Asbestos Lung Cancer
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Lung cancer is the second most common type of cancer. It is the leading cause of cancer deaths in the U.S. accounting for about 135,000 deaths annually.[1] Lung cancer comes in different forms, including small cell, non-small cell, and carcinoid lung cancers.
Smoking is overwhelmingly the most common risk factor for lung cancer, accounting for almost 90 percent of cases. However, asbestos exposure is also a risk factor. Smoking combined with asbestos exposure significantly increases lung cancer risk.[2] The prognosis for asbestos-caused lung cancer is poor, however early diagnosis and treatment can increase life expectancy.
Mesothelioma vs. Lung Cancer
Asbestos exposure puts people at risk for both mesothelioma and lung cancer. Often, mesothelioma is mistaken for lung cancer. Mesothelioma is more rare with asbestos exposure being the biggest risk factor. While lung cancer begins with cancerous cells in the lungs, mesothelioma develops in the pleura, a layer of tissue separate from the lungs and surrounding these organs.[3]
Mesothelioma is often misdiagnosed 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. Common symptoms include chest pains, coughing, and difficulty breathing. In both cancers, cells are very similar, so when tissue is examined it is easy to misdiagnose mesothelioma as lung cancer.
Types of Lung Cancer
Non-small cell lung cancer is the most common type of lung cancer, accounting for about 85 percent of cases.[1] There are several sub-types, including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. For the early stages of this cancer, five year survival rates are between 30 and 50 percent. For more advanced stages, survival rates drop to five percent or less.
Small cell lung cancer makes up 10 to 15 percent 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 early stages, survival rates are between 20 and 30 percent and only two percent or less for later stages.
The most rare lung cancer type, accounting for less than five percent of cases, is called 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, as 93 percent for early stage cases and 57 percent for later stages.
Lung Cancer Symptoms
Lung cancers caused by asbestos exposure causes symptoms similar to those caused by other factors. These include persistent cough, changes in an existing cough, shortness of breath, coughing up blood, chest pains, hoarseness, wheezing, weight loss, headaches, and bone pain.[5]
Diagnosis
Diagnosis begins with a physical exam and description of symptoms. After a physical exam, imaging screenings are used to examine the lungs and chest cavity. X-rays are sometimes used, however CT scans provide a better picture of lungs and 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 are representative of lung cancer or mesothelioma. This identification is not always straightforward. Once a diagnosis of lung cancer has been made, it 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 successful a strategy for treatment. Lung cancer is typically treated with 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 an 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 the 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. There are factors called the Helsinki criteria that doctors often use 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
In study after study, smoking has been shown 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 deadly. Smoking and asbestos exposure multiplies a persons 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 is 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.
Page Edited by Patient Advocate Dave Foster
Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available.
