Five Basic Medical Facts About Bronchogenic Carcinoma or Lung Cancer Caused By Asbestos Exposure

For some basic facts about asbestos-related lung cancer, or bronchogenic carcinoma, we will draw upon an article, “Asbestos: When the Dust Settles—An Imaging Review of Asbestos-related Disease”, which was published in the October 2002 edition of RadioGraphic medical journal.

  1. The link between asbestos exposure and lung cancer has been suspected since the 1930s but was proved in the 1950s.

  2. Amphiboles [(one type of asbestos fiber)] are more potent than chrysotile [(another type of asbestos fiber)] in inducing lung cancer (between 10 and 50 times greater potency has been quoted).

  3. The latent period is variable. Some cases occur less than 10 years after exposure, but the risk is increased until at least 30 years later. One report cited a lag of 50 years.

  4. The exact mechanism of carcinogenesis is unclear. Asbestos-related cancers can occur anywhere in the lungs. The evidence regarding a link between asbestos and a particular histologic type or lobar distribution of lung cancer is somewhat contradictory.

  5. The investigation and staging of asbestos-related lung cancers are the same as for non-asbestos-related cancers. The prognosis is similar to that for non-asbestos-related lung cancers, but the restrictive effect of coexistent asbestosis or diffuse pleural thickening could compromise patients’ respiratory function and fitness for attempted resection.

[Footnotes omitted.]

Asbestos lung cancer cases can be filed as lawsuits against the manufacturers of asbestos-containing products used in the past or their respective asbestos bankruptcy trusts.


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The Disturbing Story Of What Asbestos Exposure Has Done To The People Of Ambler, Pennsylvania, In The Past And Up To The Present Time, As Regards Asbestos-Related Diseases

Today’s post is a follow-up to one we wrote back in July 2014, “Penn Medical School Will Study Cluster Of Mesothelioma Cases In Ambler, PA, The Site Of A Long-Closed Asbestos Factory”.

In an October 19, 2014 article,  “Penn study seeks to track Ambler’s asbestos legacy”, reporter Sandy Bauers, of the Philadelphia Inquirer, brings to life the story behind this upcoming medical study and provides the human aspect of this most unfortunate situation.

From that Inquirer news article:

Joe Amento, a lifelong resident of Ambler, was 53 when he died of a rare cancer with one main cause – exposure to asbestos.

He was fine at Christmas 2002. In January, a pain in his side kept him awake at night. He was found to have the disease in March. Before August, he was gone.

He left a wife, two children, and a community that to this day wrestles with the uncertain legacy of the huge asbestos factories that once brought the town jobs and prosperity, then sickness and death.

Amento never worked in the factories. He simply lived nearby. But his father, like many, found a job there as a young Italian immigrant.

Although the last factory closed decades ago, the piles of asbestos waste have remained in what are now two Superfund sites.

Even as the U.S. Environmental Protection Agency monitors the completed cleanup at one site, and heavy machinery growls as it progresses at the second, many in the community remain edgy.

Mesothelioma has a 40-year latency period – the time between exposure and sickness. So people who have lived or worked just blocks away wonder: “Am I going to get sick?”

The University of Pennsylvania’s Center of Excellence in Environmental Toxicology has received a $10 million federal grant to seek answers….

And later from that same insightful article:

When the first of Ambler’s factories began making asbestos insulation in 1897, little was known – or later acknowledged – about the harm the tiny fibers could do to the human lungs.

As time passed, the piles of asbestos-containing waste outside the plants grew so high that people dubbed them the white mountains of Ambler. One topped out at 92 feet.

Even in summer, children sledded down the hills on flattened cardboard boxes. The area was a magnet for kids with bikes. Joe Amento was among them, said his brother, Pete.

The two sites total about 55 acres, a big chunk of land in the small, quaint town of Ambler, which was built around the factories as workers moved in.

A municipal park was once built atop the second site. It later was closed.

Even today, playgrounds, backyards, and businesses are less than a block away. That big hill behind the McDonald’s on West Butler Pike near the train station? It’s a dirt-encased pile that contains asbestos.

It seemed every family knew someone who had a lung disease. Joe Amento’s father died of asbestosis….

This in-depth piece of reporting about what has happened, and is still happening, in Ambler, Pennsylvania due to asbestos exposure — both occupational and “environmental”, if you will — is worth your time if you have any interest in the tragedy of asbestos-related diseases.


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Pleural Disease Diagnosis Indicates Signifcant Past Exposure To Asbestos And Means There Is An Increased Risk Of Asbestosis, Lung Cancer, Or Mesothelioma

The commonly encountered asbestos-related conditions and diseases mainly relate to the lungs. These include pleural effusion, pleural plaques, and diffuse pleural thickening — collectively referred to as benign pleural disease — as well as asbestosis, lung cancer, and malignant pleural mesothelioma.

In this post we focus on the several types of pleural disease associated with asbestos exposure. For the basic facts we will draw upon an article, “Asbestos: When the Dust Settles—An Imaging Review of Asbestos-related Disease”, which was published in the October 2002 edition of RadioGraphic medical journal.

As an introduction, while asbestosis, asbestos lung cancer, and mesothelioma may be more well-known asbestos-related medical conditions, pleural disease is the most commonly encountered asbestos-related disease. Pleural disease can occur as pleural effusion, plaques, or thickening, as well as atelectasis.

From the above mentioned RadioGraphic medical journal article:

Pleural Effusion

Benign pleural effusions are thought to be the earliest pleural-based phenomenon (1) (Fig 1)…. They usually occur within 10 years of exposure (12), but they can also develop much later…. The development of effusions is thought to be exposure-dependent (11), but they can occur even after minimal exposure (13) and can be dependent on occupation (11).

Pleural Plaques

The most common manifestation of asbestos exposure is pleural plaques, which are discrete areas of fibrosis that usually arise from the parietal pleura but may arise from visceral pleura. They tend to occur 20–30 years after exposure (1). The classic distribution of plaques seen on chest radiographs is the posterolateral chest wall between the seventh and tenth ribs, lateral chest wall between the sixth and ninth ribs, the dome of the diaphragm (virtually pathognomonic), and the mediastinal pleura (1,14) (Fig 2).

Diffuse Pleural Thickening

Diffuse pleural thickening is less specific for asbestos exposure because other causes of exudative effusions can lead to it. It results from thickening and fibrosis of the visceral pleura, which leads to fusion with the parietal pleura (Fig 7), and is preceded by benign pleural effusion (1) (Fig 8). Histologically, there is similarity between pleural thickening and plaques, except that fusion of the pleural layers is suggestive of more intense inflammation (22).

Round Atelectasis

The pathogenesis of round atelectasis is not certain, but it is thought to be due to an inflammatory reaction and fibrosis in the superficial layer of the pleura. As the fibrous tissue matures, it contracts, causing pleura to fold into the lung, which in turn causes atelectasis (28). Asbestos-related round atelectasis is also known as asbestos pseudotumor or Blesovsky syndrome.

The typical chest radiographic appearance is of a rounded peripheral “mass” with or without lung distortion (Fig 10a). Pleural thickening is usually seen. The CT features are of a round or oval mass that abuts the pleura, a “comet tail” of bronchovascular structures going into the mass, and thickening of the adjacent pleura (1,29) (Figs 10b, 11).

The medical significance of a diagnosis of pleural disease is that it often indicates there has been a significant past exposure to asbestos and, as such, it probably means that there is an increased risk of developing asbestosis, lung cancer, or mesothelioma for that person.


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PD-L1 May Be A Possible Immunotherapy Target In Malignant Pleural Mesothelioma According To New Research Presented At The 2014 European Society For Medical Oncology Congress In Madrid, Spain

This is our second post from a recent European Society for Medical Oncology (ESMO) report about some of the research results presented ESMO 2014 Congress in Madrid, Spain.

Our first post, from last week, was “Radiation Therapy After Chemotherapy And Surgery For Malignant Pleural Mesothelioma Does Not Improve Outcomes In Terms Of Time To Recurrence / Relapse Nor Overall Survival”.

Now from that same ESMO report, “Studies report new findings on treatment options for mesothelioma”, we learn that when a protein called programmed cell-death ligand 1 (PD-L1) that is found in patients with malignant pleural mesothelioma (MPM) they tend to have poorer outcomes. In turn, this presents the issue of whether PD-L1 is a possible immunotherapy target in mesothelioma.

Here is some of the research on this issue that was presented at the ESMO 2014 Congress:

“We report that PD-L1 is expressed in 20% of malignant pleural mesothelioma patients and is associated with poor outcome, which suggests that this pathway could be targeted with PD-1/PD-L1 inhibitors,” says study author Dr Susana Cedres, from Vall d’Hebron Institute Oncology, Barcelona, Spain….

Most importantly, patients who were negative for PD-L1 expression survived around 11 months longer than patients who were positive for PD-L1 expression (median survival 4.79 vs 16.3 months)….

“The results of our study could offer new treatment to this population of patients, identifying a subset of malignant pleural mesothelioma who expressed PD-L1 and could be treated with targeted therapies to PD-L1,” Cedres says.

We will continue to watch for new studies about good treatments for mesothelioma going forward.


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Radiation Therapy After Chemotherapy And Surgery For Malignant Pleural Mesothelioma Does Not Improve Outcomes In Terms Of Time To Recurrence / Relapse Nor Overall Survival

At the recent ESMO 2014 Congress in Madrid, Spain, researchers presented new data about mesothelioma treatment outcomes involving radiotherapy, also known as radiation therapy.

From this European Society for Medical Oncology (ESMO) report about some of the research results presented that conference, “Studies report new findings on treatment options for mesothelioma”:

“Mesothelioma remains a difficult disease to find better treatment options for, so we asked whether high-dose hemithoracic radiotherapy would decrease the rate or delay the time of local recurrence after chemotherapy and radical surgery,” says lead author Prof Rolf A. Stahel, from the Clinic and Policlinic for Oncology, at the University Hospital Zurich, Switzerland, and current President of the European Society for Medical Oncology….

While there had been preliminary evidence suggesting that the addition of radiotherapy might improve outcomes, the study failed to find any differences in relapse-free survival between patients treated with the additional radiotherapy, and those who were not.

Stahel says researchers were hoping for a more positive signal from the study. “We aimed for a six month delay in local recurrence, which would be meaningful because it’s an aggressive treatment for patients.”

In summary, Stahel says, “It demonstrates that, like in other solid tumours, when two modalities are not sufficient it’s very rare that the third modality
added would make a benefit.”

In our next post we will report on another malignant pleural mesothelioma study that was presented at the ESMO 2014 Congress.


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Medical Study Confirms That Peritoneal Mesothelioma And Pleural Mesothelioma Can Develop Up To 50 Years After Person’s First Exposure To Asbestos

A new medical study out of Australia examined the long-term impacts of asbestos exposure and highlighted the duration of the increased risk of getting mesothelioma.

Peritoneal mesothelioma and pleural mesothelioma are are almost always caused by asbestos exposure.

From a news article about this Australian study, “Mesothelioma risk endures over long-term”:

Researchers used conditional logistic regression to model the relationship between the time since first asbestos exposure and the risk of pleural mesothelioma and the rarer peritoneal mesothelioma.

They found the rate and risk of pleural mesothelioma increased until 45 years after the first exposure. After 45 years the risk rate then appeared to slow down.

However, the rate of peritoneal mesothelioma over 10-50 years continued to increase….

“The risk of mesothelioma does not appear to decline over time and this stresses that the need to prevent people being exposed to asbestos is paramount.”

We know that mesothelioma is a devastating disease from our legal representation of workers and their families in lawsuits filed against asbestos companies as well as workers’ compensation claims against employers.


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Mesothelioma / Asbestos Lung Cancer / Asbestosis: The Basic Facts About These Asbestos-Related Diseases

An estimated 2,000-3,000 new cases of malignant mesothelioma are diagnosed each year in the US.

Malignant mesothelioma is most often diagnosed in people over 50; more often in men than women; and, the risk increases with age.

There are 3 types of malignant mesothelioma:

  • Pleural Mesothelioma, which accounts for 75% of cases and starts in the chest cavity
  • Peritoneal Mesothelioma, which accounts for about 10-20% of cases and starts in the abdomen
  • Pericardial Mesothelioma, which is rare and starts in the heart

Workers exposed to asbestos in the past are at risk for developing mesothelioma, asbestos lung cancer, and asbestosis.

Asbestos-related lung cancer occurs inside the lungs.

Asbestosis is not a cancer; rather it is pulmonary fibrosis, or scarring of the lungs, that was caused by years of breathing in asbestos dust and asbestos fibers.


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Asbestos And Mesothelioma Information From United States Government Helps With Understanding The Medical Diagnosis And The Disease Process

We understand that when you are, or a loved one is, diagnosed with an asbestos-related disease such as asbestosis, lung cancer, or mesothelioma there is a pressing need to learn more about the situation.

It is important in this situation to visit “trusted” web sites with accurate information.

Here are some web sites from the US Government which can be relied upon as regards the medical facts concerning an asbestos cancer or asbestos disease diagnosis and what it means.

Asbestos – Health Effects (ATSDR)

Asbestos Exposure and Cancer Risk (National Cancer Institute – US NIH)

Asbestosis (Medline Plus – US NIH)

Lung Cancer (Medline Plus – US NIH)

Mesothelioma (Medline Plus – US NIH)

What Are Asbestos-Related Lung Diseases? (National Heart Lung and Blood Institute – US NIH)

Moving beyond the medical aspect, if you have any questions about the legal compensation claims related to asbestosis, lung cancer, or mesothelioma, please feel free to contact me by email or by phone: 800-426-9535.


 Mesothelioma, Asbestos, and Legal Compensation: Basic Facts

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Asbestos Diseases Continue To Be Diagnosed Today, Many Years After Exposure, And In All Types Of People, Not Just Building Trades Workers

There is a new comprehensive article about the affects of asbestos diseases in Britain which highlights the long latency period and why many “unexpected” people develop mesothelioma, for example.

This article, “Asbestos: The Killer That Still Surrounds Us“, by Harry de Quetteville, was published online September 1, 2014.  It deserves a full read by anyone who is interested in the asbestos-mesothelioma experience, from the diagnosis to the end.

From this compelling article:

The reason that we are feeling its deadly effects now is that, though asbestos use has been illegal for years (all types of asbestos were eventually banned by law in 1999), it usually takes decades for mesothelioma to develop. And the mesothelioma scourge is not confined to veterans of industrial building jobs. Asbestos has been, and in many cases still is, embedded in the homes we live in, the offices we work in, the schools we are educated in, and the stores we shop in. As a result, mesothelioma is no respecter of class, wealth, occupation, or age.

As regards this aspect, the article includes a three-part depiction titled “How asbestos causes mesothelioma“.

And here is another excerpt from this recent article about asbestos diseases:

With most cancers, it is hard to know the exact cause. Though some smokers get lung cancer, for example, not all lung cancer sufferers have smoked. But mesothelioma is different. In almost every case, the cause is exposure to asbestos – a fibrous building material once dubbed “miraculous”, but now known to be mortally dangerous.

The article includes a time line, “A brief history of asbestos“, with information about the rise and fall of asbestos use around the globe.

Again, I encourage you to take a few minutes to read “Asbestos: The Killer That Still Surrounds Us“.


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More Learned About Role Of CD157 As Regards Malignant Pleural Mesothelioma Which Could Be Useful In Planning Mesothelioma Treatments

We are always on the look-out for developments that may advance the treatment options for mesothelioma patients.

In mid-August 2014 we found this news report, “CD157 important in malignant pleural mesothelioma”, from which we get this recent research information:

CD157 plays a pivotal role in the progression of malignant pleural mesothelioma (MPM) and may be useful in the stratification of patients into different prognostic groups, Italian research suggests.

CD157 is known to contribute to tumour progression in ovarian cancer by promoting mesenchymal differentiation, and parallels between ovarian and mesothelial cancer indicate that CD157 might also be involved in MPM, explain Ada Funaro (University of Torino) and colleagues.

To investigate this hypothesis, Funaro and team conducted in vitro and in vivo assays using human MPM cell lines and MPM surgical tissue samples….

“These data suggest that CD157 could be a promising candidate as a predictive marker of response to platinum-based therapy in biphasic MPM patients”, Funaro and co-authors conclude in Oncotarget.

We will monitor the medical literature for further advancements relevant to the care and possible cure of malignant mesothelioma.


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