Understanding the root cause of a disease forms a significant part of defense in toxic tort cases. Foremost among these involve determining whether the suspected product could cause the disease in question, and if the plaintiff was exposed in adequate amounts. Meanwhile, genetic science, in cases of cancer, especially mesothelioma, proves to be an added factor in investigations. In addition to being applicable in defense for asbestos cases, newly discovered medical research that questions the direct linkage of asbestos and mesothelioma may play a vital role in other toxic tort cases involving cancer.
By the virtue of being a genetic disease, cancer is caused by gene mutations that regulate cellular growth and multiplication. Evidence has been found that links malignant mesothelioma to various causes, some of which do not relate to asbestos. Furthermore, extensive epidemiological data suggests that most pleural mesotheliomas in women, along with almost all peritoneal mesotheliomas in both genders in the US show no relation to asbestos.
In recent advancements, experts in the field detailed cutting-edge insights on the onset of mesothelioma at a summit in July 2019. It was reportedly stated at this event that an increasing number of cancers are now being attributed to inherited mutations of DNA repair and other genes. These mutations, when present, are found to accelerate the build-up of DNA damage or the percentage of cells carrying that damage, and this may also apply to mesothelioma cases.
Essentially, these genetic cases fall under two categories: somatic or random genetic mutations and germline genetic mutations. Somatic mutations arise naturally and accumulate as a person ages due to DNA changes that occur during stem cell divisions. Notably, random mutations are accountable for two-thirds of the risk for many types of cancer. Meanwhile, some mesotheliomas are associated with inherited germline mutations. Approximately 12% of patients present pathogenic germline mutations of BAP1 and other tumor suppressor genes, and these cases are often among individuals who rarely report asbestos exposure.
In conclusion, there are several important takeaways from this analysis. Most importantly, when analyzing a toxic tort case involving cancer, the most obvious “toxin” may not necessarily be the root cause. Medical practitioners should consider genetic testing when there’s doubt about the cause, despite potential opposition from plaintiffs’ counsel. Additionally, it’s essential to note that genetic germline mutations do not automatically equate to an “eggshell plaintiff,” and the capacity of mutations themselves to cause the disease adds a layer of complexity to the application of the eggshell plaintiff doctrine.
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