Mesothelioma, Lung Cancer and Asbestosis

Exposure to asbestos can cause mesothelioma, lung cancer, asbestosis or a non-cancerous thickening of the outside lining of the lung, called pleural thickening. Other cancers believed by some to be related to asbestos include laryngeal, pharyngeal, and colon cancer.

Mesothelioma

Mesothelioma is a cancer of the outside lining of the lung (the pleura) or the stomach wall (peritoneum) whose only known cause in the United States is exposure to asbestos. For this reason, mesothelioma is called a “signal cancer” for asbestos exposure.

The period between a person’s first exposure to asbestos fibers and the onset of cancer is called “latency.” The latency for mesothelioma can be very long, sometimes as long as 15 to 40 years or more. Mesothelioma can be a very “low dose” disease, meaning that exposure to asbestos for as little as 3 months can cause mesothelioma many years later. Wives of asbestos workers, for example, have developed mesothelioma just from washing their husband’s clothes, while their children have also contracted mesothelioma from living in the same house.

In the United States, almost 3,000 people each year contract asbestos-induced mesothelioma.

Though there is no known cure for mesothelioma, treatment options have advanced considerably in the last 10 years.

If you or a member of your family have been diagnosed with mesothelioma, it is very important to be treated at a medical center that specializes in the treatment of asbestos disease and mesothelioma. The University of Chicago has an internationally recognized center for the treatment of mesothelioma. Sometimes a combination of surgery and chemotherapy can be an optimal treatment plan.

Please click here to view Medical Treatment Options for mesothelioma.

Lung Cancer

Asbestos can cause lung cancer in the upper, middle, or lower lobes of the lungs. All of the cell types of lung cancer (adenocarcinoma, squamous cell, oat cell, etc.) can be caused by exposure to asbestos.

Early Detection: There have been some very promising studies that suggest that early diagnosis of lung cancer through the use of CT Scans can significantly prolong life. If lung cancer can be detected when it is very small (about the size of a “bb” or the tip of a pencil), treatment is less complicated and survival is longer.

Usually when lung cancer is as small as a pencil tip, there are no symptoms. Some physicians recommend people who are at high risk of getting lung cancer (smokers or persons heavily exposed to asbestos) should consider an annual “low-dose” CT Scan to detect very small lung nodules that may be cancerous.

Asbestos exposure and cigarette smoke can come together to cause lung cancer. For example, an individual who smoked cigarettes and also had exposure to asbestos may be 80 times more likely to develop lung cancer than a smoker unexposed to asbestos. For this reason, it has been said that there is a “synergistic” effect between asbestos and cigarette smoke in causing lung cancer.

Please click here to view Medical Treatment Options for lung cancer.

Please click here to learn more about Early Detection of Lung Cancer through Low-Dose CT Scans.

Asbestosis

Asbestosis is a scarring or “fibrosis” of the inside portion of the lung called the “parenchyma.” Asbestosis can cause shortness of breath, because the scarring interferes with gas exchange or getting oxygen into the blood stream.

Diagnosis of Asbestosis: The scarring from asbestosis can be diagnosed from a chest x-ray, but a high resolution CT scan (HRCT) is a far more sensitive test . The most sensitive test is to view lung tissue under a microscope to make a “pathological diagnosis” of asbestosis. Pathologists can search for asbestosis (internal scaring) in lung tissue taken from a lung biopsy or from an autopsy or post-mortem examination.

Breathing Tests or PFT’s: A pulmonary function test (PFT) or breathing test can assess whether or to what extent a person’s asbestosis is contributing to breathing problems or impairment.

Since emphysema caused by cigarette smoke can also cause shortness of breath, it is important to have a breathing test which measures the TLC (total lung capacity) and DLCO (diffusing capacity).

When a person’s total lung capacity (TLC) is reduced below 80% of predicted normal, it is usually a sign that impairment may be caused by asbestosis. By contrast, for a person with emphysema, the total lung capacity (TLC) is usually above 100% of predicted normal. This over-capacity is caused by cysts or holes in the lungs of an emphysema patient, which can be distinguished from asbestosis through a CT scan.

Asbestosis is said to be an insidious disease, because it can slowly progress over time. Impairment can be slight, moderate or severe, and such impairment can be complicated by emphysema, often caused by past cigarette use.

Though there is no cure for asbestosis, it is important to follow up with your physician to assess any progression or to be able to diagnose any of the more serious forms of asbestos disease as soon as possible.

Post Mortem or Autopsy

Many times a post-mortem or autopsy is recommended to confirm a diagnosis of mesothelioma, asbestos-induced lung cancer or asbestosis.

For mesothelioma, “special stains” (technically called “immuno-histo-chemical stains”) are used on tumor tissue to rule in the diagnosis of mesothelioma and to rule out the diagnosis of other non-asbestos-induced cancers.

Asbestos fibers remain in the lungs many decades after exposure and can be counted or quantified with asbestos tissue analysis. Coated asbestos fibers (called “asbestos bodies”) can easily be seen under a simple light microscope and can confirm an occupational exposure to asbestos.

The presence of asbestos fibers can also be detected by powerful microscopes called a TEM (transmitting electron microscope) or an SEM (scanning electron microscope). Scarring of the lungs in the presence of these asbestos bodies confirm a diagnosis of asbestosis.

Many asbestos workers who have no evidence of asbestos scarring on the inside of their lungs from chest x-rays or CT scans will nevertheless have positive findings for asbestosis when lung tissue is examined under a microscope by a pathologist.

It is important, therefore, to consider allowing an autopsy or a post-mortem examination if the diagnosis of mesothelioma, asbestos-induced lung cancer or asbestosis is uncertain.

x-ray

Fluid Buildup on the lungs can cause shortness of breath, which can be detected on a chest x-ray. This fluid on the lungs may be an early sign of mesothelioma. Usually the fluid is drained and inspected (cytology report). A biopsy may be ordered to inspect possible cancer in the tissue of the lung or stomach lining (pathology report).

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