients. And my grandfather always said, if you care about your business, the business will take care of you.

And I think that's kind of been the guiding principle I've had over the years. We care about our clients. And ultimately our clients care about us. And we've been able to do this for 25 years. And it's been a privilege to represent victims. And it's a responsibility, but we're thankful that we've been given the opportunity to what we believe is being on the right side, helping people obtain justice.

So that's kind of been our goal. Yeah, I don't want to, sorry, Paul, didn't mean to talk about that. One of the things that he's done that really singles him out and makes him unique is that we have a network of people available 24 seven to talk to, not an answering service, not people that are ignorant about the disease, people that actually have worked with it, their family members have died from it or similar cancers.

So if someone calls us or wants to meet with us on a Christmas day, we have someone available. I mean, literally we'll pick up the phone anytime and make sure they're okay. If they have a need, medical, legal, financial, we're always there to, Paul has made this available to them and they're greatly appreciative of it. So Dave, that's actually where I was going.

I think that's fantastic. How should people, if they're listening to this and they have a family member maybe diagnosed with mesothelioma, what does that support network need to look like? And how is the care for that person or the need for that person as potentially their health declines? How do you should be looking at that or what kind of resources or support to frame that up?

Can you maybe go into some more detail of how to prepare people for this? Well, it's one of those things that's sort of like being hit by a train, right? So you have to do the best you can, but get them to the right medical center and then they're gonna have support people there. And then we're behind them, helping them, making sure they get their finances straightened out, social security.

There's a caveat to social security disability where people that have this disease are expedited. So instead of waiting six months, they only have to wait 20 days. So we make sure they're getting that. We have on many occasions got stepped into that process. People got confused or the people at the Medicare, Medicaid office in their area, so security office weren't aware of these rules.

We went to the meeting or on the phone with them at the meeting or talked to the manager and said, no, no, no. We're not waiting six months. They don't need to. And we expedite that process. So, and then we also have a network of nurses and doctors and other support people out there that can help. Doctors that may not be treating that person, but still are able to talk to them and kind of walk them through the next steps, what they have to think about.

And then if it's hospice or palliative care, when that comes, we also have people that can help them with that as well. So kind of walk them through that process, just hold their hand. Awesome, well, we're starting to get to time, but I wanted to tee it up and ask you, Paul, is there anything else that you would like to share with the audience that we didn't cover today?

And also, what is the best way for them to get in contact to find out more about your services and what you offer for patients? I guess what I would say, and I've said this to individuals and family members over the years, is don't wait. If you have a question, you're not sure, just give us a call, okay?

We're probably, I'm almost certain somebody else over the last 25 years has asked us that question. We know the answer, but let's assume we don't know the answer. It's about a new treatment they heard about or a medical location or something that only a doctor would know. We have the resources to contact a doctor very quickly, get an answer and get back to you.

So just give us a call, you know, the number I'm sure will be on here, but it's 1-800-996-4000. Just give us a call. Rather than worrying about it, having a sleepless night, just give us a call. We'll get you the answer. You don't have to be our client. You just have to be somebody who needs help and we're happy to help you.

That's just what we wanna do at this point. I love that. Dave, where's your final word on this on just kinda how people should think about it or if there's anything else we didn't cover today? I think being proactive is a thing. Make that call regardless of whether it is medical, financial, legal, some cases someone may have passed away and they didn't even know they had meso.

What do we do? And that's probably the question I get most often. I'm calling you because what do I do next? What are the next steps? And then we have just this fantastic group of people with incredible diversity of experiences that are able to help them, right? Meet with them in their home. They never have to travel anywhere, right?

There's no, we never inconvenience anybody. They never have to go to court. We're able to take care of them or get them to the doctor or whatever it is. And so just like Paul said, be proactive, make that call. And if we're not the right fit or they have another attorney, that doesn't matter. We're not gonna hang up on, we're gonna help them and be there for them and intervene and do whatever we can.

Doctor, lawyer, whatever it is. So CPA doesn't matter. Awesome. Well, thank you so much for listening to the first episode of Miso, a Mesothelioma podcast. We're so glad that you were here. If you like this, please leave us a review. Please leave us a comment. Let us know what you would like to hear about. We have some great patient stories coming about how people overcome the challenges, what they did, some tips on how to navigate this process.

Thank you so much. My name is Matt Bertram and this is Miso. Thank you for listening to Miso, the Mesothelioma podcast. For more information, resources and support, visit our sponsors, Danziger and Dejano at dandel.com.

Frequently asked questions

Source: Paul Danziger, founding partner, speaking in this episode.

Sources

• Secondary exposure: Asbestos Exposure and Cancer Risk, National Cancer Institute
• Statute of limitations: Statute of limitations, Legal Information Institute, Cornell Law School

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