Lung Cancer Disease

What is Lung Cancer?



Also called: Bronchogenic carcinoma

Lung cancer is a malignant (cancerous) tumor that starts from cells of the lung.

The lungs are a pair of sponge-like organs found in the chest that take in oxygen when we breathe in and get rid of carbon dioxide when we breathe out. The right lung is a bit larger than the left lung, which is smaller to accommodate for the size of the heart on the left side of the body. The right lung has three sections, called lobes, and the left lung has two.

Lung cancer is the rapid growth of abnormal cells in the lung. It can start anywhere in the lungs and affect any part of the respiratory system.

Lung cancer is the leading cause of cancer deaths in both men and women. Fewer than half of the people who develop lung cancer live 1 more year. And only 15% of people who develop lung cancer live for 5 more years.

Type of Lung Cancer



Lung cancer is commonly divided into two types:

1. Small Cell Lung Cancer (SCLC). Small cell lung cancer spreads early in the course of the disease and occurs almost exclusively in smokers. Surgical removal usually isn't an option for this type of cancer; instead, it's best treated with chemotherapy and radiation. Even so, the five-year survival rate for small cell lung cancer is very low.

• Non-Small Cell Lung Cancer (NSCLC). Non-small cell lung cancer, which is more common, accounts for more than 75 percent of lung cancers. If caught early when it's confined to a small area, it often can be removed surgically. There are four major categories of non-small cell lung cancer:
• Squamous cell carcinoma: is a cancer that begins in squamous cells, which are thin, flat cells found in the passages of the respiratory and digestive tracts as well as in the surface of the skin and the lining of the hollow organs of the body. This type of NSCLC is linked to a history of smoking and usually found centrally, near a bronchus. It is also called epidermoid carcinoma. This cancer forms in cells lining the airways. It's the most common type in men.
• Adenocarcinoma: This type of cancer usually begins in the mucous-producing cells of the lung. It's the most common type in women and in people who have never smoked or were exposed to secondhand smoke.
• Large cell carcinoma: is a type of lung cancer in which the cells are large and look abnormal when viewed under a microscope. It can be found in any part of the lung and tends to grow and spread rapidly. This type of cancer originates in the peripheral part of the lungs.
• Bronchoaveolar carcinoma: This uncommon type of non-small cell lung cancer tends to grow more slowly than other forms of the disease. It occurs more often in smokers than in nonsmokers and tends to arise in more than one location at the same time.

What causes lung cancer?

Although smoking is by far the leading risk factor for lung cancer, it is known that there are several other risk factors linked to the disease. Some of the risk factors for lung cancer are discussed below:

1. Smoking

Tobacco smoking is believed to be responsible for 80 percent of all cases of lung cancer. The risk of lung cancer increases with the length of time a person has been smoking, the number of packs per day smoked, and how deeply the smoke is inhaled. However, if a person quits smoking before lung cancer develops, the lung tissue slowly returns to normal, which lowers the risk of lung cancer.

Some people think that smoking cigars and pipes is less harmful than smoking cigarettes. However, research has shown that cigar and pipe smoking are almost as likely to cause lung cancer as cigarette smoking. Even cigar and pipe smokers who do not inhale are at increased risk for lung, mouth and other types of cancers.

Secondhand smoke, also called environmental tobacco smoke, describes the smoke in the air when someone else smokes. Exposure to secondhand smoke is called involuntary or passive smoking and increases lung cancer risk. For example, nonsmoking spouses of smokers and people exposed to tobacco smoke in the workplace are more likely to get lung cancer.

2. Asbestos

Asbestos is any of several minerals that occur naturally as fibers. These fibers tend to break easily into particles, which can float in the air and become inhaled, where they can lodge in the lungs, damaging cells and increasing the risk for lung cancer. Formerly used as fireproof insulating materials, asbestos is rarely used today in the workplace or in home products, as it has since been implicated as a cause of certain cancers.

Workers who have been exposed to large amounts of asbestos — such as those in industries like shipbuilding, insulation work, and asbestos mining and manufacturing — have a higher risk of getting lung cancer. The risk of lung cancer is even higher among asbestos workers who also smoke.

3. Radon

Radon is an invisible, odorless and tasteless radioactive gas that occurs naturally in soil and rock. It can cause damage to the lungs that may lead to lung cancer. People who work in mines may be exposed to radon; occasionally, radon can also accumulate indoors. Radon levels in homes may be measured by a kit found in most hardware stores.

4. Marijuana

Many of the carcinogens found in tobacco are also found in marijuana, which actually has more tar than regular cigarettes. Research suggests that marijuana may also cause cancers of the mouth and throat.

5. Lung diseases

Certain lung diseases, such as tuberculosis and some types of pneumonia, often leave scars on the lung that can increase the risk of developing lung cancer.

6. Personal and family history

A person who has had lung cancer once is at increased risk for developing a second lung cancer. Siblings and children of people who have had lung cancer may also have a slightly higher risk.

What are the symptoms of lung cancer?

Because most lung cancers do not cause any symptoms until they have spread, only about 15 percent of lung cancers are found in the early stages. When lung cancer is found early, it is often as a result of a chest X-ray, CT scan or other test that was being done for another reason. Symptoms of lung cancer may include:

• A cough that does not go away and gets worse over time.
• Constant chest pain, often made worse by deep breathing.
• Hoarseness.
• Weight loss and loss of appetite.
• Coughing up blood.
• Shortness of breath.
• Recurring infections such as bronchitis and pneumonia.
• New onset of wheezing.
• Swelling of the neck and face.
  

Remember that these symptoms may be caused by conditions other than lung cancer. It is important to check with a doctor.

Diagnostic Tests for Lung Cancer:



If there is any reason to suspect lung cancer, the doctor will take a medical history and conduct a physical exam. The doctor may also order a chest X-ray and other tests. If lung cancer is suspected, sputum cytology (the microscopic examination of cells obtained from a deep-cough sample of mucus in the lungs) is a simple test that may be useful in detecting lung cancer.

To confirm the presence of lung cancer, the doctor must examine tissue from the lung. A biopsy — the removal of a small sample of tissue for examination under a microscope by a pathologist — can show whether a person has cancer. A number of procedures may be used to obtain this tissue:

* Bronchoscopy: The doctor puts a bronchoscope (a thin, lighted tube) into the mouth or nose and down through the windpipe and into the bronchi. This test can help find tumors or it can be used to take samples of tissue or fluids to see if cancer cells are present.

* Needle aspiration: A needle is inserted through the chest into the tumor to remove a sample of tissue.

* Thoracentesis: Using a needle, the doctor removes a sample of the fluid that surrounds the lungs. This test is done to check whether fluid around the lungs is caused by cancer or by a benign condition such as heart failure or an infection.

* Thoracotomy: Surgery to open the chest is sometimes needed to diagnose lung cancer. This procedure is a major operation performed in a hospital.

If the diagnosis is cancer, the doctor will conduct additional tests to determine the stage (or extent) of the disease (stages of lung cancer are discussed later). Some tests used to determine the cancer stage include:

* Computed tomography (CT) scan: A CT scan is an X-ray procedure in which the X-ray beam moves around the body, taking pictures from different angles. These images are combined by a computer to produce a detailed cross-sectional picture of the inside of the body.

* Magnetic resonance imaging (MRI): MRI uses large magnets and radio waves to produce computer-generated cross-sectional pictures of internal organs.

* Radionuclide scanning: Scanning can show whether cancer has spread to other organs, such as the liver. The patient swallows or receives an injection of a mildly radioactive substance. A machine (scanner) measures and records the level of radioactivity in certain organs to reveal abnormal areas.

* Bone scan: A bone scan is a type of radionuclide scanning that can show whether cancer has spread to the bones.

* Mediastinoscopy: A mediastinoscopy can help show whether the cancer has spread to the lymph nodes in the chest. With the patient asleep, tissue samples are taken from the lymph nodes along the windpipe through a small hole cut into the neck. Examining the tissue under a microscope can show if cancer cells are present.

* Bone marrow biopsy: A needle is used to remove a small piece of bone, usually from the back of the hipbone, and the sample is checked for cancer cells.

* Blood tests: Certain blood tests are often done to help see if the lung cancer has spread to the liver or bones.

Lung Cancer Treatment

Lung cancer treatment depends on the type and stage of cancer, as well as the overall health of the patient.

Treatment may include surgery to remove the cancer, radiation therapy, or medications (chemotherapy). Treatment for non–small and small cell cancer may be different.

Lung cancer treatment may include one or more of the following therapies:

1. Surgery

Surgery is taking out the cancer. Surgery is the most effective treatment for early-stage non–small cell lung cancers (stages I and II). In some cases, only the portion of the lung that contains the tumor is removed. In others, one lobe or even the entire lung may be taken. Surgery to remove all or part of a lung often involves opening one side of the chest, a procedure called a thoracotomy.

Operations to treat lung cancer include:

• Wedge resection: In this operation, the doctor removes only the section of the lung that contains the tumor along with a margin of normal tissue.
• Lobectomy: The most common type of surgery, lobectomy involves removing an entire lobe of one lung.
• Pneumonectomy: In this operation, an entire lung is removed. Because pneumonectomy will decrease lung function considerably, as well as lead to other complications, it's performed only when absolutely necessary and then only if the patient breathing capacity is sufficient to allow breathing with a single lung.
  

Lung function studies and a lung scan are often done before surgery to predict whether the patient will have enough remaining lung function after surgery to live a fairly normal life.

2. Radiation therapy

Radiation therapy uses high-dose X-rays to kill cancer cells. Radiation therapy is often used in combination with surgery or chemotherapy or both. Radiation following surgery for stages IIA, IIB, and IIIA (with lymph node involvement) may reduce the risk of cancer returning in the chest.

The way in which radiation is delivered depends on the type and stage of the cancer being treated. Radiation therapy may be given before, during or after chemotherapy. In all cases, however, the goal of treatment is to destroy cancer cells while harming as little normal tissue as possible.

Small cell lung cancer often spreads to the brain. For that reason, the doctor may sometimes recommend brain radiation therapy to prevent cancer from metastasizing to that part of the body or to eliminate micrometastases that aren't yet detectable with imaging studies. Brain radiation therapy can cause short-term memory problems, fatigue, nausea and other serious side effects.

3. Chemotherapy

Because most small cell lung cancers have spread beyond the lungs by the time they're discovered, an operation usually isn't a treatment option. Instead the most effective treatment is chemotherapy, either alone or in combination with radiation therapy.

Chemotherapy uses medications or drugs to kill cancer cells. Chemotherapy is the most effective treatment for small cell lung cancer, but it is only a cure in a small number of people. Chemotherapy has been shown to improve survival in non-small lung cancer when it is given after surgery for stages IB, IIA, IIB, and IIIA. It may also be used to treat more advanced stages (stages III and IV) of non–small cell lung cancer.

In cases of small cell lung cancer, chemotherapy may be used to shrink the cancer, to slow the cancer's growth, to prevent it from spreading further, or to relieve symptoms and make the patient more comfortable (palliative care). A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that the body can recover. Even so, because the drugs damage healthy cells along with malignant ones, they can cause serious side effects.

4. Targeted therapy

Targeted therapies use medications or antibodies to block growth factors that allow some cancers to grow. At this time, targeted therapies are used for advanced stages.

resource: Cancer Info Guide

Staging of Lung Cancer:

TNM staging is a process to measure how advanced the cancer is. The following three factors are considered:

* Tumor - size and location
* Node - lymph node involvement
* Metastasis - has the cancer spread

1. Small cell lung cancer staging:

Limited stage : The cancer is only in one lung and in lymph nodes on the same side of the chest.

Extensive stage : The cancer has spread to the other lung, to lymph nodes on the other side of the chest, or to distant organs. Many doctors consider cancer that has spread to the fluid around the lung to be extensive stage as well.

2. Non-small cell lung cancer staging:

Stage 0 : The cancer is limited to the lung and is found in a few layers of cells only. It has not grown through the top lining of the lung. Stage 0 is also called carcinoma in situ.

Stage : The cancer is in the lung only, with normal tissue around the tumor. Stage I is divided into stages IA and IB, based on the size of the tumor.

Stage II : The cancer has spread to nearby lymph nodes or to the chest wall (the ribs and muscles that make up the area of the body between the neck and abdomen); the diaphragm (thin muscle below the lungs and heart that separates the chest from the abdomen); the mediastinal pleura (thin membrane that covers the outside of the lungs in the area near the heart); or the parietal pericardium (outer layer of tissue that surrounds the heart). Stage II is divided into stage IIA and stage IIB, based on the size of the tumor and whether it has spread to the lymph nodes.

Stage III : The cancer has either:
* Spread to the lymph nodes in the mediastinum (middle area between the lungs that contains the heart, major blood vessels and other structures);or
* Spread to the lymph nodes on the opposite side of the chest or in the lower neck.

Stage III is divided into stage IIIA (which is sometimes treated with surgery) and stage IIIB (which is rarely treated with surgery).

Stage IV : The cancer has spread to other parts of the body or to another lobe of the lungs.

Resource:
National Cancer Institute
MEDLINEplus Health Information
CancerGuide

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Asbestosis - Pulmonary Asbestosis Disease

What is Asbestosis?

Asbestosis is a chronic inflammatory lung disease that occurs due to long- term exposure to asbestos fibres .

Asbestosis is a breathing disorder caused by inhaling asbestos fibers. Prolonged accumulation of these fibers in your lungs can lead to scarring of lung tissue and diminished breathing capacity. Because many other diseases also lead to lung scarring, other causes must be excluded first when a patient is found to have lung scarring (pulmonary fibrosis).

Asbestosis particularly affects the parenchymatous tissues of the lungs and has gained increased significance due to its link to mesothelioma and to other forms of lung and laryngeal cancer. Asbestosis is also frequently associated with Chronic Obstructive Pulmonary Disease (COPD).

Asbestosis, as a medical problem, was recognized early in the 20th century. A few decades later studies established asbestosis as a predisposing factor for bronchogenic carcinoma and malignant mesothelioma. The developed countries have started recognizing the harmful effects of asbestos and have replaced it with synthetic metal fibres. Legislations have been passed globally to curtail its use in industries.

Patients with particular x-ray findings or biopsy results must also have a remote history of asbestos exposure and a characteristically delayed development of the condition in considering asbestosis as a diagnosis. Smoking appears to increase the frequency and/or the rate of progression of asbestosis, possibly by preventing the efficient elimination of inhaled fibers from the airways.

What are symptoms and signs of asbestosis?

The clinical symptoms usually include slowly progressing shortness of breath and cough, often 20 to 40 years after exposure to asbestos. Breathlessness advances throughout the disease, even without further asbestos inhalation. In the absence of cigarette smoking, sputum (mucus coughed up from the lungs) production and wheezing are uncommon. The exception is workers who have been exposed to very high concentrations of asbestos fibers. Those workers may also develop symptoms as soon as 10 years after exposure. Other indications of asbestosis include abnormal lung sounds on examination, changes in the ends of the fingers and toes ("clubbing"), a blue tinge to the fingers or lips ("cyanosis"), and failure of the right side of the heart ("cor pulmonale"). Asbestosis can be a progressive disease even after exposure to asbestos has stopped.

Signs and symptoms develop when damage and scarring caused by the asbestos fibers lead to stiffness in your lung tissue so that your lungs can't contract and expand normally (a form of pulmonary fibrosis). Once exposure to asbestos is stopped, however, the fibrosis does not progress.

Some asbestosis symptoms include:

* Shortness of breath, initially only with exertion, but eventually even while resting
* Decreased tolerance for physical activity
* Coughing
* Chest pain
* Finger clubbing in some cases

Although most of these signs and symptoms are similar to those of other breathing disorders, such as asthma, the way in which they develop is different. In asbestosis the effects of the disease are insidious, occurring over months and years.

Diagnosing Asbestosis





The diagnosis of asbestosis is made when there is a history of asbestos exposure and positive results from a clinical exam. There is a well-defined latency period of approximately 20 years or more between the initial exposure to asbestos and the development of asbestos related calcification and scarring.

Asbestosis can be diagnosed by the following tests:

• Chest X-ray- irregular opacities in the lower lobes, heart border becomes shaggy. In the late stages of disease, there is a honey-comb likeness and volume loss. X rays can show shadows or spots on the lungs or an indistinct or shaggy outline of the heart that suggests the presence of asbestosis.
• CT scan- scarring and thickening can be seen on the chest x-ray and CT, but the CT scan can detect calcifications around the lung (typical of asbestosis) more often. It is considered the most accurate means for detecting asbestos related abnormalities.
• PFTs- pulmonary function testing is used to test for loss of lung volume, and for the impairment of movement of oxygen across the air sacs. Pulmonary function tests can be used to assess a patient's ability to inhale and exhale, and a computed tomography scan (CT) of the lungs can show flat, raised patches associated with advanced asbestosis.
• Blood tests are used to measure concentrations of oxygen and carbon dioxide.

Complications

The severity of asbestosis is generally related to the amount and duration of exposure to asbestos. Effects of the disease may be so mild as to cause almost no symptoms. Or the condition may create such a reduced flow of oxygen as to be disabling or even fatal. Asbestosis may lead to the following conditions:

• High blood pressure in your lungs. Asbestosis-related scar tissue may eventually compress or obliterate your lungs' small blood vessels, causing high blood pressure in your lungs' arteries (pulmonary hypertension).
• Heart problems. Pulmonary hypertension can lead to enlargement and failure of your heart's right ventricle (cor pulmonale). Your heart consists of four chambers — two upper chambers called atria and two lower chambers called ventricles. Your right ventricle assists in pumping oxygen-poor blood from your organs and tissues to your lungs, where your blood receives a new boost of oxygen. As your pulmonary arteries narrow, your heart's right ventricle must work harder to pump blood through the lungs. Initially, the heart tries to compensate by thickening its walls and dilating the right ventricle to increase the amount of blood it can hold. But this measure only works temporarily, and eventually — after a period of a few years — the right ventricle weakens and fails from the extra strain.
• Lung cancer. If you smoke and have asbestosis, your chances of developing lung cancer increase greatly, especially if you smoke more than a pack a day. Tobacco smoke and asbestos both contribute to each other's cancer-causing (carcinogenic) effects, so that the combination of both risk factors together is more dangerous than the effects of either risk factor alone.
• Other lung damage. Exposure to asbestos can lead to other health complications including changes in the thin membranes covering your lungs and lining your chest cavity (pleural membranes). Pleural changes may be the first signs of asbestos exposure and may include pleural thickening, the formation of calcium deposits in the pleura (plaques), and an abnormal accumulation of fluid between the membranes (pleural effusion). Pleural effusion itself is benign and doesn't increase your risk of asbestosis or malignant mesothelioma.
• Other cancer. Prolonged exposure — 20 years or more — to asbestos can also lead to malignant mesothelioma. Diagnosis and treatment of this cancer is often difficult. Malignant mesothelioma may occur even many years after exposure has stopped.
  

How is asbestosis treated?

Patients with asbestosis, like others with chronic lung disease, are at a higher risk of serious infection, low oxygen levels in the blood, and heart failure. These patients also may not recover as quickly from viral and bacterial infections. In addition, they may be at increased risk for certain fungal and unusual infections that take advantage of diseased or scarred lung tissue. The medical management of these patients should focus special attention on preventing and rapidly treating these infections. Flu and pneumococcal vaccinations are a part of routine care for these patients. There is, however, no treatment or cure for asbestosis. In particular, steroid and immune-based therapies have not been shown to benefit these patients.

There's no treatment to reverse the effects of asbestos on the alveoli. Treatment focuses on preventing progression of the disease and relieving symptoms. The most important factor in keeping the condition from worsening is to eliminate exposure to asbestos. For most people, scarring of lung tissue doesn't begin or progress once exposure has ended.

The following may be components of asbestosis treatment:

• Smoking cessation. If you smoke, it's important to stop, particularly because of the extremely heightened risk of lung cancer. In addition, smoking may cause emphysema, which further reduces your lung reserves.
• Vaccinations. Because of your impaired lung condition, treat a cold or a bout of the flu promptly to avoid complications. Your doctor may advise you to receive flu and pneumonia vaccines.
• Medications. The complication of pulmonary hypertension is often treated with medications to expand or relax blood vessels, and blood-thinning medications to prevent blood clots from forming and obstructing narrowed vessels.
  

To ease difficulty breathing, your doctor may prescribe supplemental oxygen or drain fluid from around your lungs, if necessary. Occasionally, severe cases of asbestosis may be treated with lung transplantation.

© 1998-2008 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research. Terms of Use.

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Asbestos Disease | Types of Asbestos Disease

Asbestosis scaring of the lung tissue Mesothelioma nodular cancer of the plural lining of the lung Lung Cancer Note: smoking greatly increases risk - 50 to 90 times

The most common forms of asbestos disease are pleural plaques, asbestosis, lung cancer, and mesothelioma.

Asbestosis

Asbestosis is a disease which is characterized by pulmonary fibrosis, a progressive scarring of the lungs caused by the accumulation of asbestos fibers. Asbestosis is associated exclusively with chronic, occupational exposure. The build up of scar tissue interferes with oxygen uptake through the lungs and can lead to respiratory and heart failure. Often, asbestosis is a progressive disease, even in the absence of continued exposure. Symptoms include shortness of breath, cough, fatigue, and vague feelings of sickness. When the fibrosis worsens, shortness of breath occurs even at rest.

Pleural Plaques

Pleural plaques and pleural calcification are markers of exposure and may develop 10 to 20 years after initial exposure. Plaques are opaque patches visible on chest x-rays that consist of dense strands of connective tissue surrounded by cells. All commercial types of asbestos induce plaques. Plaques can occur even when fibrosis is absent and do not seem to reflect the severity of pulmonary disease.

Lung Cancer

Of all the diseases related to asbestos exposure, lung cancer has been responsible for over half of the excess deaths resulting from occupational exposure. Although tissues and cells react to the presence of asbestos immediately, detectable symptoms take years, or more often decades, to manifest themselves. Asbestos-induced lung cancer may not show up on x-rays for twenty years or more after the exposure began. This delay between exposure and onset is referred to as the "latency period". Even in cases of prolonged heavy exposure, abnormalities commonly appear on x-rays only after ten or more years following exposure.

Mesothelioma

Mesothelioma is rare or nonexistent in non-asbestos exposed populations but is becoming more common among asbestos-exposed individuals.

Mesothelioma is a cancer of the lining of the lungs and not a cancer that occurs inside the lung. Mesothelioma causes the cells of the mesothelium to become abnormal and infinitely reproduce.

A normal mesothelium cell (or any cell for that matter) can only reproduce a certain amount of times. This keeps certain cells from invading other cells. Cancer occurs when those cells become mutated and their limits are removed, allowing them to reproduce uncontrollably. These abnormal cells then form a lump that is known as a tumor. In a benign tumor the abnormal cells do not spread into surrounding areas, but malignant tumors do have the ability to spread. If the tumor is left untreated then it may spread and destroy the neighboring tissue. Sometimes cells can even break off the original tumor and spread to other organs and tissue through the bloodstream or the lympathic system. The lympathic system is part of the immune system. It is a complex system that includes the bone marrow, the thymus and the spleen, and lymph nodes throughout the body that are connected by a network of lympathic vessels. When the cancer cells reach a new site they may continue to divide and form a new tumor, which is referred to as a secondary tumor or a metastasis.

Mesothelial cells line the chest cavity, the abdominal cavity, and the cavity around the heart. They also cover the outer surface of most internal organs. The tissue that is formed by these mesothelial cells is called mesothelium. Mesothelium helps protect the organs by producing a lubricating fluid that lets organs move around. This fluid makes it easier for the lungs to expand and move around inside the chest during breathing. The mesothelium in the chest is called the pleura and the mesothelium around the abdomen is known as the peritoneum. The mesothelium around the heart (or the pericardial cavity, a sac like space around the heart) is called the pericardium.

The asbestos disease mesothelioma has a long latency period, where it is present but not evident or active. The disease can lie dormant for ten to sixty years after being exposed to asbestos. Because of this, it is often hard to determine the cause of mesothelioma.

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Asbestos Exposure - How is Expose and Affect for Health?

What is Asbestos?



Asbestos is the common name for any variety of silicate materials that are fibrous in structure and are more resistant to acid and fire than other materials. It has two forms, serpentine and amphibole, and is made of impure magnesium silicate. Asbestos is used for thermal insulation, fire proofing, electrical insulation, building materials, brake linings and has been used in numerous industries.

There are six different minerals commercially available that can make up "asbestos exposure", including:

1. chrysotile,or white asbestos;
2. amosite,which usually has brown fibers;
3. crocidolite,or blue asbestos;
4. tremolite,
5. anthophyllite, which usually has gray fibers
6. actinolite.

Of these differerence minerals, chrysotile and amosite are most often used.

Asbestos is a potent carcinogen, that is, a cancer-causing substance, and is a serious health hazard. It is the known cause of pleural plaques, asbestosis, mesothelioma, and causes cancers of the lung, esophagus, and colon. Diseases caused by asbestos have a long latency period, usually taking ten to forty years before showing any symptoms of the disease. This is especially apparent today, when people who worked with installing asbestos as insulation and other materials in the 1970s are just now coming to realize that they are developing cancer at alarming rates.

Asbestos Exposure in My Home

The U.S. Environmental Protection Agency provides information in its website about possible locations in the home where asbestos hazards may be found9:

1. Some roofing and siding shingles are made of asbestos cement.
2. Houses built between 1930 and 1950 may have asbestos as insulation.
3. Asbestos may be present in textured paint and patching compounds used on wall and ceiling joints. Their use was banned in 1977.
4. Artificial ashes and embers sold for use in gas-fired fireplaces may contain asbestos.
5. Older products such as stove-top pads may have some asbestos compounds.
6. Walls and floors around wood burning stoves may be protected with asbestos paper, millboard, or cement sheets.
7. Asbestos is found in some vinyl floor tiles and the backing on vinyl sheet flooring and adhesives.
8. Hot water and steam pipes in older houses may be coated with an asbestos material or covered with an asbestos blanket or tape.
9. Oil and coal furnaces and door gaskets may have asbestos insulation.




How might I be exposed to asbestos?

We are all exposed to low levels of asbestos in the air we breathe. These levels range from 0.00001 to 0.0001 fibers per milliliter of air and generally are highest in cities and industrial areas.

People working in industries that make or use asbestos products or who are involved in asbestos mining may be exposed to high levels of asbestos. People living near these industries may also be exposed to high levels of asbestos in air.

Asbestos fibers may be released into the air by the disturbance of asbestos-containing material during product use, demolition work, building or home maintenance, repair, and remodeling. In general, exposure may occur only when the asbestos-containing material is disturbed in some way to release particles and fibers into the air.

Drinking water may contain asbestos from natural sources or from asbestos-containing cement pipes.
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How can asbestos affect my health?

Asbestos mainly affects the lungs and the membrane that surrounds the lungs. Breathing high levels of asbestos fibers for a long time may result in scar-like tissue in the lungs and in the pleural membrane (lining) that surrounds the lung. This disease is called asbestosis and is usually found in workers exposed to asbestos, but not in the general public. People with asbestosis have difficulty breathing, often a cough, and in severe cases heart enlargement. Asbestosis is a serious disease and can eventually lead to disability and death.

Breathing lower levels of asbestos may result in changes called plaques in the pleural membranes. Pleural plaques can occur in workers and sometimes in people living in areas with high environmental levels of asbestos. Effects on breathing from pleural plaques alone are not usually serious, but higher exposure can lead to a thickening of the pleural membrane that may restrict breathing.
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How likely is asbestos exposure to cause cancer?

The Department of Health and Human Services (DHHS), the World Health Organization (WHO), and the EPA have determined that asbestos is a human carcinogen.

It is known that breathing asbestos can increase the risk of cancer in people. There are two types of cancer caused by exposure to asbestos: lung cancer and mesothelioma. Mesothelioma is a cancer of the thin lining surrounding the lung (pleural membrane) or abdominal cavity (the peritoneum). Cancer from asbestos does not develop immediately, but shows up after a number of years. Studies of workers also suggest that breathing asbestos can increase chances of getting cancer in other parts of the body (stomach, intestines, esophagus, pancreas, and kidneys), but this is less certain. Early identification and treatment of any cancer can increase an individual's quality of life and survival.

Cigarette smoke and asbestos together significantly increase your chances of getting lung cancer. Therefore, if you have been exposed to asbestos you should stop smoking. This may be the most important action that you can take to improve your health and decrease your risk of cancer.

Is there a medical test to show whether I've been exposed to asbestos?

Low levels of asbestos fibers can be measured in urine, feces, mucus, or lung washings of the general public. Higher than average levels of asbestos fibers in tissue can confirm exposure but not determine whether you will experience any health effects.

A thorough history, physical exam, and diagnostic tests are needed to evaluate asbestos-related disease. Chest x-rays are the best screening tool to identify lung changes resulting from asbestos exposure. Lung function tests and CAT scans also assist in the diagnosis of asbestos-related disease.

References
Agency for Toxic Substances and Disease Registry (ATSDR). 2001. Toxicological Profile for Asbestos. Update. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

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Early Detection of Mesothelioma and Lung Cancer

Early detection and diagnosis of mesothelioma offers you the best chance of effectively fighting the disease. More often than not, patients suffering from mesothelioma will be treated with chemotherapy. Chemotherapy works to attack cancer cells and prevents them from multiplying, however, the science has not bee perfected so healthy cells are often destroyed alongside the cancer cells. This problem is the cause of many of the unpleasant side effects of chemotherapy treatments.

Mesothelioma

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to high levels of asbestos fibers.

Lung Cancer

Lung Cancer is the leading cause of death for both men and women. According to the American Cancer Society (ACS), in 2007 there will be about 213,000 new cases of lung cancer, and approximately 160,000 deaths. Average five-year survival rates for patients diagnosed with lung cancer are less than 15%. Five year survival rates for patients with advanced stage IV lung cancer are only about 5%. The population at highest risk for lung cancer includes approximately 5 million men and women between the ages of 50 and 69 who are current or former smokers.

Mesothelioma and Lung Cancer Study’s Objective in Evaluating LDCT Screening

December 24, 2007 — According to a recent and promising study in The Oncologist, researchers found that LDCT may be helpful in detecting pleural abnormalities including the early diagnosis of malignant pleural mesothelioma. Researchers evaluated low dose computed tomography (LDCT), i.e., spiral or helical computed tomography, screening of those exposed to asbestos. LDCT proved more effective at early detection of lung cancer than a chest radiograph (x–ray).

The objective of the study was to create a nonrandomized trial to evaluate the feasibility of baseline and annual repeat screening using LDCT for the early diagnosis of lung cancer and malignant pleural mesothelioma in a population that had been exposed to asbestos. 1,045 volunteers, already enrolled in a surveillance program for asbestos–exposed workers and former workers, were recruited for the study. The volunteers, between the age of 40–75, had no history of prior cancer, or other severe, preexisting conditions and no chest CT scan in the last two years. Participants underwent a structured interview regarding their medical and occupational history, including their involvement with asbestos. Researchers determined that the median age was 58 years, with an average amount of time exposed to asbestos of 30 years. Most participants, sixty–six percent, had smoked for almost 20 years.

After participants were screened, blood samples were taken and they were given respiratory tests, a chest x–ray and an initial LDCT screening. All LDCT images were reviewed by two radiologists and their findings were individually recorded, discussed and documented. In many participants, LDCT revealed nodules on their lungs, round or oval–shaped lesions, both benign and malignant. The nodules were identified and classified into categories. Positive baseline results were defined as noncalcified nodules (enlarged nodules that may be malignant) and pleural thickening (a hardening of the lungs). Participants with positive findings received a high–resolution CT–scan and additional diagnostic tests. If the nodule was not benign, it was treated by a CT–guided biopsy and video–assisted thoracoscopic surgery, or by a bronchoscopy—a procedure that allows your doctor to look at your airway through a thin viewing instrument called a bronchoscope.

LDCT Screening Results—Will LDCT Be Helpful in Early Diagnosis of Mesothelioma?

Results of LDCT screening were:

• 834 noncalcified (benign) nodules were detected in 44% of the participants on an initial LDCT compared to 43 noncalcified nodules in 4% of participants by chest x–ray.
• There were nine cases of lung cancer detected by LDCT and none by chest x–ray. Of the nine lung cancers detected, eight lung cancers were Stage I and one was Stage IIA. All were treated with potentially curative surgery.
• In addition, one person had a thymic carcinoid detected by LDCT. There were 11 false positive results.” (The Oncologist, August 21, 2007).
  

It was determined that annual repeat LDCT screening could provide useful information on the natural history and significance of asbestos–related pleural abnormalities.”" Researchers concluded that LDCT significantly increases the likelihood of detecting small nodules, and thus lung cancer, at an earlier, more curable stage.”" (The Oncologist, August 21, 2007) LDCT was 19 times more likely to detect nodules than the x–ray, and none of the malignant nodules were detected by x–ray.

LDCT’s sensitivity for detecting lung cancer is four times greater than the sensitivity of an x–ray. (American Family Physician, March 15, 2005) The assumption is that a 5– to 10–mm nodule found by LDCT is more curable than a 2– to 3–cm lesion seen on chest radiographs. (American Journal of Respiratory and Critical Care Medicine, March, 2001) . It is reasonable to expect that novel insights into the significance of pleural abnormalities may emerge from novel imaging techniques with higher resolution capabilities than 5–mm collimation CT. (The Oncologist, August 21, 2007)"

Although no cases of mesothelioma were detected in this study using LDCT, a very high number of pleural abnormalities were detected. Imaging is crucial in the diagnosis of mesothelioma. X–rays of the pleura (lining of the lungs) are used to show lung abnormalities such as pleural effusions (excess fluid between the two membranes that envelops the lungs) and pleural thickening which are symptoms of mesothelioma. Further clinical trials are necessary to evaluate the possibilities of using LDCT to detect and diagnose mesothelioma."
resource : Brayton Purcell LLP

Study of the Protein Osteopontin Produced Encouraging Results.

According to a recent article published in the December 2005 New England Journal of Medicine, a recent study of the protein osteopontin produced encouraging results. Comparing patients diagnosed with mesothelioma, patients exposed to asbestos but disease free and healthy control subjects, revealed clear differences in the patients with malignant disease. Although more research is needed to confirm the accuracy of this investigation, a strong correlation between osteopontin levels and mesothelioma was found.

A significantly higher concentration of osteopontin was detected in patients with diagnosed cases of mesothelioma compared to subjects with asbestos exposure. When compared, the levels of osteopontin were not significantly different in unexposed control subjects versus those subjects exposed to asbestos. Nearly 78% of mesothelioma patients showed elevated osteopontin levels. Levels were elevated in both patients with early stage disease (Stage I) and advanced disease. In over 85% of cases, osteopontin levels differentiated patients with mesothelioma versus benign lung conditions.

Definitive detection of mesothelioma in the earlier stages makes surgical removal of tumors possible before the disease has had a chance to spread. Once spread occurs, the effectiveness of surgical treatment drops dramatically. In end?stage disease, surgery is simply a palliative measure to improve breathing capability with little of no curative value.

While it is not clear that this information will lead to longer survival, we do know that the earlier treatment can begin, the better chance for a prolonged life expectancy and with time, hopefully a cure. ( Mesothelioma Web).

Osteopontin is a type of protein that is involved in communication between cells, including signaling involved in the development of cancer. Osteopontin has also been linked to processes involved in cancer progression and spread. Furthermore, it can be found in circulating blood and would therefore be easily measured in individuals at a high risk of developing specific types of cancer.

In order to evaluate osteopontin as a potential marker for mesothelioma, researchers from several institutions conducted a clinical study to compare osteopontin levels in patients diagnosed with mesothelioma and patients with benign (non-cancerous) lung conditions. This study included 76 patients who had been diagnosed with mesothelioma, 69 individuals who had asbestos-related benign lung conditions and 45 healthy individuals who had not been exposed to asbestos. All individuals had their blood drawn and tested for osteopontin levels.

Overall, osteopontin levels were strongly associated with mesothelioma:

* Osteopontin levels were significantly higher in the group of patients diagnosed with mesothelioma compared to those individuals with asbestos-related lung complications (133 ng/ml versus 30 ng/ml, respectively).

* Osteopontin levels were not significantly different between individuals with asbestos-related lung conditions and those who were never exposed to asbestos.

* Osteopontin levels correctly identified nearly 78% of patients with mesothelioma, and accurately distinguished between mesothelioma and benign lung conditions at a rate of 85.5%.

* Osteopontin could accurately identify individuals with stage I mesothelioma (earliest stage - prior to spread), as well as those with advanced disease.

The researchers concluded that osteopontin may be a promising marker for the detection of mesothelioma. Furthermore, osteopontin identified patients with early-stage mesothelioma, a stage at which surgical removal is possible. However, further studies are necessary to confirm these findings, as well as determine whether early detection through osteopontin can improve survival.

Patients who have been exposed to asbestos may wish to speak with their physician regarding the risks and benefits of osteopontin testing or the participation in a clinical trial further evaluating screening measures for this disease. Two sources of information regarding clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com

Reference: Pass HI, Lott D, Lonardo F, et al. Asbestos exposure, pleural mesothelioma, and serum osteopontin levels. New England Journal of Medicine. 2005;353:1564-1573.

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New Research and Treatment of Maglinant Mesothelioma

There is always research going on in the area of mesothelioma. Scientists are looking for causes and ways to prevent mesothelioma. Doctors are working to improve accuracy of diagnosis and effectiveness of treatment. Despite recent progress, much remains to be learned about the best way to treat these cancers.

Causes and Prevention

Much of the research on mesothelioma has focused on learning exactly how asbestos changes mesothelial cells and their DNA to cause these cancers. Understanding how these fibers produce cancer might help us develop ways to prevent those changes.

The risk of asbestos in developing mesothelioma is a definite public health concern. We are continuously learning more about which fibers can produce cancer, how they cause these cancers, and what levels of exposure can be considered safe. Now that we know about the dangers of asbestos, we can limit or stop exposure in homes, public buildings, and the workplace. Unfortunately, regulations protecting workers from asbestos exposure are much less stringent in some countries and nonexistent in others.

Research is also underway to clarify the role (if any) of SV40, a virus that has been linked to mesothelioma in some studies.

New Drugs

Because chemotherapy drugs have not been very effective against advanced mesothelioma, several new approaches to cancer treatment are now being studied. These include anti-angiogenesis drugs (which kill cancers by stopping their blood supply) such as Bevacizumab (Avastin) and anti-growth factor drugs (which interfere with substances some cancer cells produce to stimulate their own growth) such as Erlotinib (Tarceva).

Multimodality Therapy

Doctors are always learning more about the best way to treat patients with mesotheliomas. The roles of surgery, radiation therapy, and chemotherapy in the treatment of mesothelioma are highly debated. Treatments that use some combinations of surgery, radiation therapy, and chemotherapy, called multimodality therapy, are now being studied and may provide the most promising option for some patients. New chemotherapy drugs are currently being tested in clinical trials, together with other types of treatment.

Ranpirnase (Onconase) is an enzyme that breaks down RNA and in preliminary studies has helped some patients with mesothelioma to love longer. Larger clinical trials are currently in progress. Another new drug being tested in mesothelioma clinical trials is suberoylanilide hydroxamic acid (vorinostat, [SAHA]), which may reduce growth of mesothelioma cells by inhibiting an enzyme that controls certain proteins called histones, which regulate DNA.

Gene Therapy

A new approach to cancer therapy being tested on mesothelioma is gene therapy. One of these approaches to treating mesothelioma uses special viruses that have been modified in the laboratory. The modified virus is injected into the pleural space and infects the mesothelioma cells. When this infection occurs, the virus injects a gene into the mesothelioma for interferon-beta, an immune system hormone (cytokine) that may help activate immune system cells to attack the cancer.

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New Studies Show Danger of Indoor Pollution

Researchers are growing increasingly concerned about the indoor pollution that is affecting us on a daily basis without our knowledge.

Many people are unaware that the substances and chemicals that we’re exposed to in our daily routines within our homes, schools and offices are just as damaging, if not more, than the pollution that inhabits the outdoors.

Studies on Exposure to Pollutants.

Recent studies conducted by the Environmental Protection Agency (EPA) show that indoor air levels contain more than a 100 times the amount of asbestos and other harmful substances then outdoor levels.

Although homes that are tightly sealed, which were constructed within the past few decades, prevent fossil fuels from entering, they are also unable to “breathe” and as a result can’t properly dilute the pollutants within the building.

Effects of Indoor Pollutants

The EPA is concerned of the temporary effects, such as headaches, dizziness and irritation to the eyes of indoor pollutants, as well as long term effects.

Depending upon the pollutant, long term effects can include heart disease, respiratory disease, and even leads to certain cancers such as mesothelioma.

Sources of Pollution.

Some common sources of indoor air pollution include:

• Central heating
  
• Household cleaning products
  
• Insulation
  
• Wood Products
  
• Dry Cleaned Clothing (Source: Daily Herald)

From : ASBESTOS NEWS

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