For decades, mesothelioma has been documented primarily in men with direct occupational asbestos exposure: military veterans and former workers in construction, shipbuilding and manufacturing. With a latency period of 20 to 60 years from initial exposure to diagnosis, patients are typically older than 65.

For physicians, the data raises practical questions about risk assessment and early detection of pleural mesothelioma in patients who don’t fit the established profile. The results point to gaps in how risk is understood and whether younger patients are being identified early enough.

Why Are Younger People Getting Mesothelioma?

Memorial Sloan Kettering spotlighted the case of Reicy Bobadilla, MD, to illustrate how unpredictable this disease can be in younger people. An orthopedic surgeon in the Dominican Republic, she was 43 when colleagues urged her to get a scan for a persistent cough. She had no family history of cancer, no known genetic predisposition and hadn’t identified a known source of asbestos exposure. Her diagnosis was mesothelioma.

The study, published in JCO Precision Oncology, is what Dr. Offin describes as the first report from a hospital on the growing appreciation of mesothelioma in younger people. Many of those patients, especially those diagnosed under 35, didn’t know how they may have been exposed to asbestos. Women with mesothelioma made up a disproportionately high share of the studied group, and about 70% had a family history of cancer, most often breast, lung or colon cancer.

Experts have long established that asbestos exposure is the primary cause of mesothelioma. Certain inherited gene mutations like those in BAP1 and BRCA1/BRCA2 may add to the risk of someone exposed to asbestos developing mesothelioma. While this study found mutations in some younger patients, Dr. Bobadilla had none. Cases like hers are pushing doctors to look more carefully at potential asbestos exposures younger people may have experienced.

How Younger People May Have Been Exposed to Asbestos

Doctors at Memorial Sloan Kettering specifically pointed to the collapse of the World Trade Center towers on September 11, 2001 as a possible asbestos exposure source for the younger patient population. The towers extensively contained asbestos building materials, and their destruction released a massive cloud of toxic dust into the air, exposing hundreds of thousands of people. Because mesothelioma typically takes 20 to 60 years to develop after exposure, children exposed in the wake of September 11 are entering the window when symptoms could become more pronounced.

Secondary exposure is another possibility. First responders and recovery workers faced the heaviest exposure from 9/11 and could have unknowingly brought asbestos fibers home on clothing, skin or hair. Family members who regularly worked around asbestos in firefighting, construction or manufacturing could have unknowingly brought fibers home as well.

Older apartment buildings, homes and military housing also often contain legacy asbestos. The mineral was widely used in construction materials through much of the 20th century. People who grew up in older homes with asbestos could have had significant exposure.

Baby powder containing asbestos-contaminated talc was widely used on infants and children for decades. Talc has also been a primary ingredient in makeup and other personal hygiene products. Asbestos and talc form near each other and talc can become contaminated when mined. Studies have linked asbestos-contaminated cosmetic talc to mesothelioma cases where it was the only identified source of exposure.

Early Detection and Treatment for Younger Mesothelioma Patients

According to Memorial Sloan Kettering, Dr. Adusumilli says the medical community should consider mesothelioma when a younger person presents with symptoms like a persistent cough, chest pain or shortness of breath that doesn’t improve with antibiotics. Dr. Bobadilla’s case illustrates how easy it can be to dismiss those symptoms. She’d been coughing for 2 weeks before colleagues urged her to get a scan, and her first instinct was that they were overreacting.

Early mesothelioma diagnosis changes outcomes. Because Dr. Bobadilla was diagnosed early and was in excellent physical shape, Drs. Adusumilli and Offin told her at their first appointment that her cancer was treatable and her prognosis was very good. She had 4 cycles of chemotherapy, then surgery and a month of daily radiation, continuing to see patients and performing surgeries throughout her treatment. Her most recent scans show no signs of the cancer returning.

Mesothelioma treatment for someone in their 30s or 40s can differ significantly from treatment for a patient in their 70s. Doctors can analyze tumor tissue to identify specific characteristics of the cancer cells and match patients to targeted therapies or clinical trials. Dr. Offin noted that younger patients should seek care at a comprehensive cancer center, and that where a patient receives their first treatment matters.The study’s authors hope their findings push the medical community to think differently about who gets mesothelioma and how quickly it gets identified. For younger patients who do receive a diagnosis, our Patient Advocates can help connect them with specialists, navigate treatment options and find supportive services.

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The study is enrolling 30 patients with the epithelioid subtype of pleural mesothelioma. To be eligible, participants have tumors that can’t be fully removed surgically. Patients must also have already completed chemotherapy or immunotherapy. Instead of aiming for a full resection, surgeons will perform a limited partial pleurectomy and decortication designed to ease symptoms such as pain, fluid buildup and shortness of breath.

Key Facts

• The University of Chicago trial is enrolling 30 pleural mesothelioma patients.
• It’s limited to patients with borderline resectable or unresectable epithelioid disease.
• Patients must complete chemo or immunotherapy (induction systemic therapy) before surgery.
• The main goal is symptom control and quality of life.
• Most patients are expected to go home in 3 to 5 days after surgery.

For patients and families, the biggest takeaway is this isn’t a curative surgery study. It’s a palliative-intent clinical trial for a specific group of patients who usually would receive medication-based therapy alone.

What the Trial Is Testing

Dr. Darren Bryan, thoracic surgeon at the University of Chicago, spoke with us and said the procedure is much different from the more aggressive mesothelioma surgeries patients may know about. “The goal of traditional mesothelioma surgery is the removal of all tumor that can be seen or felt. The goal of a limited pleurectomy and decortication operation is symptom control through removal of the pleura on the chest wall, and getting the lung to re-expand,” Dr. Bryan explained.

The operation has two parts. Surgeons remove affected pleura from the chest wall, which may help the lung stick back to the rib cage and reduce future fluid buildup. They also remove pleura from the lung in areas where tumor is compressing it, helping the lung re-expand.

The mediastinum, pericardium and diaphragm are left untouched in this trial. That makes it different from standard or extended P/D, which are usually offered only when surgeons believe all visible disease can be removed.

Why This Approach Matters

During our conversation, Dr. Bryan shared that he and his team noticed something unexpected: some patients whose tumors weren’t fully removed during surgery still reported fewer mesothelioma symptoms afterward, including less chest pain and shortness of breath. That pattern made them wonder whether intentional partial removal could help patients feel better without trying to eliminate the tumors entirely.

“We began to ask, ‘Could we potentially use surgery to help people live comfortably for a longer time?’” he told us. “That is what this trial is attempting to answer.”

That question is especially important for patients with unresectable pleural mesothelioma, who today are generally treated with systemic therapy alone. Dr. Bryan said his team wanted to study whether a limited surgery could work with chemo, immunotherapy or other systemic treatments rather than replace them.

“The hoped-for model is that surgery improves symptoms and local ‘pleural mechanics’ enough to help patients continue with systemic therapy in better condition,” he said.

Who May Be a Good Fit

The best candidates for this trial are patients with epithelioid pleural mesothelioma, according to Dr. Bryant. Their disease must not have spread beyond the chest, but must still be ineligible for full resection because of the amount or location of disease.

That criteria may include patients with significant diaphragm or mediastinal involvement, where surgeons are unlikely to achieve a complete resection. He added that the study may be especially appealing to patients who are focused on improving their quality of life.

Patients with the biphasic or sarcomatoid subtypes of mesothelioma aren’t eligible. Neither are patients whose cancer has spread beyond the chest.

What Patients Should Know

The study’s main goal is to see whether partial pleurectomy can help control symptoms and preserve quality of life. Dr. Bryan says researchers will also track complications, length of hospital stay, how soon patients can resume systemic therapy, and survival.

He emphasized this is still a major surgery, even if it’s smaller in scope than traditional mesothelioma operations. For unresectable patients, joining the clinical trial means undergoing an operation they otherwise wouldn’t have had. For borderline resectable patients, it means not attempting a full resection.

“The most important point is that this is a palliative-intent, symptom-focused surgical study for a very specific group of patients,” Bryan said. “This is not an attempt at curative surgery.”

He added, “Now more than ever, patients and providers are rightfully focused on quality of life.” Dr. Bryan believes this is the right time to test the approach because palliative care and quality of life have become a bigger focus in cancer care, while mesothelioma surgery has become safer and better tolerated.

If the study shows a meaningful quality-of-life benefit, Dr. Bryan told us it could lead to a larger randomized trial. This could potentially open surgical options to mesothelioma patients who previously weren’t considered candidates.

Patients interested in the study will undergo mesothelioma biopsy confirmation, imaging, pulmonary function testing, lab work and multidisciplinary review. The hospital must also accept the patient’s insurance, and the surgery would be billed through standard care.

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On March 27, 2026, the U.S. Senate unanimously passed a resolution to designate April 1 to 7 as National Asbestos Awareness Week. Senators Jeff Merkley (D-OR) and Steve Daines (R-MT) championed the bipartisan resolution that calls on the U.S. Surgeon General to issue a renewed asbestos warning. 

Senators Dick Durbin (D-IL), Ed Markey (D-MA), Alex Padilla (D-CA) and Cory Booker (D-NJ) co-sponsored the resolution that underscores asbestos remains a serious public health threat. Their support signals concern over asbestos exposure crosses party lines and reflects a growing recognition that the U.S. has more to do to protect workers, families and communities from this known carcinogen.

“Global Asbestos Awareness Week reminds us that the asbestos crisis is not over in the United States. Asbestos is a known human carcinogen with no safe level of exposure and prevention remains the most effective way to save lives,” Linda Reinstein, president and CEO of the Asbestos Disease Awareness Organization, tells us.

“One life lost from an asbestos-caused disease is tragic. Over a million is unconscionable. ADAO thanks bipartisan Senate champions, including Senator Jeff Merkley and Senator Steve Daines, for their leadership in advancing public health protections,” Reinstein adds.

Asbestos Still Claims Tens of Thousands of Lives

The World Health Organization estimates that globally asbestos causes more than 200,000 deaths every year. It’s responsible for more than 70% of all deaths from work-related cancers. In the U.S. alone, approximately 40,000 people die from asbestos-related diseases each year.

Asbestos is the primary cause of mesothelioma. This rare and aggressive cancer can take 20 to 60 years to develop after exposure, which means many people diagnosed today had their first contact with asbestos decades ago, often without knowing it.

Legacy asbestos in older buildings continues to put workers at risk today. WHO notes that anyone working on buildings where asbestos is still present faces potential exposure. That means the risk persists, even many years after asbestos products were installed and in countries that have already enacted bans.

Secondary asbestos exposure also puts families at serious risk. Asbestos fibers from worksites cling to the clothing and hair of workers, which can then expose family members in their home when hugging their loved one or laundering work clothes. These fibers can also be transferred to upholstery and carpeting in the home. The Journal of Lung Health and Diseases estimates secondhand asbestos exposure accounts for around 30% of U.S. mesothelioma cases. 

The Global Asbestos Ban Remains Incomplete

In the U.S., the situation remains complicated. The Environmental Protection Agency finalized a rule in 2024 restricting chrysotile asbestos, the last form still commercially used in the country. But that rule doesn’t address legacy asbestos, the material already present in older buildings and products. ADAO calls legacy asbestos an urgent and unresolved public health threat.

Industry groups are challenging the EPA’s chrysotile rule before the Fifth Circuit Court of Appeals, with oral arguments scheduled for early June 2026. A successful challenge could weaken years of regulatory progress. 

“During Global Asbestos Awareness Week, we call on the United States to match the science with action. Americans remain at risk from ongoing asbestos exposure. Bipartisan Senate leadership continues to play a critical role in advancing prevention, education and policy solutions to end this public health crisis,” Reinstein says.

Nearly 70 countries have banned asbestos, but major producers and consumers including China, India and Russia haven’t. India banned asbestos mining in 2011 but continues to import and process chrysotile asbestos in large quantities, according to a peer-reviewed analysis in Public Health Action. Chrysotile is widely used in asbestos-cement roofing.

Countries with strong health infrastructure are more likely to recognize the problem, enact bans and track disease. Those without it often can’t, meaning the true global death toll likely exceeds reported figures.

What Global Asbestos Awareness Week Does and Why It Matters

Global Asbestos Awareness Week brings together scientists, policymakers, public health professionals and people facing asbestos-related diseases. ADAO’s 2026 program includes multilingual educational materials, survivor stories, daily thematic events and expanded digital tools. The week wraps up with a Virtual Candlelight Vigil honoring those who have lost their lives to asbestos-related diseases.

International organizations have joined the effort. The Institution of Occupational Safety and Health serves as a Day Six Partner for Prevention this year, citing asbestos as one of the most persistent occupational health hazards in the world. IOSH’s involvement shows how this awareness initiative has grown from a U.S.-focused campaign into a global movement.

ADAO’s 2026 legal advocacy targets several fronts at once. The organization works to defend the EPA’s chrysotile asbestos rule, enforce deadlines under the Toxic Substances Control Act and advance the Alan Reinstein Ban Asbestos Now Act through Congress. Each of those efforts connects directly to the awareness week’s core message: awareness must lead to prevention and prevention requires enforceable policy.

Prevention remains the only known way to stop asbestos-related diseases. No cure exists for mesothelioma or asbestosis and research into treatment continues. That makes the focus on education and policy not just timely, it’s essential.

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The 1977 paper concluded there was no reason to believe cosmetic talc use could cause cancer. Two public health historians uncovered documents showing Roe shared an advance draft with J&J and revised it based on the company’s feedback before publication. The Lancet’s editors called that undisclosed relationship a “clear breach of publishing ethics.”

This retraction matters beyond the journal world. Defense attorneys in talc lawsuits have used the 1977 paper for decades to argue that cosmetic talc doesn’t cause cancer. Plaintiffs’ attorneys say they now plan to use the retraction directly in upcoming trials against Johnson & Johnson.

How Historians Uncovered the Conflict

Two public health historians brought the conflict of interest to The Lancet’s attention. David Rosner at Columbia University and Gerald Markowitz at John Jay College of Criminal Justice sent a letter to the journal on Dec. 8, 2025, detailing what they found in corporate discovery documents.

Those documents showed Roe shared an advance draft of the 1977 paper with J&J before publication. He then revised it based on the company’s feedback. Neither The Lancet nor its readers knew about Roe’s relationship with J&J at the time of publication.

Rosner and Markowitz found the evidence in ToxicDocs, an open-source database containing more than 15 million pages of documents related to asbestos, lead and other industrial contaminants. Court discovery surfaced the materials in talc-related lawsuits. Rosner said the findings revealed how clearly J&J executives understood what they were doing and how willing a respected scientist was to cooperate with them.

The Lancet’s editors responded quickly after receiving the letter. In their published reply, they said that had editors at the time known about his undeclared relationship with J&J, they wouldn’t have published the paper.

Why the 1977 Paper Mattered

The paper’s original publication came at a crucial moment. In the 1970s, U.S. health officials and the cosmetics industry were fighting over whether to regulate asbestos-contaminated talc. The unsigned Lancet commentary helped the industry push back against proposed federal rules.

Rosner and Markowitz wrote that the paper gave the industry’s opposition added legitimacy. It claimed that cosmetic manufacturers in the U.S. and the U.K. had already ensured their products were nearly free of asbestos, so regulation wasn’t necessary. That argument influenced both federal policy and later litigation.

J&J is pushing back on the retraction. The company claims Rosner and Markowitz are paid expert witnesses for plaintiffs in talc litigation. In a statement, J&J called the retraction part of what it described as “underhanded litigation tactics.” J&J also said FDA officials knew at the time that Roe wrote the paper as an opinion piece.

What This Means for Talc Lawsuits

The retraction carries direct implications for J&J’s ongoing legal battles. J&J faces more than 67,000 lawsuits from people who say they developed ovarian cancer or mesothelioma after using talc-based baby powder and other talc products.

Leigh O’Dell, an attorney representing women who say J&J’s talc caused their cancers, called the retraction “a clear specific example of J&J’s ghost-writing efforts being called out by an independent third party.” O’Dell said her team will use The Lancet’s withdrawal of the paper in trials moving forward. That position reflects a broader shift in how plaintiffs’ attorneys approach J&J’s scientific record.

Recent verdicts show juries are already holding J&J accountable. In December 2025, a Baltimore jury awarded $1.56 billion to Cherie Craft, a Maryland woman diagnosed with peritoneal mesothelioma after decades of using J&J’s talc-based baby powder. J&J has tried to resolve the broader talc litigation through multiple bankruptcy attempts. But federal courts have rejected the proposal each time. The company stopped selling talcum powder worldwide in 2023 and switched to a cornstarch-based baby powder formula. Though the company maintains its talc products have always been safe.

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PITAC is minimally invasive while still fighting this aggressive cancer. Dr. Backhus explains the aerosolized chemo may reach “the cracks and crevices” of the chest better than traditional chemo for mesothelioma can after surgery. She added that PITAC may help fill a gap between major surgery and simple symptom control.

For patients ineligible for more radical mesothelioma surgeries, PITAC may offer an important option. It can both treat the cancer and relieve uncomfortable symptoms like pleural effusions, improving quality of life.

A Lower-Risk Option For Select Patients

Dr. Backhus says PITAC stands out because more patients may be eligible for it than radical surgery. “It threads a needle,” she tells us, describing it as a treatment with early promise and “very, very low” harm compared with higher-risk operations.

That matters in pleural mesothelioma, where treatment decisions are often difficult and highly individualized. Backhus says some patients aren’t well enough to tolerate a major surgery such as pleurectomy/decortication.

The role of surgery for pleural mesothelioma has been at the center of debate since the MARS 2 trial results were released. The results put the survival benefits of  pleurectomy/decortication surgery in question. However, a recent Mount Sinai study spotlighted nuances in the discussion, finding that with careful patient selection, lung-sparing surgery can have positive outcomes and very low mortality. And now PITAC may expand options for those patients who don’t qualify for P/D.

Why Careful Patient Selection Matters for PITAC

PITAC is best suited for mesothelioma patients with pleural effusion and cancer spread contained in the chest, a 2025 University of Pisa study reports. Based on these criteria, Dr. Backhus shares that the first Stanford PITAC patient was a strong PITAC candidate.

“So her tumor burden was incredibly low,” Dr. Backhus explains. “But she was symptomatic because she had these effusions.”

The patient, a woman in her 70s, had previously undergone surgery and HIPEC for peritoneal mesothelioma. She had been without evidence of disease for more than a year before developing a pleural effusion that raised concern for mesothelioma in the chest.

Dr. Backhus recounts she took the patient to surgery for a pleural biopsy and pleurodesis. Even though she saw no visible pleural disease, blind biopsies came back positive for mesothelioma. The team hoped the procedure would both treat the effusion and possibly delay systemic therapy.

How PITAC Compares With Other Mesothelioma Surgical Options

Dr. Backhus performed PITAC through a standard video-assisted thoracic surgery approach using 2 small ports. The chemo is misted into the chest, given time to absorb into the tissue and then a chest tube is placed to complete the procedure.

PITAC patients typically go home within about 2 days, she explains, and pain is generally manageable. A pleurodesis, which manages the fluid buildup of a pleural effusion but doesn’t treat cancer directly, has a typical hospital stay of 3 to 5 days. P/D surgery with hyperthermic intrathoracic chemotherapy usually involves a hospital stay of 7 to 10 days and a surgical recovery of several months.

“If PITAC is a level two,'” Dr. Backhus says, “then P/D with HITHOC is like a level 15 on a scale of one to 10.” PITAC treats the cancer like P/D with HITHOC, but with the reduced physical toll of a pleurodesis.

Where PITAC Fits in the Treatment Landscape

Dr. Backhus explains PITAC can be a good option for patients who want both palliative therapies to stay as comfortable as possible and to remove, kill or slow cancer cells. Tumor-removing (cytoreductive) surgeries and cancer-targeted chemo (cytotoxic) are often paired as with P/D and HITHOC. PITAC offers similar benefits, but with a minimally invasive procedure.

“If you want to be palliated, but you also still want to try to maintain some degree of cytotoxicity to buy you more time, in addition to symptom palliation, then that’s what we’re talking about here,” Dr. Backhus says. For patients with extensive pleural disease, she says she still favors P/D with HITHOC.

PITAC may be the more appropriate path for patients who aren’t healthy enough for that level of intervention. It may also benefit patients for whom P/D would actually be more challenging. This includes those with very little visible disease, where removing the pleural lining is technically more difficult.

How Can Pleural Mesothelioma Patients Access PITAC?

Right now, Stanford is offering PITAC through a registry and using clinical judgment to select patients. Backhus tells us the team is tracking quality-of-life measures and closely monitoring whether pleural effusions recur, which is one of the easiest early signs to follow.

The next step is a phase 1 pilot study focused on safety. She says if effusions stay controlled and quality of life holds, future research can take on bigger questions about disease control and survival.

“At minimum we have to try not to harm this vulnerable group of patients,” Backhus adds. “And if we can, on top of that, actually try to combat the disease and keep it at bay and prolong life, then that would be a huge win.”

Why PITAC’s Potential for Pleural Mesothelioma Is Encouraging

At a time when mesothelioma specialists are still looking for better ways to balance disease control and quality of life, Dr. Backhus says there’s reason to be cautiously optimistic. The data so far are encouraging on safety. But she cautions that unanswered questions remain about long-term outcomes.

Enduring effectiveness is a concern for pleural patients who can experience mesothelioma recurrence. She says for now, “we don’t know” how lasting PITAC results are.

Side effects are also a concern. The main risk she discusses with her patients is the possibility of chemo affecting the kidneys. While PITAC uses a targeted mist rather than the usual delivery through the bloodstream, some of the chemo drugs can be absorbed through the pleural surface in the chest.

But Dr. Backhus adds that with PITAC “the downside” is “very little.” She says that this procedure has the potential to open options to patients who are ineligible for aggressive surgery but want a more of an intervention plan than chemo alone.

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Moore died in December 2021 from mesothelioma at age 88. She had initially filed a personal injury lawsuit arguing her cancer was directly connected to her decades of using J&J’s talcum powder. The lawsuit alleged the talc was contaminated with asbestos. Upon her passing, her daughters transitioned her original lawsuit to a wrongful death claim.

The October 2025 jury verdict was historic. Jurors found J&J 100% responsible for Moore’s mesothelioma diagnosis, answering yes to 25 questions covering negligence, product defects, intentional concealment and knowledge of asbestos contamination risks.

They found J&J acted with malice, oppression or fraud and awarded Moore’s family a total of $966 million. This included $16 million in compensatory damages for Moore’s pain and her three daughters’ loss, as well as $950 million to punish J&J for its conduct.

Moore’s family says they will fight Judge Kwan’s ruling. Meanwhile, J&J faces tens of thousands of talc lawsuits still working through the courts, including a December 2025 Baltimore jury verdict awarding $1.56 billion to Cherie Craft, a Maryland woman whose mesothelioma has been linked to J&J talc products.

Moore’s Family Will Appeal Judge Kwan’s Ruling

Mae Moore’s family will appeal Judge Kwan’s ruling. Their attorneys have said publicly the family respectfully disagrees with the court’s decision and intends to fight it.

The court documents Moore’s family filed describe a teacher, widow and mother of three daughters who trusted a product she used her entire life. “Mae K. Moore was exposed to asbestos on a regular and frequent basis while she used asbestos-containing talcum powder products on herself and her children from approximately the 1930s to today.”

She and her family, the complaint states, relied on J&J “to provide any safety information to her and her family and to make sure any life-threatening hazards were communicated.” The complaint alleges J&J assured consumers there was “zero chance” of exposing their families to asbestos, and that those assurances “were false when they were made, and J&J knew they were false when they made those statements.”

Moore’s daughters Joy Moore, Kathryn Pratt and Carol Farquharson filed their wrongful death lawsuit in February 2022. The complaint alleged J&J had known for decades its talc products contained asbestos fibers  and had actively concealed that knowledge from consumers and federal regulators alike. The jury agreed with the family’s account of what J&J knew and when.

Judge Kwan’s Ruling and What It Means for the Appeal

While Judge Kwan left the jury’s finding J&J caused Moore’s mesothelioma intact, she disagreed J&J acted with malice. In her ruling she wrote the plaintiffs hadn’t “clearly and convincingly established” J&J knew about asbestos in its products and “failed to act.”Before delivering their verdict in October 2025, the jury was presented with J&J’s own internal documents and correspondence with outside experts. This included reports from as early as the 1930s.

Examples From the Trial Record

• May 1958: A Battelle Memorial Institute report documented J&J’s attempts to float asbestos out of its talc.
• August 1959: A Battelle report documented ultrasonic grinding attempts.
• April 1960: A Battelle report documented attempts using reagents.
• April 1969: An internal J&J document showed the company knew tremolite found in its talc products could cause “pulmonary diseases and cancer” and acknowledged the risk of litigation.
• July 1971: An internal memo stated “there is no place for asbestos in talc, trace amounts were not acceptable, and any talc with asbestos should be removed from the market.”
• August 1971: An internal J&J memo acknowledged “the need to upgrade the quality control for talc and baby powder to address the asbestos content.”

On appeal, the family’s attorneys will likely work with the same evidence the jury saw before a different, higher court judge. They’ll argue the trial court assessed that evidence incorrectly. New evidence is generally not permitted on appeal. J&J plans to appeal the causation finding and the $16 million compensatory damages award.

J&J Still Faces Tens of Thousands of Talc Lawsuits

Judge Kwan’s ruling is one development in a much larger legal fight. J&J still faces lawsuits from more than 67,000 plaintiffs who say they developed ovarian cancer or mesothelioma after using J&J baby powder and other talc products.

Also in October 2025, a Connecticut judge increased an earlier verdict against J&J to $25 million in the case of Evan Plotkin, an artist and father of three diagnosed with mesothelioma in 2021. Ben Braly of the DOBS law firm, which also represented Moore’s family, said the firm hoped “Johnson & Johnson will take this opinion to heart and consider the damage they caused to people like Evan Plotkin across the country.”

In December 2025, a Baltimore jury awarded $1.56 billion to Cherie Craft, a Maryland woman diagnosed with peritoneal mesothelioma after decades of using J&J’s talc-based baby powder. The award surpassed the Moore verdict as the largest ever against J&J for a single plaintiff.

J&J has tried to resolve the broader talc litigation through bankruptcy three times. Federal courts rejected the proposal each time, ruling J&J didn’t meet the financial distress standard required for bankruptcy protection.

The company stopped selling talc-based powder worldwide in 2023 and switched to a cornstarch formula. It maintains its talc products were safe, didn’t contain asbestos and don’t cause cancer.

J&J Welcomes the Ruling but Plans to Appeal

J&J’s worldwide vice president of litigation Erik Haas said Judge Kwan made the right call in overturning the punitive damages award. However, he said the company plans to appeal leaving the compensatory damages intact.

In a statement, Haas called the punitive damages award “devoid of evidentiary support and patently unconstitutional.” He took issue with the jury’s finding that J&J’s talc products caused Moore’s mesothelioma and said decades of extensive testing showed J&J’s talc products didn’t contain asbestos.

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The decision reverses a 2024 jury verdict that awarded $4 million each to the estates of Thomas Wells and Joyce Walder, two Libby residents who died from mesothelioma. Libby was the site of one of the nation’s most significant asbestos contamination disasters, linked to decades of vermiculite mining and processing. 

A three-judge panel of the U.S. Court of Appeals for the Ninth Circuit ruled Feb. 24 that Montana’s common carrier exception shields railroads from strict liability. The ruling applies when federal law imposes a public duty on railroads to transport materials.

“We agree that the district court interpreted the scope of the common carrier exception too narrowly,” wrote Circuit Judge Morgan B. Christen, who authored the opinion. 

Hundreds of claims were filed against BNSF after mining company W.R. Grace & Co. entered bankruptcy. This case was the first against the railroad to reach trial.

Why The Court Reversed the Verdict 

Federal law obligates railroads to transport certain materials as common carriers, and Montana law exempts them from strict liability when fulfilling that duty. The appeals court found BNSF was transporting asbestos-contaminated vermiculite under that federal obligation, and because the jury had already cleared the railroad of negligence, the court overturned the verdict and entered judgment in favor of BNSF.

“The dangerous condition here—accumulated asbestos dust—arose solely from BNSF’s operation as a common carrier executing its federally mandated duty to transport vermiculite,” Christen wrote in the ruling.

The lawyer representing the estates for Walder and Wells told the Montana Free Press they are considering an appeal. “We respect the Court but disagree with its decision and believe it misapplied Montana law,” Jinnifer Mariman, an attorney with the Kalispell-based McGarvey Law Firm, told MTFP. “We are talking with our clients and evaluating our options for an appeal.”

Libby’s History of Asbestos Health Hazards

For decades, vermiculite mined near Libby, Montana was contaminated with asbestos fibers. The material was processed and shipped nationwide, but dust from mining and transportation spread throughout the community, including the railyard and near the tracks. 

The estates of Wells and Walder, who both lived near the BNSF railyard, claimed that this contamination and their subsequent exposure to asbestos were what led to their mesothelioma diagnoses. BNSF denied any knowledge that the vermiculite was contaminated.

“I respect the court’s ruling and the judicial process, but I believe this outcome is unjust for the families of the deceased plaintiffs. Decades of asbestos contamination devastated the community and led to the nation’s first public health emergency declaration in 2009,” Linda Reinstein, co-founder of the Asbestos Disease Awareness Organization, told us.

Reinstein noted that the decision adds to the community’s long history of loss. She also said the decision may influence other asbestos cases involving rail carriers.

“This ruling will likely be cited in other cases involving the transport of hazardous materials under a common carrier framework,” she added. “The scientific consensus remains clear that asbestos is a carcinogen linked to serious disease and death.”

The U.S. Environmental Protection Agency declared a public health emergency in Libby in 2009 and designated the area a Superfund site. Federal cleanup efforts have cost more than $600 million. 

Former residents developed asbestos-related illnesses, including mesothelioma, at significant rates. Asbestos exposure is the primary cause of this rare and aggressive cancer.

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The Galleri test looks for fragments of DNA associated with cancer. The company says the test can detect more than 50 types of cancer, including mesothelioma. The news is a reminder that this cancer screening technology is still developing and is not yet a proven replacement for standard screening or medical follow-up.

Key Facts From The Trial

1. This trial was conducted with the support of the National Health Service in Britain.
2.  It enrolled 142,000 healthy adults between the ages of 50 and 77. 
3. Participants’ blood was drawn 3 times over a 3-year period. 
4. One group’s blood samples were tested using the Galleri test. If a person tested positive, they were referred to medical care providers. 
5. The trial results showed the use of the Galleri test didn’t lead to a significant reduction in cancers diagnosed at stage 3 and stage 4. 

Grail plans to present more detailed results from this trial at a cancer-related conference in the spring. The fact that there was no significant reduction in the number of late-stage cancers is a crucial finding in a trial of this scale.

What “No Reduction In Late-Stage Cancers” Means

Numbered stages are used to convey the extent of cancers like mesothelioma in the body. As with other cancers, stages 3 and 4 are late mesothelioma stages. 

They refer to cancers that have advanced with tumor growth and spread. Stage 3 means the cancer has spread near the site where it first developed. Stage 4 means the cancer has spread to other parts of the body.

The trial was designed to show that the blood test would reduce Stage 3 and Stage 4 diagnoses. Grail’s own analysis shows that didn’t happen.

Grail Still Says The Results Show Potential

Despite this finding, the company’s executives said that the results of the trial indicated the Galleri test still has some benefits. The decrease in the number of Stage 4 cancers was cited as being particularly promising.

“It’s absolutely right to say we didn’t hit the primary endpoint,” said Harpal Kumar, Grail’s chief scientific officer. “But what we did see was a very compelling clinical benefit here.”

What This Means for Mesothelioma Patients and Families

Because mesothelioma is such a rare cancer without distinct symptoms, early detection is difficult. Screening tests exist for some cancers, like breast and colon, but not for many other hard-to-treat cancers.

The results don’t mean the Galleri test can’t detect cancer early, just that using it didn’t lead to a significant reduction in Stage 3 and Stage 4 diagnoses. For mesothelioma patients and families, the Galleri test’s ability to detect more than 50 cancers, including mesothelioma, makes Grail’s more detailed findings this spring worth watching.

What Patients Should Know About The Galleri Test

The Galleri test has been available in the U.S. since 2021, but the FDA hasn’t approved it yet. Grail has applied for FDA approval and is seeking Medicare coverage through new legislation. Without insurance coverage, the test costs $949 out of pocket.

If a doctor recommends the Galleri blood test to screen for cancer, patients should know it supplements standard screenings rather than replacing them. Doctors don’t recommend skipping a colonoscopy or mammogram in 

Questions To Ask Your Doctor

If you’re exposed to asbestos, you may be concerned about the risk of developing mesothelioma. It can be helpful to bring prepared questions to discuss with your doctor.

Suggested Questions

• What is my risk of getting mesothelioma?
• What type of preventative screening should I undergo?
• What does a negative result on a blood test for mesothelioma mean?
• What follow-up tests would I need if the blood test indicated a possible cancer?

The most important thing to know is that screening only becomes useful if you have an appropriate plan in place. If you’re concerned about developing mesothelioma, it’s important to talk to a doctor who understands your risk.

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Key Facts About the New Study

1. Outcomes: 0% in-hospital mortality and 0% 30-day mortality, 4.2% 90-day mortality
2. Patients: 71 people with pleural mesothelioma received P/D surgery at Mount Sinai between 2015 and 2021
3. Cancer subtype: Nearly 80% had epithelioid mesothelioma, a subtype of this cancer with a specific type of cells that responds better to surgery
4. Pre-surgery process: All patients had PET/CT images and underwent workup for pleurectomy

P/D surgery is often referred to as a “lung-sparing” procedure because it aims to surgically remove the pleural tumor without removing the lung. As the chair of Thoracic Surgery at Mount Sinai Health System and the study’s lead author Dr. Raja Flores tells us, “The results suggest that pleurectomy and decortication is a safe procedure for the correct kind of patient.”  

Mount Sinai Study vs. MARS2 Trial

The Mount Sinai study, published in The Annals of Thoracic Surgery, was designed with the MARS2 trial directly in mind, covering the same time period, 2015 to 2021. The MARS2 trial, conducted in the U.K., compared outcomes of patients who received chemotherapy alone to those who received chemotherapy and P/D surgery.

Its results sparked a major debate about whether combining chemotherapy and P/D surgery created worse survival outcomes. The Mount Sinai researchers identified patient selection, cancer subtype, extent of surgery and use of imaging as key areas to address in their own study.

MARS2 didn’t mandate PET/CT imaging for trial entry and it included patients with sarcomatoid and biphasic mesothelioma, unlike the Mount Sinai study, which excluded patients with sarcomatoid mesothelioma. MARS2 also performed extended P/D in 89% of surgical patients, the more invasive version of the procedure that also involves removal of the diaphragm or pericardium, unlike standard P/D which removes tumors while leaving the lung intact.

MARS2 authors concluded that radical mesothelioma surgery shouldn’t be offered outside of a clinical trial. Mount Sinai, however, found that strictly limiting who receives surgery and how extensively it’s performed can improve outcomes.

Who Might Be A Candidate For Surgery?

Pleurectomy/decortication isn’t appropriate for all patients, and who is eligible is closely tied to how the surgery is performed. As Dr. Flores says, the difference in outcomes between MARS2 and this study may have resulted from differences “in how and in whom” the surgery was performed. He explains, “The bottom line is that this surgery is safe when patients are carefully selected and surgery is tailored to balance tumor removal with what a patient can tolerate.”

In this study, removal of the diaphragm and pericardium was rare. The authors note that removing the diaphragm increases the risk of developing abdominal mesothelioma, one of the reasons lung-sparing procedures are preferred. This is a shift from more aggressive approaches in the past that included procedures like extrapleural pneumonectomy. EPP removes the entire lung and surrounding tissues.

Dr. Flores adds, “This study reinforces that surgery should remain part of the conversation for mesothelioma treatment and can lead to long-term survivorship.” The Mount Sinai results suggest that with the right patient and the right approach, P/D surgery can be both safe and effective.

Questions To Ask Your Physician If You Are Considering Surgery

If you or a loved one has received a mesothelioma diagnosis and been told that surgery isn’t an option, particularly following the MARS2 trial, the Mount Sinai findings suggest it may be worth a closer look at the specifics of your case. These questions can help start that conversation and help you decide whether a second opinion makes sense.

• What is my mesothelioma subtype?
• What imaging and tests have been performed?
• Would the procedure be lung-sparing?
• What other treatments would be part of my care?

Patient selection and surgical approach play a significant role in outcomes, and not all mesothelioma programs evaluate these factors the same way. Consulting a specialist experienced in mesothelioma surgery can help determine whether P/D is appropriate for your individual diagnosis and health.

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Chief Restructuring Officer Dean Vomero stated in Vanderbilt’s bankruptcy filing the company “was cash-flow positive absent the growing costs of the talc-related litigation.” As part of its restructuring plan, Vanderbilt intends to auction its assets, with Commodore Materials placing an opening bid of $50 million.

These talc lawsuits allege that the talc Vanderbilt once mined and sold was contaminated with asbestos. The plaintiffs connect their exposure to Vanderbilt’s asbestos-contaminated talc to their diagnoses of asbestos-related diseases. Asbestos is the primary cause of mesothelioma and also causes asbestos lung cancer and ovarian cancer.

The company denies its talc was contaminated, but stopped mining it in 2008. It now focuses on producing clay for pharmaceutical, agricultural, personal-care and construction. 

Recent Vanderbilt Legal Defeats

Vanderbilt’s bankruptcy comes after a series of costly legal defeats, including a $15 million verdict awarded to the family of Nicholas Barone in 2024. A Connecticut jury found Vanderbilt responsible for Barone’s mesothelioma diagnosis and death.

Barone was exposed to Vanderbilt’s talc while working as a process engineer at a General Electric plant between 1965 and 1967. GE had purchased hundreds of thousands of pounds of talc from International Talc. Vanderbilt had acquired International Talc in 1974. GE used the talc in molding compounds during the time Barone worked there.

The jury reached its verdict in just 2 hours, finding Vanderbilt showed “reckless indifference to others” through efforts to suppress knowledge about asbestos contamination of its talc. The Barone case proved particularly damaging because it established Vanderbilt’s liability as the successor to International Talc Co. 

This verdict followed another significant loss in March 2023. A  jury awarded $20 million to the widow of a Rhode Island man who developed mesothelioma after exposure to Vanderbilt’s talc products. 

Broader Industry Trend of Bankruptcy Filings

Vanderbilt isn’t alone in facing mesothelioma lawsuits over asbestos-contaminated talc. And it isn’t alone in pursuing bankruptcy protection as a way to manage legal expenses.

For example, Johnson & Johnson created a subsidiary, which then absorbed all of the company’s talc liabilities and attempted to declare bankruptcy. The aim was to resolve tens of thousands of claims alleging its talc-based baby powder caused ovarian cancer. 

J&J’s bankruptcy attempts have failed multiple times in court, leaving it to continue defending itself in court. While the pharmaceutical giant  continues to deny its talc was asbestos-contaminated, it’s faced significant verdicts against it. 

The Missouri Court of Appeals in 2020 upheld a landmark jury verdict in favor of 22 women who developed ovarian cancer. While the court reduced the historic verdict from $4.69 billion to $2.1 billion, upholding the jury’s findings set a critical precedent.

Law firms representing people diagnosed with asbestos-related diseases have successfully shown companies were aware that because talc and asbestos minerals form near each other in the earth, talc can easily become contaminated during mining. Industrial talc has contained asbestos levels as high as 50% to 70%, and cosmetic talc products dating to the 1960s reached contamination levels of up to 30%.

Not every case has resulted in compensation for those exposed. However, the trend of juries holding companies responsible for asbestos-contaminated products and a failure to warn consumers has given survivors hope. And this may lead more companies to follow Vanderbilt in pursuing bankruptcy. 

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