Doctor Dispenses Hope to Patients

September 07, 2007

Sofia Kosmetatos, The Detroit News - ROYAL OAK, MI - A former GM pipe fitter with asbestosis, Richard Marshall, quickly recounts the measures he has taken to prevent aggravating his scarred lungs.

For one, he avoids sick people and bars that are smoky. He also carries antibiotics when traveling overseas in case he develops pneumonia. And he visits Dr. Michael Harbut every few months.

A native of Detroit, the soft-spoken occupational and environmental medicine doctor treats and diagnoses hundreds of patients with incurable asbestos-related diseases each year, including many former automobile workers and workers from other industries located in Michigan.

Harbut, one of the nation's best-known asbestos doctors, has written the standards for diagnosing asbestosis -- a scarring of the lungs caused by asbestos exposure -- for the American Thoracic Society. In partnership with Karmanos Cancer Institute, Dr. Harbut is helping to guide research to more quickly diagnose deadly asbestos-caused cancers and track asbestos-related diseases in residents living in homes with contaminated insulation.

Linda Reinstein, executive director and co-founder of the Asbestos Disease Awareness Organization, a nonprofit organization representing asbestos victims and their families said, "he offers hope." After her husband Alan was diagnosed with mesothelioma, a cancer in the lining of the lungs, heart or intestines, she founded the organization in 2004.

Reinstein said "for patients that have been diagnosed with incurable diseases hope is a vital type of medicine."

It is unclear how many Americans have asbestos-related diseases, said Harbut, noting that cases are significantly underreported. This is partly the case because doctors often attribute lung problems to other causes, such as smoking, Harbut said.

But statistics from Environmental Working Group, a Washington, D.C.-based nonprofit organization, show that 10,000 Americans die each year from asbestos-related diseases, twenty five percent of them from mesothelioma.

The nonprofit and Harbut both say that the numbers will only get worse, as many people who were exposed in the 1960s and 1970s are just now starting to exhibit symptoms or die from asbestos-related diseases. According to Environmental Working Group, asbestos diseases have a 20- to 50-year latency period, and will likely cause 100,000 more Americans to die by the year 2015.

There is currently no cure for asbestos-related disease. Medical treatment for patients with asbestosis or other non-malignant diseases typically involves symptom management to try to prevent further complications. For example, someone short of breath could be prescribed an inhaler. For patients with cancer, the options might involve chemotherapy or surgery.

Dr. Harbut's primary mission is to advance the medicine and science that will give patients with asbestos-related diseases longevity and quality of life.

For patients diagnosed with mesothelioma, a fast-moving cancer that is difficult to diagnose, every second counts. This is why Dr. Harbut, in partnership with Karmanos Cancer Institute, helped develop a blood test a few years ago to help in screening for the disease.

"With this blood test" he said, "even if you can give somebody a couple of months, it's an important gift."

The partnership, co-directed at Karmanos by Harbut, called the National Center for Vermiculite and Asbestos-Related Cancers, is at the forefront of asbestos-related research. A $2 million federally funded project is studying the relationship of asbestos-related cancers and other diseases to homes containing vermiculite insulation laden with asbestos.

In the ?70s and ?80s, tons of that type of insulation was processed by W.R. Grace and Co. plants in Dearborn and other parts of Michigan and was used in some 800,000 homes, including an estimated 280,000 homes in Southeast Michigan. Dr. Harbut estimates that in total it probably used in approximately 20 million homes in the U.S.

Dr. Harbut cares for patients from around the country and the state at the Center for Occupational and Environmental Medicine. His modest practice is tucked in a storefront near downtown Royal Oak.

Earlier this year and last summer, workers who worked in utility tunnels on Capitol Hill traveled to Michigan to be examined by him, after finding out that they had been misled by their employer about the extent of their asbestos exposure in the workplace.

A former autoworker from Redford diagnosed with asbestosis, Irene Karkoski, is one of many patients who can't say enough about Harbut's bedside manner. He his very thorough, never rushes through appointments and rarely keeps patients waiting. Patients seeing him for the first time are often told to plan on a 3 to 4 hour visit.

Karkoski, age 80, breathes air through thin plastic tubes attached to a portable oxygen tank around the size of a two-liter soda bottle. It's one of the treatments Dr. Harbut prescribed to help her breathe -- and Karkoski welcomes every step that helps maintain her good health.

She said, "I haven't been in the hospital for over two years."