Asbestos Lung Cancer
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Lung cancer is the second most common type of cancer and the leading cause of cancer deaths in the U.S., and some cases are triggered by asbestos exposure.[1] The prognosis for asbestos lung cancer is poor. Early diagnosis and treatment can increase life expectancy.
Mesothelioma vs. Lung Cancer
Asbestos exposure puts people at risk for both mesothelioma and lung cancer. Lung cancer risk is especially great in those exposed to asbestos who also smoke.[2]
Often, mesothelioma is mistaken for lung cancer. Mesothelioma is rare, with asbestos exposure being the biggest risk factor. While lung cancer begins with malignancy in the lungs, mesothelioma develops in the pleura, a layer of tissue separate from the lungs and surrounding these organs.[3]
Doctors often misdiagnose mesothelioma because lung cancer is much more common. Mesothelioma is often a last resort diagnosis after doctors have ruled out other illnesses.
Symptoms of these two cancers are similar. Both cancers can cause:
- Chest pain
- Coughing
- Fatigue
- Weight loss
- Difficulty breathing
In both cancers, cells are very similar, so it is easy to misdiagnose mesothelioma as lung cancer when tissue is examined.
Types of Lung Cancer
Non-small cell lung cancer is the most common type of lung cancer, accounting for about 85% of cases.[1] There are several subtypes, including:
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell carcinoma
For the early stages of this cancer, five-year survival rates are between approximately 61%. For those with intermediate stages, 35%, and those with distant metastatic disease, 5%.
Small cell lung cancer makes up 10 to 15% of lung cancer diagnoses.[4] These types of cancer spread more quickly and aggressively. Small cell cancer five-year survival rates are lower than non-small cell lung cancer. In the early stages, survival rates are between 20 and 30% and only 2% or less for later stages.
The rarest lung cancer type, accounting for less than 5% of cases, is a lung carcinoid tumor.[4] This cancer grows slowly and does not spread like other types of lung cancer. This slow growth creates higher survival rates, 93% for early-stage cases and 57% for later stages.
As with any cancer type or stage, it is important to recognize several components go into five-year survival rates. It is best to speak with your care team to get a personalized assessment based on your specific disease characteristics.
Lung Cancer Symptoms
Lung cancers caused by asbestos exposure cause symptoms similar to those caused by other factors. These include:[5]
- Persistent cough
- Changes in an existing cough
- Shortness of breath
- Coughing up blood
- Chest pain
- Hoarseness
- Wheezing
- Weight loss
- Headaches
- Bone pain
- Fatigue
Diagnosis
Diagnosis for both lung cancer and mesothelia can often be similar. It usually begins with a physical exam and description of symptoms.
After a physical exam, doctors use imaging screenings to examine the lungs and chest cavity. This usually begins with X-rays. CT scans are helpful next steps, providing a better picture of lungs to look for tumors. It is important to inform your doctor at this point if you have been exposed to asbestos.
Typically, the next step is a biopsy if an image shows abnormal tissue. A biopsy removes tissue for testing. Looking at the tissue sample under the microscope, a pathologist determines if the cells are cancerous.
If they are cancerous, it must be determined if the cells represent lung cancer or mesothelioma. This identification is not always straightforward. Once a lung cancer diagnosis has been made, it is according to tumor size, number, and how far the cancer has spread.[6]
Treatment
Treatment is dependent on diagnosis and staging. This information helps a medical team devise a successful strategy for treatment.
Lung cancer treatment typically includes a combination of surgery, chemotherapy, and radiation. Targeted drug therapies may also be used. For patients with advanced lung cancer, treatment may focus on palliative rather than curative care.[6]
Asbestosis and Lung Cancer
Asbestosis is an illness caused by asbestos exposure. Inhaled asbestos fibers lodge in lung tissue, causing irritation and cell damage. Eventually, this cell damage can form tough scar tissue.
Scar tissue leads to symptoms like chest pains, persistent dry cough, and shortness of breath. Asbestosis is not lung cancer; however, research shows it is a consistent marker for lung cancer caused by asbestos.[7]
Not all lung cancers are caused by asbestos exposure. There are numerous potential risk factors. Asbestosis does not seem to cause lung cancer, but its presence indicates a person’s lung cancer was likely caused by asbestos exposure.
The connection is so strong that even in smokers, the presence of asbestos usually pinpoints asbestos as the cause of lung cancer.
The Helsinki Criteria
While recent research shows that asbestosis is a clear factor indicating asbestos as a lung cancer cause, it is not the only risk factor.
Doctors often use the Helsinki criteria to determine if asbestos caused a patient’s lung cancer. One criterion is the latency period. For asbestos to cause lung cancer, it must not develop for at least a decade after exposure.[8]
Another criterion is the presence of asbestos fibers in the lungs. The amount of asbestos exposure also plays a role. Asbestosis is another factor included in this set of criteria.
Using the Helsinki criteria, doctors must determine if a patient has at least two factors that attribute their cancer to asbestos exposure.[8]
How Smoking Affects Asbestos Lung Cancer
Multiple studies have shown smoking to increase lung cancer risk. This is particularly true in people who have been exposed to asbestos. The combination of these two risk factors is particularly concerning. Smoking and asbestos exposure increase a person’s chance of developing lung cancer.
Quitting smoking reduces the risk of lung cancer, especially for individuals who have been exposed to asbestos. It is important that anyone exposed to asbestos quit smoking as soon as possible.[9]
If you have been exposed to asbestos, it is important to understand the signs and symptoms of lung cancer. Screening and proper diagnosis are crucial to getting the best prognosis. This is a deadly cancer exacerbated by smoking. Treating lung cancer does not necessarily cure it. Survival rates may be better than for mesothelioma; however, early detection and treatment are crucial for increasing your chances of beating this disease.
Get Your FREE Mesothelioma PacketPage Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.