Asbestos—Have You Been Exposed?

The folks at Asbestos.com have asked me to give you a heads up about mesothelioma, an environmental cancer. If you are like me, when you hear “asbestos” and “mesothelioma,” you think of those TV commercials for lawyers asking you to call them if you know have been exposed. In my book A Nurse Practitioner’s Guide to Smart Health Choices, I write: “We are only beginning to understand the extent to which toxins (or poisons) in our environment are increasing the occurrence of cancers. Substances like pesticides, herbicides, asbestos, arsenic, nickel, nuclear waste, and industrial emissions have all been implicated in causing cancer.” My advice? If after reading the following information you think you are at risk, contact your healthcare provider and check out Asbestos.com before you call a lawyer.

Where Can Asbestos Be Found?

Asbestos was extensively used in the construction industry for both commercial and residential building. The material was valued very highly, mainly because of its durable and fire-resistant properties. These qualities made asbestos the perfect choice for a number of things, but mainly insulation.

Almost all homes built during or prior to the 1980s were constructed using one or more asbestos-containing construction materials. A home remodeled during this period may also have asbestos-containing materials.

What’s the Danger?

The material is safe if left undisturbed; however, once asbestos is damaged or deteriorated, it releases tiny fibers into the air that can then be easily inhaled or ingested. The shape of these fibers reacts negatively with human tissue and biological processes. Once the fibers are inhaled, they become lodged in the tissues of the linings of organs, most commonly the lungs and digestive system. Over time, the lodged fibers cause inflammation and cellular damage, possibly leading to asbestos cancer.

Is It Still Around?

Today, the use of asbestos in the United States is more regulated, but most US residents are under the impression that asbestos was banned in the late 1980s. The Environmental Protection Agency tried to enforce a ban in 1989, but it was thrown out by the Fifth Circuit Court of Appeals in 1991.

Who Is at Risk?

Most diagnosed mesothelioma cases caused by asbestos can be traced back to military or occupational exposure. Aside from the military, the most common occupations affected by asbestos include firefighters, electricians, and auto mechanics.

Firefighters and electricians are most commonly exposed to asbestos in the homes they enter, whereas auto mechanics may beexposed by working with asbestos-containingproducts like brake pads. Secondhand exposure is also a danger for families of those people who worked with asbestos. The fibers can become attached to clothing and brought home to a worker’s family.

What Is Mesothelioma?

Malignant mesothelioma is a form of cancer that starts in the thin tissue layer (ie, mesothelium) lining the inside of the chest and abdomen and the space around the heart. The most common areas for this type of cancer to develop are in the lining of the chest (ie, pleura) and abdominal (ie, peritoneum) cavities. Mesothelioma is almost exclusively caused by asbestos exposure. When asbestos fibers are inhaled, they travel to the ends of small air passages, enabling them to reach the pleura and damage mesothelial cells. Asbestos fibers can also damage a cell’s DNA, leading to uncontrolled cell growth. Asbestos fibers that have been swallowed can reach the abdominal cavity, where they help cause peritoneal mesothelioma.

An estimated 2000–3000 new cases of mesothelioma are diagnosed each year, making this type of cancer relatively rare. Although the incidence of mesothelioma increased from the 1970s to the early 1990s, it has been slowly decreasing in recent years.

Is There a Cure for Mesothelioma?

Regrettably, successful treatment of mesothelioma is not very common. That’s because mesothelioma has an abnormally long latency period. On average, it takes anywhere from 25 to 50 years for visible symptoms to occur. The early symptoms are often very similar to those of less serious illnesses. Common symptoms of pleural mesothelioma include pain in the lower back or at the side of the chest, shortness of breath, cough, fever, sweating, fatigue, weight loss, trouble swallowing, hoarseness, swelling of the face and arms, and muscle weakness; symptoms of peritoneal mesothelioma can include abdominal pain, swelling or edema of the abdomen, weight loss, and nausea and vomiting. Because these symptoms are nonspecific and may sometimes go unchecked until they become severe, mesothelioma is not usually diagnosed until its later stages, when treatment options become more limited.

The main factors that determine the best treatment for mesothelioma include the size and location of the tumor, whether it has metastasized to lymph nodes or other organs, and the health and personal preferences of the affected person. In addition to the stage of the tumor, a better prognosis depends on a good performancestatus (ie, being able to carry out normal tasks of daily life), younger age, an epithelioid subtype, the absence of chest pain, no significant weight loss, normal blood levels of L-lactate dehydrogenase (LDH), and normal red blood cell, white blood cell, and platelet counts. Treatment options like surgical removal of the affected area, for example, are more likely to be safe in younger people. Because of the long latency period, however, most people don’t know they have mesothelioma until they are too old to survive a procedure like that. Mesotheliomas are difficult to treat with radiation because they are not usually present as a single tumor. Several chemotherapy drugs, often used in combination, have been employed to treat mesothelioma. Palliative procedures are sometimes used to control fluid buildup and other symptoms of mesothelioma.

In Closing…