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AWARENESS

Asbestos Diseases

Mesothelioma

What is Mesothelioma?

Mesothelioma is an incurable cancer caused by the inhalation of asbestos dust and fibre. Mesothelioma usually affects the lining of the lung (called the pleura) however in some instances it can affect the lining of the abdominal cavity (called the peritoneum). These types of mesothelioma are known as pleural mesothelioma and peritoneal mesothelioma respectively.

Mesothelioma occurs when asbestos fibres affect the pleura or peritoneum and cause it to form a thickening/mass. This restricts the lung movement and causes pleural fluid to accumulate in the lung. In the case of peritoneal mesothelioma, it affects movement of the gastrointestinal tract. Pleural mesothelioma is by far the most common form of the condition however rarer forms of mesothelioma include pericardial and testicular mesothelioma being mesothelioma of the heart and testicles.

Mesothelioma

SubTypes of Mesothelioma

There are 2 well recognised subtypes of mesothelioma, epithelioid and sarcomatoid. A person can suffer from one or more subtypes of mesothelioma. Persons who have both subtypes of mesothelioma are considered to have biphasic mesothelioma. The main difference between these two subtypes if the rate at which the mesothelioma develops and progresses.

Cause of Mesothelioma

There is only one accepted cause of mesothelioma in Australia and that is asbestos exposure. Sadly, mesothelioma can be caused by even small exposures to asbestos such as when installing a fence or when carrying out a renovation. Cigarette smoking does not cause mesothelioma.

Symptoms

Mesothelioma has many symptoms, which vary depending on where the cancer is located, the most common of which include:

  • Chest pain (caused by the tumour itself or the fluid in the lung) which manifests in a dull ache, stabbing or burning pain
  • Loss of appetite
  • Weight loss
  • Insomnia
  • Fatigue
  • Night sweats
  • A persistent dry cough
  • Lumps on the chest
  • A painful and/or swollen abdomen (peritoneal mesothelioma)
  • Nausea
  • Vomiting

Diagnosis

Pleural mesothelioma is usually diagnosed after a routine chest x-ray or CT scan or after a person presents to their doctor with one or more of the symptoms set out above and are referred for a chest x-ray or CT scan.

Radiological scanning usually shows a person is suffering from a pleural effusion or pleural thickening. After discovery of these features a person is generally referred for a pleural aspiration where the pleural fluid is drained from a person’s lung. The fluid is drained for relief of symptoms (breathlessness and chest pain) and a small sample is sent away for testing.

Sometimes a diagnosis is unable to be made on the pleural fluid and on these occasions a person is referred to a cardiothoracic surgeon who performs a pleural biopsy where a sample of the tumour is taken and examined under a microscope. There are several methods a doctor may utilise to perform their biopsy including a fine needle biopsy, a CT guided pleural biopsy or a video assisted thorascopic (VATS) biopsy.

Asbestosis

What is Asbestosis?

Asbestosis is interstitial lung disease process caused by moderate to heavy exposure to asbestos. Asbestosis is where the asbestos fibres cause scarring affecting the lower lobes of both of the lungs. Unlike mesothelioma, asbestosis is not a form of cancer. However, like mesothelioma it is incurable.

Asbestosis is a condition which affects people to varying degrees depending upon on the level of fibrosis and the affect on a person’s lung function. The fibrosis causes the lungs to become hard resulting in them being unable to expand as they normally would which impacts a person’s breathing.

Asbestosis

Symptoms

Asbestosis is a slowly progressive condition which can worsen over time meaning persons with progressive asbestosis become more breathless over time. Unlike mesothelioma most people die with asbestosis rather than from it.

Common symptoms of asbestosis are shortness of breath, chest tightness, a persistent cough, chest pain and in severe cases finger clubbing and cardiac failure. Persons who suffer from asbestosis can be more susceptible to chest infections and pneumonia.

Diagnosis

Doctors consider a number factors when diagnosing a person with asbestosis. They consider a person’s level of asbestos exposure in conjunction with their radiology, lung function test results and clinical features (specifically crackles which are able to be heard in the lungs upon inhalation).

If you have been exposed to asbestos and are suffering from symptoms commonly associated with asbestosis, we recommend you consult with your general practitioner and request a referral for a high resolution CT scan (HRCT) to be performed in the prone and supine positions (meaning on your front and back). In rare circumstances, doctors may diagnose asbestosis by way of a lung biopsy where they take a sample of the lung and look using a microscope for asbestos fibres in the lung tissue.

Treatment

There is currently no cure for asbestosis. There are however treatments that improve sufferers’ quality of life including breathing exercises and, in some circumstances antifibrotic medication. These treatments aim at improving a person’s quality of life, prognosis however sadly do not provide a cure.

Occupations Affected by Asbestosis

Countless occupations used asbestos in their day to day operations resulting in miners, carpenters, laggers, asbestos sprayers, mechanics, electricians, painters as well as refinery, shipyard and mill workers.

Lung Cancer

What is Lung Cancer?

A person may develop lung cancer for a variety of different reasons. It may be a family predisposition, but it can also be caused by asbestos exposure and cigarette smoking.

Lung cancer is adenocarcinoma that arises in the airway or parenchyma of the lung. This is opposed to mesothelioma which is cancer arising in the pleura of the lung. Lung cancer occurs reasonably frequently in smokers who have been exposed to asbestos. The reason for this is asbestos exposure and smoking work together synergistically to increase a person’s risk of developing lung cancer. Asbestos exposure has also been linked to oesophageal and a variety of other cancers.

Lung Cancer

Symptoms

Advanced lung cancer has similar symptoms to those of mesothelioma including shortness of breath, cough, chest pain, dysphagia (trouble swallowing), hoarse voice, weight loss, loss of appetite, fatigue and on occasion frequent chest infections.

Diagnosis

Lung cancer is generally initially detected through periodic CT scans. Low dose CT scans are now being used for early detection of lung cancer. The earlier lung cancer is detected generally the better the outcome.

Following a CT scan or another radiological scan a biopsy of the growth on a person’s lung (the suspected lung cancer) it taken and examined by an expert pathologist. The biopsy is usually performed with a bronchoscope or by way of a needle centesis.

Treatment

Lung cancer unlike mesothelioma and asbestosis can be cured. The use of low dose CT scans for early detection of lung cancer has led to better outcomes in recent years. When detected early, lung cancer can be surgically removed from the lung. Follow up chemotherapy, radiotherapy and immunotherapy are then used as curative and palliative therapy.