01. Lung Cancer Overview
Asbestos and Lung Cancer
Any lung cancer associated with asbestos exposure can be classified as asbestos lung cancer. Asbestos-related lung cancer is indistinguishable from any other lung cancer by symptoms, prognosis or treatment options. Experts have estimated that up to 18% of lung cancers may be caused by asbestos.
Individuals who suspect they may have been exposed to asbestos should talk to a doctor. A health care professional can help monitor for signs of asbestos-related diseases, such as asbestos lung cancer.
Asbestos-Related Lung Cancer Quick Facts
What Is It?
Any lung cancer associated with asbestos exposure is considered asbestos-related lung cancer.
What Causes It?
Inhalation of asbestos fibers brings them into contact with lung tissue. Once in the lung tissue, asbestos fibers can cause damage that leads to cancer.
How Many Cases Are There?
According to experts, about 2,000 – 3,200 people die from asbestos lung cancer each year in the United States.
What Are the Symptoms?
Common symptoms include chest pain, shortness of breath and cough.
What Is the Life Expectancy for Lung Cancer Caused by Asbestos?
The 5-year survival rate for lung and bronchus cancer is about 22%.
How Long Does It Take for Asbestos to Cause Lung Cancer?
The time period between asbestos exposure and onset of lung cancer is called the latency period. In one study, asbestos workers experienced a latency period of 10.5 years between exposure and diagnosis of lung cancer.
However, the study examined current and former smokers who were also exposed to asbestos. Non-smokers with a history of asbestos exposure may experience a longer time period between exposure and cancer onset.
Types of Asbestos Lung Cancer
Asbestos can cause two main forms of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Between 80% and 85% of all lung cancers are NSCLC.
Small Cell Lung Cancer (SCLC)
SCLC is a form of lung cancer composed of cells that are smaller in comparison to those of NSCLC. SCLC tends to grow and spread faster than NSCLC. However, these properties make SCLC more responsive to chemotherapy and radiation treatment.
Non-Small Cell Lung Cancer (NSCLC)
NSCLC is a form of lung cancer composed of cells that are larger in comparison to those of SCLC. This form of lung cancer also has subtypes including adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
02. How Asbestos Causes Lung Cancer
How Does Asbestos Cause Lung Cancer?
Asbestos is a well-established cause of both lung cancer and malignant mesothelioma. When people inhale asbestos fibers, the fibers can become lodged in lung tissue. If the fibers remain in lung tissue, they may cause cancer there. If the fibers migrate through the lungs, into the lining around the lungs (the pleura), they can cause mesothelioma.
According to the International Agency for Research on Cancer (IARC), asbestos may cause cancer in multiple ways.
- Free Radicals: Asbestos fibers can produce molecules called free radicals. Free radicals can interact with and damage important DNA. This genetic damage can allow or cause cancer to develop.
- Physical Interference: Asbestos fibers physically obstruct important cellular processes. This disruption can cause cells to copy incorrectly, leading to cancer.
- Inflammation: It is difficult for the body to clear or remove asbestos fibers. This allows the fibers to interact with tissue for years or decades. During that time, the asbestos fibers can cause chronic inflammation and irritation. Chronic inflammation can cause cellular damage, uncontrolled growth and other abnormalities associated with cancer.
The processes above can take place over a period of many years. Thus, a significant period of time may pass between asbestos exposure and the development of lung cancer. This time period between exposure and cancer diagnosis is called the latency period.
One study of asbestos-exposed workers found a 10.5-year latency period for lung cancer. However, individual latency periods were as brief as about two years and as lengthy as about 19 years.
Given the latency period, it is important for individuals to keep their own asbestos exposure history in mind. Reporting past asbestos exposure can help doctors quickly determine an accurate diagnosis.
How Do Doctors Determine if Asbestos Caused Lung Cancer in a Specific Case?
Doctors may use the Helsinki Criteria to attribute lung cancer to past asbestos exposure. The Helsinki Criteria was established in 1997. It provided a framework for uniformly determining if and when asbestos likely caused lung diseases.
A number of characteristics may allow a case of lung cancer to be attributed to asbestos, such as:
- Previously confirmed diagnosis of asbestosis
- Presence of pleural plaques (scar tissue on the lining of the lungs) with a history of substantial asbestos exposure
- High asbestos fiber counts in lung biopsy tissue
There is one requirement that all cases of asbestos lung cancer must meet. A period of 10 years must have passed between asbestos exposure and development of lung cancer.
Resources for Asbestos-Related Lung Cancer Patients
03. Reducing Risks
Risk Factors for Asbestos Lung Cancer
Asbestos can be blamed for thousands of lung cancer cases each year, but other factors can also increase the risk of lung cancer. According to the National Cancer Institute, smoking causes most cases of lung cancer.
Other lung cancer risk factors include:
- Air pollution
- Chromium [VI]
- Diesel exhaust
- Heavy meat consumption
- Secondhand smoke
- Tar and soot
Individuals may encounter these carcinogens in a number of settings. Several of the substances above are more often found in industrial or occupational settings. Others, such as radon, secondhand smoke and asbestos, may be present in homes. Asbestos, for example, may be found in homes, schools, buildings and numerous jobsites.
According to experts, smoking is the biggest risk factor for lung cancer.
Asbestos Exposure at Work
In the past, manufacturers used asbestos in a number of industrial and household products. This provided opportunities for both occupational asbestos exposure and non-occupational exposure. Modern safety regulations help limit the potential for asbestos exposure at home and work. However, past uses of asbestos products may still be found in older buildings.
Today, individuals in various industries may still risk exposure. For instance, those involved in construction occupations continue to face an increased risk of asbestos exposure compared to the public. Other occupations, such as shipyard workers and military personnel, were often exposed to this dangerous mineral in the past.
Individuals in these and other industries who believe they may have faced exposure on the job should talk to a doctor.
Decreasing Lung Cancer Risks
Concerned individuals can take steps to decrease exposure to the risk factors above.
Test Your Home
Experts can test your home for radon and/or asbestos. The Centers for Disease Control and Prevention (CDC) provides information on testing and addressing radon in the home.
The United States Environmental Protection Agency (EPA) provides information on testing and removal of asbestos in the home. Asbestos should only be handled by certified professionals. Before any renovation projects, building and homeowners should consider having an asbestos inspection. This can identify any asbestos materials present. Professionals can determine next steps to prevent exposure.
A smoker can reduce their lung cancer risk at any time by quitting smoking. There are multiple smoking cessation aids available. Ask your doctor which is most appropriate for you.
Those who have never smoked can avoid the associated increase in risk by continuing to not smoke.
Avoid Secondhand Smoke
If you interact with a smoker at any time, ask them to smoke outside. You can also avoid areas where people commonly smoke such as bars or restaurants.
Do Smoking and Asbestos Exposure Increase Cancer Risk?
Asbestos exposure and smoking can both increase the risk of lung cancer. One study evaluated the rate of lung cancer in men exposed to asbestos through work. The men with the highest levels of asbestos exposure had about 16% higher risk of lung cancer than the general population.
Another study found medium to high asbestos exposure could roughly double a person’s lung cancer risk.
According to multiple studies, the risk of lung cancer increases with the amount of asbestos exposure. Thus, the more a person is exposed to asbestos, the higher their risk of lung cancer will be.
Smoking can significantly increase an individual’s risk of lung cancer. According to the CDC, smokers are 15 to 30 times more likely to develop or die from lung cancer than non-smokers.
The risk climbs even higher for those exposed to both asbestos and cigarette smoke. In one study, the lung cancer risk from asbestos and smoking was more than four times that of either risk factor alone.
Research shows asbestos-exposed smokers may be able to decrease their risk of lung cancer by quitting smoking.
04. Prognosis and Survival
Prognosis and Survival in Asbestos-Related Lung Cancer
Survival in asbestos lung cancer depends on several factors including treatment, stage at diagnosis and patient health. In the last 10 to 15 years, researchers have made strides in early diagnosis and treatment of lung cancer. These advances have improved lung cancer life expectancy.
5-Year Survival Rates for Asbestos Lung Cancer in the United States
|Cancer Stage||Small Cell Lung Cancer||Non-Small Cell Lung Cancer|
Source: American Cancer Society
Note: Survival rates shown are for all forms of lung cancer, including those unrelated to asbestos. Asbestos lung cancer is clinically indistinguishable from other lung cancers.
Ultimately, prognosis varies based on a number of factors including overall patient health, cancer stage and treatment approach. An experienced asbestos lung cancer doctor can advise you on the best ways to improve survival and quality of life.
Common Symptoms of Asbestos-Related Lung Cancer
Lung cancer does not always cause symptoms. This may make it difficult to identify in early stages. Reported lung cancer symptoms include:
- Chest pain or discomfort
- Coughing up bloody phlegm
- Difficulty breathing
- Difficulty swallowing
- Loss of appetite
- Swelling in the face and/or neck veins
- Unexplained weight loss
A number of conditions other than lung cancer can also cause the symptoms above. For instance, patients have reported coughing and difficulty breathing with asbestosis and mesothelioma. Individuals should report any known asbestos exposure to a doctor if such symptoms arise. This can help the doctor determine the true source of the symptoms.
Diagnosis of Asbestos-Related Lung Cancer
Physicians may suspect a patient has lung cancer for a number of reasons. For instance, potential lung cancer symptoms and a history of smoking or asbestos exposure may lead a doctor to consider a lung cancer diagnosis. In such cases, health care providers may call for any combination of the tests below.
The physician may check the patient for discernible signs of health or disease. This may include unusual lumps or breath sounds.
A health care provider may prescribe an X-ray of the chest. This will provide an image of the organs and bones inside the chest. It may detect areas of abnormal tissue that could be cancerous.
Computed Tomography (CT) Scan
A CT scan takes a series of X-rays to provide a detailed image. In lung cancer, a CT scan may reveal tissue or tumor cells that do not show on a regular X-ray.
Doctors may send blood, urine or coughed-up mucus for laboratory testing. Under a microscope, these samples may reveal cancer cells.
In some advanced cases of lung cancer, fluid may collect within the exterior lining of the lungs (the pleura). If this occurs, a doctor may need to test this fluid for the presence of cancer cells. Thoracentesis is a procedure that removes this fluid buildup, for testing or otherwise. This procedure is also called pleurocentesis.
Biopsy procedures remove a small tissue sample of a suspected area of cancer. A specialist can then test the tissue for signs of cancer or other conditions.
Asbestos Lung Cancer Treatment
Similar to treatment for mesothelioma, asbestos lung cancer treatment may include traditional options such as surgery and chemotherapy. Doctors often treat lung cancer with a multimodal treatment approach in which the patient receives more than one form of therapy.
Asbestos-Related Lung Cancer Treatment Options
If a patient is eligible, they may undergo surgical removal of lung cancer. This involves removal of cancer tissue within or surrounding the lung. Only a small percentage of SCLC patients are eligible for surgery.
SCLC patients are often treated with chemotherapy. This cancer treatment kills fast-growing cells. Doctors may combine two chemotherapy drugs for lung cancer: cisplatin or carboplatin with etoposide, pemetrexed, gemcitabine or docetaxel.
Radiation therapy may be recommended for all stages of lung cancer. This treatment uses targeted energy to kill cancer cells. Radiation may be administered concurrently with chemotherapy.
This cancer treatment allows the immune system to attack and kill cancer cells. Immunotherapy may be recommended for second-line treatment of SCLC. Opdivo® and Yervoy® have both shown some success in treating lung cancer.
Photodynamic therapy (PDT) uses light to kill cancer cells. Doctors may recommend PDT for lung cancer treatment in very specific situations. These situations include tumors blocking the airway or causing bleeding or persistent coughing.
Cryotherapy uses freezing temperatures to kill cancer cells. It may be an option for lung cancer patients who are ineligible for surgery. Cryotherapy has shown promise in treating NSCLC.
Treatment decisions will account for patient health, cancer stage and a number of other factors. An asbestos lung cancer specialist can help determine which treatment option is best for your individual situation.
08. Common Questions
Common Questions About Asbestos and Lung Cancer
What’s the Difference Between Mesothelioma and Asbestos Lung Cancer?
- Both mesothelioma and lung cancer are caused by asbestos. Pleural mesothelioma is a form of cancer that arises in the lining outside the lung (the pleura). Mesothelioma may also develop in the lining of the abdomen (peritoneum) or heart (pericardium). Asbestos lung cancer is a cancer that arises in the lung itself.
How Are Asbestosis and Lung Cancer Related?
- Asbestos causes both asbestosis and lung cancer. However, asbestosis is not a form of cancer. Asbestosis is a chronic lung disease in which scar tissue forms in the lungs. The scarring makes it difficult for asbestosis patients to breathe. Asbestosis shares many symptoms in common with lung cancer. Conversely, asbestos lung cancer is a tumor that develops in the lung tissue.
Do All Asbestos-Exposed Individuals Get Lung Cancer or Mesothelioma?
- Asbestos exposure does not guarantee a lung cancer or mesothelioma diagnosis. However, it does increase the risk of both diseases. Individuals concerned about lung cancer or mesothelioma risk should share their concerns and history of asbestos exposure with a physician.
How Can I Pay for the Best Asbestos Lung Cancer Treatment?
- If you or a loved one were diagnosed with lung cancer after being exposed to asbestos, you may be eligible for compensation. You should speak with an asbestos lawyer today to understand your rights.