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The McAfee guide to uninstalling McAfee Antivirus | John …

Theres days when I see despicable, disgusting shit like this and realize that my 10 years I spent working for a huge corporation would have been much more fun had I worked for John instead, if only my manager knew the proper straw for bath salts, if he had a magical collection of self spawning guns, I might have just, maybepossibly not wasted 10 years of my life..what a shit showanyways, that was like watching a train plow into a huge chicken coop full of babies, I couldnt stop watching, and when it was over, I couldnt stop laughing.

Today WAS a crappy day, today sucked..until I watched that, thanks John, I needed that, your a sick man, I love it when I see someone act out the shit that goes on in my head.

Jason (still trapped in corporate hell, just a smaller corporate hell for 1/2 the money)

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The McAfee guide to uninstalling McAfee Antivirus | John …

John McAfee Says There is a War on Cryptocurrencies …

On the latest episode of John McAfee Says, the tech activist and internet security expert declared that there is an ongoing war against cryptocurrencies.

He aired this revelation in a video posted on his Twitter on May 27. According to McAfee, powerful forces are trying to derail the progress of the cryptocurrency revolution. McAfee began by unequivocally stating the reality of the ongoing fight:

Whether you know it as a war [against crypto] or not, it is, in fact, a war.

He listed the government, banks, credit card companies, and the SEC as some of the enemy combatants. These institutions have banded together to quell the relentless march of progress represented by the crypto renaissance.

McAfees warnings may have merit as many banks and credit card companies have recently startedwithdrawing support for cryptocurrency payments. While governments and regulatory bodies like the SEC are also trying to abscond with cryptos as securities.

He then urged all fellow crypto believers to take action, saying:

What can we do? Take action. Write your Congressman; it sounds silly [but] while they are still in power, make them work. Go into your bank and demand that they allow crypto transactions. If they say no, ask them to recommend a bank that will. Demand the credit card companies to allow crypto payments.

According to McAfee, change will only come when crypto enthusiasts become proactive and take matters into their own hands. He urged them to write the SEC, strongly calling on the Commission to not classify cryptocurrencies as securities.

We are not a security; we are coins, we are currency. They are frightened of us, he said.

In a related development, Team McAfee recently published the Declaration of Currency Independence. The 849-word document is a pledge of solidarity to the core ethos of the cryptocurrency movement.

The text bears some similarities with the 1776 United States Declaration of Independence. Both documents even begin with the now famous when in the course of human events opening phrase.

One recurring theme within the document is Value and how the current fiat monetary system has fundamentally manipulated the maintenance of the integrity of value. As a result, the declaration states that cryptocurrency is the only way to restore the concept of value to what it should be.

It reads:

Where value was once proven by the strength of the State at the end of a barrel, humans have developed, demonstrated, and proliferated a technology capable of proving value through the expenditure of electricity via the irrevocable proof of math. Such a concept has never been accomplished prior to the initiation of the Bitcoin blockchain.

Team McAfee under the leadership of John McAfee himself is requesting for readership and signing of the document. The declaration is available in 14 languages including English, Spanish, French, and Dutch.

Do you believe that there is a deliberate attempt to stifle the growth and adoption of cryptocurrencies? Keep the conversation going in the comment section below.

Image courtesy of Twitter @officialmcafee, Shutterstock

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John McAfee Says There is a War on Cryptocurrencies …

Aerospace – Wikipedia

Aerospace is the human effort in science, engineering and business to fly in the atmosphere of Earth (aeronautics) and surrounding space (astronautics). Aerospace organizations research, design, manufacture, operate, or maintain aircraft or spacecraft. Aerospace activity is very diverse, with a multitude of commercial, industrial and military applications.

Aerospace is not the same as airspace, which is the physical air space directly above a location on the ground. The beginning of space and the ending of the air is considered as 100km above the ground according to the physical explanation that the air pressure is too low for a lifting body to generate meaningful lift force without exceeding orbital velocity.[1]

In most industrial countries, the aerospace industry is a cooperation of public and private industries. For example, several countries have a civilian space program funded by the government through tax collection, such as National Aeronautics and Space Administration in the United States, European Space Agency in Europe, the Canadian Space Agency in Canada, Indian Space Research Organisation in India, Japanese Aeronautics Exploration Agency in Japan, RKA in Russia, China National Space Administration in China, SUPARCO in Pakistan, Iranian Space Agency in Iran, and Korea Aerospace Research Institute (KARI) in South Korea.

Along with these public space programs, many companies produce technical tools and components such as spaceships and satellites. Some known companies involved in space programs include Boeing, Airbus, SpaceX, Lockheed Martin, MacDonald Dettwiler and Northrop Grumman. These companies are also involved in other areas of aerospace such as the construction of aircraft.

Modern aerospace began with Engineer George Cayley in 1799. Cayley proposed an aircraft with a “fixed wing and a horizontal and vertical tail,” defining characteristics of the modern airplane.[2]

The 19th century saw the creation of the Aeronautical Society of Great Britain (1866), the American Rocketry Society, and the Institute of Aeronautical Sciences, all of which made aeronautics a more serious scientific discipline.[2] Airmen like Otto Lilienthal, who introduced cambered airfoils in 1891, used gliders to analyze aerodynamic forces.[2] The Wright brothers were interested in Lilienthal’s work and read several of his publications.[2] They also found inspiration in Octave Chanute, an airman and the author of Progress in Flying Machines (1894).[2] It was the preliminary work of Cayley, Lilienthal, Chanute, and other early aerospace engineers that brought about the first powered sustained flight at Kitty Hawk, North Carolina on December 17, 1903, by the Wright brothers.

War and science fiction inspired great minds like Konstantin Tsiolkovsky and Wernher von Braun to achieve flight beyond the atmosphere.

The launch of Sputnik 1 in October 1957 started the Space Age, and on July 20, 1969 Apollo 11 achieved the first manned moon landing.[2] In April 1981, the Space Shuttle Columbia launched, the start of regular manned access to orbital space. A sustained human presence in orbital space started with “Mir” in 1986 and is continued by the “International Space Station”.[2] Space commercialization and space tourism are more recent focuses in aerospace.

Aerospace manufacturing is a high-technology industry that produces “aircraft, guided missiles, space vehicles, aircraft engines, propulsion units, and related parts”.[3] Most of the industry is geared toward governmental work. For each original equipment manufacturer (OEM), the US government has assigned a Commercial and Government Entity (CAGE) code. These codes help to identify each manufacturer, repair facilities, and other critical aftermarket vendors in the aerospace industry.

In the United States, the Department of Defense and the National Aeronautics and Space Administration (NASA) are the two largest consumers of aerospace technology and products. Others include the very large airline industry. The aerospace industry employed 472,000 wage and salary workers in 2006.[4] Most of those jobs were in Washington state and in California, with Missouri, New York and Texas also being important. The leading aerospace manufacturers in the U.S. are Boeing, United Technologies Corporation, SpaceX, Northrop Grumman and Lockheed Martin. These manufacturers are facing an increasing labor shortage as skilled U.S. workers age and retire. Apprenticeship programs such as the Aerospace Joint Apprenticeship Council (AJAC) work in collaboration with Washington state aerospace employers and community colleges to train new manufacturing employees to keep the industry supplied.

Important locations of the civilian aerospace industry worldwide include Washington state (Boeing), California (Boeing, Lockheed Martin, etc.); Montreal, Quebec, Canada (Bombardier, Pratt & Whitney Canada); Toulouse, France (Airbus/EADS); Hamburg, Germany (Airbus/EADS); and So Jos dos Campos, Brazil (Embraer), Quertaro, Mexico (Bombardier Aerospace, General Electric Aviation) and Mexicali, Mexico (United Technologies Corporation, Gulfstream Aerospace).

In the European Union, aerospace companies such as EADS, BAE Systems, Thales, Dassault, Saab AB and Leonardo S.p.A. (formerly Finmeccnica)[5] account for a large share of the global aerospace industry and research effort, with the European Space Agency as one of the largest consumers of aerospace technology and products.

In India, Bangalore is a major center of the aerospace industry, where Hindustan Aeronautics Limited, the National Aerospace Laboratories and the Indian Space Research Organisation are headquartered. The Indian Space Research Organisation (ISRO) launched India’s first Moon orbiter, Chandrayaan-1, in October 2008.

In Russia, large aerospace companies like Oboronprom and the United Aircraft Building Corporation (encompassing Mikoyan, Sukhoi, Ilyushin, Tupolev, Yakovlev, and Irkut which includes Beriev) are among the major global players in this industry. The historic Soviet Union was also the home of a major aerospace industry.

The United Kingdom formerly attempted to maintain its own large aerospace industry, making its own airliners and warplanes, but it has largely turned its lot over to cooperative efforts with continental companies, and it has turned into a large import customer, too, from countries such as the United States. However, the UK has a very active aerospace sector, including the second largest defence contractor in the world, BAE Systems, supplying fully assembled aircraft, aircraft components, sub-assemblies and sub-systems to other manufacturers, both in Europe and all over the world.

Canada has formerly manufactured some of its own designs for jet warplanes, etc. (e.g. the CF-100 fighter), but for some decades, it has relied on imports from the United States and Europe to fill these needs. However Canada still manufactures some military aircraft although they are generally not combat capable. Another notable example was the late 1950s development of the Avro Canada CF-105 Arrow, a supersonic fighter-interceptor that was cancelled in 1959 a highly controversial decision.

France has continued to make its own warplanes for its air force and navy, and Sweden continues to make its own warplanes for the Swedish Air Forceespecially in support of its position as a neutral country. (See Saab AB.) Other European countries either team up in making fighters (such as the Panavia Tornado and the Eurofighter Typhoon), or else to import them from the United States.

Pakistan has a developing aerospace engineering industry. The National Engineering and Scientific Commission, Khan Research Laboratories and Pakistan Aeronautical Complex are among the premier organizations involved in research and development in this sector. Pakistan has the capability of designing and manufacturing guided rockets, missiles and space vehicles. The city of Kamra is home to the Pakistan Aeronautical Complex which contains several factories. This facility is responsible for manufacturing the MFI-17, MFI-395, K-8 and JF-17 Thunder aircraft. Pakistan also has the capability to design and manufacture both armed and unarmed unmanned aerial vehicles.

In the People’s Republic of China, Beijing, Xi’an, Chengdu, Shanghai, Shenyang and Nanchang are major research and manufacture centers of the aerospace industry. China has developed an extensive capability to design, test and produce military aircraft, missiles and space vehicles. Despite the cancellation in 1983 of the experimental Shanghai Y-10, China is still developing its civil aerospace industry.

The aircraft parts industry was born out of the sale of second-hand or used aircraft parts from the aerospace manufacture sector. Within the United States there is a specific process that parts brokers or resellers must follow. This includes leveraging a certified repair station to overhaul and “tag” a part. This certification guarantees that a part was repaired or overhauled to meet OEM specifications. Once a part is overhauled its value is determined from the supply and demand of the aerospace market. When an airline has an aircraft on the ground, the part that the airline requires to get the plane back into service becomes invaluable. This can drive the market for specific parts. There are several online marketplaces that assist with the commodity selling of aircraft parts.

In the aerospaces & defense industry, a lot of consolidation has appeared over the last couple of decades. Between 1988 and 2011, worldwide more than 6,068 mergers & acquisitions with a total known value of 678 bil. USD have been announced.[6] The largest transactions have been: the acquisition of Goodrich Corporation by United Technologies Corporation for 16.2 bil. USD in 2011,[7] Allied Signal merged with Honeywell in a stock swap valued 15.6 bil. USD in 1999,[8] the merger of Boeing with McDonnell valued at 13.4 bil. USD in 1996,[9] Marconi Electronic Systems, a subsidiary of GEC, was acquired by British Aerospace for 12.9 bil. USD in 1999[10] (now called: BAE Systems), and Raytheon acquired Hughes Aircraft for 9.5 bil. USD in 1997.

Functional safety relates to a part of the general safety of a system or a piece of equipment. It implies that the system or equipment can be operated properly and without causing any danger, risk, damage or injury.

Functional safety is crucial in the aerospace industry, which allows no compromises or negligence. In this respect, supervisory bodies, such as the European Aviation Safety Agency (EASA),[11] regulate the aerospace market with strict certification standards. This is meant to reach and ensure the highest possible level of safety. The standards AS 9100 in America, EN 9100 on the European market or JISQ 9100 in Asia particularly address the aerospace and aviation industry. These are standards applying to the functional safety of aerospace vehicles. Some companies are therefore specialized in the certification, inspection verification and testing of the vehicles and spare parts to ensure and attest compliance with the appropriate regulations.

Spinoffs refer to any technology that is a direct result of coding or products created by NASA and redesigned for an alternate purpose.[12] These technological advancements are one of the primary results of the aerospace industry, with $5.2 billion worth of revenue generated by spinoff technology, including computers and cellular devices.[12] These spinoffs have applications in a variety of different fields including medicine, transportation, energy, consumer goods, public safety and more.[12] NASA publishes an annual report called Spinoffs, regarding many of the specific products and benefits to the aforementioned areas in an effort to highlight some of the ways funding is put to use.[13] For example, in the most recent edition of this publication, Spinoffs 2015, endoscopes are featured as one of the medical derivations of aerospace achievement.[12] This device enables more precise and subsequently cost-effective neurosurgery by reducing complications through a minimally invasive procedure that abbreviates hospitalization.[12]

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Aerospace – Wikipedia

The Aerospace Corporation – Official Site

Advanced Technology. Objective Analysis. Innovative Solutions.

As an independent, nonprofit corporation operating the only federally funded research and development center for the space enterprise, The Aerospace Corporation performs objective technical analyses and assessments for a variety of government, civil, and commercial customers. With more than five decades of experience, Aerospace provides leadership and support in all fields and disciplines of research, design, development, acquisition, operations, and program management.

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The Aerospace Corporation – Official Site

Aerospace – definition of aerospace by The Free Dictionary

Hickling, along with thousands of other aerospace veterans who left or were laid off during the consolidation of the 1990s, reflects how radically the region’s economy has shifted away from its historic dependence on aerospace jobs.That’s a far cry from 1985, when aerospace was a nascent $250 million business for Goodrich, representing just 7 percent of sales.Rexnord Aerospace will partner with Dixie Aerospace to market, sell and distribute PSI Bearings, Shafer Roller Bearings, Tuflite Composite Bearings and Shafer Tooling to the aerospace market.The aerospace cluster is just starting to take off,” said Jack Kyser, the chief economist for the Los Angeles Economic Development Corporation.The increased use of composite materials in aerospace applications will dramatically change the economics of flight and the process of developing aircraft.The great power that has yet to be released in growing the aerospace industry in California is truly the suppliers and manufacturers who are contractors to the aerospace corporations,” Runner told business people gathered for the Santa Clarita 2000 Aerospace Conference.Jefferies Quarterdeck, the aerospace and defense investment banking group of Jefferies & Company, Inc.Called “Other State’s Incentives to Attract or Encourage Aerospace Manufacturing,” the draft report notes that despite defense cutbacks of the early 1990s, there is potential growth for the industry, notably in space projects.The Aerospace & Defense in the United Kingdom industry profile is an essential resource for top-level data and analysis covering the Aerospace & Defense industry.British Aerospace and Marconi – together employing some 130,000 people worldwide, more than 18,000 of them in the United States – said most jobs would be safeguarded.Catherine Gridley, President, Smiths Aerospace Customer Services said: “PBLs have transformed the supply chain resulting in a win-win situation for customers and suppliers.The study, “Beyond Consolidation – A Study of the Continuing Transformation of Aerospace and Defense in Southern California,” concludes the region can pick up 73,000 new aerospace jobs over the next 20 years, mainly from commercial space activity.

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Aerospace – definition of aerospace by The Free Dictionary

Aerospace Industries & Solutions | TE Connectivity

White Paper

Evaluating Connectors for Gigabit and 10-Gigabit Ethernet

As military and aerospace application move toward Gigabit and 10G networks, standard military connector technology has not kept pace. To evaluate the suitability of various connectors, we tested differential near-end crosstalk in links containing a traditional MIL-DTL-38999 connector and two connectors from TE Connectivity (TE) designed specifically for gigabit and 10G applications.

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Aerospace Industries & Solutions | TE Connectivity

Second Amendment to the United States Constitution – Wikipedia

The Second Amendment (Amendment II) to the United States Constitution protects the right of the people to keep and bear arms and was adopted on December 15, 1791, as part of the first ten amendments contained in the Bill of Rights.[1][2][3][4] The Supreme Court of the United States has ruled that the right belongs to individuals for self defense,[5][6] while also ruling that the right is not unlimited and does not prohibit all regulation of either firearms or similar devices.[7] State and local governments are limited to the same extent as the federal government from infringing this right, per the incorporation of the Bill of Rights.[8]

The Second Amendment was based partially on the right to keep and bear arms in English common law and was influenced by the English Bill of Rights of 1689. Sir William Blackstone described this right as an auxiliary right, supporting the natural rights of self-defense and resistance to oppression, and the civic duty to act in concert in defense of the state.[9]

While both James Monroe and John Adams supported the Constitution being ratified, its most influential framer was James Madison. In Federalist No. 46, Madison wrote how a federal army could be kept in check by state militias, “a standing army … would be opposed [by] a militia.” He argued that state militias “would be able to repel the danger” of a federal army, “It may well be doubted, whether a militia thus circumstanced could ever be conquered by such a proportion of regular troops.” He confidently contrasted the federal government of the United States to the European kingdoms, which he contemptuously described as “afraid to trust the people with arms.” He assured his fellow citizens that they need never fear their government because “besides the advantage of being armed, which the Americans possess over the people of almost every other nation, the existence of subordinate governments, to which the people are attached, and by which the militia officers are appointed, forms a barrier against the enterprises of ambition”.[10][11]

By January 1788, Delaware, Pennsylvania, New Jersey, Georgia and Connecticut ratified the Constitution without insisting upon amendments. Several specific amendments were proposed, but were not adopted at the time the Constitution was ratified. For example, the Pennsylvania convention debated fifteen amendments, one of which concerned the right of the people to be armed, another with the militia. The Massachusetts convention also ratified the Constitution with an attached list of proposed amendments. In the end, the ratification convention was so evenly divided between those for and against the Constitution that the federalists agreed to amendments to assure ratification.

In United States v. Cruikshank (1876), the Supreme Court of the United States ruled that, “The right to bear arms is not granted by the Constitution; neither is it in any manner dependent upon that instrument for its existence. The Second Amendments means no more than that it shall not be infringed by Congress, and has no other effect than to restrict the powers of the National Government” and thus limited the scope of the Second Amendment’s protections to the federal government.[12] In United States v. Miller (1939), the Supreme Court ruled that the Second Amendment did not protect weapon types not having a “reasonable relationship to the preservation or efficiency of a well regulated militia”.[13][14]

In the twenty-first century, the amendment has been subjected to renewed academic inquiry and judicial interest.[14] In District of Columbia v. Heller (2008), the Supreme Court handed down a landmark decision that held the amendment protects an individual’s right to keep a gun at home for self-defense.[15][16] This was the first time in American history The Court had ruled the Second Amendment guarantees an individual’s right to own a gun.[17][18][16] In McDonald v. Chicago (2010), the Court clarified its earlier decisions that limited the amendment’s impact to a restriction on the federal government, expressly holding that the Due Process Clause of the Fourteenth Amendment incorporates the Second Amendment against state and local governments.[19] In Caetano v. Massachusetts (2016), the Supreme Court reiterated its earlier rulings that “the Second Amendment extends, prima facie, to all instruments that constitute bearable arms, even those that were not in existence at the time of the founding” and that its protection is not limited to “only those weapons useful in warfare”.[20]

Due to these decisions, the debate between various organizations regarding gun control and gun rights continues.[21]

Contents

There are several versions of the text of the Second Amendment, each with capitalization or punctuation differences. Differences exist between the drafted and ratified copies, the signed copies on display, and various published transcriptions.[22][23][24][25][26][27][28][29] The importance (or lack thereof) of these differences has been the source of debate regarding the meaning and interpretation of the amendment, particularly regarding the importance of the prefatory clause.[30][31]

One version was passed by the Congress, and a slightly different version was ratified.[32][33][34][35][36] As passed by the Congress and preserved in the National Archives, with the rest of the original handwritten copy of the Bill of Rights prepared by scribe William Lambert, the amendment says:[37]

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

Here is the amendment as ratified by the States and authenticated by Thomas Jefferson, the Secretary of State:[38]

A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.

The right to bear arms in English history is regarded in English law as a subordinate auxiliary right of the primary rights to personal security, personal liberty, and private property. According to Sir William Blackstone, “The … last auxiliary right of the subject … is that of having arms for their [defense], suitable to their condition and degree, and such as are allowed by law. Which is declared by statute, and is indeed a public allowance, under due restrictions, of the natural right of resistance and self-preservation, when the sanctions of society and laws are found insufficient to restrain the violence of oppression.”[39]

The English Bill of Rights of 1689 emerged from a tempestuous period in English politics during which two issues were major sources of conflict: the authority of the King to govern without the consent of Parliament, and the role of Catholics in a country that was becoming ever more Protestant. Ultimately, the Catholic James II was overthrown in the Glorious Revolution, and his successors, the Protestants William III and Mary II, accepted the conditions that were codified in the Bill. One of the issues the Bill resolved was the authority of the King to disarm his subjects, after James II had attempted to disarm many Protestants, and had argued with Parliament over his desire to maintain a standing (or permanent) army.[40] The bill states that it is acting to restore “ancient rights” trampled upon by James II, though some have argued that the English Bill of Rights created a new right to have arms, which developed out of a duty to have arms.[41] In District of Columbia v. Heller (2008), the Supreme Court did not accept this view, remarking that the English right at the time of the passing of the English Bill of Rights was “clearly an individual right, having nothing whatsoever to do with service in the militia” and that it was a right not to be disarmed by the Crown and was not the granting of a new right to have arms.[42]

The text of the English Bill of Rights of 1689 includes language protecting the right of Protestants against disarmament by the Crown. This document states: “That the Subjects which are Protestants may have Arms for their Defence suitable to their Conditions and as allowed by Law.”[43] It also contained text that aspired to bind future Parliaments, though under English constitutional law no Parliament can bind any later Parliament.[44] Nevertheless, the English Bill of Rights remains an important constitutional document, more for enumerating the rights of Parliament over the monarchy than for its clause concerning a right to have arms.

The statement in the English Bill of Rights concerning the right to bear arms is often quoted only in the passage where it is written as above and not in its full context. In its full context it is clear that the bill was asserting the right of Protestant citizens not to be disarmed by the King without the consent of Parliament and was merely restoring rights to Protestants that the previous King briefly and unlawfully had removed. In its full context it reads:

Whereas the late King James the Second by the Assistance of diverse evill Councellors Judges and Ministers imployed by him did endeavour to subvert and extirpate the Protestant Religion and the Lawes and Liberties of this Kingdome (list of grievances including) … by causing severall good Subjects being Protestants to be disarmed at the same time when Papists were both Armed and Imployed contrary to Law, (Recital regarding the change of monarch) … thereupon the said Lords Spirituall and Temporall and Commons pursuant to their respective Letters and Elections being now assembled in a full and free Representative of this Nation takeing into their most serious Consideration the best meanes for attaining the Ends aforesaid Doe in the first place (as their Auncestors in like Case have usually done) for the Vindicating and Asserting their ancient Rights and Liberties, Declare (list of rights including) … That the Subjects which are Protestants may have Arms for their Defence suitable to their Conditions and as allowed by Law.[43]

The historical link between the English Bill of Rights and the Second Amendment, which both codify an existing right and do not create a new one, has been acknowledged by the U.S. Supreme Court.[45][46]

The English Bill of Rights includes the proviso that arms must be as “allowed by law.” This has been the case before and after the passage of the Bill. While it did not override earlier restrictions on the ownership of guns for hunting, it is subject to the parliamentary right to implicitly or explicitly repeal earlier enactments.[47]

There is some difference of opinion as to how revolutionary the events of 168889 actually were, and several commentators make the point that the provisions of the English Bill of Rights did not represent new laws, but rather stated existing rights. Mark Thompson wrote that, apart from determining the succession, the English Bill of Rights did “little more than set forth certain points of existing laws and simply secured to Englishmen the rights of which they were already posessed [sic].”[48] Before and after the English Bill of Rights, the government could always disarm any individual or class of individuals it considered dangerous to the peace of the realm.[49] In 1765, William Blackstone wrote the Commentaries on the Laws of England describing the right to have arms in England during the 18th century as a subordinate auxiliary right of the subject that was “also declared” in the English Bill of Rights.[50][51]

The fifth and last auxiliary right of the subject, that I shall at present mention, is that of having arms for their defence, suitable to their condition and degree, and such as are allowed by law. Which is also declared by the same statute 1 W. & M. st.2. c.2. and is indeed a public allowance, under due restrictions, of the natural right of resistance and self-preservation, when the sanctions of society and laws are found insufficient to restrain the violence of oppression.[52]

Although there is little doubt that the writers of the Second Amendment were heavily influenced by the English Bill of Rights, it is a matter of interpretation as to whether they were intent on preserving the power to regulate arms to the states over the federal government (as the English Parliament had reserved for itself against the monarch) or whether it was intent on creating a new right akin to the right of others written into the Constitution (as the Supreme Court decided in Heller). Some in the United States have preferred the “rights” argument arguing that the English Bill of Rights had granted a right. The need to have arms for self-defence was not really in question. Peoples all around the world since time immemorial had armed themselves for the protection of themselves and others, and as organized nations began to appear these arrangements had been extended to the protection of the state.[53] Without a regular army and police force (which in England was not established until 1829), it had been the duty of certain men to keep watch and ward at night and to confront and capture suspicious persons. Every subject had an obligation to protect the king’s peace and assist in the suppression of riots.[54]

Early English settlers in America viewed the right to arms and/or the right to bear arms and/or state militias as important for one or more of these purposes (in no particular order):[56][57][58][59][60][61][62][63]

Which of these considerations were thought of as most important and ultimately found expression in the Second Amendment is disputed. Some of these purposes were explicitly mentioned in early state constitutions; for example, the Pennsylvania Constitution of 1776 asserted that, “the people have a right to bear arms for the defence of themselves and the state”.[70]

During the 1760s pre-revolutionary period, the established colonial militia was composed of colonists, including many who were loyal to British imperial rule. As defiance and opposition to British rule developed, a distrust of these Loyalists in the militia became widespread among the colonists, known as Patriots, who favored independence from British rule. As a result, some Patriots created their own militias that excluded the Loyalists and then sought to stock independent armories for their militias. In response to this arms build up, the British Parliament established an embargo of firearms, parts and ammunition against the American colonies.[71]

British and Loyalist efforts to disarm the colonial Patriot militia armories in the early phases of the American Revolution resulted in the Patriot colonists protesting by citing the Declaration of Rights, Blackstone’s summary of the Declaration of Rights, their own militia laws and common law rights to self-defense.[72] While British policy in the early phases of the Revolution clearly aimed to prevent coordinated action by the Patriot militia, some have argued that there is no evidence that the British sought to restrict the traditional common law right of self-defense.[72] Patrick J. Charles disputes these claims citing similar disarming by the patriots and challenging those scholars’ interpretation of Blackstone.[73]

The right of the colonists to arms and rebellion against oppression was asserted, for example, in a pre-revolutionary newspaper editorial in 1769 Boston objecting to the British army suppression of colonial opposition to the Townshend Acts:

Instances of the licentious and outrageous behavior of the military conservators of the peace still multiply upon us, some of which are of such nature, and have been carried to such lengths, as must serve fully to evince that a late vote of this town, calling upon its inhabitants to provide themselves with arms for their defense, was a measure as prudent as it was legal: such violences are always to be apprehended from military troops, when quartered in the body of a populous city; but more especially so, when they are led to believe that they are become necessary to awe a spirit of rebellion, injuriously said to be existing therein. It is a natural right which the people have reserved to themselves, confirmed by the Bill of Rights, to keep arms for their own defence; and as Mr. Blackstone observes, it is to be made use of when the sanctions of society and law are found insufficient to restrain the violence of oppression.[72]

The armed forces that won the American Revolution consisted of the standing Continental Army created by the Continental Congress, together with regular French army and naval forces and various state and regional militia units. In opposition, the British forces consisted of a mixture of the standing British Army, Loyalist militia and Hessian mercenaries. Following the Revolution, the United States was governed by the Articles of Confederation. Federalists argued that this government had an unworkable division of power between Congress and the states, which caused military weakness, as the standing army was reduced to as few as 80 men.[74] They considered it to be bad that there was no effective federal military crackdown on an armed tax rebellion in western Massachusetts known as Shays’ Rebellion.[75] Anti-federalists on the other hand took the side of limited government and sympathized with the rebels, many of whom were former Revolutionary War soldiers. Subsequently, the Constitutional Convention proposed in 1787 to grant Congress exclusive power to raise and support a standing army and navy of unlimited size.[76][77] Anti-federalists objected to the shift of power from the states to the federal government, but as adoption of the Constitution became more and more likely, they shifted their strategy to establishing a bill of rights that would put some limits on federal power.[78]

Modern scholars Thomas B. McAffee and Michael J. Quinlan have stated that James Madison “did not invent the right to keep and bear arms when he drafted the Second Amendment; the right was pre-existing at both common law and in the early state constitutions.”[79] In contrast, historian Jack Rakove suggests that Madison’s intention in framing the Second Amendment was to provide assurances to moderate Anti-Federalists that the militias would not be disarmed.[80]

One aspect of the gun control debate is the conflict between gun control laws and the right to rebel against unjust governments. Blackstone in his Commentaries alluded to this right to rebel as the natural right of resistance and self preservation, to be used only as a last resort, exercisable when “the sanctions of society and laws are found insufficient to restrain the violence of oppression”.[81] Some believe that the framers of the Bill of Rights sought to balance not just political power, but also military power, between the people, the states and the nation,[82] as Alexander Hamilton explained in his Concerning the Militia essay published in 1788:

… it will be possible to have an excellent body of well-trained militia, ready to take the field whenever the defence of the State shall require it. This will not only lessen the call for military establishments, but if circumstances should at any time oblige the Government to form an army of any magnitude, that army can never be formidable to the liberties of the People, while there is a large body of citizens, little, if at all, inferior to them in discipline and the use of arms, who stand ready to defend their own rights, and those of their fellow-citizens. This appears to me the only substitute that can be devised for a standing army, and the best possible security against it, if it should exist.[82][83]

Some scholars have said that it is wrong to read a right of armed insurrection in the Second Amendment because clearly the founding fathers sought to place trust in the power of the ordered liberty of democratic government versus the anarchy of insurrectionists.[84][85] Other writers, such as Glenn Reynolds, contend that the framers did believe in an individual right to armed insurrection. They cite examples, such as the Declaration of Independence (describing in 1776 “the Right of the People to…institute new Government”) and the Constitution of New Hampshire (stating in 1784 that “nonresistance against arbitrary power, and oppression, is absurd, slavish, and destructive of the good and happiness of mankind”).[86]

There was an ongoing debate beginning in 1789 about “the people” fighting governmental tyranny (as described by Anti-Federalists); or the risk of mob rule of “the people” (as described by the Federalists) related to the increasingly violent French Revolution.[87] A widespread fear, during the debates on ratifying the Constitution, was the possibility of a military takeover of the states by the federal government, which could happen if the Congress passed laws prohibiting states from arming citizens,[88] or prohibiting citizens from arming themselves.[72] Though it has been argued that the states lost the power to arm their citizens when the power to arm the militia was transferred from the states to the federal government by Article I, Section 8 of the Constitution, the individual right to arm was retained and strengthened by the Militia Acts of 1792 and the similar act of 1795.[89][90]

Note: On May 10, 1776, Congress passed a resolution recommending that any colony with a government that was not inclined toward independence should form one that was.[91]

Virginias Constitution lists the reasons for dissolving its ties with the King in the formation of its own independent state government. Including the following:

* These same reasons would later be outlined within the Declaration of Independence.

A Declaration of Rights. Section 13. That a well-regulated militia, composed of the body of the people, trained to arms, is the proper, natural, and safe defence of a free State; that standing armies, in time of peace, should be avoided, as dangerous to liberty; and that in all cases the military should be under strict subordination to, and governed by, the civil power.[92]

Article 13. That the people have a right to bear arms for the defence of themselves and the state; and as standing armies in the time of peace are dangerous to liberty, they ought not to be kept up; And that the military should be kept under strict subordination to, and governed by, the civil power.[93]

IMPORTANT NOTE: This is the first instance in relationship to U.S. Constitutional Law of the phrase “right to bear arms.”

It is of relevance that Pennsylvania was a Quaker Colony traditionally opposed to bearing arms. “In settling Pennsylvania, William Penn had a great experiment in view, a holy experiment, as he term[ed] it. This was no less than to test, on a scale of considerable magnitude, the practicability of founding and governing a State on the sure principles of the Christian religion; where the executive should be sustained without arms; where justice should be administered without oaths; and where real religion might flourish without the incubus of a hierarchical system.”[94] The Non-Quaker residents, many from the Western Counties, complained often and loudly of being denied the right to a common defense. By the time of the American Revolution, through what could be described as a revolution within a revolution, the pro-militia factions had gained ascendancy in the state’s government. And by a manipulation through the use of oaths, disqualifying Quaker members, they made up a vast majority of the convention forming the new state constitution; it was only natural that they would assert their efforts to form a compulsory State Militia in the context of a “right” to defend themselves and the state.[95]

Articles XXV-XXVII. 25. That a well-regulated militia is the proper and natural defence of a free government. 26. That standing armies are dangerous to liberty, and ought not to be raised or kept up, without consent of the Legislature. 27. That in all cases, and at all times, the military ought to be under strict subordination to and control of the civil power.[96]

A Declaration of Rights. Article XVII. That the people have a right to bear arms, for the defence of the State; and, as standing armies, in time of peace, are dangerous to liberty, they ought not to be kept up; and that the military should be kept under strict subordination to, and governed by, the civil power.[97]

Article XL. And whereas it is of the utmost importance to the safety of every State that it should always be in a condition of defence; and it is the duty of every man who enjoys the protection of society to be prepared and willing to defend it; this convention therefore, in the name and by the authority of the good people of this State, doth ordain, determine, and declare that the militia of this State, at all times hereafter, as well in peace as in war, shall be armed and disciplined, and in readiness for service. That all such of the inhabitants of this State being of the people called Quakers as, from scruples of conscience, may be averse to the bearing of arms, be therefrom excused by the legislature; and do pay to the State such sums of money, in lieu of their personal service, as the same; may, in the judgment of the legislature, be worth. And that a proper magazine of warlike stores, proportionate to the number of inhabitants, be, forever hereafter, at the expense of this State, and by acts of the legislature, established, maintained, and continued in every county in this State.[98]

Chapter 1. Section XVIII. That the people have a right to bear arms for the defence of the themselves and the State; and as standing armies, in the time of peace, are dangerous to liberty, they ought not to be kept up; and that the military should be kept under strict subordination to, and governed by, the civil power.[99]

A Declaration of Rights. Chapter 1. Article XVII. The people have a right to keep and to bear arms for the common defence. And as, in time of peace, armies are dangerous to liberty, they ought not to be maintained without the consent of the legislature; and the military power shall always be held in an exact subordination to the civil authority and be governed by it.[100]

In March 1785, delegates from Virginia and Maryland assembled at the Mount Vernon Conference to fashion a remedy to the inefficiencies of the Articles of Confederation. The following year, at a meeting in Annapolis, Maryland, 12 delegates from five states (New Jersey, New York, Pennsylvania, Delaware, and Virginia) met and drew up a list of problems with the current government model. At its conclusion, the delegates scheduled a follow-up meeting in Philadelphia, Pennsylvania for May 1787 to present solutions to these problems, such as the absence of:[104][105]

It quickly became apparent that the solution to all three of these problems required shifting control of the states’ militias to the federal congress and giving that congress the power to raise a standing army.[106] Article 1, Section 8 of the Constitution codified these changes by allowing the Congress to provide for the common defense and general welfare of the United States by doing the following:[107]

Some representatives mistrusted proposals to enlarge federal powers, because they were concerned about the inherent risks of centralizing power. Federalists, including James Madison, initially argued that a bill of rights was unnecessary, sufficiently confident that the federal government could never raise a standing army powerful enough to overcome a militia.[108] Federalist Noah Webster argued that an armed populace would have no trouble resisting the potential threat to liberty of a standing army.[109][110] Anti-federalists, on the other hand, advocated amending the Constitution with clearly defined and enumerated rights providing more explicit constraints on the new government. Many Anti-federalists feared the new federal government would choose to disarm state militias. Federalists countered that in listing only certain rights, unlisted rights might lose protection. The Federalists realized there was insufficient support to ratify the Constitution without a bill of rights and so they promised to support amending the Constitution to add a bill of rights following the Constitution’s adoption. This compromise persuaded enough Anti-federalists to vote for the Constitution, allowing for ratification.[111] The Constitution was declared ratified on June 21, 1788, when nine of the original thirteen states had ratified it. The remaining four states later followed suit, although the last two states, North Carolina and Rhode Island, ratified only after Congress had passed the Bill of Rights and sent it to the states for ratification.[112] James Madison drafted what ultimately became the Bill of Rights, which was proposed by the first Congress on June 8, 1789, and was adopted on December 15, 1791.

The debate surrounding the Constitution’s ratification is of practical importance, particularly to adherents of originalist and strict constructionist legal theories. In the context of such legal theories and elsewhere, it is important to understand the language of the Constitution in terms of what that language meant to the people who wrote and ratified the Constitution.[113]

The Second Amendment was relatively uncontroversial at the time of its ratification.[114] Robert Whitehill, a delegate from Pennsylvania, sought to clarify the draft Constitution with a bill of rights explicitly granting individuals the right to hunt on their own land in season,[115] though Whitehill’s language was never debated.[116]

There was substantial opposition to the new Constitution, because it moved the power to arm the state militias from the states to the federal government. This created a fear that the federal government, by neglecting the upkeep of the militia, could have overwhelming military force at its disposal through its power to maintain a standing army and navy, leading to a confrontation with the states, encroaching on the states’ reserved powers and even engaging in a military takeover. Article VI of the Articles of Confederation states:

In contrast, Article I, Section 8, Clause 16 of the U.S. Constitution states:

A foundation of American political thought during the Revolutionary period was concerned about political corruption and governmental tyranny. Even the federalists, fending off their opponents who accused them of creating an oppressive regime, were careful to acknowledge the risks of tyranny. Against that backdrop, the framers saw the personal right to bear arms as a potential check against tyranny. Theodore Sedgwick of Massachusetts expressed this sentiment by declaring that it is “a chimerical idea to suppose that a country like this could ever be enslaved … Is it possible … that an army could be raised for the purpose of enslaving themselves or their brethren? or, if raised whether they could subdue a nation of freemen, who know how to prize liberty and who have arms in their hands?”[120] Noah Webster similarly argued:

George Mason also argued the importance of the militia and right to bear arms by reminding his compatriots of England’s efforts “to disarm the people; that it was the best and most effectual way to enslave them … by totally disusing and neglecting the militia.” He also clarified that under prevailing practice the militia included all people, rich and poor. “Who are the militia? They consist now of the whole people, except a few public officers.” Because all were members of the militia, all enjoyed the right to individually bear arms to serve therein.[10][122]

Writing after the ratification of the Constitution, but before the election of the first Congress, James Monroe included “the right to keep and bear arms” in a list of basic “human rights”, which he proposed to be added to the Constitution.[123]

Patrick Henry argued in the Virginia ratification convention on June 5, 1788, for the dual rights to arms and resistance to oppression:

According to Thom Hartmann, the Virginians James Madison, Patrick Henry, and George Mason were concerned that “slave patrols,” organized groups of white men who enforced discipline upon enslaved African Americans, needed to remain armed and, therefore, the Constitution needed to clarify that states have the right to organize white men in such militias.[125] Also, Patrick Henry argued against the ratification of both the Constitution and the Second Amendment.[69] Most Southern white men age 1845 were required to serve on such patrols. For example, Georgia law required the slave patrol militia, led by commissioned militia officers, to visit each plantation each month, to inspect slave dwellings for weapons and to apprehend and punish slaves who were found off premises.[126] Patrick Henry formulated his concern that: “If there should happen an insurrection of slaves, the country cannot be said to be invaded. They cannot, therefore, suppress it without the interposition of Congress…Congress, and Congress only [under the Constitution without a Second Amendment], can call forth the militia.”[125]

Legal historian Paul Finkelman disputes Hartmann’s claim that the Second Amendment was adopted to protect slave patrols, arguing that Hartmann’s claim is “factually incorrect and misleading” and that there is no historical evidence for this assertion.[69]

James Madison’s initial proposal for a bill of rights was brought to the floor of the House of Representatives on June 8, 1789, during the first session of Congress. The initial proposed passage relating to arms was:

The right of the people to keep and bear arms shall not be infringed; a well armed and well regulated militia being the best security of a free country: but no person religiously scrupulous of bearing arms shall be compelled to render military service in person.[127]

On July 21, Madison again raised the issue of his bill and proposed a select committee be created to report on it. The House voted in favor of Madison’s motion,[128] and the Bill of Rights entered committee for review. The committee returned to the House a reworded version of the Second Amendment on July 28.[129] On August 17, that version was read into the Journal:

A well regulated militia, composed of the body of the people, being the best security of a free State, the right of the people to keep and bear arms shall not be infringed; but no person religiously scrupulous shall be compelled to bear arms.[130]

In late August 1789, the House debated and modified the Second Amendment. These debates revolved primarily around risk of “mal-administration of the government” using the “religiously scrupulous” clause to destroy the militia as Great Britain had attempted to destroy the militia at the commencement of the American Revolution. These concerns were addressed by modifying the final clause, and on August 24, the House sent the following version to the Senate:

A well regulated militia, composed of the body of the people, being the best security of a free state, the right of the people to keep and bear arms shall not be infringed; but no one religiously scrupulous of bearing arms shall be compelled to render military service in person.

The next day, August 25, the Senate received the amendment from the House and entered it into the Senate Journal. However, the Senate scribe added a comma before “shall not be infringed” and changed the semicolon separating that phrase from the religious exemption portion to a comma:

A well regulated militia, composed of the body of the people, being the best security of a free state, the right of the people to keep and bear arms, shall not be infringed, but no one religiously scrupulous of bearing arms shall be compelled to render military service in person.[131]

By this time, the proposed right to keep and bear arms was in a separate amendment, instead of being in a single amendment together with other proposed rights such as the due process right. As a Representative explained, this change allowed each amendment to “be passed upon distinctly by the States.”[132] On September 4, the Senate voted to change the language of the Second Amendment by removing the definition of militia, and striking the conscientious objector clause:

A well regulated militia, being the best security of a free state, the right of the people to keep and bear arms, shall not be infringed.[133]

The Senate returned to this amendment for a final time on September 9. A proposal to insert the words “for the common defence” next to the words “bear arms” was defeated. A motion passed to replace the words “the best,” and insert in lieu there of “necessary to the” .[134] The Senate then slightly modified the language to read as the fourth article and voted to return the Bill of Rights to the House. The final version by the Senate was amended to read as:

A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed.

The House voted on September 21, 1789 to accept the changes made by the Senate.

The enrolled original Joint Resolution passed by Congress on September 25, 1789, on permanent display in the Rotunda, reads as:

A well regulated militia, being necessary to the security of a free State, the right of the People to keep and bear arms, shall not be infringed.

[135]

On December 15, 1791, the Bill of Rights (the first ten amendments to the Constitution) was adopted, having been ratified by three-fourths of the states, having been ratified as a group by all the fourteen states then in existence except Connecticut, Massachusetts, and Georgia which added ratifications in 1939; Vermont ratified them all.[136]

During the first two decades following the ratification of the Second Amendment, public opposition to standing armies, among Anti-Federalists and Federalists alike, persisted and manifested itself locally as a general reluctance to create a professional armed police force, instead relying on county sheriffs, constables and night watchmen to enforce local ordinances.[71] Though sometimes compensated, often these positions were unpaid held as a matter of civic duty. In these early decades, law enforcement officers were rarely armed with firearms, using billy clubs as their sole defensive weapons.[71] In serious emergencies, a posse comitatus, militia company, or group of vigilantes assumed law enforcement duties; these individuals were more likely than the local sheriff to be armed with firearms.[71]On May 8, 1792, Congress passed “[a]n act more effectually to provide for the National Defence, by establishing an Uniform Militia throughout the United States” requiring:

[E]ach and every free able-bodied white male citizen of the respective States, resident therein, who is or shall be of age of eighteen years, and under the age of forty-five years (except as is herein after excepted) shall severally and respectively be enrolled in the militia…[and] every citizen so enrolled and notified, shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch with a box therein to contain not less than twenty-four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball: or with a good rifle, knapsack, shot-pouch and powder-horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder; and shall appear, so armed, accoutred and provided, when called out to exercise, or into service, except, that when called out on company days to exercise only, he may appear without a knapsack.[137]

The act also gave specific instructions to domestic weapon manufacturers “that from and after five years from the passing of this act, muskets for arming the militia as herein required, shall be of bores sufficient for balls of the eighteenth part of a pound.”[137] In practice, private acquisition and maintenance of rifles and muskets meeting specifications and readily available for militia duty proved problematic; estimates of compliance ranged from 10 to 65 percent.[138] Compliance with the enrollment provisions was also poor. In addition to the exemptions granted by the law for custom-house officers and their clerks, post-officers and stage drivers employed in the care and conveyance of U.S. mail, ferrymen, export inspectors, pilots, merchant mariners and those deployed at sea in active service; state legislatures granted numerous exemptions under Section 2 of the Act, including exemptions for: clergy, conscientious objectors, teachers, students, and jurors. And though a number of able-bodied white men remained available for service, many simply did not show up for militia duty. Penalties for failure to appear were enforced sporadically and selectively.[139] None is mentioned in the legislation.[137]

The first test of the militia system occurred in July 1794, when a group of disaffected Pennsylvania farmers rebelled against federal tax collectors whom they viewed as illegitimate tools of tyrannical power.[140] Attempts by the four adjoining states to raise a militia for nationalization to suppress the insurrection proved inadequate. When officials resorted to drafting men, they faced bitter resistance. Forthcoming soldiers consisted primarily of draftees or paid substitutes as well as poor enlistees lured by enlistment bonuses. The officers, however, were of a higher quality, responding out of a sense of civic duty and patriotism, and generally critical of the rank and file.[71] Most of the 13,000 soldiers lacked the required weaponry; the war department provided nearly two-thirds of them with guns.[71] In October, President George Washington and General Harry Lee marched on the 7,000 rebels who conceded without fighting. The episode provoked criticism of the citizen militia and inspired calls for a universal militia. Secretary of War Henry Knox and Vice-President John Adams had lobbied Congress to establish federal armories to stock imported weapons and encourage domestic production.[71] Congress did subsequently pass “[a]n act for the erecting and repairing of Arsenals and Magazines” on April 2, 1794, two months prior to the insurrection.[141] Nevertheless, the militia continued to deteriorate and twenty years later, the militia’s poor condition contributed to several losses in the War of 1812, including the sacking of Washington, D.C., and the burning of the White House in 1814.[139]

In May of 1788, Richard Henry Lee wrote in Additional Letters From The Federal Farmer #169 or Letter XVIII regarding the definition of a “militia”:

A militia, when properly formed, are in fact the people themselves, and render regular troops in a great measure unnecessary.

In June of 1788, George Mason addressed the Virginia Ratifying Convention regarding a “militia:”

A worthy member has asked, who are the militia, if they be not the people, of this country, and if we are not to be protected from the fate of the Germans, Prussians, &c. by our representation? I ask who are the militia? They consist now of the whole people, except a few public officers. But I cannot say who will be the militia of the future day. If that paper on the table gets no alteration, the militia of the future day may not consist of all classes, high and low, and rich and poor; but may be confined to the lower and middle classes of the people, granting exclusion to the higher classes of the people. If we should ever see that day, the most ignominious punishments and heavy fines may be expected. Under the present government all ranks of people are subject to militia duty.

In 1792, Tench Coxe made the following point in a commentary on the Second Amendment:[142]

As civil rulers, not having their duty to the people duly before them, may attempt to tyrannize, and as the military forces which must be occasionally raised to defend our country, might pervert their power to the injury of their fellow citizens, the people are confirmed by the next article in their right to keep and bear their private arms.[143][144]

The earliest published commentary on the Second Amendment by a major constitutional theorist was by St. George Tucker. He annotated a five-volume edition of Sir William Blackstone’s Commentaries on the Laws of England, a critical legal reference for early American attorneys published in 1803.[145] Tucker wrote:

A well regulated militia being necessary to the security of a free state, the right of the people to keep, and bear arms, shall not be infringed. Amendments to C. U. S. Art. 4. This may be considered as the true palladium of liberty … The right of self defence is the first law of nature: in most governments it has been the study of rulers to confine this right within the narrowest limits possible. Wherever standing armies are kept up, and the right of the people to keep and bear arms is, under any colour or pretext whatsoever, prohibited, liberty, if not already annihilated, is on the brink of destruction. In England, the people have been disarmed, generally, under the specious pretext of preserving the game: a never failing lure to bring over the landed aristocracy to support any measure, under that mask, though calculated for very different purposes. True it is, their bill of rights seems at first view to counteract this policy: but the right of bearing arms is confined to protestants, and the words suitable to their condition and degree, have been interpreted to authorise the prohibition of keeping a gun or other engine for the destruction of game, to any farmer, or inferior tradesman, or other person not qualified to kill game. So that not one man in five hundred can keep a gun in his house without being subject to a penalty.[146]

In footnotes 40 and 41 of the Commentaries, Tucker stated that the right to bear arms under the Second Amendment was not subject to the restrictions that were part of English law: “The right of the people to keep and bear arms shall not be infringed. Amendments to C. U. S. Art. 4, and this without any qualification as to their condition or degree, as is the case in the British government” and “whoever examines the forest, and game laws in the British code, will readily perceive that the right of keeping arms is effectually taken away from the people of England.” Blackstone himself also commented on English game laws, Vol. II, p.412, “that the prevention of popular insurrections and resistance to government by disarming the bulk of the people, is a reason oftener meant than avowed by the makers of the forest and game laws.”[145] Blackstone discussed the right of self-defense in a separate section of his treatise on the common law of crimes. Tucker’s annotations for that latter section did not mention the Second Amendment but cited the standard works of English jurists such as Hawkins.[147]

Further, Tucker criticized the English Bill of Rights for limiting gun ownership to the very wealthy, leaving the populace effectively disarmed, and expressed the hope that Americans “never cease to regard the right of keeping and bearing arms as the surest pledge of their liberty.”[145]

Tucker’s commentary was soon followed, in 1825, by that of William Rawle in his landmark text, A View of the Constitution of the United States of America. Like Tucker, Rawle condemned England’s “arbitrary code for the preservation of game,” portraying that country as one that “boasts so much of its freedom,” yet provides a right to “protestant subjects only” that it “cautiously describ[es] to be that of bearing arms for their defence” and reserves for “[a] very small proportion of the people[.]”[148] In contrast, Rawle characterizes the second clause of the Second Amendment, which he calls the corollary clause, as a general prohibition against such capricious abuse of government power, declaring bluntly:

No clause could by any rule of construction be conceived to give to congress a power to disarm the people. Such a flagitious attempt could only be made under some general pretence by a state legislature. But if in any blind pursuit of inordinate power, either should attempt it, this amendment may be appealed to as a restraint on both.[149]

Speaking of the Second Amendment generally, Rawle said:[150]

The prohibition is general. No clause in the Constitution could by any rule of construction be conceived to give to congress a power to disarm the people. Such a flagitious attempt could only be made under some general pretence by a state legislature. But if in any blind pursuit of inordinate power, either should attempt it, this amendment may be appealed to as a restraint on both.[150][151]

Rawle, long before the concept of incorporation was formally recognized by the courts, or Congress drafted the Fourteenth Amendment, contended that citizens could appeal to the Second Amendment should either the state or federal government attempt to disarm them. He did warn, however, that “this right [to bear arms] ought not…be abused to the disturbance of the public peace” and, paraphrasing Coke, observed: “An assemblage of persons with arms, for unlawful purpose, is an indictable offence, and even the carrying of arms abroad by a single individual, attended with circumstances giving just reason to fear that he purposes to make an unlawful use of them, would be sufficient cause to require him to give surety of the peace.”[148]

Joseph Story articulated in his influential Commentaries on the Constitution[152] the orthodox view of the Second Amendment, which he viewed as the amendment’s clear meaning:

The right of the citizens to keep and bear arms has justly been considered, as the palladium of the liberties of a republic; since it offers a strong moral check against the usurpations and arbitrary power of rulers; and it will generally, even if these are successful in the first instance, enable the people to resist and triumph over them. And yet, though this truth would seem so clear, and the importance of a well-regulated militia would seem so undeniable, it cannot be disguised, that among the American people there is a growing indifference to any system of militia discipline, and a strong disposition, from a sense of its burdens, to be rid of all regulations. How it is practicable to keep the people duly armed without some organization, it is difficult to see. There is certainly no small danger, that indifference may lead to disgust, and disgust to contempt; and thus gradually undermine all the protection intended by this clause of our National Bill of Rights.[153][154]

Story describes a militia as the “natural defence of a free country,” both against foreign foes, domestic revolts and usurpation by rulers. The book regards the militia as a “moral check” against both usurpation and the arbitrary use of power, while expressing distress at the growing indifference of the American people to maintaining such an organized militia, which could lead to the undermining of the protection of the Second Amendment.[154]

Abolitionist Lysander Spooner, commenting on bills of rights, stated that the object of all bills of rights is to assert the rights of individuals against the government and that the Second Amendment right to keep and bear arms was in support of the right to resist government oppression, as the only security against the tyranny of government lies in forcible resistance to injustice, for injustice will certainly be executed, unless forcibly resisted.[155] Spooner’s theory provided the intellectual foundation for John Brown and other radical abolitionists who believed that arming slaves was not only morally justified, but entirely consistent with the Second Amendment.[156] An express connection between this right and the Second Amendment was drawn by Lysander Spooner who commented that a “right of resistance” is protected by both the right to trial by jury and the Second Amendment.[157]

Originally posted here:

Second Amendment to the United States Constitution – Wikipedia

Amendment II – The United States Constitution

The right to keep and bear arms is a lot like the right to freedom of speech. In each case, the Constitution expressly protects a liberty that needs to be insulated from the ordinary political process. Neither right, however, is absolute. The First Amendment, for example, has never protected perjury, fraud, or countless other crimes that are committed through the use of speech. Similarly, no reasonable person could believe that violent criminals should have unrestricted access to guns, or that any individual should possess a nuclear weapon.

Inevitably, courts must draw lines, allowing government to carry out its duty to preserve an orderly society, without unduly infringing the legitimate interests of individuals in expressing their thoughts and protecting themselves from criminal violence. This is not a precise science or one that will ever be free from controversy.

One judicial approach, however, should be unequivocally rejected. During the nineteenth century, courts routinely refused to invalidate restrictions on free speech that struck the judges as reasonable. This meant that speech got virtually no judicial protection. Government suppression of speech can usually be thought to serve some reasonable purpose, such as reducing social discord or promoting healthy morals. Similarly, most gun control laws can be viewed as efforts to save lives and prevent crime, which are perfectly reasonable goals. If thats enough to justify infringements on individual liberty, neither constitutional guarantee means much of anything.

During the twentieth century, the Supreme Court finally started taking the First Amendment seriously. Today, individual freedom is generally protected unless the government can make a strong case that it has a real need to suppress speech or expressive conduct, and that its regulations are tailored to that need. The legal doctrines have become quite complex, and there is room for disagreement about many of the Courts specific decisions. Taken as a whole, however, this body of case law shows what the Court can do when it appreciates the value of an individual right enshrined in the Constitution.

The Second Amendment also raises issues about which reasonable people can disagree. But if the Supreme Court takes this provision of the Constitution as seriously as it now takes the First Amendment, which it should do, there will be some easy issues as well.

District of Columbia v. Heller (2008) is one example. The right of the people protected by the Second Amendment is an individual right, just like the right[s] of the people protected by the First and Fourth Amendments. The Constitution does not say that the Second Amendment protects a right of the states or a right of the militia, and nobody offered such an interpretation during the Founding era. Abundant historical evidence indicates that the Second Amendment was meant to leave citizens with the ability to defend themselves against unlawful violence. Such threats might come from usurpers of governmental power, but they might also come from criminals whom the government is unwilling or unable to control.

McDonald v. City of Chicago (2010) was also an easy case under the Courts precedents. Most other provisions of the Bill of Rights had already been applied to the states because they are deeply rooted in this Nations history and tradition. The right to keep and bear arms clearly meets this test.

The text of the Constitution expressly guarantees the right to bear arms, not just the right to keep them. The courts should invalidate regulations that prevent law-abiding citizens from carrying weapons in public, where the vast majority of violent crimes occur. First Amendment rights are not confined to the home, and neither are those protected by the Second Amendment.

Nor should the government be allowed to create burdensome bureaucratic obstacles designed to frustrate the exercise of Second Amendment rights. The courts are vigilant in preventing government from evading the First Amendment through regulations that indirectly abridge free speech rights by making them difficult to exercise. Courts should exercise the same vigilance in protecting Second Amendment rights.

Some other regulations that may appear innocuous should be struck down because they are little more than political stunts. Popular bans on so-called assault rifles, for example, define this class of guns in terms of cosmetic features, leaving functionally identical semi-automatic rifles to circulate freely. This is unconstitutional for the same reason that it would violate the First Amendment to ban words that have a French etymology, or to require that French fries be called freedom fries.

In most American states, including many with large urban population centers, responsible adults have easy access to ordinary firearms, and they are permitted to carry them in public. Experience has shown that these policies do not lead to increased levels of violence. Criminals pay no more attention to gun control regulations than they do to laws against murder, rape, and robbery. Armed citizens, however, prevent countless crimes and have saved many lives. Whats more, the most vulnerable peopleincluding women, the elderly, and those who live in high crime neighborhoodsare among the greatest beneficiaries of the Second Amendment. If the courts require the remaining jurisdictions to stop infringing on the constitutional right to keep and bear arms, their citizens will be more free and probably safer as well.

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Amendment II – The United States Constitution

Second Amendment legal definition of Second Amendment

The Second Amendment to the U.S. Constitution reads:

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

The subject matter and unusual phrasing of this amendment led to much controversy and analysis, especially in the last half of the twentieth century. Nevertheless, the meaning and scope of the amendment have long been decided by the Supreme Court.

Firearms played an important part in the colonization of America. In the seventeenth and eighteenth centuries, European colonists relied heavily on firearms to take land away from Native Americans and repel attacks by Native Americans and Europeans. Around the time of the Revolutionary War, male citizens were required to own firearms for fighting against the British forces. Firearms were also used in hunting.

In June 1776, one month before the signing of the Declaration of Independence, Virginia became the first colony to adopt a state constitution. In this document, the state of Virginia pronounced that “a well regulated Militia, composed of the body of the people, trained to arms, is the proper, natural, and safe defence of a free State.” After the colonies declared their independence from England, other states began to include the right to bear arms in their constitution. Pennsylvania, for example, declared that

the people have a right to bear arms for the defence of themselves and the state; and as standing armies in the time of peace are dangerous to liberty, they ought not to be kept up; And that the military should be kept under strict subordination to, and governed by, the civil power.

The wording of clauses about bearing arms in late-eighteenth-century state constitutions varied. Some states asserted that bearing arms was a “right” of the people, whereas others called it a “duty” of every able-bodied man in the defense of society.

Pennsylvania was not alone in its express discouragement of a standing (professional) army. Many of the Framers of the U.S. Constitution rejected standing armies, preferring instead the model of a citizen army, equipped with weapons and prepared for defense. According to Framers such as Elbridge Gerry of Massachusetts and George Mason of Virginia a standing army was susceptible to tyrannical use by a power-hungry government.

At the first session of Congress in March 1789, the Second Amendment was submitted as a counterweight to the federal powers of Congress and the president. According to constitutional theorists, the Framers who feared a central government extracted the amendment as a compromise from those in favor of centralized authority over the states. The Revolutionary War had, after all, been fought in large part by a citizen army against the standing armies of England.

The precise wording of the amendment was changed two times before the U.S. Senate finally cast it in its present form. As with many of the amendments, the exact wording proved critical to its interpretation.

In 1791 a majority of states ratified the Bill of Rights, which included the Second Amendment. In its final form, the amendment presented a challenge to interpreters. It was the only amendment with an opening clause that appeared to state its purpose. The amendment even had defective punctuation; the comma before shall seemed grammatically unnecessary.

Legal scholars do not agree about this comma. Some have argued that it was intentional and that it was intended to make militia the subject of the sentence. According to these theorists, the operative words of the amendment are “[a] well regulated Militia shall not be infringed.” Others have argued that the comma was a mistake, and that the operative words of the sentence are “the right of the people to bear arms shall not be infringed.” Under this reading, the first part of the sentence is the rationale for the absolute, personal right of the people to own firearms. Indeed, the historical backdrophighlighted by a general disdain for professional armieswould seem to support this theory.

Some observers argue further that the Second Amendment grants the right of insurrection. According to these theorists, the Second Amendment was designed to allow citizens to rebel against the government. Thomas Jefferson is quoted as saying that “a little rebellion every now and then is a good thing.”

The Supreme Court makes the ultimate determination of the Constitution’s meaning, and it has defined the amendment as simply granting to the states the right to maintain a militia separate from federally controlled militias. This interpretation first came in United States v. Cruikshank, 92 U.S. 542, 23 L. Ed. 588 (1875). In Cruikshank, approximately one hundred persons were tried jointly in a Louisiana federal court with felonies in connection with an April 13, 1873, assault on two AfricanAmerican men. One of the criminal counts charged that the mob intended to hinder the right of the two men to bear arms. The defendants were convicted by a jury, but the circuit court arrested the judgment, effectively overturning the verdict. In affirming that decision, the Supreme Court declared that “the second amendment means no more than that [the right to bear arms] shall not be infringed by Congress, and has no other effect than to restrict the powers of the national government.”

In Presser v. Illinois, 116 U.S. 252, 6 S. Ct. 580, 29 L. Ed. 615 (1886), Herman Presser was charged in Illinois state court with parading and drilling an unauthorized militia in the streets of Chicago in December 1879, in violation of certain sections of the Illinois Military Code. One of the sections in question prohibited the organization, drilling, operation, and parading of militias other than U.S. troops or the regular organized volunteer militia of the state. Presser was tried by the judge, convicted, and ordered to pay a fine of $10. On appeal to the U.S. Supreme Court, Presser argued, in part, that the charges violated his Second Amendment right to bear arms. The Court disagreed and upheld Presser’s conviction. The Court cited Cruikshank for the proposition that the Second Amendment means only that the federal government may not infringe on the right of states to form their own militias. This meant that the Illinois state law forbidding citizen militias was not unconstitutional. However, in its opinion, the Court in Presser delivered a reading of the Second Amendment that seemed to suggest an absolute right of persons to bear arms: “It is undoubtedly true that all citizens capable of bearing arms constitute the reserved military force or reserve militia of the United States,” and “states cannot prohibit the people from keeping and bearing arms.”

Despite this generous language, the Court refused to incorporate the Second Amendment into the Fourteenth Amendment. Under the first section of the Fourteenth Amendment, passed in 1868, states may not abridge the Privileges and Immunities of citizens of the United States. The privileges and immunities of citizens are listed in the Bill of Rights, of which the Second Amendment is part. Presser had argued that states may not, by virtue of the Fourteenth Amendment, abridge the right to bear arms. The Court refused to accept the argument that the right to bear arms is a personal right of the people. According to the Court, “The right to drill or parade with arms, without, and independent of, an act of congress or law of the state authorizing the same, is not an attribute of national citizenship.”

The Presser opinion is best understood in its historical context. The Northern states and the federal government had just fought the Civil War against Southern militias unauthorized by the federal government. After this ordeal, the Supreme Court was in no mood to accept an expansive right to bear arms. At the same time, the Court was sensitive to the subject of federal encroachment on States’ Rights.

Private militias are armed military groups that are composed of private citizens and not recognized by federal or state governments. Private militias have been formed by individuals in America since the colonial period. In fact, the Revolutionary War against England was fought in part by armies comprising not professional soldiers but ordinary male citizens.

Approximately half the states maintain laws regulating private militias. Generally, these laws prohibit the parading and exercising of armed private militias in public, but do not forbid the formation of private militias. In Wyoming, however, state law forbids the very formation of private militias. Under section 19-1-106 of the Wyoming Statutes, “No body of men other than the regularly organized national guard or the troops of the United States shall associate themselves together as a military company or organization, or parade in public with arms without license of the governor.” The Wyoming law also prohibits the public funding of private militias. Anyone convicted of violating the provisions of the law is subject to a fine of not more than $1,000, imprisonment of six months, or both, for each offense.

In states that do not outlaw them, private militias are limited only by the criminal laws applicable to all of society. Thus, if an armed private militia seeks to parade and exercise in a public area, its members will be subject to arrest on a variety of laws, including disturbing-the-peace, firearms, or even riot statutes.

Many private militias are driven by the insurrection theory of the Second Amendment. Under this view, the Second Amendment grants an unconditional right to bear arms for Self-Defense and for rebellion against a tyrannical governmentwhen a government turns oppressive, private citizens have a duty to “insurrect,” or take up arms against it.

The U.S. Supreme Court has issued a qualified rejection of the insurrection theory. According to the Court in Dennis v. United States, 341 U.S. 494, 71 S. Ct. 857, 95 L. Ed. 1137 (1951), “[W]hatever theoretical merit there may be to the argument that there is a ‘right’ to rebellion against dictatorial governments is without force where the existing structure of the government provides for peaceful and orderly change.” Scholars have interpreted this to mean that as long as the government provides for free elections and trials by jury, private citizens have no right to take up arms against the government.

Some people have disagreed with the Supreme Court’s definition of tyranny. Many of these people label the state and federal governments as tyrannical based on issues such as taxes and government regulations. Others cite governments ponsored racial and ethnic Integration as driving forces in their campaign against the federal and state governments. Many of these critics have formed private militias designed to resist perceived government oppression.

Some private militias have formed their own government. The legal problems of these private militias are generally unrelated to military activities. Instead, any criminal charges usually arise from activities associated with their political beliefs. The Freemen of Montana is one such militia. This group denied the legitimacy of the federal government and created its own township called Justus. The Freemen established its own court system, posted bounties for the arrest of police officers and judges, and held seminars on how to challenge laws its members viewed as beyond the scope of the Constitution. According to neighbors, the group also established its own common-law court system and built its own jail for the imprisonment of trespassers and government workers, or “public hirelings.”

In the 1990s, the Freemen came to the attention of federal prosecutors after members of the group allegedly wrote worthless checks and money orders to pay taxes and to defraud banks and credit card companies. One Freeman had also allegedly threatened a federal judge, and some had allegedly refused to pay taxes for at least a decade.

In March 1996, law enforcement officials obtained warrants for the arrest of many of the Freemen. However, remembering the violence that occurred when officials attempted to serve arrest warrants on another armed group in Waco, Texas, in 1993, law enforcement authorities did not invade the Freemen’s 960-acre ranch in Jordan, Montana. Although the Freemen constituted an armed challenge to all government authority, its beliefs and its military activities were not illegal, and most of its members were charged with nonviolent crimes, such as Fraud and related conspiracy. Two men were also charged with threatening public officials. In addition, several Freemen faced charges of criminal syndicalism, which is the advocacy of violence for political goals.

Amar, Akhil Reed. 2002. “Second Thoughts.” Law and Contemporary Problems 65 (spring).

Barry, Monica Sue. 1996. “Stockpiling Weapons: Can Private Militias Receive Protection under the First and Second Amendments?” Thomas Jefferson Law Review 18 (spring).

Hardaway, Robert, Elizabeth Gormley, and Bryan Taylor. 2002. “The Inconvenient Militia Clause of the Second Amendment: Why the Supreme Court Declines to Resolve the Debate over the Right to Bear Arms.” St. John’s Journal of Legal Commentary 16 (winter).

Dennis v. United States.

Several decades later, the Supreme Court ignored the contradictory language in Presser and cemented a limited reading of the Second Amendment. In United States v. Miller, 307 U.S. 174, 59 S. Ct. 816, 83 L. Ed. 1206 (1939), defendants Jack Miller and Frank Layton were charged in federal court with unlawful transportation of firearms in violation of certain sections of the National Firearms Act of June 26, 1934 (ch. 757, 48 Stat. 12361240 [26 U.S.C.A. 1132 et seq.]). Specifically, Miller and Layton had transported shotguns with barrels less than 18 inches long, without the registration required under the act.

The district court dismissed the indictment, holding that the act violated the Second Amendment. The United States appealed. The Supreme Court reversed the decision and sent the case back to the trial court. The Supreme Court stated that the Second Amendment was fashioned “to assure the continuation and render possible the effectiveness of militia forces.”

The Miller opinion confirmed the restrictive language of Presser and solidified a narrow reading of the Second Amendment. According to the Court in Miller, the Second Amendment does not guarantee the right to own a firearm unless the possession or use of the firearm has “a reasonable relationship to the preservation or efficiency of a well regulated militia.”

The legislative measures that inspire most Second Amendment discussions are Gun Control laws. Since the mid-nineteenth century, state legislatures have been passing laws that infringe a perceived right to bear arms. Congress has also asserted the power to regulate firearms. No law regulating firearms has ever been struck down by the Supreme Court as a violation of the Second Amendment.

Historically, the academic community has largely ignored the Second Amendment. However, gun control laws have turned many laypersons into scholars of the Second Amendment’s history. The arguments for a broader interpretation are many and varied. Most center on the Original Intent of the Framers. Some emphasize that the Second Amendment should be interpreted as granting an unconditional personal right to bear arms for defensive and sporting purposes. Others adhere to an insurrection theory, under which the Second Amendment not only grants the personal right to bear arms, it gives citizens the right to rebel against a government perceived as tyrannical.

In response to these arguments, supporters of the prevailing Second Amendment interpretation maintain that any right to bear arms should be secondary to concerns for public safety. They also point out that other provisions in the Constitution grant power to Congress to quell insurrections, thus contradicting the insurrection theory. Lastly, they argue that the Constitution should be interpreted in accordance with a changing society and that the destructive capability of semiautomatic and automatic firearms was not envisioned by the Framers.

In response to the last argument, critics maintain that because such firearms exist, it should be legal to use them against violent criminals who are themselves wielding such weapons.

In the 2000s, federal courts continue to revisit the scope and detail of the Second Amendment right to bear arms. In particular federal courts have recast much of the debate as one over whether the Second Amendment protects a “collective” right or an “individual” right to bear arms. If the Second Amendment protects only a collective right, then only states would have the power to bring a legal action to enforce it and only for the purpose of maintaining a “well-regulated militia.” If the Second Amendment protects only an individual right to bear arms, then only individuals could bring suit to challenge gun-control laws that curb their liberty to buy, sell, own, or possess firearms and other guns.

Not surprisingly, courts are conflicted over how to resolve this debate. In United States v. Emerson, 270 F.3d 203 (5th Cir. 2001), the U.S. Court of Appeals for the Fifth Circuit found that the original intent of the Founding Fathers supported an individual-rights interpretation of the Second Amendment, while the Ninth Circuit came to the opposite conclusion in Nordyke v. King, 319 F.3d 1185 (9th Cir. 2003). Although no court has concluded that the original intent underlying the Second Amendment supports a claim for both an individual- and a collective rights based interpretation of the right to bear arms, the compelling historical arguments marshaled on both sides of the debate would suggest that another court faced with the same debate may reach such a conclusion.

Amar, Akhil Reed. 1992. “The Bill of Rights and the Fourteenth Amendment.” Yale Law Journal 101 (April).

Becker, Edward R. 1997. “The Second Amendment and Other Federal Constitutional Rights of the Private Militia.” Montana Law Review 58 (winter).

Bogus, Carl T., ed. 2000. The Second Amendment in Law and History: Historians and Constitutional Scholars on the Right to Bear Arms. New York: New Press.

Dolan, Edward F., and Margaret M. Scariano. 1994. Guns in the United States. New York: Watts.

Dunlap, Charles J., Jr. 1995. “Revolt of the Masses: Armed Civilians and the Insurrectionary Theory of the Second Amendment.” Tennessee Law Review 62 (spring).

Hanson, Freya Ottem. 1998. The Second Amendment: The Right to Own Guns. Springfield, N.J.: Enslow.

Hook, Donald D. 1992. Gun Control: The Continuing Debate. Washington, D.C.: Second Amendment Foundation.

Hoppin, Jason. 2003. “Ninth Circuit Upholds Controversial Ruling on Second Amendment.” Legal Intelligencer (May 8).

. 2003. “Second Amendment Fight Steals Show in Gun Ban Case: Panel Enters Fray over Individual Rights.” San Francisco Recorder (February 19).

McAffee, Thomas B. 1997. “Constitutional Limits on Regulating Private Militia Groups.” Montana Law Review 58 (winter).

Gun Control.

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Second Amendment legal definition of Second Amendment

Mesothelioma Cancer | Prognosis, Treatment and Survival

Mesothelioma is a rare, aggressive form of cancer that develops in the lining of the lungs, abdomen, or heart. Caused by asbestos, mesothelioma has no known cure and has a very poor prognosis.

According to a 2017 report by the Centers for Disease Control, 2,400 2,800 people are diagnosed with mesothelioma in the United States each year. People who have worked with or been exposed to asbestos have the highest risk of developing mesothelioma. After being exposed to asbestos, mesothelioma symptoms can take 20 50 years to appear.

The life expectancy for mesothelioma patients is poor, as there is no cure for the disease. The stage of the disease, cell type, and location of the tumor(s) are the most important factors for a patients survival. Factors such as the patients overall health, age, and whether the cancer has spread also impact prognosis.

After receiving a mesothelioma diagnosis, there are a number of vital decisions that must be made. The Mesothelioma Cancer Alliance is dedicated to providing patients with the best resources available on current treatment, stories of survival and hope, and financial assistance.

Heather Von St. James is a 12-year pleural mesothelioma survivor who has become a spokeswoman for mesothelioma awareness and a proponent of banning asbestos.

She also works with newly diagnosed mesothelioma patients as a mentor and advocate, helping them understand their treatment and legal options.

Heather offers valuable insights into her successful treatment approach with Dr. David Sugarbaker. She has a unique perspective on life after surviving a mesothelioma diagnosis and enjoys sharing her story. Click here to connect with Heather.

Mesothelioma is most commonly classified by the location in the body where it develops. Specifically, the cancer forms in the lining of certain organs or spaces within the body, known as the mesothelium. Mesothelioma typically develops in one of three specific areas.

The most common type, pleural mesothelioma is caused by the inhalation of asbestos fibers.

Inhaled or swallowed asbestos fibers can become trapped in the lining of the abdomen (the peritoneum).

In rare cases, asbestos fibers can get lodged in the pericardium, the lining around the heart cavity.

Mesothelioma symptoms can take 20 50 years to appear after the first exposure to asbestos. The signs of mesothelioma often look like those of other diseases, which can lead to misdiagnosis. When someone exhibits mesothelioma symptoms, doctors perform a variety of tests to rule out other diseases. It normally takes weeks or months for doctors to arrive at an accurate mesothelioma diagnosis.

Upon diagnosis, the doctor will categorize the disease into one of four stages. While there are several staging systems, the TNM System which stands for tumor, lymph nodes, and metastasis is the most commonly used.

The mesothelioma tumor is located in only one area and has not spread to other parts of the body.

A large tumor may have progressed to nearby areas and/or the lymph nodes, but has not gone on any further.

Tumors have typically spread beyond the local area to several nearby locations and the lymph nodes.

The tumors have spread into multiple areas and throughout the lymphatic system, invading other organs throughout the body.

Typically, Stage 1 and Stage 2 mesothelioma can be treated effectively with surgery and other forms of therapy. However, Stage 3 and Stage 4 mesothelioma are often treated palliatively.

Treatment for mesothelioma is similar to other types of cancer. The most common treatments are surgery, chemotherapy, and radiation. Newer treatments are being studied as part of clinical trials and may be available for some patients who do not respond to conventional therapies.

In some cases, treatment can improve a patient’s prognosis, extending his/her life significantly. Treatment can also be used palliatively to reduce pain and discomfort caused by the symptoms of mesothelioma.

Finding a mesothelioma doctor and creating a custom treatment plan based on your diagnosis is the most important decision you can make to improve prognosis. Browse our catalog of top mesothelioma doctors around the country.

Mesothelioma clinics and cancer centers offer patients a way to get the most comprehensive care, using the latest technology and techniques available. Locate the best mesothelioma clinics near you.

The costs of treating mesothelioma are significant. If you were exposed to asbestos on the job, in your home, or elsewhere, you have the right to recover these expenses from those responsible for the exposure.

Financial assistance is available to help offset the high cost of mesothelioma treatment. The primary ways mesothelioma patients and their families can receive compensation are:

Those who have been diagnosed with mesothelioma or other types of terminal cancer can find tremendous comfort in the support they get from family, friends and caregivers.

FREE Mesothelioma Awareness Wristbands and Treatment Guide.

JM Mazurek; G Syamlal; JM Wood; SA Hendricks, A Weston. U.S. Centers for Disease Control. Malignant Mesothelioma Mortality United States, 19992015. March 3, 2017:66(8);214218. DOI: 10.15585/mmwr.mm6608a3

National Cancer Institute Malignant Mesothelioma (Source)

Wagner, J.C., Sleggs, C.A., and Marchand, Paul. Diffuse Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province. Department of Thoracic Surgery: University of The Witswatersrand. Johannesburg, South Africa. 1960.

Grondin, Sean C., Sugarbaker, David J. Pleuropneumonectomy in the Treatment of Malignant Pleural Mesothelioma Chest December 1999 116:suppl 3 450S-454S;

Rusch, Valerie W. Indications for pneumoctomy. Extrapleural pneumonectomy

Roggli VL, Sharma A, Butnor KJ, Sporn T, Vollmer RT (2002). “Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases”. Ultrastruct Pathol 26(2): 5565.

Brigham and Womens Hospital International Mesothelioma Program (Source)

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Mesothelioma Cancer | Prognosis, Treatment and Survival

Mesothelioma – What is Malignant Mesothelioma Cancer

Malignant mesothelioma is a rare, asbestos-related cancer. It forms on the protective tissues covering the lungs, abdomen and heart. Symptoms include coughing, chest pain and shortness of breath. Treatments combining surgery, radiation and chemotherapy improve survival and life expectancy.

Mesothelioma is a rare cancer caused by exposure to asbestos.

The disease forms on the mesothelium a protective lining that covers the lungs, abdomen, heart and testes.

Tumors can be benign (noncancerous). But when tumors are cancerous, doctors call the disease malignant mesothelioma. It is often shortened to mesothelioma.

The American Cancer Society records about 3,000 new cases of mesothelioma each year in the U.S.

Asbestos remains the primary cause of mesothelioma.

The cancer develops when a person ingests asbestos, and it causes changes to a persons DNA. Our genes are made of DNA. Some of the genes in our body control how cells grow, multiply and die. Changes in our genes may cause cells to divide out of control and may lead to cancer.

A person inhales or swallows airborne asbestos fibers.

The asbestos fibers become lodged in the lining of the lungs, abdomen or heart.

The embedded fibers damage the mesothelial cells and cause inflammation.

Over time, tumors begin to form on the damaged mesothelium.

These mesothelioma symptoms usually do not show until tumors have grown and spread. Mesothelioma latency is 20-50 years. Thats how long it takes from initial exposure to accurate diagnosis. For that reason, many people with mesothelioma are in their 60s or 70s.

You should talk to a mesothelioma specialist soon if you have a history of asbestos exposure and experience these symptoms. An early diagnosis may improve your prognosis and life expectancy.

Select the diagnosis you or your loved one is facing and receive a free guide with the right information for you:

Asbestos use in the military was widespread from 1940 to 1980. Veterans from all branches of the U.S. armed forces were at risk of exposure. Navy veterans are most at risk. This branch used the largest quantity of asbestos products.

LEARN ABOUT VETERANS

More than 75 occupations have exposed workers to asbestos. Auto mechanics, textile workers, steel mill workers, construction workers and firefighters are among the most at risk.

LEARN ABOUT OCCUPATIONS

Asbestos workers unknowingly carried asbestos fibers on their body and clothing. This resulted in secondary asbestos exposure among residents such as women and children.

LEARN ABOUT SECONDARY EXPOSURE

Oncologists name each type of mesothelioma by the location in the body where it develops.

The pleural and peritoneal types of mesothelioma are the most common. Pericardial accounts for 1 percent of cases. Another rare type is testicular mesothelioma. It represents less than 1 percent of all mesotheliomas.

Prognosis, symptoms and treatment options vary by type.

Younger patients and women have a better mesothelioma prognosis than older men. People diagnosed with peritoneal mesothelioma also have a higher chance of survival.

Patients eligible to undergo multimodal therapy, which is a combination of two or more standard-of-care treatments, have a better life expectancy and improved prognosis.

A patients mesothelioma cell type also plays a significant role in prognosis and life expectancy. The three types of cells include:

Epithelioid: These cells are the most responsive to treatment, which improves prognosis and life expectancy. They comprise 50 percent of mesothelioma diagnoses.

Sarcomatoid: These cells are the least responsive to treatment. Patients with this cell type have a poorer prognosis and shorter life expectancy. These cells comprise 10 percent of diagnoses.

Biphasic: A combination of epithelioid and sarcomatoid cells. This type is less responsive to treatment. But prognosis and life expectancy depends on the ratio of both types of cells. This type accounts for 30-40 percent of diagnoses.

The life expectancy for most patients is about 12 months after diagnosis.

Stage and cell type of the cancer are the factors that most affect prognosis. Age, gender and patients asbestos exposure history also affect survival outlook.

Eating a nutrient-rich diet, undergoing cancer treatments, including multimodal therapy, and staying healthy can improve prognosis.

The cancer is localized. Surgery is most effective at this stage. Survival rate is higher. Median life expectancy at stage 1 is 22.2 months.

LEARN ABOUT STAGE 1

Tumors have started to spread from the original location into adjacent structures. Surgery is still an option. Median life expectancy at stage 2 is 20 months.

LEARN ABOUT STAGE 2

Cancer has progressed to a more advanced stage with spread into the regional lymph nodes. Surgery may still be an option. Median life expectancy at stage 3 is 17.9 months.

LEARN ABOUT STAGE 3

Cancer has spread extensively in the area where it developed. Chemotherapy and immunotherapy control symptoms and prolong survival. Median life expectancy at stage 4 is 14.9 months or less.

LEARN ABOUT STAGE 4

Mesothelioma is a rare cancer. It represents only 0.3 percent of all cancer diagnoses. Most doctors and oncologists have never encountered it.

A 2009 study published in the Journal of General Internal Medicine states that cancer care requires the technical knowledge and skills of specialty physicians such as medical oncologists, surgeons and radiation oncologists.

These are factors that impact a mesothelioma patients survival. Thats why finding a mesothelioma specialist is so important.

Finding a mesothelioma specialty center with experienced mesothelioma doctors is crucial to survival.

More than 70 percent of mesothelioma patients undergo chemotherapy

Mesothelioma treatment helps patients live longer lives. But not every patient is eligible for each type of mesothelioma treatment.

The most common treatments for mesothelioma include:

Surgery: Offers greatest chance of survival. Usually used for diagnosis, tumor removal or palliative care to reduce pain. Patients with strong health and limited cancer spread are good candidates.

Chemotherapy: More than 70 percent of patients undergo chemotherapy. It uses powerful drugs to shrink tumors and kill cancer cells.

Radiation Therapy: Used to reduce pain from growing tumors. When combined with surgery and chemotherapy, it reduces risk of local recurrence. It can be used at any cancer stage.

Immunotherapy: This experimental treatment boosts the immune system to fight the cancer. Primarily used in clinical trials.

Multimodal Therapy: A combination of two or more treatments. Clinical studies show this approach improves survival rates.

HIPEC: A multimodal treatment for peritoneal mesothelioma patients. Surgery is first used to remove as many tumors as possible. Heated chemotherapy is then applied to the abdominal cavity to destroy remaining cancer cells.

Palliative Treatments: May include surgery, radiation, chemotherapy or HIPEC. The purpose is not curative care. Instead, the goal is to reduce pain and improve quality of life. Good for any mesothelioma patient.

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Thank you for the doctor referral info. We met with the doctor and came away with what seemed like a weight lifted.

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Clinical trials offer mesothelioma patients access to experimental therapies. They also provide scientific and medical information for researches to develop new treatments. Patients in clinical trials also receive excellent medical care.

Herbal medicines, mind-body therapies, holistic healing and other complementary therapies may benefit patients.

The median value for mesothelioma claims, according to a 2010 report from the RAND Corporation, a nonprofit institution that conducts research and analysis on asbestos bankruptcy trusts.

Many companies that produced, distributed or used asbestos products knew it was deadly. But they neglected to warn their employees. Filing a lawsuit can help mesothelioma patients cover lost wages, medical expenses and other costs.

A person with mesothelioma can file a personal injury lawsuit. Mesothelioma lawyers file these against companies responsible for their clients asbestos exposure. Families can file wrongful death claims when a loved one dies of mesothelioma.

Qualified mesothelioma attorneys can help you decide when to file a lawsuit. They can also guide you through the process. Time is of the essence because statute of limitations may expire. A mesothelioma lawyer will review your case so you receive the highest compensation.

Support is available for mesothelioma patients, survivors and loved ones in many forms.

The Mesothelioma Centers monthly online support group meets every second Wednesday. Licensed mental health counselor Dana Nolan runs the support group. Patients and survivors can share their experiences with others on a similar cancer journey.

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Mesothelioma – What is Malignant Mesothelioma Cancer

Mesothelioma – Wikipedia

Cancer associated with asbestos

Mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs (known as the mesothelium).[9] The most common area affected is the lining of the lungs and chest wall.[1][3] Less commonly the lining of the abdomen and rarely the sac surrounding the heart,[10] or the sac surrounding the testis may be affected.[1][11] Signs and symptoms of mesothelioma may include shortness of breath due to fluid around the lung, a swollen abdomen, chest wall pain, cough, feeling tired, and weight loss.[1] These symptoms typically come on slowly.[2]

More than 80% of mesothelioma cases are caused by exposure to asbestos.[3] The greater the exposure the greater the risk.[3] As of 2013 about 125 million people have been exposed to asbestos at work.[12] High rates of disease occur in people who mine asbestos, produce products from asbestos, work with asbestos products, live with asbestos workers, or work in buildings containing asbestos.[3] Asbestos exposure and the onset of cancer are generally separated by about 40 years.[3] Washing the clothing of someone who worked with asbestos also increases the risk.[12] Other risk factors include genetics and infection with the simian virus 40.[3] The diagnosis may be suspected based on chest X-ray and CT scan findings, and is confirmed by either examining fluid produced by the cancer or by a tissue biopsy of the cancer.[2]

Prevention centers around reducing exposure to asbestos.[4] Treatment often includes surgery, radiation therapy, and chemotherapy.[5] A procedure known as pleurodesis, which involves using substances such as talc to scar together the pleura, may be used to prevent more fluid from building up around the lungs.[5] Chemotherapy often includes the medications cisplatin and pemetrexed.[2] The percentage of people that survive five years following diagnosis is on average 8% in the United States.[6]

In 2015 about 60,800 people had mesothelioma and 32,000 died from the disease.[7][8] Rates of mesothelioma vary in different areas of the world.[3] Rates are higher in Australia, the United Kingdom, and lower in Japan.[3] It occurs in about 3,000 people per year in the United States.[13] It occurs more often in males than females.[3] Rates of disease have increased since the 1950s.[3] Diagnosis typically occurs after the age of 65 and most deaths occur around 70 years old.[3] The disease was rare before the commercial use of asbestos.[3]

Symptoms or signs of mesothelioma may not appear until 20 to 50 years (or more) after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space (pleural effusion) are often symptoms of pleural mesothelioma.[14]

Mesothelioma that affects the pleura can cause these signs and symptoms:[14]

In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread to other parts of the body.

The most common symptoms of peritoneal mesothelioma are abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other features may include weight loss, fever, night sweats, poor appetite, vomiting, constipation, and umbilical hernia.[15] If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.[citation needed]These symptoms may be caused by mesothelioma or by other, less serious conditions.

Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:[citation needed]

Pericardial mesothelioma is not well characterized, but observed cases have included cardiac symptoms, specifically constrictive pericarditis, heart failure, pulmonary embolism, and cardiac tamponade. They have also included nonspecific symptoms, including substernal chest pain, orthopnea (shortness of breath when lying flat), and cough. These symptoms are caused by the tumor encasing or infiltrating the heart.[10]

In severe cases of the disease, the following signs and symptoms may be present:[citation needed]

If a mesothelioma forms metastases, these most commonly involve the liver, adrenal gland, kidney, or other lung.[16]

Working with asbestos is the most common risk factor for mesothelioma.[17] However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Tentative evidence also raises concern about carbon-fibre nanotubes.[18][19]

The incidence of mesothelioma has been found to be higher in populations living near naturally occurring asbestos. People can be exposed to naturally occurring asbestos in areas where mining or road construction is occurring, or when the asbestos-containing rock is naturally weathered. Another common route of exposure is through asbestos-containing soil, which is used to whitewash, plaster, and roof houses in Greece.[12] In central Cappadocia, Turkey, mesothelioma was causing 50% of all deaths in three small villagesTuzky, Karain, and Sarhdr. Initially, this was attributed to erionite. Environmental exposure to asbestos has caused mesothelioma in places other than Turkey, including Corsica, Greece, Cyprus, China, and California.[12][20][21] In the northern Greek mountain town of Metsovo, this exposure had resulted in mesothelioma incidence around 300 times more than expected in asbestos-free populations, and was associated with very frequent pleural calcification known as “Metsovo Lung”.[22][23]

The documented presence of asbestos fibers in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibers.[citation needed]

Exposure to talc is also a risk factor for mesothelioma; exposure can affect those who live near talc mines, work in talc mines, or work in talc mills.[24]

In the United States, asbestos is considered the major cause of malignant mesothelioma[25] and has been considered “indisputably”[26] associated with the development of mesothelioma. Indeed, the relationship between asbestos and mesothelioma is so strong that many consider mesothelioma a signal or sentinel tumor.[27][28][29][30] A history of asbestos exposure exists in most cases.

Pericardial mesothelioma may not be associated with asbestos exposure.[10]

Asbestos was known in antiquity, but it was not mined and widely used commercially until the late 19th century. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among naval personnel (e.g., Navy, Marine Corps, and Coast Guard), shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the official position of the U.S. Occupational Safety and Health Administration (OSHA) and the U.S. EPA is that protections and “permissible exposure limits” required by U.S. regulations, while adequate to prevent most asbestos-related non-malignant disease, are not adequate to prevent or protect against asbestos-related cancers such as mesothelioma.[31] Likewise, the British Government’s Health and Safety Executive (HSE) states formally that any threshold for exposure to asbestos must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE assumes that no such “safe” threshold exists. Others have noted as well that there is no evidence of a threshold level below which there is no risk of mesothelioma.[32] There appears to be a linear, dose-response relationship, with increasing dose producing increasing risk of disease.[33] Nevertheless, mesothelioma may be related to brief, low level or indirect exposures to asbestos.[26] The dose necessary for effect appears to be lower for asbestos-induced mesothelioma than for pulmonary asbestosis or lung cancer.[26] Again, there is no known safe level of exposure to asbestos as it relates to increased risk of mesothelioma.

The time from first exposure to onset of the disease, is between 25 and 70 years.[34] It is virtually never less than fifteen years and peaks at 3040 years.[26][35] The duration of exposure to asbestos causing mesothelioma can be short. For example, cases of mesothelioma have been documented with only 13 months of exposure.[36][37]

Exposure to asbestos fibers has been recognized as an occupational health hazard since the early 20th century. Numerous epidemiological studies have associated occupational exposure to asbestos with the development of pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumors, and diffuse malignant mesothelioma of the pleura and peritoneum. Asbestos has been widely used in many industrial products, including cement, brake linings, gaskets, roof shingles, flooring products, textiles, and insulation.[38]

Commercial asbestos mining at Wittenoom, Western Australia, took place from 1937 to 1966. The first case of mesothelioma in the town occurred in 1960. The second case was in 1969, and new cases began to appear more frequently thereafter. The lag time between initial exposure to asbestos and the development of mesothelioma varied from 12 years 9 months up to 58 years.[39] A cohort study of miners employed at the mine reported that 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.[citation needed]

Occupational exposure to asbestos in the United States mainly occurs when people are maintaining buildings that already have asbestos. Approximately 1.3 million US workers are exposed to asbestos annually; in 2002, an estimated 44,000 miners were potentially exposed to asbestos.[24]

Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases.[11][40][41] This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers via washing a worker’s clothes or coming into contact with asbestos-contaminated work clothing.[12][24] To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.[citation needed]

Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or DIY activities may expose themselves to asbestos dust. In the UK, use of chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos were banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.[citation needed]

In a recent research carried on white American population in 2012, it was found that people with a germline mutation in their BAP1 gene are at higher risk of developing mesothelioma and uveal melanoma.[42]

Erionite is a zeolite mineral with similar properties to asbestos and is known to cause mesothelioma.[11] Detailed epidemiological investigation has shown that erionite causes mesothelioma mostly in families with a genetic predisposition.[12][20][21] Erionite is found in deposits in the Western United States, where it is used in gravel for road surfacing, and in Turkey, where it is used to construct homes. In Turkey, the United States, and Mexico, erionite has been associated with mesothelioma and has thus been designated a “known human carcinogen” by the US National Toxicology Program.[21]

In rare cases, mesothelioma has also been associated with irradiation of the chest or abdomen, intrapleural thorium dioxide (thorotrast) as a contrast medium, and inhalation of other fibrous silicates, such as erionite or talc.[11][24] Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.[24] This has been confirmed in animal studies,[43][44] but studies in humans are inconclusive.[43][45][46]

The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibers in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fiber can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibers from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibers may be deposited in the gut after ingestion of sputum contaminated with asbestos fibers.[citation needed]

Pleural contamination with asbestos or other mineral fibers has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than “feathery fibers” (chrysotile or white asbestos fibers).[26] However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. “We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately,” said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System.[47]

Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibers. It has been suggested that in humans, transport of fibers to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localized lesions of accumulated asbestos fibers in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumor.[citation needed]

Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibers remain unclear despite the demonstration of its oncogenic capabilities (see next-but-one paragraph). However, complete in vitro transformation of normal human mesothelial cells to a malignant phenotype following exposure to asbestos fibers has not yet been achieved. In general, asbestos fibers are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.[citation needed]

Analysis of the interactions between asbestos fibers and DNA has shown that phagocytosed fibers are able to make contact with chromosomes, often adhering to the chromatin fibers or becoming entangled within the chromosome. This contact between the asbestos fiber and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.[citation needed]

Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:[citation needed]

Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:

Several genes are commonly mutated in mesothelioma, and may be prognostic factors. These include epidermal growth factor receptor (EGFR) and C-Met, receptor tyrosine kinases which are overexpressed in many mesotheliomas. Some association has been found with EGFR and epithelioid histology but no clear association has been found between EGFR overexpression and overall survival. Expression of AXL receptor tyrosine kinase is a negative prognostic factor. Expression of PDGFRB is a positive prognostic factor.[49] In general, mesothelioma is characterized by loss of function in tumor suppressor genes, rather than by an overexpression or gain of function in oncogenes.[50]

As an environmentally triggered malignancy, mesothelioma tumors have been found to be polyclonal in origin, by performing a X-inactivation based assay on epitheloid and biphasic tumors obtained from female patients.[51] These results suggest that an environmental factor, most likely asbestos exposure, may damage and transform a group of cells in the tissue, resulting in a population of tumor cells that are, albeit only slightly, genetically different.[citation needed]

Asbestos fibers have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic (chromosome-breaking) and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.[citation needed]

Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor- (TGF-) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.[citation needed]

Diagnosis of mesothelioma can be suspected with imaging but is confirmed with biopsy. It must be clinically and histologically differentiated from other pleural and pulmonary malignancies, including reactive pleural disease, primary lung carcinoma, pleural metastases of other cancers, and other primary pleural cancers.[11]Primary pericardial mesothelioma is often diagnosed after it has metastasized to lymph nodes or the lungs.[10]

Diagnosing mesothelioma is often difficult because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient’s medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma.[14] A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytopathology if this fluid is aspirated with a syringe.[10] For pleural fluid, this is done by thoracentesis or tube thoracostomy (chest tube); for ascites, with paracentesis or ascitic drain; and for pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).[citation needed] However, with primary pericardial mesothelioma, pericardial fluid may not contain malignant cells and a tissue biopsy is more useful in diagnosis.[10] Using conventional cytology diagnosis of malignant mesothelioma is difficult, but immunohistochemistry has greatly enhanced the accuracy of cytology.[citation needed]

Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. Alternatively, the chest surgeon might directly open the chest (thoracotomy). If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, an open surgical procedure may be necessary.[citation needed]

Immunohistochemical studies play an important role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics, such as breast or lung cancer that has metastasized to the pleura. There are numerous tests and panels available, but no single test is perfect for distinguishing mesothelioma from carcinoma or even benign versus malignant. The positive markers indicate that mesothelioma is present; if other markers are positive it may indicate another type of cancer, such as breast or lung adenocarcinoma. Calretinin is a particularly important marker in distinguishing mesothelioma from metastatic breast or lung cancer.[11]

There are three main histological subtypes of malignant mesothelioma: epithelioid, sarcomatous, and biphasic. Epithelioid and biphasic mesothelioma make up approximately 75-95% of mesotheliomas and have been well characterized histologically, whereas sarcomatous mesothelioma has not been studied extensively. Most mesotheliomas express high levels of cytokeratin 5 regardless of subtype.[11]

Epithelioid mesothelioma is characterized by high levels of calretinin.[11]

Sarcomatous mesothelioma does not express high levels of calretinin.[11]

Other morphological subtypes have been described:

Staging of mesothelioma is based on the recommendation by the International Mesothelioma Interest Group.[52] TNM classification of the primary tumor, lymph node involvement, and distant metastasis is performed. Mesothelioma is staged IaIV (one-A to four) based on the TNM status.[52][53]

Mesothelioma can be prevented in most cases by preventing exposure to asbestos. The US National Institute for Occupational Safety and Health maintains a recommended exposure limit of 0.1 asbestos fiber per cubic centimeter.[24]

There is no universally agreed protocol for screening people who have been exposed to asbestos. Screening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.[54] Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by mesothelioma cells.[55]

Mesothelioma is generally resistant to radiation and chemotherapy treatment. Long-term survival and cures are exceedingly rare.[11] Treatment of malignant mesothelioma at earlier stages has a better prognosis. Clinical behavior of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favors local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease. The histological subtype and the patient’s age and health status also help predict prognosis. The epithelioid histology responds better to treatment and has a survival advantage over sarcomatoid histology.[56]

Surgery, by itself, has proved disappointing. In one large series, the median survival with surgery (including extrapleural pneumonectomy) was only 11.7 months.[57] However, research indicates varied success when used in combination with radiation and chemotherapy (Duke, 2008), or with one of the latter. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed.[citation needed] In localized pericardial mesothelioma, pericardectomy can be curative; when the tumor has metastasized, pericardectomy is a palliative care option. The entire tumor is not often able to be removed.[10]

For patients with localized disease, and who can tolerate a radical surgery, radiation can be given post-operatively as a consolidative treatment. The entire hemithorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations. It can also induce severe side-effects, including fatal pneumonitis.[58] As part of a curative approach to mesothelioma, radiotherapy is commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.[citation needed]

Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy, when given alone with curative intent, has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be beyond human tolerance.[citation needed] Radiotherapy is of some use in pericardial mesothelioma.[10]

Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive “curative” surgery.[59] This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the group of patients treated with cisplatin in the combination with pemetrexed and who also received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.[citation needed] Cisplatin and pemetrexed together give patients a median survival of 12.1 months.[11]

Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.[60]

In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.[citation needed]

In pericardial mesothelioma, chemotherapy – typically adriamycin and/or cisplatin – is primarily used to shrink the tumor and is not curative.[10]

Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Gurin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.[citation needed]

This technique is used in conjunction with surgery,[61] including in patients with malignant pleural mesothelioma.[62] The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained. High concentrations of selected drugs are then administered into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.[citation needed]

All of the standard approaches to treating solid tumorsradiation, chemotherapy, and surgeryhave been investigated in patients with malignant pleural mesothelioma. Although surgery, by itself, is not very effective, surgery combined with adjuvant chemotherapy and radiation (trimodality therapy) has produced significant survival extension (314 years) among patients with favorable prognostic factors.[63] However, other large series of examining multimodality treatment have only demonstrated modest improvement in survival (median survival 14.5 months and only 29.6% surviving 2 years).[57] Reducing the bulk of the tumor with cytoreductive surgery is key to extending survival. Two surgeries have been developed: extrapleural pneumonectomy and pleurectomy/decortication. The indications for performing these operations are unique. The choice of operation namely depends on the size of the patient’s tumor. This is an important consideration because tumor volume has been identified as a prognostic factor in mesothelioma.[64] Pleurectomy/decortication spares the underlying lung and is performed in patients with early stage disease when the intention is to remove all gross visible tumor (macroscopic complete resection), not simply palliation.[65] Extrapleural pneumonectomy is a more extensive operation that involves resection of the parietal and visceral pleurae, underlying lung, ipsilateral (same side) diaphragm, and ipsilateral pericardium. This operation is indicated for a subset of patients with more advanced tumors, who can tolerate a pneumonectomy.[66]

Mesothelioma often has a poor prognosis. Typical survival despite surgery is between 12 and 21 months depending on the stage of disease at diagnosis with about 7.5% of people surviving for 5 years.[67]

Women, young people, people with low-stage cancers, and people with epithelioid cancers have better prognoses.[11] Negative prognostic factors include sarcomatoid or biphasic histology, high platelet counts (above 400,000), age over 50 years, white blood cell counts above 15.5, low glucose levels in the pleural fluid, low albumin levels, and high fibrinogen levels. Several markers are under investigation as prognostic factors, including nuclear grade, and serum c-reactive protein. Long-term survival is rare.[49]

Pericardial mesothelioma has a 10-month median survival time.[10]

In peritoneal mesothelioma, high expression of WT-1 protein indicates a worse prognosis.[11]

Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate varies from one country to another, from a low rate of less than 1 per 1,000,000 in Tunisia and Morocco, to the highest rate in Britain, Australia and Belgium: 30 per 1,000,000 per year.[68] For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.[69] Worldwide incidence is estimated at 1-6 per 1,000,000.[11] Incidence of mesothelioma lags behind that of asbestosis due to the longer time it takes to develop; due to the cessation of asbestos use in developed countries, mesothelioma incidence is expected to decrease.[24] Incidence is expected to continue increasing in developing countries due to continuing use of asbestos.[11] Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.[citation needed] Less than 5% of mesotheliomas are pericardial. The prevalence of pericardial mesothelioma is less than 0.002%; it is more common in men than women. It typically occurs in a person’s 50s-70s.[10][70]

Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[71] Between 1973 and 1984, the incidence of pleural mesothelioma among Caucasian males increased 300%. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women.[citation needed] More than 80% of mesotheliomas are caused by asbestos exposure.[11]

The incidence of peritoneal mesothelioma is 0.53.0 per million per year in men, and 0.22.0 per million per year in women.[72]

Mesothelioma accounts for less than 1% of all cancers diagnosed in the UK, (around 2,600 people were diagnosed with the disease in 2011), and it is the seventeenth most common cause of cancer death (around 2,400 people died in 2012).[73]

The connection between asbestos exposure and mesothelioma was discovered in the 1970s. In the United States, asbestos manufacture stopped in 2002. Asbestos exposure thus shifted from workers in asbestos textile mills, friction product manufacturing, cement pipe fabrication, and insulation manufacture and installation to maintenance workers in asbestos-containing buildings.[24]

Mesothelioma, though rare, has had a number of notable patients:

Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould, a well-regarded paleontologist, was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote “The Median Isn’t the Message”,[80] in which he argued that statistics such as median survival are useful abstractions, not destiny. Gould lived for another 20 years, eventually succumbing to cancer not linked to his mesothelioma.

Some people who were exposed to asbestos have collected damages for an asbestos-related disease, including mesothelioma. Compensation via asbestos funds or class action lawsuits is an important issue in law practices regarding mesothelioma.[citation needed]

The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars.[81] The amounts and method of allocating compensation have been the source of many court cases, reaching up to the United States Supreme Court, and government attempts at resolution of existing and future cases. However, to date, the US Congress has not stepped in and there are no federal laws governing asbestos compensation.[82]In 2013, the “Furthering Asbestos Claim Transparency (FACT) Act of 2013” passed the US House of representatives and was sent to the US Senate, where it was referred to the Senate Judiciary Committee.[83] As the Senate did not vote on it before the end of the 113th Congress, it died in committee. It was revived in the 114th Congress, where it has not yet been brought before the House for a vote.[84]

The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. In 1960, an article published by Wagner et al. was seminal in establishing mesothelioma as a disease arising from exposure to asbestos.[85] The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. Prior to the use of advanced microscopy techniques, malignant mesothelioma was often diagnosed as a variant form of lung cancer.[86] In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker.[87] The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.[citation needed]

In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.[citation needed]

Despite proof that the dust associated with asbestos mining and milling causes asbestos-related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called “Is this Killer in Your Home?” in Australia’s Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, “The Health Hazard at Wittenoom”, containing the results of air sampling and an appraisal of worldwide medical information.[citation needed]

By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.[citation needed]

In Leeds, England the Armley asbestos disaster involved several court cases against Turner & Newall where local residents who contracted mesothelioma claimed compensation because of the asbestos pollution from the company’s factory. One notable case was that of June Hancock, who contracted the disease in 1993 and died in 1997.[88]

The WT-1 protein is overexpressed in mesothelioma and is being researched as a potential target for drugs.[11]

There are two high-confidence miRNAs that can potentially serve as biomarkers of asbestos exposure and malignant mesothelioma. Validation studies are needed to assess their relevance.[89]

Mesothelioma at Curlie (based on DMOZ)

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Mesothelioma – Wikipedia

Mesothelioma | 2018 Statistics, Symptoms, Treatment Options

Most often, mesothelioma is treated with a multimodal plan, or combination, of conventional cancer treatment methods including surgery and chemotherapy. Treatment will either focus on extending life expectancy or, at a late stage, focus on palliative care to relieve side effects. Research and clinical trials have found new hope for a potential cure with emerging treatments, like immunotherapy, to combat the disease and improve life expectancy.

After receiving a mesothelioma diagnosis, the most important step is finding a mesothelioma doctor who specializes in asbestos-related diseases. They will be the best person to determine the most effective treatment options for your individual case, and will also be aware of the latest treatment advancements or clinical trials available. Creating a custom treatment plan with a mesothelioma doctor is the most effective way to improve prognosis.

Learn More About Mesothelioma Treatments

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Mesothelioma | 2018 Statistics, Symptoms, Treatment Options

What is Mesothelioma Cancer? | Mesothelioma Book

Mesothelioma is a cancer found in the lining surrounding the lungs, the stomach, the heart or the testicles. This cancer takes its name from the name that is given to this lining – the mesothelium. The pleura is the name for the mesothelial tissue surrounding the lungs and lining the chest cavity. If the cancer is in this lining, it is called “pleural mesothelioma.” Pleural mesothelioma is the most common type of mesothelioma.

The peritoneum is the lining that covers most of the organs in the abdominal cavity, while the pericardium is the lining that covers and protects the heart. If the cancer is in either of these areas, it is called “peritoneal mesothelioma” or “pericardial mesothelioma.”

Like other forms of cancer, mesothelioma occurs when cells become abnormal and divide or grow out of control. When someone has mesothelioma, the lubricating fluid in the lining may be over-produced. This excess fluid encases the organs with a thick layer of tumor tissue, described as a rind type of layer, that puts pressure on the organs. People with pleural mesothelioma often complain of shortness of breath and a buildup of fluid in the chest area. In advanced cases of mesothelioma, cells metastasize, or grow and invade other organs and spread to other areas of the body.

The only agreed upon cause of mesothelioma is exposure to asbestos.

It often takes 10 to 60 years after exposure to asbestos before the symptoms of mesothelioma develop.

This period of time is referred to as a latency period. Because of the latency period, the disease commonly affects men and women that are at least 50 years of age and that worked with asbestos between 10 and 60 years ago.

However, there are many known cases of people developing mesothelioma at an earlier age. Often these are the sons and daughters whose parents were exposed to asbestos and who unwittingly brought the invisible dust home on their clothes or who did home remodeling projects and used products, such as joint compound, that contained asbestos. In some cases the child was around the parent as the parent changed the brakes – lined with asbestos – in the family car. This is called secondary exposure to asbestos.

Many people working 10 to 60 years ago were not required to use any type of protection in the workplace while they were exposed to asbestos even though the companies that manufactured the products containing asbestos had full knowledge that it was dangerous and that exposure to it would harm the health of many of the workers.

As with other cancers, a speedy diagnosis is important to effective treatment of mesothelioma. If you believe that you may have mesothelioma and that you worked with asbestos in the past, you should inform your doctor of this fact.

If you wish to learn more about mesothelioma, CLICK HERE to receive a free book written by medical professionals who have treated mesothelioma.

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What is Mesothelioma Cancer? | Mesothelioma Book

Mesothelioma.net | Resources for Mesothelioma Victims & Families

While this thank you is long overdue, it is still deeply, deeply heartfelt. My family will be forever grateful to you for your care, compassion, encouragement and for making it possible for us to gather with family and seek help without any worry about work responsibilities. You have such an exemplary and kind heart and we cannot thank you enough for all you did (and continue to do so) to help us get through this difficult time.

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Mesothelioma.net | Resources for Mesothelioma Victims & Families

Mesothelioma | Overview, Top Treatments & Survival Tips

Selecting a Top Doctor is Critical

Selecting a mesothelioma specialist is one of the most important decisions a patient can make. Specialists are doctors who are experienced and knowledgeable about treating a specific disease. General oncologists do not have much experience in treating mesothelioma because only 2,000 to 3,000 cases are diagnosed in the U.S. each year.

A specialist can give patients a more accurate diagnosis which can expand treatment options and improve their prognosis. Treatment prescribed by a specialist can significantly extend a patient’s life. Not every specialist treats every type of mesothelioma. Depending on the stage, type, location, severity and more, certain specialists are a better fit than others.

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Mesothelioma | Overview, Top Treatments & Survival Tips

Mesothelioma Causes, Symptoms, Treatment & Prognosis

Mesothelioma facts

What is mesothelioma?

Mesothelioma is a rare form of cancer (malignancy) that most frequently arises from the cells lining the sacs of the chest (the pleura) or the abdomen (the peritoneum). Pleural mesothelioma is the most common form, often becoming apparent with symptoms in the chest area such as chest pain, cough, and/or shortness of breath. Shortness of breath often occurs due to a large pleural effusion (fluid in the thoracic cavity). Peritoneal mesothelioma is much less common. This can affect the organs in the abdomen, and its symptoms are related to this area of the body, that is, abdominal swelling, nausea, vomiting, and bowel obstruction. The rarest form of mesothelioma is pericardial mesothelioma, which involves the sac surrounding the heart.

There are two major cell types of mesothelioma, epithelial and sarcomatoid. Sometimes both of these cell types can be present, also referred to as biphasic. The sarcomatoid type is rarer and occurs in only about 15% of cases; it portends a poorer prognosis. In very rare cases, mesothelioma can originate from benign, non-malignant cells. Surgery cures this so-called benign mesothelioma.

There are many causes of chest pain. A serious form of chest pain is angina, which is a symptom of heart disease and results from inadequate oxygen supply to the heart muscle. Angina can be caused by coronary artery disease or spasm of the coronary arteries. Chest pain can also be due to a heart attack (coronary occlusion), aortic aneurysm dissection, myocarditis, esophageal spasm, esophagitis, rib injury or disease, anxiety, and other important diseases. Do not try to ignore chest pain and “work (or play) through it.” Chest pain is a warning to seek medical attention.

What are mesothelioma symptoms?

Most people present with complaints of shortness of breath. They also can have complaints of chest pain and cough. Patients may also be asymptomatic, with the disease discovered by physical exam or an abnormal chest X-ray.

As the disease progresses, shortness of breath increases, and weight loss, decreased appetite, and night sweats can develop. Local invasion by the tumor can result in changing of voice, loss of function of the diaphragm, and symptoms specific to the area and involvement of adjacent structures.

What causes mesothelioma?

Most people with malignant mesothelioma have worked on jobs where they breathed asbestos. Usually, this involves men over 40 years of age. Others have been exposed to asbestos in a household environment, often without knowing it. The number of new cases of mesothelioma has been relatively stable since 1983, the same time that the U.S. Occupational Safety and Health Administration (OSHA) instituted restrictions on asbestos. In Europe, the number of new cases of mesothelioma continues to rise.

How much asbestos exposure does it take to get mesothelioma?

An exposure of as little as one or two months can result in mesothelioma 30 or 40 years later and in some cases, as much as 70 years later.

How long does it take after asbestos exposure for mesothelioma to show up?

People exposed in the 1940s, ’50s, ’60s, and ’70s are now being diagnosed with mesothelioma because of the long latency period of asbestos disease.

How do health care professionals diagnose mesothelioma?

Pathological examination from a biopsy diagnoses mesothelioma. A health care professional removes tissue. Then a pathologist places it under a microscope and makes a definitive diagnosis and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid buildup around the lungs (pleural effusions), shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an X-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

What is the prognosis for mesothelioma?

Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated. Unfortunately, oftentimes health care professionals find mesothelioma at a stage in which a cure is unobtainable. Many will succumb to the disease within one year of diagnosis.

Treatment options are determined by the stage of mesothelioma (the extent to which the tumor has spread in the body). There are three staging systems currently in use, and each one measures somewhat different variables.

The oldest staging system and the one most often used is the Butchart system, based mainly on the extent of primary tumor mass and divides mesotheliomas into four stages.

The more recent TNM system considers variables of tumor in mass and spread, lymph node involvement, and metastasis.

TNM system: variables of T (tumor), N (lymph nodes), and M (metastasis)

The Brigham system is the latest system and stages mesothelioma according to resectability (the ability to remove the tumor surgically) and lymph node involvement.

What is the treatment for mesothelioma?

There are three traditional kinds of treatment for patients with malignant mesothelioma. Often physicians combine two or more of these in the course of treatment:

Surgery: There are several types of surgery used in treating mesothelioma.

Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are (internal radiation therapy).

If fluid has collected in the chest or abdomen, your doctor may drain the fluid out of your body by putting in a needle into the chest or abdomen and using gentle suction to remove the fluid. If a doctor removes fluid from the chest, this is called thoracentesis. If a physician removes fluid from the abdomen, this is called paracentesis. Your doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.

Health care professionals administer adjuvant radiation in a manner to avoid exposure of the opposite lung to radiation and its potential side effects.

Chemotherapy is the use of drugs to kill cancer cells. Health care professionals administer chemotherapy by pill, or it may be put into the body by a needle in the vein or muscle. Often, a platinum-based chemotherapy (cisplatin or carboplatin) drug is given along with a second agent, pemetrexed. The side effects can be quite toxic, therefore they are used in people who are physically well enough to tolerate these side effects.

Chemotherapeutic agents can be administered either systemically (through the bloodstream) or intrapleurally (in the pleural cavity). When it is administered intrapleurally, the treatment is localized at the site of the tumor. These drugs are generally very toxic and you should discuss their use very carefully with your physician.

Is there any promising research or are there promising drugs for mesothelioma?

Medical researchers are testing new approaches to treat malignant mesothelioma. They often combine traditional treatments or include something entirely new. They include:

Research is being conducted at various cancer centers all over the United States.

A recent study involving L-NDDP produced two cases of remission in mesothelioma patients. Another study found that a drug known as lovastatin might hold promise for mesothelioma patients.

To learn more about mesothelioma clinical studies and journal medical journal articles, visit the Mesothelioma Web (http://www.mesotheliomaweb.org).

What other kinds of information is available for people with mesothelioma?

There are numerous cancer web sites, some specific to mesothelioma. Because they are often difficult to locate, we have listed some relevant medical web sites that have information about mesothelioma.

American Institute for Cancer Research(http://www.aicr.org)

American Thoracic Society(http://www.thoracic.org/)

Canadian Cancer Society(http://www.bc.cancer.ca)

Mesothelioma Web(http://www.mesotheliomaweb.org)

Medically Reviewed on 7/5/2018

References

Mujoomdar, A.A., and D.J. Sugarbaker. “Hyperthermic Chemoperfusion for the Treatment of Malignant Pleural Mesothelioma.” Semin Thorac Cardiovasc Surg 20.4 Winter 2008: 298-304.

Ried, Michael, et al. “Cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion for malignant pleural tumours: perioperative management and clinical experience.” Eur J Cardio-thoracic Surgery 43.4 April 2013: 801-807.

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Mesothelioma Causes, Symptoms, Treatment & Prognosis

Malignant Mesothelioma Cancer | Prognosis, Treatment & Legal Help

Many families find themselves overwhelmed by the cost of mesothelioma treatment and the challenges of caring for a loved one full time. You should not have to worry about how you can afford legal help, too.

A good malignant mesothelioma attorney will provide a free initial consultation on your case. You should also not be charged anything to get started on your claim. Instead, the mesothelioma attorney should be willing to handle your case on a contingency-fee basis. That means you dont pay anything until the attorney recovers compensation for you.

Contact us to discuss your legal options for pursuing compensation after a mesothelioma diagnosis. As an added service to veterans, our attorneys also take care of VA claims for those diagnosed with mesothelioma.

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Malignant Mesothelioma Cancer | Prognosis, Treatment & Legal Help

Mesothelioma: How Has Paul Kraus Survived For Over 20 Years?

Looking for mesothelioma information? The following section provides extensive information about mesothelioma, including symptoms, treatment, and more. Click on an item in the menu below to jump to that topic:

Mesothelioma is a rare form of cancer that develops from cells of the mesothelium, the lining that covers many internal organs. There are approximately 2,000 cases of mesothelioma diagnosed in the United States each year. Mesothelioma is caused by exposure to asbestos, a naturally-occurring carcinogen that was put into thousands of industrial and consumer products even after many companies knew that it was dangerous.

Although rare, mesothelioma cancer is not a death sentence. The worlds longest-living mesothelioma survivor wrote a free book to provide helpful insight, resources, and share his survival experiences.

Mesothelioma is a rare form of cancer, known as the asbestos caused cancer, that develops from cells of the mesothelium, the lining that covers many of the internal organs of the body.

The main purpose of the mesothelium is to produce a lubricating fluid between tissues and organs. This fluid provides a slippery and protective surface to allow movement.

For example, it allows the lungs to expand and contract smoothly inside the body each time you take a breath. When the cells of the mesothelium turn cancerous they become mesothelioma thats where the name comes from.

Mesothelioma is a rare disease and there are only approximately 2,000 cases diagnosed in the United States every year. There are many more cases diagnosed throughout the world, especially in Australia and the U.K. where large amounts of asbestos was used.

Number of cases per year in other countries:

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There are four types of malignant mesothelioma: Pleural, peritoneal, pericardial and testicular. Pleural mesothelioma affects the outer lining of the lungs and chest wall and represents about 75% of all cases. Peritoneal mesothelioma affects the abdomen and represents about 23%. Incidences of cases in the lining of the testis and the heart represent about 1% each.

Pleural mesothelioma affects the lining of the lungs

When then pleural lining around the lungs and chest wall are involved in this cancer it is called pleural mesothelioma. There are actually two layers of tissue that comprise the pleural lining. The outer layer, the parietal pleura, lines the entire inside of the chest cavity. The inner layer is called the visceral pleura and it covers the lungs.

Mesothelioma usually affects both layers of the pleura. Often it forms in one layer of the pleura and invades the other layer. The cancer may form many small tumors throughout this tissue.

Learn More About Pleural Mesothelioma

The Peritoneal Cavity surrounds the liver, stomach, intestines and reproductive organs.

When the peritoneum, the protective membrane that surrounds the abdomen is involved in this cancer it is called peritoneal mesothelioma. Just like pleural mesothelioma, there are two layers of tissues involved with the peritoneum, the parietal layer covers the abdominal cavity, while the visceral layer surrounds the stomach, liver and other organs.

The cancer often forms many small tumors throughout the tissue. One doctor has described it as if someone took a pepper shaker and scattered the pepper over the tissue.

Learn More About Peritoneal Mesothelioma

In addition to the different types of locations within the body, there are also different cell types. These types are all considered mesothelioma, but they can affect the patients prognosis.

The three mesothelioma cell types are: epithelioid, sarcomatoid and biphasic.

Epithelioid mesothelioma cells are the most common type of mesothelioma cell and has the best prognosis of the three cell types. Notice the dark purple, elongated egg shaped cells amongst the healthy pink colored tissue.

Sarcomatoid mesothelioma cells are the rarest of the three cell types and tends to be more aggressive than epitheloid cells. Notice the dark purple nodules amongst the healthy light purple colored tissue.

Biphasic mesothelioma cells are mixtures of both cell types (epithelioid and sacromatoid) and usually has a prognosis that reflects the dominant cell type.

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More Symptoms

Mesothelioma is caused by exposure to asbestos and it is therefore considered the asbestos caused cancer.

Asbestos has been in use since ancient times, but after the Industrial Revolution its use became widespread and was used all over the world in thousands of industrial and consumer products even after many companies knew that it was dangerous. Construction materials, automotive parts and household products such as hair dryers and oven mitts contained asbestos in the past.

Today, asbestos has been outlawed in most places around the world, however, asbestos has not been outlawed in the United States and is still found in millions of homes and public buildings, such as schools, offices and parking garages.

Learn More About Causes

Asbestos under the microscope looks like hundreds of tiny swords

Asbestos is actually a naturally occurring mineral found throughout the world. It was called the magic mineral because it is resistant to heat and corrosion. Also, it is a fiber so it can be woven into other materials.

Asbestos is composed of millions of sharp microscopic fibers. These fibers are so small that the body has difficulty filtering them out. This means that if you around airborne asbestos you may inhale it or ingest it. This is known as asbestos exposure.

The actual process as to how asbestos causes mesothelioma is still being investigated. Most scientists believe that when the small sharp fibers are ingested or inhaled they cause cell damage which can cause chronic inflammation.

This inflammation can then set the stage for disease after many years or even decades. Some scientists believe that a persons immune system may actually help prevent the cancer, even if that person is exposed to asbestos.

Find Out More On Asbestos

Since asbestos causes this rare disease, how to people get exposed to asbestos? While asbestos was in thousands of products, workers in some professions had more exposure to this carcinogen than others.

Examples of occupations that exposed workers to asbestos includes: Navy veterans, construction trades such as electricians, mechanics, and plumbers, people working in power houses and power plants, firefighters, and refinery workers. Individuals in these professions often had a multitude of asbestos containing products on their various job sites.

Most asbestos containing products were removed voluntarily by the late 1970s. However, because there is no comprehensive ban on asbestos in the U.S. and because of the long latency period, people are still being diagnosed with mesothelioma today.

Learn More About Occupational Asbestos Exposure

Old Advertisement for Asbestos Sheets

The history of asbestos in the United States and other industrialized countries is a sad story of corporate greed. Companies that produced asbestos containing products saw their workers becoming sick with lung scarring, asbestosis, and cancer nearly 100 years ago.

Some companies even brought in researchers and scientists to better understand the health impact of asbestos. Once it was shown that their magic mineral was toxic to human beings, the industry faced a dilemma.

Should they protect workers, warn consumers, notify public health officials, and most importantly, phase out this dangerous mineral? Their answer was no.

Instead industry did just the opposite. They warned no one, kept their knowledge about asbestos secret and continued to use it for decades! Only by the 1960s did independent researchers like Dr. Irving Selikoff of Mt. Sinai School of Medicinebegin to connect asbestos exposure to disease.

By then hundreds of thousands of men, women, and children were already exposed to this deadly mineral. The EPA would ban asbestos in 1989. However, the asbestos industry would sue the EPA and win.

In 1991 the ban was lifted. Even today, there is no comprehensive asbestos ban in the United States. Sad but true.

(Asbestos Medical and Legal Aspects by Barry Castleman)

Asbestos fibers cling to the clothing of workers and can be transferred to others, such as children or spouses.

People exposed directly to asbestos are called primary exposed. Sometimes the person who is primary exposed will transfer asbestos fibers from their clothes to the clothes of another person. The person who gets this transfer of asbestos exposure is said to have secondary exposure.

One example of secondary exposure is called the deadly hug. Sadly, the deadly hug happens when an adult comes home from work with asbestos on their clothes and hugs their son or daughter, unknowingly transferring the dangerous fibers to their child. There have been many cases of adults being diagnosed with mesothelioma whose only exposure to asbestos came from their time as a child.

Read About Secondary Exposure

There is a long latency period for mesothelioma which is the time from asbestos exposure to diagnosis of the cancer. This period can range anywhere from 20 to 50 years. There are different theories as to why there is such a long latency period and why most people exposed to asbestos do not get mesothelioma.

One theory suggests that there may be other variables that play a role. For example, some doctors believe that the condition or competency of a persons immune system could determine whether asbestos in their body leads to cancer.

Other possibilities include a persons genes and diet.

When doctors suspect a patient has mesothelioma they will initiate a work-upin order to make a diagnosis. This work-up may include imaging scans, biopsies, pathology exams, blood tests and staging.

Diagnosing Mesothelioma

Various types of scans may be used to determine if there are signs of tumors or other abnormalities. These scans may include X-rays, CT scans, MRIs, or PET scans.

More on Imaging

If scans reveal what doctors believe may be a cancer then a biopsy may be suggested. A biopsy is a procedure where doctors remove a small piece of the suspected tumor tissue from the patients body.

More on Biopsies

Blood tests and biomarkers may sometimes be used to determine if mesothelioma is present in the body. While these tests are helpful they are not considered as important as the biopsy which is considered the gold standard.

More on Biomarkers

The biopsy material will then be given to a pathologist. A pathologist will use special stains and other tests to determine if there is cancer and identify exactly what type of cancer was removed from the patient.

More on Pathology Exams

If mesothelioma is diagnosed, doctors may stage the disease. Over the years a variety of staging systems have been used. The one used most frequently today groups the disease into localized (only in the mesothelium) or advanced (spread outside the mesothelium).

More on Staging

The prognosis of mesothelioma or any other cancer depends on a number of variables. Those variables include:

More on Prognosis

A doctor specializing in mesothelioma can properly diagnose you and determine the best course of treatment. Find a mesothelioma specialist or doctor near you.

The treatments for mesothelioma can be divided into three paths: Conventional Therapies, Clinical Trials, and Alternative Modalities.

Conventional therapies include chemotherapy, radiation therapy and surgery. The standard chemo drugs used are Alimta (pemetrexed) and cisplatin (or carboplatin). They are often prescribed for the various types of mesothelioma, regardless of location. Both chemo and radiation therapy are known as cytotoxic or cell killing therapies. They work indiscriminately, killing both healthy and cancer cells. This is the reason that they can have severe side effects.

Learn About Treatment

The standard of care in many hospitals is to treat peritoneal mesothelioma with surgery and HIPEC. HIPEC stands for hyperthermic intraperitoneal perioperative chemotherapy which basically means flushing the surgical area with heated chemotherapy during the surgical procedure. The obvious advantage of this approach is that it enables doctors to put the chemo in exactly the place it needs to be.

Of all the conventional treatments available, surgery is generally considered the most effective. For pleural mesothelioma, there are various types of surgical procedures, including lung sparring surgery (also called pleurectomy/decorticiaton or PD) and extrapleural pneumonectomy (also called EPP).

Pleurectomy/decortication surgery is a two-part surgery that removes the lining surrounding one lung (pleurectomy), then removes any visible cancer seen growing inside the chest cavity (decortication). The advantage of P/D or lung sparring surgery is exactly what the name implies a lung is not removed.

An extrapleural pneumonectomy (EPP) is a much more invasive surgery than PD. An EPP involves removing a lung, the diaphragm, portions of the chest lining and heart lining, and nearby lymph nodes.

Numerous studies have been performed comparing the prognosis with a pleurectomy/decortications surgery versus an extrapleural pneumonectomy. While there is no consensus on the subject, the latest reports suggest that PD may be a better choice for many patients because survival is generally equivalent to EPP and PD is less invasive and therefore easier to tolerate.

There are also other surgical procedures used to treat pleural effusion. Pleural effusion is the buildup of excess fluid in the pleural space between the visceral and parietal linings of the lungs. Examples of these procedures include pleurodesis and thoracentesis.

More on Surgery

Clinical trials are treatments that are still being tested. These treatments may include chemotherapy or other more innovative approaches based on immune therapy, gene therapy or other biological approaches. One example of new treatments being tried in mesothelioma involve the use of monoclonal antibodies. Monoclonal antibodies are essentially an immune system therapy that tries to use antibodies to target cancer cells. The National Cancer Institute indexes clinical trials offered throughout the country.

Discover Clinical Trials

Alternative modalities include a large number of approaches such as intravenous vitamin therapy, herbs and Traditional Chinese Medicine, cannabis oil, dietary approaches, and mind-body medicine. It is important to note that while none of these modalities are FDA approved, there are a number of long-term mesothelioma survivors who have used them, including Paul Kraus.

Read About Alternative Treatments

Mesothelioma is not the only disease caused by asbestos. Asbestosis which is essentially scarred lung tissue, pleural plaques and some lung cancers can also be caused by asbestos. There may also be compensation available to victims of these diseases as well. Treatments vary by condition.

Learn About Other Asbestos Diseases

Factors such as multi-drug resistance, therapy related side effects, and disease recurrence after therapy have all been implicated as problems that prevent successful treatment of malignant mesothelioma. However, recent scientific evidence suggests that some common dietary phytochemicals, such as curcumin and quercetin, may have the ability to regulate microRNAs associated with malignant mesothelioma and possibly inhibit the cancer by regulating the expression of various genes which are known to be aberrant in malignant mesothelioma.

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Mesothelioma: How Has Paul Kraus Survived For Over 20 Years?


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