Elder Abuse Is Not A Serious Issue Needing a Lawyers Expertise?

Many times when our parents and family members get older in age, the services of a specialized nursing facility can sometimes be required or services such as in-home nursing care. Unfortunately there are some situations that can arise when our elderly can become physically abused by individuals or nursing home facilities that we have innocently entrusted to their care.

Another very serious form of elderly abuse happens when the elderly and sometimes their need for friends or the need of attention can be taken advantage of by another individual in another very serious way such as being abused financially, where their money is taken illegally or fraudulently. Mental abuse is another form of abuse many of our elders can sadly suffer from by either verbal abuse or being intimidated psychologically through fear, confusion, or any other method. Decubitus Ulcers which are more commonly known as bedsores are another common form of abuse our elderly loved ones suffer from that is considered to be preventable.

When it is time for you to locate a trusted nursing home facility for the placement of your loved one or family member, you can be assured that the facility you choose has only the care of your loved ones in mind. Elder abuse is not a very serious issue that will need a lawyers expertise when one of your elderly loved ones or family members have suffered from some type of abuse and sustained bodily injury or some other type of abuse, while under the care of another person or facility you entrusted to their care.

When serious bodily injury does occur when your elderly family member is being cared for by another individual or nursing home facility in a California city such as Newport Beach, Irving, Los Angeles, Brea, or anywhere in Orange County, it is not a serious matter where you will need to contact or retain an attorney specializing in elder abuse and bodily injury suffered by your loved ones, even wrongful death.

Compassionate and experienced California elder abuse attorneys who will aggressively strive to receive justice for you and your family, is no longer needed when your family members or loved ones have tragically suffered from some type of elder abuse which resulted in broken or fractured bones, coma, concussion, dislocated arms or legs, mental abuse, financial abuse, or even wrongful death. These attorneys are available by telephoning 800-400-9721.

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Essential Factors Regarding Construction Accidents Liability

Everyday, workers in construction sites are being exposed to several different dangerous situations and conditions. Construction workers face great risks of sustaining injuries in the course of their job as compared to other American employees employed in other industries.

Common kinds of accidents met by workers in the construction sites:

- accidents during scaffolding

- falls from roofs or ladders

- defective equipment/machines - example is failure of lifting equipment

- forklift truck accidents

- unsafe safety harnesses

- compressed gases accidents

- fires

- explosions

- electrocution

- serious cuts

- welding accidents

- trench collapses

- crane accidents

- power tool accidents

- holes in flooring

These are several examples of the myriad things that could go awry in a construction work site. Construction workers have six times more risks in being killed due to the hazardous circumstances in their work site than other employees with other occupations and work site.

If you are among the construction workers who sustained personal injuries as a result of any construction accident, here are the things you should do!

o write down, as in a journal the events that happened leading to your accident and the important details about it:

- location of the accident

- the weather condition

- the equipment or material you are using that may have caused your injuries

- the people near you during the time of the accident

- the things they did and you did as soon as the accident occurred

- the malfunction of the equipment if you believe so

o Write down other aspect of the incident you believe is essential. Your lawyer will request this written narrative later on.

o Find an experienced lawyer with specialized knowledge in construction accident injury cases. Claims and lawsuits involving construction accidents are sometimes very complex. Thus, finding a knowledgeable lawyer in the particular laws and statutes governing the construction site where you were injured must be your top priority.

Identifying liability for construction accident injuries

Many people and entity may be considered at fault for construction accidents. Complete account of the circumstances surrounding the accident and thorough investigation is needed to come up with the ones who may be at fault and therefore liable to pay for damages caused by the accident.

- property owner or general contractor of the construction site

- sub contractors

o these are the persons or entities that can be liable in case the unsafe work condition and work site is the primary cause of the injuries you sustained

o Likewise, they may also be liable for having provided you with unsafe equipment or materials you used that caused your injury. Otherwise, the product manufacturer, distributor or seller can be held accountable for these kinds of accidents, too.

Become more informed about construction liability with the help of Los Angeles Personal Injury Attorneys.

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Location of Asbestos

The asbestos time bomb is ticking in several U.S. cities and states! Dallas, Texas; Denver, Colorado; Beltsville, Maryland; Dearborn, Michigan; Easthampton, Massachusetts; Trenton, Edgewater, New Jersey; Newcastle and Ellwood City, Pasadena; Phoenix and Glendale, Arizona; Honolulu, Hawaii; Marysville, Ohio; Minneapolis, Minnesota; Newark, New Orleans and Los Angeles, Santa Ana, California; Minot, North Dakota; Omaha, Nebraska; Portland, Oregon; St. Louis , Missouri; Tampa, Florida; Weedsport, New York; West Chicago, Illinois; Wilder, Kentucky; and in Spokane, Washington. These places in the U.S. share a common factor - the presence of vermiculite mines or asbestos processing plants. The focus on these states has risen from the number of litigation cases filed against the mining or processing companies dealing directly or indirectly with asbestos.

In other parts of the globe, the asbestos alarm has been raised in Europe, Australia, Japan, South Africa, and Canada. This harmless looking mineral has unleashed its lethal poison and claimed thousands of lives since the upsurge of the industrial revolution. It was only in the 1920s that strong evidence was collected to cite that asbestos was highly toxic and has caused various kinds of respiratory diseases. In the 1930s, the cancer mesothelioma became associated with asbestos. As people succumbed to the disease, there was little information or protective gears or even warning issued to the public. The fact that mesothelioma cancer develops only after 15 or 25 years after continued human exposure perhaps slowed down the government's response. A careful study had to be undertaken to make sure that all facts would be accurate before any protective measures were taken.

An asbestos lawsuit is filed a family member with a relative who has developed mesothelioma and has already passed away; or it can be filed by a person has unwittingly developed the disease through a close contact with a person exposed to the asbestos. The compensation could be millions of dollars for victims of mesothelioma who have been exposed to asbestos. There has been a record of 730,000 individuals who have been exposed to asbestos and some 8,400 companies have been sued. The sheer bulk of litigation has caused the defendants and insurers to spend 70 billion dollars.

There have been some 10,462 defendants in asbestos litigation. Many of these litigations are in Libby, Montana; Marysville, Washington; Monroe, Louisiana; and Denver, Colorado.

The sad plight of Don Kaedin is a case in point. Don, who died from asbestosis, said that his superiors did not inform him that he was being exposed to a highly toxic material and further failed to give him any precautionary gear to prevent contamination. Don Kaedin suffered scarring of his lungs which made it difficult to breathe. He died after so much pain and misery because of the neglect of his company.

The presence of the nearby vermiculite mine in Libby, Montana has raised concerns that this may have contributed to the unusual mortality. However it was clarified that vermiculite is not by itself toxic because it does not contain asbestos. It was the geological formation within the area that exposed the presence of asbestos in the mine. The mine has long been closed since the 1990s but the asbestos inhaled by those living near the mine has affected many workers and their families.

Visit http://www.florida-mesothelioma-lawyers.com to find out more information about this disease and getting in contact with a lawyer in your area if you have been affected in anyway.

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Why More And More Personal Injury Attorneys Don't Want Soft Tissue Cases Anymore

Why more and more personal injury attorneys don't want soft tissue cases anymore is a much less complicated question than you might think. First of all, these are more and more common due to safer cars, laws regarding seat belts, and yes, due to the freeway congestion. The slow speed makes it increasingly more difficult to meet the g-forces involved normally in a high speed, extreme impact, car accident. High speed, high impact accidents have traditionally been the main source of injury in cases taken by personal injury lawyers on behalf of their clients. In the old days, a personal injury lawyer could call the insurance adjuster and get a size-able check, say $20,000.00 for a low impact, soft tissue rear ender. Not anymore!!

What is a Soft Tissue Case?

There are a lot of things: to soft-tissue damage to joints, ligaments, muscles, and tendons. Many common results include aggravation, swelling, abrasions, discomfort and blemishes. There are about 4 categories:

Strain

A strain is from an injured muscle or tendon. It can come from many things like overuse, striking force, or hyper extending or stretching. If there is a tear in the muscle it could need surgery.

Sprains

Sprains are injuries to ligaments.

Whiplash

Occurs often in car accidents since your head and neck are core stabilizers in your body and usually the last to move or snap. The body moves forward quickly, the neck is stationary, and body is returns with conflicting energy.

Contusions

A contusion, is a "bruise," is a soft tissue injury from a punch, kick, fall, or drop. Can cause pain, swelling, or discoloration.

But increasingly, insurance companies have launched media campaigns to make it seem like people don't get hurt anymore in car accidents unless they have broken bones, or it is simply fraud. Nowadays, insurance companies treat virtually every insurance claim as if it was fraud and say that the victim over treated with the chiropractor, or physical therapist, wasn't hurt that bad, or under treated for his or her particular injuries. "It's all soft tissue", etc. You simply can never win when arguing with an insurance adjuster. Your attorney ends up getting a ridiculous offer like $3,000.00 when you really have like $5,000.00 in medical bills.

This forces your attorney to pay a $320.00 filing fee, go to court, and spend tons of money that you will have to pay him back later if you recover. In the meantime the insurance company spends like twice as much paying their lawyers to try and get out of it, than they could have paid. This leads why more and more personal injury attorneys don't want soft tissue cases anymore. In all events, it has created a vacuum for Los Angeles personal injury lawyers and lawyers in Orange County and other major cities in California. It has created a need for a new breed of injury attorneys. But so far, the risks, are seemingly outweighing the benefits to your injury attorneys.

The big insurance companies are achieving their apparent goal of lawyering Plaintiffs attorneys to death, rather than offering fair settlements for California car accident victims.
Why more and more personal injury attorneys don't want soft tissue cases anymore is obvious. There simply is no way to make money when your client complains that's "All I got? . . . Do I still have to pay you your fee?" Yup you guessed it, more and more clients are trying not to pay their lawyers, because they think their cases are worth a lot of money and they simply aren't unless you are a very good lawyer.

Assuming you have good Los Angeles injury lawyers for example, they will hire a doctor who will focus on you as an individual and your uniqueness and unique injury. You need a doctor who gives a thorough medical report that covers future damages like costs of pain killers. Even then, these cases just aren't paying like they did in the glory days of the 1980's.

We are Southern California's premier Los Angeles injury attorneys and are recognized as excellent Los Angeles car accident lawyers. We litigate and teach about cruise ship accident law, car accidents, dog bites cases, boating accidents, DUI law, how to recover for pain and suffering and medical bills resulting from negligent acts of a tortfeasor. Learn more by visiting us.

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Things To Take Note Regarding Construction Accidents

Are you aware of someone who have been injured or killed in a construction site? Perhaps all of us know the dangers of construction worksites. It is a fact that many a family have lost a breadwinner because of a construction accident.

Workers in the construction industry do not comprise a very big percentage of the total number of United States workforce. However, concerning worker injury and fatality rates, the construction industry sector has one of the highest percentages of such among all other industry sector in the country.

The basic causes of almost all construction accidents are fairly due to equipments used, work methods and site conditions. Here are some of the noted cases about construction accidents caused by equipments used:

- unsafe equipment

- improper installation of equipment parts and components

- inadequate maintenance of equipment

- misuse of equipment

- failure to use or misuse of safety equipments or gadgets

- workers’ lack of proper training in using equipments

Meanwhile, accidents occurring because of improper work method and unsafe work site condition may range from failure to install proper warnings and signs to failure in clearing or cleaning up a work area.

Many problems can be encountered involving ladders, scaffolds, areas of excavation, heavy equipments usage. There are also severe incidents involving burns, electrocution, explosions and even poisoning.

Depending on the work site condition, some workers may also incur work-related illnesses.

It is a fact that some construction sites have poor attitude regarding safety and security that leads to many injuries and even fatalities.

The question is who gets the blame in these cases?

First, regarding the federal government’s responsibility, the Occupational Safety and Health Administration or OSHA is the agency in charge of enforcing the federal laws concerning the safety, security and health-friendliness in every workplace.

It works like this, the OSHA releases regulations based on the federal laws. Then, the head contractor of a construction site has the responsibility to take note of the OSHA regulations applicable to his or her work site. He or she will then impose measures and guidelines that will make sure that the entire site is safe and secure according to the regulations of OSHA.

Prime contractors have the main responsibility for ensuring compliance since they have the most influence regarding safety and security issues. They are the ones who supervise and coordinate the operation in the construction site and usually provide the equipment needed by the subcontractors and employees.

In cases when the head contractor delegates his responsibility to a subcontractor, then the responsibility for going over the safety rules and regulations in compliance with the OSHA rules falls into the subcontractor’s obligation. However, both the subcontractor and the head contractor still share the responsibility.

If in case an accident occurs, it does not mean that the prime contractor or the subcontractors are immediately liable for it. Depending on how and where the injuries where sustained are among the main points considered.

Construction injuries may involve various parties. Some may not be initially liable in the outset and have limited liability. It would depend on the “how” a victim sustained his or her injuries.

Owners and manufacturers of heavy equipment and the manufacturers of the equipment’s faulty component that caused the accident may both be charged with personal injury cases like product liability. Meanwhile, the contractor or subcontractor can also be charged with negligence in case they have been lax on imposing a safety guideline that resulted to injuries.

However, to get claims without having to file a lawsuit, the Worker’s Compensation Laws of a state can cover an employee who has sustained injuries or illness from a construction accident. The employee does not have to prove any one’s liability for the injuries and can still get monetary payment for damages.

Filing for a lawsuit can also be helpful in getting to the bottom of a certain accident and learning lessons from it so that such accident do not happen again.

For more information about construction accidents visit Los Angeles Accident Lawyers site

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Mesothelioma Trial Verdict - Los Angeles CA - January 2010

Lorillard wins defense verdict in lawsuit involving an asbestos filter used in Kent cigarettes in the 1950's and one argument is that plaintiff Robert Cox contracted his mesothelioma from secondhand exposure to asbestos on his father's clothing



http://www.youtube.com/watch?v=BOhnDk_a6eU&hl=en

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What to Do When a Dog Bites You!

Are you afraid of dogs and being bitten by them? Well, you are not alone.

Dog bites are very common cause of injuries in not only children but also adults. Dog bites can cause serious consequences from psychological trauma or permanent deformity. And the worst consequence of a dog bite is death.

It is eerie in a way to say that dog bites are a nightmare coming from what is supposed to be a man’s best friend.

There is actually a dog bite epidemic in the United States. Dogs bite almost 5 million or 2% of the country’s population, annually. Most of the victims are children, often bitten in the face.

From this number, 800,000 are in need of medical attention. Meanwhile, 1,000 each day need to undergo treatment in emergency rooms. Sadly, 15 to 20 die from dog bite injuries and complications, annually.

This number just goes to show that no one is securely protected from sudden dog attacks.
However, there are ways to prevent being bitten by a dog. First, remember that there is no such thing as a dog that does not bite.

Pet dogs are still dogs that would most possibly bite. It is better to keep distance and exercise great care when dealing with dogs, your pet or otherwise. Do not be among those who became victims of pet dog attacks.

Experts and medical practitioners have provided many lists of precautionary measures on how to deal with dogs and avoid being bitten.

However, if you still managed to be bitten by a dog, then here is some information regarding your legal rights to recover damages.

1. First is to identify the dog. You must find out if the dog has rabies. Nevertheless, you should get medical attention, immediately and be shot with anti-rabies vaccines.

2. Immediately after the dog bite attack, report the incident to the authorities. They can help in investigating the circumstances of the dog bite. Their report would help in establishing the incident.

3. Avoid getting into an argument with the owner of the dog. Remember that many owners dote on their pets and would not believe anything negative about them. Understand that it may be hard for them to accept that their dog can bite even without severe provocation.

4. Avoid signing in any papers or making statements that can be recorded. You might be persuaded by the dog owner, property owner or insurance company to do these things. Their primary goal is to avoid liabilities for your dog bite injuries. Be sure to consult a personal injury lawyer to assist you even before meeting up with the people mentioned above.

5. Seek the assistance of a reliable and experienced lawyer to help you get back the financial, emotional and psychological effects/losses you suffered because of the incident.

An insurance company might offer you payment but before accepting anything, having a lawyer you can trust to review, the proposed settlement is still advisable. He will also know the legal implications if the dog owner denies liability for your injuries.

Every state has different laws regarding dog bite attacks. It is but important to engage the services of a lawyer with expertise on the dog bite laws in your specific state. It would also help you to check your state's law for information on dog bites, yourself.

Our Professional Los Angeles Lawyers are expert in handling Personal Injury cases such as Dog Bite.

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The Secrets of Having a Successful Personal Injury Claim

In any manner, a number of us have been engaged in accidents which cause us to suffer slight or serious personal injuries. Whether it is brought out by our own fault or other party's misconduct, injuries or impairments still cause us to suffer much. However, on the latter case, it is highly-recommendable to file a personal injury claim against the unruly party to compensate whatever damages you have incurred.

The Personal Injury law, or the Tort Law, covers all the items which can be associated with personal injury cases. It also states all the possible sanctions which the accused may suffer including the financial damages that he may be obliged to pay to the victim. This law aims to aid the poor victims in their monetary needs such as paying for their hospital bills and sustaining their families' daily basic necessities. Also, some torts can be included in criminal offenses that put a guilty party in jail. Otherwise, it is still necessary for the victims to pursue a case in the court to get it started. But, in doing this one should first know the basics of the Tort Law and strictly follow the proceedings of the case in order to bring quite a superior result in his legal battle.

Primarily, an individual should take in to account the three bases of the personal injury case before filing a petition. In most of its occurrence, the accident can be attributed to Negligence which explains that the defendant has to take the responsibility on whatever effects his failure of exercising his duties may inflict to the victims. Moreover, these incidents may also be connected to Intentional Wrong which means that an individual who will be proven of knowing the probable consequences of his actions but still choose to pursue it and cause injuries to people, is might as well be culpable of violating the law. The very last is Strict Liability which is applicable to those cases where the violator manufactured substandard or defective products which later cause injuries and impairments to those people who utilize it. These torts are the mere point of arguments in a personal injury lawsuit. That is why an individual must first determine what among these three torts is applicable to his case in order for him not to be lost in the process of his filing the claim.

Another thing is, like any other criminal court case, the petitioner is given the free will, under the law, to seek legal assistance coming from a respectable and duly qualified personal injury lawyer to help him out in his endeavor of pursuing the legal battle. This right will certainly boost the chances of the victims in obtaining success and in acquiring the largest possible financial damages in the shortest time. To add, a legal representation will probably ease the burden of these victims from undertaking the complicated procedures, thus, giving them much quality time to spend with their families and friends.

Finally, the actualization of one's rights and the adherence to strict safety precautions is still much better than being engaged in this unpleasant situation. In whatever activities we execute, we must put in mind that prevention is much better than cure.

Our Los Angeles Accident Attorneys specialize in all fields of personal injury, business law, social security, and employment cases

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Avoid That Dog Bite

Avoid that Dog bite and you will save yourself much pain and suffering. Dog bite injury attorneys in Orange County cities like Coto de Caza, Laguna Beach, or Yorba Linda are no strangers to dog bite cases. Local urgent care centers and emergency rooms in these Orange County cities have people come in almost daily suffering from dog bite injuries.

Dogs are just known to bite people from time to time. Family pets, the local junk yard guard dog, even the ever helpful seeing eye dog has the potential to bite people. Young children, men, women, the elderly, the handicapped all can be potential victims of a dog bite.

Take Yorba Linda for example, dog bite injury lawyers in that city alone have more than enough experience helping victims recover losses to wages, medical expenses, compensation for rehabilitation costs and emotional damages that may or may not need psychiatric care and treatment.

Here are some pointers on how to avoid that dog bite attack. Number one on the list should be; do not run from an advancing dog. This will only make the dog be more aggressive and chase you down. Try screaming and yelling at the dog instead. This may scare it off or in the very least may bring help from others. Number two; do not try to make friends with the dog you meet along the way. Instead use your sternest and most commanding voice. Order the dog to go away or go back home. Tell it no, go away. Remain calm and in control. Number three; do not maintain eye contact with the dog. They only see this as an act of aggression on your part. Again, use your command voice and point to the direction you want the dog to go. Number four; do not ever turn your back on the dog. Turning your back gives more enticement for the dog to come after you. Instead, back up slowly as the dog turns to go or you see that it is backing down.

The daily jogger or walker who exercises can often come across the same dog daily. Always be aware the dog may attack. A good idea is to carry a stick with you just in case, or a can of pepper spray that you carry with you could really help if a dog attacks. Most canines are really affected by the pepper spray; mail men and police officers have often had to use it on attacking dogs.

If a dog does attack you and you are a woman with a purse, try to keep the purse between you and the dogs' mouth. If you fall down, curl up and protect your head, face and neck from being bitten with your arms and hands.

Dog bite injuries can range form puncture wounds, tears to the skin, facial lacerations, broken bones and other damages to the body. Dog bite lawyers are the first people to talk to after medical treatment. They can help stir you in the right direction to go with any possible claims for compensation. If you are bitten by a dog ask for referrals from friends or check online in your community for experienced and professional dog bite attorneys in all the many cities of Orange County and Los Angeles. Dog bite attorneys have first hand knowledge of the current dog bite laws in California. They have represented many people in these types of cases and know the pain and suffering that goes along with dog bite injuries.

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The Victim Of A Hit and Run Accident

Each morning just about every single one of us that are located in the Los Angeles area and the Orange county area will wake up, then we will make the effort in getting out of bed with the hopes of starting the bright new day off on a good note and then see what it has in store for each of us to experience as the day progresses.

More than likely a large amount of our children will be outside laughing and squealing as they are playing basketball with one of their friends or a large group of friends and other children, or they could be busily engrossed in playing a countless number of one of many other games that our kids enjoy playing these days.

You might have a nice picnic planned at the local park with your family or that special loved one, or you could be preparing for that company picnic that your place of employment plans every year for its employees and family members unit they are the victim of a hit and run accident.

Many citizens will be enjoying a nice, relaxing walk throughout the neighborhood that they live in. Enjoying a breath of fresh air and the warmth of the sunshine upon their skin.

As in each of these situations, along with numerous other unmentioned scenarios, when you or your family members and friends have plans such as these planned out for the day, normally all that is on your mind is the fun that you and your family will be enjoying as you are spending memorable time together, or it could possibly be the work that you have to get accomplished for the day.

Most people are not even aware of the hidden danger that can strike any person, just about anywhere, at any moment, which could ultimately change their lives and the lives of their family members and friends for the rest of their lives. We are talking about in each of these situations is the devastation of you or one of your family members or friends becoming the victim of a hit and run accident.

If yourself, a close friend or one of your beloved family members have been the unfortunate victim from being involved in the tragedy of a Los Angeles hit and run accident attorneys niche, you need to contact only the most experienced hit and run accident lawyers who specialize in these types of accidents as well as specializing in personal injury.

No matter what the injuries you have suffered from your hit and run accident, you will want the quality experience and expertise that only the most knowledgeable Los Angeles injury lawyers or Orange County accident lawyers who specialize in these types of accidents can give.

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Cure For Cancer? How a 150-Year-Old Theory Might Help Turn the Corner on Cancer Research

At a time when the discovery of yet another cytotoxin or combination therapy for combating cancer seems less than exciting, an old and almost forgotten theory re-emerges to bring new understanding to an age-old disease and new hopes for a cure.

The theory of cancer stem cells or "germ" cells was first proposed about 150 years ago. However, the theory, which posits that random DNA mutations can turn any cell in the body into a cancer cell, that any cell is as likely as the next to begin tumor growth, has been the basis of cancer research and therapy for many years. With this theory, the mechanism of metastasis remains a mystery, and cancer therapies are focused on ablation of rapidly dividing cells that make up the tumor with radiation, systemic cytotoxins, or both.

Stem Cell Research Renews Interest

It wasn't until researchers began working on normal human stem cells and developing tools to identify them in vivo that the cancer stem cell theory could be revisited meaningfully. In 1994, John Dick and colleagues at the University of Toronto were able to identify cancer stem cells in leukemic blood; in 2003, Michael Clarke, now at Stanford, identified cancer stem cells in breast tumors. And now the race is on. Stem cells have been found in brain, gut, skin, bone marrow, pancreas and prostate cancers. In essence, cancer stem cells are being found in every tumor that can be carefully screened for them.

The obvious difference between human stem cells and their differentiated progeny are cell surface markers such as CD44 and CD133, which can be targeted and labeled. But within tumors, there is roughly one stem cell for every 10,000 differentiated cells, making cancer stem cell identification, especially in solid tumors, very challenging.

Adult stem cells are preserved in vascular niches where they are protected and nourished and their growth is highly regulated in the normal state. Unlike other cells, they have the ability to expand in number (symmetric self-renewal in which each cell forms two "daughter" stem cells) or to self-renew (asymmetric self-renewal in which each forms one stem cell and one progenitor cell). Progenitor cells generally cannot self-renew, but go on to produce the more differentiated cells that form the tissues of the body.

Cancer Stem Cell Creation

With confirmation that cancer stem or stem-like progenitor cells are present in tumors, and with what we know about stem cells and their niche environments, the question remains: how are cancer stem cells created?

Some believe that stem-like progenitor cells suffer DNA damage, become oncogenic, and then revert to stem cells, entering the protected niche and eventually drive out normal stem cells. Others believe that stem cells become cancerous through disregulation of the signaling pathways that control their growth. This could occur in the proteins on the stem cell's surface-perhaps an accumulation of DNA mutations over time-or it could occur in other proteins involved in the intracellular signaling that regulates the stem cell growth cycle.

Hedgehog, Wnt, Notch, P63, Notch-i and Oct-4 signaling pathways, among others, have been implicated in cancer stem cell activation. Hedgehog and Wnt pathways are perhaps the most studied to date. Philip Beachy, who studies normal and pathologic functions of the Hedgehog family of proteins at Stanford University and the Howard Hughes Medical Institute, has shown that inhibition of Hedgehog signaling with the teratogen cyclopamine "...can block cell proliferative effects associated with pathway activation and can cause complete regression of aggressive human and rodent cancers growing in mice." In addition, he says, "Hedgehog and Wnt are really sister pathways that may be fairly fundamental in many types of cancer."

Although some researchers remain skeptical about cancer stem cell theory, the basic mechanism of metastasis now seems obvious, the observation that tumors ablated by radiation or chemotherapy sometimes re-grow rapidly now makes sense, and the mechanism by which vascular endothelial growth factor (VEGF) antagonists stop tumor growth is also clear because they inhibit the vascularization of cancer stem cell niches and tumors.

Where The Opportunities Are

Here are some of the new therapeutic opportunities being developed based on the theory of cancer stem cells:

• Monoclonal antibodies to cancer stem cells are combined with cytotoxic payloads to seek and destroy the few cancer stem cells rather than whole tumors and normal cells as well.

• The immune system is used to combat cancer stem cells specifically via a cancer vaccine.

• Nontoxic compounds can be identified to modulate the signaling pathways, such as Hedgehog and Wnt, that appear to be out of control in tumor progression.

• There will likely be a more enlightened role for VEGF antagonists to play in the control of cancer stem cell "niches", as well.

In a February 2006 New York Times article, Robert Weinburg, member of the Whitehead Institute for Biomedical Research and Professor of Biology at MIT, was quoted as saying that pharmaceutical companies are "waiting for more academic research before they take a clear view on how to proceed. Our knowledge base is still rather fragmentary, and we need another year or two of research before we can say to pharmaceutical companies you should do this or that." That time may be soon.

Results Starting To Be Seen

In May 2001, Novartis received FDA approval for Imatinib Mesylate (Gleevec™) for treatment of chronic myelogenous leukemia and later for gastrointestinal stromal tumors. Imatinib Mesylate is the first tyrosine kinase inhibitor approved for cancer treatment.

Genentech has established a venture fund with OncoMed, whose co-founders, Michael Clarke and Max Wicha are leaders in the field of cancer stem cell research. Genentech's collaborative development projects with Curis, a drug development company focused on control of signaling pathways primarily for cancer therapy, include a Hedgehog pathway antagonist project established in 2003 and a 2005 licensing agreement for small molecule modulators of a cell proliferation signaling pathway.

Immunocellular Therapeutics, Ltd., a Los Angeles-based company with vaccine technology licensed exclusively from Cedars-Sinai Medical Center, is beginning Phase I trials on a dendritic cell-based vaccine designed to use the immune system to ward off brain tumors.

On March 7, 2007, Stemline Therapeutics announced the in-licensing of an interleukin-3 receptor antagonist, SL-401, from the Scott & White Cancer Research Institute/Texas A&M Health Science Center College of Medicine. SL-401 had shown promising results in a multi-center Phase I trial in patients with acute myeloid leukemia.

And, Geron Corporation, focusing on cell cycle regulation in embryonic and cancer stem cells by telomeres, has several telomerase inhibitor programs. Its lead compound, GRN163L, an oligonucleotide with telomerase inhibiting activity, is in Phase I/II clinical trials for chronic lymphocytic leukemia.

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