asbestosis

Introduction

Asbestosis is a chronic (long-term) lung condition caused by prolonged exposure to asbestos.

Asbestos is a general term for a group of minerals made of microscopic fibres. In the past, it was widely used in construction.

Asbestos can be very dangerous. It does not present a health risk if it is undisturbed, but if material containing asbestos is chipped, drilled, broken or allowed to deteriorate, it can release a fine dust that contains asbestos fibres.
                                      

When the dust is breathed in, the asbestos fibres enter the lungs and can gradually damage them over time. For asbestosis to develop, prolonged exposure to relatively high numbers of the fibres is necessary. However, it is not the only factor, as many people avoid getting asbestosis, despite heavy exposure.

                                 
Symptoms of asbestosis

Breathing in asbestos fibres may eventually scar the lungs of some people, which can lead to a number of symptoms, including:

    shortness of breath – this may only occur after physical activity at first, but it can eventually become a more constant problem
    a persistent cough
    wheezing
    fatigue (extreme tiredness)
    chest pain
    in more advanced cases, clubbed (swollen) fingertips

Nowadays, most people who are diagnosed with asbestosis were exposed many years ago, before there were effective controls on exposure to asbestos fibres in the workplace.

See your GP if you have the above symptoms and you think you may have been exposed to asbestos in the past.

Read more about diagnosing asbestosis.
Treating asbestosis

There is no cure for asbestosis once it has developed, because it is not possible to reverse the damage to the lungs.
                                               
One of the most important things someone with the condition can do is to stop smoking, if they smoke. This is because the symptoms are more likely to get worse in people who smoke, and smoking also increases the risk of lung cancer in people with asbestosis.

If necessary, treatments such as oxygen therapy can improve the quality of life of someone with asbestosis.

Outlook

The outlook for asbestosis can vary significantly, depending on the extent of damage to the lungs and whether any other conditions are present.

Asbestosis can get worse over time and severe cases can place a significant strain on a person's health and shorten their life expectancy, but in many cases the condition progresses very slowly or not at all.

However, people with asbestosis have a higher risk of developing other serious and potentially life-threatening conditions, such as:

    pleural disease – where the membrane covering the lungs (pleura) becomes thicker, which can further contribute to breathlessness and chest discomfort
    mesothelioma – a type of cancer that affects the membrane that covers the lungs, heart and gut
    lung cancer

Overall, more people with asbestosis die as a result of one of the cancers mentioned above, or from natural causes, than from asbestosis itself.

Read More

MESOTHELIOMA

Greater than 80% of mesothelioma cases are caused by exposure to asbestos. The greater the exposure the greater the risk.^[3]As of 2013 about 125 million people have been exposed to asbestos at work.^[7] High rates of disease occur in people who mine asbestos, produce products from asbestos, work with asbestos products, live with asbestos workers, or work in buildings containing asbestos. Often it is around 40 years between exposure and the cancer starting.^[3] Washing the clothing of someone who worked with asbestos also increases the risk.^[7] Other risk factors include genetics and infection with the simian virus 40.^[3] The diagnosis may be suspected based on chest X-ray and CT scan findings, and is confirmed by either examining fluid produced by the cancer or by a tissue biopsy of the cancer.^[6]

                                              

Prevention centers around reducing exposure to asbestos.^[8] Treatment often includes surgery, radiation therapy, and chemotherapy. A procedure known as pleurodesis, which involves using substances such as talc to scar together the pleura, may be used to prevent more fluid from building up around the lungs.^[9]Chemotherapy often includes the medications cisplatin and pemetrexed.^[6]The percentage of people that survive five years following diagnosis is on average 8% in the United States.^[10]
                                                

In 2013 about 50,000 people had mesothelioma and 34,000 died from the disease.^[11][12] Rates of mesothelioma vary in different areas of the world. Rates are higher in Australia, the United Kingdom, and lower in Japan.^[3] It occurs in about 3,000 people per year in the United States.^[13] It occurs more often in males than females. Rates of disease have increased since the 1950s. Diagnosis typically occurs after the age of 65 and most deaths occur around 70 years old. The disease was rare before the commercial use of asbestos.^[3]
                                               

Read More

MESOTHELIOMA TREATMENT

Important considerations in determining a mesothelioma treatment plan include the cancer stage, primary site affected and cell type. Treatment options also depend on whether the cancer is localized to the chest or has spread to the chest wall, diaphragm, or lymph nodes as well as your age and overall health. The three standard therapies used to treat mesothelioma include surgery, chemotherapy, and radiation.

                                                  

• 

  Surgery

  For patients with an early-stage mesothelioma diagnosis, surgery can be used to remove all or most of the tumor(s). Depending on the tumor location, surgery may include removing the mesothelial lining, one or more lymph nodes, or part or all of a lung or other organ.
• 

  Chemotherapy

  Chemotherapy drugs work by attacking fast-growing cells, such as cancer cells. Often used in conjunction with surgery, chemotherapy can kill any remaining mesothelioma cells that the surgeon was unable to remove physically.
• 

  Radiation Therapy

  Through the use of targeted radiation, mesothelioma tumors can often be shrunk, making them easier to be removed through surgery. Depending on the tumor location, the radiation can be delivered using an external or an internal source.
                                    

In many cases, mesothelioma specialists will recommend a multimodal approach, which uses a combination of these three types of treatment. In various studies, multimodal treatment has been shown to be more effective than any of these individual treatments alone. For example, surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has resulted in an increase in the life expectancy of peritoneal mesothelioma patients in recent years.

Multimodal treatment typically consists of a primary treatment used in combination with a neoadjuvant therapy (a “helper” treatment before the primary treatment) or an adjuvant treatment (a helper treatment after the primary treatment).
                                            
 For example, one multimodal approach might include:

• Neoadjuvant therapy: Radiation to shrink the tumor size
• Primary treatment: Surgery to remove the tumor
• Adjuvant therapy: Chemotherapy to kill any remaining cells

The treatment plan will be developed in conjunction with a mesothelioma specialist who can provide details about the specific therapy approach being taken.

Read More