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Mesothelioma and immunodeficiency disorders are related because the immune system plays a role in defending the body against malignancy. Individuals with deficient immune systems may be at more significant risk of developing mesothelioma after asbestos exposure.
What Is Immunodeficiency?
Also sometimes called an immune deficiency, immunodeficiency is not a disease or a condition in itself but a symptom or complication. Any disorder that causes immunodeficiency causes the immune system to malfunction. This results in more frequent, long-lasting, and severe infections.
Immunodeficiency may be primary or secondary:
- Primary: A primary immunodeficiency disorder is one that is genetic, hereditary, or present when a baby is born. In rare cases a primary disorder may not be diagnosed until adulthood. These disorders are numerous but not common.
- Secondary: Secondary immunodeficiency is caused by a medication or drug or by an acquired illness. For instance, HIV (human immunodeficiency virus) is a viral infection that can develop into AIDS (acquired immune deficiency syndrome), which severely impairs the immune system. Secondary immunodeficiency is more common and can be caused by a range of things, including infections, cancer, poor nutrition, and immune-suppressing drugs.
How Does Mesothelioma Affect the Immune System?
Mesothelioma, like other cancers, impacts the immune system both due to the cancer itself and its treatments. One of the main ways that cancer affects immunity is by disrupting the production of white blood cells in bone marrow, for instance, if the tumors metastasize to bone tissue.
A recent study found that cancer also disrupts immunity locally, in the area around the tumors. The disruption, the researchers found, stopped when the tumors were surgically removed.
The researchers saw variations in this effect depending on the cancer type. What they all had in common was that the disruption made it more difficult for the immune system to defend against infections. The result is that people with cancer are more vulnerable to illnesses and are likely to have more severe infections.
Having mesothelioma or any type of cancer affects the immunity and illness in several other ways:
- Tumors in the chest cavity block mucous drainage, which can make a patient more susceptible to a respiratory infection.
- Any tissue damaged by tumors is more likely to become infected.
- Chemotherapy and radiation therapy can both decrease the production of white blood cells in the body.
- Immunotherapy, which targets the immune system to fight cancer, can have the unwanted side effect of weakening it overall.
- Poor nutrition and malnutrition are common issues in cancer patients. Both can lower the effectiveness of the immune system, leading to illness.
Immunodeficiency and Cancer Risk
Cancer can trigger immune system deficiencies, but the opposite is also true. Having an immunodeficiency disorder increases the risk of developing cancer.
This finding from studies indicates that the immune system plays an important role in protecting the body from cancer cells. It also explains why immunotherapy treatments for cancer have been successful in some patients.
One study looked specifically at patients with primary immunodeficiency disorders. Researchers at the Roswell Park Cancer Institute’s Department of Immunology used the United States Immune Deficiency Network database to determine how many people with primary disorders also have cancer.
They found that the increase in cancer rates among these immunodeficient patients is significant compared to the general population. The study also found that the increased rate was not typical in more common cancers but was noticeable in specific types, especially those related to infections.
For instance, lymphoma related to the Epstein-Barr virus was more common in primary immunodeficiency patients. Overall, the incidence of cancer in patients with primary immunodeficiency disorders is 42% higher.
The researchers believe there are two main reasons to explain this phenomenon: these patients lack the immune function to fight infections that may cause cancer; they also have deficiencies in DNA repair mechanisms, leading to runaway mutations that trigger cancer.
The Immune System and Mesothelioma
A long mystery about mesothelioma is why some people exposed to asbestos develop it, and others do not. Asbestos exposure is strongly connected to mesothelioma and is considered the leading cause of this type of cancer. Yet, most people who experienced asbestos exposure, even for decades at work, do not develop mesothelioma.
Research is beginning to point to immunodeficiency as a reason. People exposed to asbestos who are later diagnosed with mesothelioma may have a compromised immune system, either from a primary or secondary cause.
Studies have found that the function of the immune system is the most likely explanation as to why most people do not have mesothelioma after exposure.
Researchers have found that people exposed to asbestos almost always develop pleural plaques, indicating that asbestos does get to the pleural tissue and cause damage. Still, there is evidence that the immune system prevents that damage from turning into cancer in most people.
Immunodeficiency and Mesothelioma
Case studies of individuals with primary or secondary immunodeficiency disorders back up the idea that the immune system protects most people from asbestos and developing mesothelioma:
- For instance, a young man diagnosed with HIV and later AIDS developed mesothelioma without any known history of asbestos exposure. There are multiple cases like this.
- Immunodeficiency caused by medications has also been shown to lead to mesothelioma. One case studied involved a woman who had a lung transplant. She took immune-suppressing drugs to prevent her body from rejecting the organ, and eventually, she developed mesothelioma.
Living with Mesothelioma and Immunodeficiency
Not only does immunodeficiency make an individual more susceptible to mesothelioma, but it can also help cancer spread more rapidly. Patients with mesothelioma and immune system problems have poorer prognoses and survival times.
Treatment is more difficult when the immune system is not able to function normally. One reason is that a patient may not be eligible for more aggressive procedures.
A major surgery, for instance, is much riskier for someone with a compromised immune system, and aggressive chemotherapy may be too much for a patient with poor immune function to handle.
The Potential of Immunotherapy
Through research, experts know how cancer damages or weakens the immune system. This information has helped develop better treatments. Medication that uses the immune system against tumors and cancer cells is called immunotherapy.
Immunotherapies take several different approaches. A pair of immunotherapy drugs (nivolumab and ipilimumab) approved to treat mesothelioma are immune checkpoint inhibitors. They disrupt the processes cancer cells use to hide from immune cells.
The complication of immunodeficiency is just one more reason to seek specialists when getting treatment for asbestos-related illnesses. For anyone with known immunodeficiency disorders, early screening for any type of cancer is essential for an early diagnosis and a better prognosis.
If you have been exposed to asbestos or are worried you may have a compromised immune system, see your doctor immediately.Get Your FREE Mesothelioma Packet
Page 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.