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Researchers Consider the Role of Gender in Surviving Mesothelioma

It’s more common for men to develop pleural mesothelioma, a cancer of the lining of the lung, than women. That’s likely due to the greater presence of men in the kinds of heavy industrial jobs such as ship building, mining and automotive repair where asbestos was prevalent, particularly in earlier decades.

Still, mesothelioma is not exclusive to men or gender specific. Women also develop the disease associated with asbestos exposure, sometimes from laundering the dust-covered clothes of a family member who brings home asbestos on their work clothing. A group of researchers at Brigham and Woman’s Hospital in Boston, Mass., has published a new study in the Annals of Thoracic Surgery evaluating the role of gender in survival with mesothelioma.

The researchers examined the cases of more than 700 patients who underwent surgery at Brigham and Woman’s Hospital between 1987 and 2008 to treat mesothelioma. Of the patients, approximately 145 were women.

The researchers observed that women generally tended to develop the disease at a younger age and to live longer with the disease after surgery. Given that, the researchers say women patients with mesothelioma are good candidates for aggressive treatments. including extrapleural pneumonectomy, surgery to remove a diseased lung and surrounding layer of tissue known as the pleura. It is one of the major curative procedures performed on patients with mesothelioma, but not all patients are healthy enough to undergo the invasive surgery.

According to federal statistics compiled by the National Institute for Occupational Safety and Health, 14,598 men and 3,485 women died of malignant pleural mesothelioma between 1999 and 2005 in the United States.

Labels: Asbestos, Cancer
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All Forms of Asbestos Cause Mesothelioma, Claims to Contrary Chrysotile Industry Bias

Richard Lemen, retired assistant U.S. Surgeon General, said that scientific evidence has shown that all forms of asbestos including chrysotile are associated with increased risk of lung cancer and mesothelioma, a cancer of the lining of the lung or abdomen.

In a short article in the journal Environmental Health Perspectives, Lemen said there is scientific debate about the potency of mineral fibers of various types and lengths. But the fundamental conclusion is that all forms of asbestos are carcinogenic to humans, Lemen said, citing the most recent 2009 evaluation by the International Agency for Research on Cancer.

Only scientists with asbestos industry bias make claims that chrysotile asbestos has not been conclusively linked to mesothelioma, Lemen said. Chrysotile accounts for nearly all asbestos fibers used today. The asbestos industry and countries that export asbestos such as Canada and Russia have vigorously resisted efforts to ban chrysotile.

The International Agency for Research on Cancer’s first evaluation on asbestos, published in 1977, stated that mesotheliomas of the lung and abdomen have been observed after worker exposure to crocidolite, amosite and chrysotile. The three mineral fibers are commonly known as blue asbestos, brown asbestos and white asbestos respectively.

Since then, Lemen said science has not changed its view that all forms of asbestos, including chrysotile, cause mesothelioma.

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Asbestos Fuels Mesothelioma Epidemic in Hong Kong

With a booming Asian economy, Hong Kong used asbestos extensively in the 1950s and 1960s, particularly in the shipyard and construction industries. Asbestos exposure is closely associated with asbestos-related respiratory diseases such as pleural mesothelioma that often appear decades after workers inhale asbestos fibers.

Since 2000, Hong Kong has experienced an epidemic of malignant mesothelioma, a cancer of the lining of the lungs or abdomen, according to a recent article in the journal Environmental Health Perspectives. The epidemic parallels the peak usage of asbestos in the early 1960s since symptoms of asbestos-related disease typically take 30 to 40 years to appear.

Researchers from Australia and China predict that the number of cases of mesothelioma in Hong Kong will peak around 2014, then slowly taper off based on data from the Hong Kong Cancer Registry.

Malignant mesothelioma was rare before the 1950s, but has increased sharply since the 1970s in many parts of the world. Exposure to asbestos in the workplace is considered the highest risk factor for developing asbestos cancer.

The researchers observed a notable increase in incidence of mesothelioma from 1976 to 2006 in Hong kong. The highest incidence was among males 70 years or older.

The increasing incidence of mesothelioma in Hong Kong is similar to trends observed in many countries including France, Germany, Great Britain, the Netherlands, Australia and Japan. The number of cases of mesothelioma in the United States, which restricts asbestos use, has increased to 2,500 to 3,000 a year. The incidence of mesothelioma in many South American countries such as Brazil is expected to keep rising for 10 to 20 more years because of later restrictions on asbestos use.

Hong Kong banned the import and sale of blue asbestos (crocidolite) and brown asbestos (amosite) in 1996. But the country has allowed the continued use of chrysotile asbestos in various industries. While the asbestos industry has claimed that chrysotile asbestos is less toxic than other forms, health organizations have said chrysotile asbestos is a human carcinogen and also causes malignant mesothelioma.

Given the continuing use of chrysotile asbestos in Hong Kong, the researchers predict the mesothelioma epidemic will continue in Hong Kong.

Labels: Asbestos, International News
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Researchers Find New Flag of Mesothelioma by Study of Cancer Patients’ Immune Reactions

Malignant mesothelioma, a cancer closely associated with asbestos exposure, remains difficult to detect so researchers have been seeking new ways to help doctors identify the disease earlier and more accurately.

Japanese researchers, writing in the journal Modern Pathology, report that CD146, a protein molecule, may be a sensitive and reliable indicator of malignant pleural mesothelioma, a cancer of the lining of the lung. Once rare, the incidence of malignant mesothelioma has been increasing worldwide and is predicted to peak around 2020. More than 100,000 people die a year of mesothelioma and other asbestos-related diseases, according to the World Health Organization.

Malignant mesothelioma is resistant to conventional cancer treatment and patients typically survive 9 to 17 months after diagnosis. The poor prognosis is partly due to the fact that most cases of malignant mesothelioma are diagnosed only after the patient has an advanced stage of cancer.

The first symptoms that people with malignant pleural mesothelioma often experience are shortness of breath and/or chest pain due to excess fluid around the lungs. Doctors refer to this fluid as pleural effusions. But the symptoms often don’t appear for 30 years or more after asbestos exposure. In many cases, excess pleural fluid or hardened areas on the lining of the lung can be benign so doctors need a way to reliably distinguish between patients with malignant mesothelioma and those with non-cancerous reactions to asbestos. The researchers say analysis of chest fluid is important in patients with a history of asbestos exposure, even if they don’t show other symptoms.

The increased presence of CD146, a protein molecule, has been linked to the advanced stage of several types of malignant cancer including prostate cancer, ovarian cancer and malignant melanoma. But scientists had not previously examined the relation between CD146 and malignant mesothelioma.

For the study, the Japanese researchers examined a total of 51 cases including 23 patients with malignant pleural mesothelioma ranging in age from .44 to 92 years old, and 28 patients with excess fluid around the lung. Their research techniques involved a study of the chemical processes of immune reactions to mesothelioma at the cell level.

In the tissue samples they examined, the researchers noted that the presence of CD146 was much greater in patients with malignant mesothelioma than in patients with benign reactions involving the lining of the lung. It’s typically not present in normal mesothelial cells. Using CD146 as their indicator, the researchers were able to distinguish which patients had malignant mesothelioma in more than 90 percent of the cases they analyzed.

The researchers propose that CD146 is a reliable predictor for distinguishing malignant mesothelioma and benign mesothelial reactions.

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Majority of World’s Population Still Exposed to Asbestos and its Deadly Effects

The use of asbestos has dropped from more than 4 million metric tons to 2.1 million metric tons in the past 25 years as one country after another has banned the cancer-causing mineral fiber. Yet, a majority of the world’s population still lives in countries including the United States that do not ban asbestos or asbestos-containing products. And demand for asbestos is surging in industrializing countries such as China and India where safeguards on worker exposure are weak or non-existent.

Today, the top users of asbestos are China, Russia, India, Kazakhstan and Brazil. These countries export asbestos-containing products to other countries including the U.S. where the products are used in the automotive and construction industries and pose an ongoing threat of asbestos exposure. Asbestos causes about half the of total deaths from workplace-related cancers such as mesothelioma, a cancer of the lining of the lung or abdomen, according to the World Health Organization.

While the U.S. stopped mining asbestos and producing asbestos in 2002, according to a recent article in Environmental Health Perspectives, a peer-reviewed scientific journal, U.S. companies imported more than 1,400 metric tons on chrysotile asbestos, primarily from Canada, in 2008. Much of it is used for roofing products. In addition, the U.S. imports large quantities of asbestos-containing products such as cement pipe, asbestos-lined brake pads and gaskets.

According to global estimates reported by the World Health Organization 125 million people are exposed to asbestos in the workplace and more than 107,000 people die each year from asbestos-related mesothelioma, lung cancer and asbestosis resulting from occupational exposures. Many experts believe current estimates of asbestos-related disease and deaths understate the actual numbers. Since mesothelioma did not receive its own classification in the International Classification of Diseases until the mid-1990s, many asbestos-related deaths were not classified as such.

Given the decades-long latency period from exposure to asbestos to development of mesothelioma, the epidemic of asbestos-related diseases is still spreading and will for decades to come, particularly in countries still heavily using asbestos.

Labels: Asbestos, International News
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Asbestos Disease Appears Most Often in Lining of Lung

A new book entitled “Breathing In America: Diseases, Progress and Hope” by the American Thoracic Society details the toll of occupational-related respiratory disease including mesothelioma—a cancer associated with breathing asbestos dust.

Asbestos exposure causes lung cancer and mesothelioma, a cancer of the lining of the lung or abdomen, as well as other diseases such as asbestosis, a chronic scarring of the lung. In New York and New Jersey in the 1970s, asbestosis could be seen in more than 70 percent of asbestos insulation workers who had worked in the industry for 20 years or longer, according to the report.

Asbestos disease most heavily affects those directly exposed to asbestos in the workplace. Among the occupations typically exposed to asbestos are miners, millers, shipyard workers, asbestos insulators, boilermakers, electricians, plumbers and carpenters. But asbestos disease can also affect families of workers who are indirectly exposed to asbestos dust brought home on the workers’ clothing.

The most common appearance of asbestos-related disease is in the pleura, the thin membrane that covers internal organs including the lungs. Areas of thickened fibrous tissue called pleural plaques may develop and plaques are often a precursor to development of mesothelioma. Excess fluid may also collect, causing shortness of breath and chest discomfort. The fluid —called pleural effusion—is produced apparently in response to the asbestos fibers causing irritation of the pleura.

Worldwide production of asbestos peaked in the 1970s, but miners in Canada, Russia and other countries still dig from the ground more than 2 million tons of asbestos a year. An estimated 125 million people are still exposed to asbestos in the workplace and more than 90,000 people die each year of malignant mesothelioma, lung cancer related to asbestos exposure and asbestosis.

The prognosis for people diagnosed with mesothelioma and lung cancer is bleak with fewer than a fifth of patients diagnosed with mesothelioma or lung cancer surviving more than five years. Research into innovative gene therapies aimed at suppressing tumor growth offer some hope.

Breathing in America was produced as part of the American Thoracic Society’s 2010 Year of the Lung campaign.

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Asbestos Diseases May Claim More than 10 Million Lives, International Ban Needed

By Wade Rawlins

All asbestos causes malignant mesothelioma and other forms of cancer. Yet even today, a large number of countries continue to import and export asbestos and use asbestos products. A ban is urgently needed on all forms of asbestos, according to an international academic society that analyzes critical occupational and environmental health issues.

In a new article in the journal Environmental Health Perspectives, 16 occupational health researchers from the U.S., Great Britain, Japan, Italy, Canada, India and South Africa —representing the Collegium Ramazzini — write that the profound tragedy is that all illnesses and deaths related to asbestos are preventable. Yet the incidence of asbestos disease increases. The researchers say the risks of asbestos exposure cannot be controlled by technology or by workplace practices. They call for a worldwide ban on the mining and manufacture of all forms of asbestos.

Decades after asbestos was declared a human carcinogen, about 125 million people around the world remain exposed to asbestos at their workplaces, according to the World Health Organization. An estimated 43,000 people died of mesothelioma in 2000 and a much larger number of lung cancer deaths were due to workplace exposure to asbestos. In the U.S., about 2,500 to 3,000 people die of mesothelioma each year and thousands more from lung cancer. Asbestos diseases may claim as many as 10 million people before asbestos is banned worldwide and all exposure is halted, the researchers say.

Despite industry claims to the contrary, all forms of asbestos cause asbestosis, a progressive lung disease as well as mesothelioma, lung cancer and cancer of the larynx. Mesothelioma is an incurable cancer of the lining of the lung or abdomen closely linked to asbestos-exposure. Typically, people who inhale asbestos fibers do not notice any symptoms of disease for 30 years or longer after exposure.

Fifty-two countries, including all members of the European Union, now ban all forms of asbestos. Yet many countries including the United States still import asbestos and make and use asbestos products. A number of countries that ban some forms of asbestos make an exception for chrysotile asbestos, which accounts for nearly 100 percent of the asbestos mined today and about 95 percent of the asbestos ever mined.

The asbestos industry claims that asbestos-related cancers are caused by forms of mineral fiber other than chrysotile asbestos and that chrysotile poses less risk to workers. But scientists and physicians generally agree that chrysotile causes various cancers including mesothelioma and lung cancer. Numerous studies refute industry reports that chrysotile is safe, according to the researchers.

Russia is now the leading producer of asbestos, followed by China, Kazakhstan, Brazil, Canada, Zimbabwe and Colombia. Most asbestos production occurs in Eastern Europe and Asia, often with little or no protection of workers or surrounding communities. Asbestos cement accounts for more than 85 percent of worldwide production.

“Scientists, physicians and responsible authorities in countries allowing the use of asbestos should have no ‘illusion’ that controlled use of chrysotile asbestos is an effective alternative to a ban on all use of asbestos,” the researchers say.

Labels: Asbestos, Mesothelioma
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Proposed Factory Demolition Underscores Ongoing Risk of Asbestos Exposure

The owner of a former West Virginia pottery factory is at odds with state environmental regulators over the demolition of crumbling buildings that contain toxic asbestos.

The West Virginia Department of Environmental Protection has gone to court to bar contractor Nick Masciarelli from demolishing the former Taylor Smith & Taylor pottery factory, contending that he has refused to remove the asbestos properly, according to a report in The Charleston Gazette.

Demolition and remodeling activities are a primary source of exposure to asbestos today. If demolition workers, asbestos removal workers and construction workers are not equipped with proper safety gear or don’t employ techniques to suppress and contain asbestos fibers, the toxic fibers or fine dust can disperse in the air and be inhaled and trapped in a worker’s lung. Over time, the fibers can cause scarring and inflammation, affecting breathing and causing serious respiratory disease including mesothelioma, an incurable cancer that affects the lining of the lung or abdomen. Pleural mesothelioma is the most common form.

Masciarelli, who purchased the property about 18 months ago, with plans to demolish the buildings, said he can’t remove the asbestos the way that state environmental regulators want because the crumbling factory buildings are dangerously unstable and unsafe for his workers to enter. A hearing is scheduled on Aug. 24.

A manufacturer of dinnerware, Taylor Smith & Taylor began in Chester, W. Virginia in 1899. TS&T was bought out in the early 1970s and closed in 1981.

While use of asbestos is limited today in the United States, new cases of mesothelioma can occur through exposure to asbestos during remediation and demolition of buildings containing asbestos if controls are insufficient to protect workers and the surrounding community. An estimated 1.3 million construction and general industry workers potentially are being exposed to asbestos today, according to the National Institute for Occupational Safety and Health.

Labels: Asbestos
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Guidelines for Mesothelioma Treatment

The incidence of malignant mesothelioma, a respiratory cancer associated with inhaling asbestos, is expected to double in many countries in the next 20 years, according to the European Society of Medical Oncology. In the United States, approximately 2,500 to 3,000 people die of mesothelioma each year.

In an article in the July issue of the Annals of Oncology, the European Society of Medical Oncology outlines treatment guidelines for patients with mesothelioma. The clinical practice guidelines are developed by the non-profit professional organization, which promotes advances in cancer treatment and prevention, to assist doctors and patients in making decisions about appropriate health care. According to the practice guidelines:

Patients with mesothelioma often first have symptoms of shortness of breath due to excess fluid in the chest. Patients with more advanced cases may have chest pain. A chest x-ray or scan may suggest a case of mesothelioma based on thickening of the membrane lining the the lung called the pleura. Laboratory examination of chest fluid can confirm a diagnosis of mestohelioma. But the lab reports are often equivocal.

Doctors should interview the patient about their work history to try to determine if they were exposed to asbestos in their workplace, the most common cause of mesothelioma. Most cases of mesothelioma are due to occupational exposure

The gold standard for diagnosis of mesothelioma is a microscopic examination of specific antigens in a tissue biopsy obtained through a surgical procedure called a pleuroscopy. A surgical instrument is inserted into the patient’s chest through an incision to collect tissue. Research studies suggest that certain proteins and oseteopontin, a human gene product, are useful indicators to support a diagnosis of methothelioma.

After doctors confirm a diagnosis, a CT scan of the patient’s chest is used to assess the advancement of the cancer. An accurate asessment of the mesothelioma’s stage is essential to determine the most appropriate treatment and the patient’s prognosis. Malignant pleural mesothelioma rarely spreads to distant parts of the body, but patients often have advanced localized cancer in their respiratory system when they are diagnosed.

Various surgical procedures have been used with varying degrees of success, according to the European Society of Medical Oncology. Surgery should be performed only on patients with less advanced cases of mesothelioma as part of a multi-pronged approach to treatment combined with chemotherapy and/or radiation. The use of radiation in treating mesothelioma has been limited because of the difficulty of irradiating such a large area of the body as a lung without irreparably harming the adjacent healthly lung. Still, it is used.

As far as chemotherapy, the use of combinations of cancer drugs, permetrexed and cisplatin, and to a lesser extent, raltitrexed and cisplatin, have led to improved survival results in patients as well as lung function and symptom control, compared to use of cisplatin in clinical trials. The combination of permetrexed and carboplatin is an effective alternative chemotherapy.

Labels: International News, Mesothelioma, Patients, Treatments, Uncategorized
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Ten-Fold Increase in Mesothelioma Deaths in Great Britain

Deaths from mesothelioma, a respiratory cancer associated with asbestos exposure, have increased more than ten-fold in Great Britain over 40 years.

A study in the July issue of the British Journal of Cancer noted that mesothelioma deaths now represented more than 1 percent of all cancer deaths in Great Britain. Mesothelioma develops in the lining of the lungs or abdomen, typically 30 years or longer after workers inhale asbestos fibers.

The researchers predict that mesothelioma will claim the lives of 91,000 people in Great Britain between 1968 and 2050, with about 61,000 of those deaths occurring after 2007.

While mesothelioma can strike anyone, about 85 percent of victims of mesothelioma in Great Britain are males, many of whom worked in trades where asbestos use was common such as plumbing, ship building, construction and sheet metal work. Asbestos is now banned in Great Britain, but was widely used in building materials until recent decades. The peak year of asbestos exposure was 1963, the study said.

The researchers predicted that mesothelioma mortality among males would peak in the year 2016 with more than 2,000 deaths annually, then decline.

The annual number of mesothelioma deaths in Great Britain has risen fairly steadily from 153 in 1968 to 1848 in 2001, according to the British Health and Safety Executive. Because of the long latency period, many of the recent mesothelioma deaths are a result of heavy asbestos exposure in earlier decades. Britain’s mesothelioma register recorded the deaths of more than 1,700 men in 2006, according to the article.

Labels: International News, Mesothelioma, News
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