Asbestos : What is asbestos?

What is asbestos?

Asbestos is a group of minerals that occur naturally as bundles of fibers. These fibers, found in soil and rocks in many parts of the world, are made of silicon, oxygen, and other elements. There are 2 main types of asbestos fibers:

• Serpentine asbestos fibers are curly. The most common asbestos in industrial use, known as chrysotile, or white asbestos, has curly fibers.
• Amphibole asbestos fibers are straight and needle-like. There are several types of amphibole fibers, including amosite, crocidolite, tremolite, actinolite, and anthophyllite.

Amphiboles (particularly crocidolite) are considered to be more likely to cause cancer, but even the more commonly used chrysotile fibers have been linked to cancer.
Asbestos fibers are strong, resistant to heat and to many chemicals, and do not conduct electricity. As a result, asbestos has been used as an insulating material since ancient times. Since the industrial revolution, asbestos has been used to insulate factories, schools, homes, and ships, and to make automobile brake and clutch parts, roofing shingles, ceiling and floor tiles, cement, textiles, and hundreds of other products.
During the first half of the 1900s, growing evidence showed that breathing in asbestos caused scarring of the lungs. In the early 1900s, exposure to asbestos dust in the workplace was not controlled. Beginning in England in the 1930s, steps were taken to protect workers in the asbestos industry by installing ventilation and exhaust systems. However, in the huge shipbuilding effort during World War II, large numbers of workers were exposed to high levels of asbestos.
As asbestos-related cancers became better recognized in the second half of the 20th century, measures were taken to reduce exposure, including establishing exposure standards. In addition to more careful handling, there has been a dramatic decrease in the import and use of asbestos since the mid-1960s, and alternative insulating materials have been developed. As a result, asbestos exposure has dropped dramatically in the United States. However, it is still used in some products, and there is still a potential for exposure to asbestos in older buildings, water pipes, and other settings. Heavier asbestos use continues in many other countries as well.

How are people exposed to asbestos?

People are exposed to asbestos mainly by inhaling fibers in the air they breathe. This may occur during mining and processing asbestos, making asbestos-containing products, or installing asbestos insulation. It may also occur when older buildings are demolished or renovated, or when older asbestos-containing materials begin to break down. In any of these situations, asbestos fibers tend to create a dust composed of tiny particles that can float in the air.
In addition, asbestos fibers can be swallowed. This may happen when people consume contaminated food or liquids (such as water that flows through asbestos cement pipes). It may also occur when people cough up asbestos they have inhaled, and then swallow their saliva.
Many people are exposed to very low levels of naturally occurring asbestos in outdoor air as a result of erosion of asbestos-bearing rocks. The potential for such exposure is higher in areas where rocks have higher asbestos content. In some areas, asbestos may be detected in the water supply as well as in the air. It may be released into the water through several sources, such as erosion or natural deposits, corrosion from asbestos cement pipes, and the break down of roofing materials containing asbestos that are then transported into sewers.
However, the people with the heaviest exposure are those who worked in asbestos industries, such as shipbuilding and insulation. Many of these people recall working in thick clouds of asbestos dust, day after day.
Family members of asbestos workers can also be exposed to higher levels of asbestos because the fibers can be carried home on the workers' clothing, and can then be inhaled by others in the household.
Exposure to asbestos is also a concern in older buildings. If building materials like insulation and ceiling and floor tiles begin to decompose over time, asbestos fibers can be found in indoor air and may pose a health threat. There is no health risk if the asbestos is bonded into intact finished products, such as walls and tiles. As long as the material is not damaged or disturbed (for example, by drilling or remodeling), the fibers are not released into the air. Maintenance workers who sweep up and dispose of the asbestos dust or handle damaged asbestos-containing materials are often exposed to higher levels than other occupants of these buildings. Removing asbestos from homes and other buildings can also cause some exposure, although modern asbestos abatement workers are trained to use appropriate protective equipment to minimize exposure.
Although use of asbestos has declined in many developed countries, its use is still a health hazard in some other parts of the world. Much of the world's asbestos production is used in Eastern Europe, Latin America, and Asia, and its use is on the rise in many of these areas. In 2005, the World Health Organization estimated that 125 million people worldwide were exposed to asbestos at work, despite the known links to cancer and other lung diseases for more than 60 years.

Does asbestos cause cancer?

Evidence from studies in both people and laboratory animals has shown that asbestos can increase the risk for some types of cancer.
When asbestos fibers in the air are inhaled, they may stick to mucus in the throat, trachea (windpipe), or bronchi (large breathing tubes of the lungs) and may be cleared by being coughed up or swallowed. But some fibers may reach the ends of the small airways in the lungs or penetrate into the outer lining of the lung and chest wall (known as the pleura). These fibers may irritate the cells in the lung or pleura and eventually cause lung cancer or mesothelioma.

Ovarian Cancer (Cancer of the Ovaries)

The ovaries The ovaries are part of a woman's reproductive system. They are in the pelvis. Each ovary is about the size of an almond. The ovaries make the female hormones -- estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus). When a woman goes through her "change of life" (menopause), her ovaries stop releasing eggs and make far lower levels of hormones. Understanding ovarian cancer Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place. Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor. Tumors can be benign or malignant: Benign tumors are not cancer: Benign tumors are rarely life-threatening. Generally, benign tumors can be removed. They usually do not grow back. Benign tumors do not invade the tissues around them. Cells from benign tumors do not spread to other parts of the body. Malignant tumors are cancer: Malignant tumors are generally more serious than benign tumors. They may be life-threatening. Malignant tumors often can be removed. But sometimes they grow back. Malignant tumors can invade and damage nearby tissues and organs. Cells from malignant tumors can spread to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the lymphatic system or bloodstream. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis. Benign and malignant cysts An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer). Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer. Ovarian cancer Ovarian cancer can invade, shed, or spread to other organs: Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus. Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants. Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.

Mesothelioma Treatment

Despite years of research since the disease was first identified, it’s still difficult to identify the best approach to treating the disease, says David Rice, MD, a cardiothoracic surgeon and nationally known mesothelioma expert who practices at the University of Texas MD Anderson Cancer Center in Houston, TX.



The very rareness of the cancer—only about 3,000 people a year are diagnosed in the United States—makes it difficult to run the kind of research studies needed to compare treatments and determine the ideal therapy at each stage of the disease. “There isn’t a lot of evidence-based science in this disease,” Dr. Rice admits. So when his patients ask him what the best treatment is for the disease, he tells them what we tell you in this section, adding that “we don’t have a reliable cure for this disease.”


Thus, a major goal of treatment is to reduce pain and suffering and prolong a patient’s life as long as possible while providing them with the highest quality of life possible.


Choosing the right mesothelioma doctor is an important first step in planning for treatment.


There are a number of mesothelioma experts, like Dr. Rice, practicing in specialized clinics throughout the country. Each of these cancer specialists has an acute knowledge of the behavior and pathology of malignant mesothelioma and its treatment. It is likely that if you are diagnosed with mesothelioma, you will be referred by your personal physician to a larger scale comprehensive cancer center.


The most important consideration in mesothelioma treatment is the cancer stage and type, said Dr. Rice. Treatment decisions also depend on whether the cancer is localized to the chest or has spread to the chest wall, diaphragm, or lymph nodes, your age and overall health, and the center where you’re being treated. Learn more about finding a doctor here.


Conventional treatments for mesothelioma involve surgery, chemotherapy, and radiation therapy.


As with most solid tumors, doctors turn to surgery, radiation and chemotherapy to manage mesothelioma. When exploring the various treatment options available with your doctor it is important to be informed about the risk and benefits of each one before making a final decision.


Surgery


Only about 1 in 5 patients with metastatic pleural mesothelioma undergo surgery. There are two main surgeries: pleurectomy/decortication, in which the surgeon tries to remove as much of the tumor from around the lung as possible, and the more radical extrapleural pneumonectomy, in which the lung itself is removed.


There is a lot of debate as to which is “best,” said Dr. Rice, although studies find that most long-term survivors have had surgery. He personally believes that pneumonectomy is best for tumor control if followed with radiation. Studies find it prevents tumor recurrence in the chest in 80 to 85 percent of patients who have the surgery.


However, Dr. Rice noted, it is a long, intensive operation with a 55 percent complication rate and a 3 percent risk of death, higher in some institutions. “So you only want to perform that surgery if the patient has a reasonably good prognosis,” said Dr. Rice. Translation: it doesn’t appear that the cancer has spread outside the chest.


Patients best suited for pneumonectomy are younger, with the epithelial form of the disease, no obvious lymph gland involvement, and are otherwise healthy enough to withstand the rigor of the procedure. Dr. Rice actually waits until he has the patient’s chest open in the operating room and biopsies the lymph nodes before deciding which procedure to perform.


Pleurectomy/decortication has a higher failure rate, with the tumor recurring in the chest cavity 50 to 80 percent of the time. However, that rate may change with improved radiotherapy techniques, Dr. Rice said. The reason for the high recurrence is that it’s impossible to completely remove the tumor without removing the lung.


However, he noted, there is no difference in survival rates between the two surgeries. Part of the reason is that the cancer has often spread to other parts of the body by the time it is diagnosed even if it appears to be confined to the chest.



Chemotherapy


Chemotherapy, also known as systemic therapy, uses oral or infusion-based medications to kill cancer cells throughout your body. Chemotherapy is used both before and after surgery, as well as in people who can’t handle surgery. It is also used in the palliative setting to reduce pain and improve quality of life.


The most commonly used chemotherapy drugs for mesothelioma are cisplatin combined with pemetrexed (Alimta) or raltitrexed (Tomudex). Other combinations include gemcitabine, carboplatin or oxaliplatin.


If you can’t manage combination therapy, your doctor may start on just one drug. Sometimes, your doctor may infuse the medication directly into your chest cavity, a procedure called pleural chemotherapy, or, abdomen, called intraperitoneal chemotherapy. You may also get a second course of chemotherapy, called “second-line” chemotherapy, with pemetrexed or other drugs, raltitrexed plus oxaliplatin, or the triple drug combination of irinotecan, cisplatin and mitomycin.


Some centers are beginning to provide intraperitoneal chemotherapy before surgery, followed by chemotherapy shortly after surgery. You can learn more about this approach here. There is also work underway to personalize chemotherapy based on the genetic characteristics of your tumor.

Radiation


Radiation can be an important part of mesothelioma treatment. The problem is that because the cancer is near the heart and lungs, it’s challenging to provide the kind of high-dose, intensive therapy needed to shrink the tumor. However, a newer option, intensity-modulated radiotherapy (IMRT), which can more accurately target cancer cells and avoid healthy tissue, may provide better results when performed by experienced clinicians.


Investigational therapies are being explored through clinical and surgical trials at many of the nation’s top cancer centers.


There are more than 50 studies on new therapies for mesothelioma in the U.S. that are looking for volunteers. Researchers are investigating new targeted drugs and chemotherapies, as well as new protocols for giving the medications; immunotherapy, which harnesses the power of the immune system to fight the disease; phototherapy, in which you are injected with a drug that bonds to cancer cells and is activated by high-intensity light; genetic therapies; and novel radiotherapy techniques like tomotherapy to treat the disease. Learn more about participating in a clinical trial here.




At some point, the management of the disease will shift from trying to cure the disease to trying to keep the patient as comfortable as possible for as long as possible.


This is the palliative care stage, when many people enter a hospice program. The primary goal at this stage is maximizing patient comfort. Medication to help with pain, difficulty breathing, and other symptoms that may be experienced is a mainstay. So is emotional and spiritual support for you and your family.


Alternative therapies for mesothelioma can be used to ease side effects of traditional cancer treatment.


Complementary and alternative medicine (CAM) includes such therapies as massage, acupuncture, and meditation. They can be a powerful part of your overall management plan, helping you better manage the stress and anxiety of the disease and conventional treatments.

Treatments for Asbestos Poisoning

Asbestos poisoning, or asbestosis, is an illness caused by prolonged and constant exposure to asbestos particles. These sharp, fibrous particles-when inhaled-will puncture and penetrate lung tissues, causing deep scarring and often leading to chronic breathing problems and cancer. Exposure to asbestos or materials containing this mineral may also result to mesothelioma, a cancer unique to such situation that directly affects the protective lining of the major organs in the body. The gravity of asbestos poisoning is directly proportional to the period and concentration of one's exposure, and of course the treatment will depend on the extent of the damage caused by asbestos fibers and particles to the body.
The side effects and health problems brought on by exposure to asbestos do not immediately manifest. Usually, the illnesses will start popping up decades after an encounter with the hazardous mineral. You will only feel the debilitating effects of asbestos exposure twenty to thirty years from now.
People over 50 are the ones who usually exhibit symptoms of asbestos poisoning and mesothelioma. This is because of the long latency period of these illnesses, and also because asbestos was not regulated until several years ago.
Asbestosis is the least serious of all the diseases caused by exposure to asbestos. However, the symptoms and effects of this disease are not to be taken lightly, as they are debilitating and sometimes fatal. Coughing, chest pains, reduced physical stamina, and shortness of breath even while at rest are the typical symptoms of asbestosis-and they worsen over time. Over-the-counter medicines may temporary alleviate the symptoms, but it is recommended that one suffering from such problems consult a physician immediately.




The common "cures" for cancer such as chemotherapy, medication, and radiation therapy will extend the life expectancy of a person suffering from mesothelioma. Surgery can also be an option, though not recommended for people who have been extremely weakened by asbestos-related conditions. Mesothelioma is often fatal, because it is not diagnosed and discovered until the cancer has significantly advanced. It is highly aggressive and a doctor will often prescribe a combination of surgery, chemotherapy, and radiation therapy to combat the development of the cancer.
The best treatment-especially for people who have not contracted the disease yet or have not exhibited the symptoms-is to avoid exposure to asbestos at all costs. This includes removing all traces of asbestos in one's environment. If you live in a house constructed in the 1940's and the 1950's, you might want to contact a professional immediately for inspection. Asbestos was not a regulated substance until several years ago, so you might find it in vintage items that have heat and fire-resistant qualities. Insulation materials installed in the roofs, attics, ceilings, and walls might also contain this deadly substance, but you cannot overlook its possible presence in furnaces, fireplaces, siding tiles, and even vinyl and rubber flooring tiles.
Asbestos removal is a job best left to the experts, who have the skills and knowledge on removing asbestos materials safely and decontaminating the structure right afterward.

How Is Mesothelioma Acquired?

Mesothelioma is a deadly cancer than affects individuals who have been exposed to asbestos. Asbestos fibers are extremely dangerous and can pose major risks for anyone who comes into contact with them.
Asbestos has been used for years in many different products, especially construction and insulation. Although the risks were not well known in its earlier use, it is now a common topic with a vast amount of information available about it. Even so, many companies are still using this toxic material in trace amount in different products.
Once asbestos fibers are released into the air, they can either be inhaled or ingested by a human. At this point, the fibers can travel to any one of the main linings of the body. The pleura is a lining that surrounds and protects the lungs. If the asbestos fibers travel and lodge into this lining, a person will develop pleural mesothelioma. The peritoneum is a lining that surrounds and protects the abdominal cavity. If asbestos is ingested and travels to this delicate covering of the abdominal viscera, peritoneal mesothelioma will begin to develop. Finally, the third type of mesothelioma is pericardial mesothelioma. This cancer results when asbestos fibers lodge in the pericardium, or protective covering of the heart. Once the fibrous pieces of asbestos travel to any one of these major linings, they will become lodged and begin to produce carcinogenic scar tissue. At that point, mesothelioma is well on its way to causing numerous health problems.





The dormancy period of all types of mesothelioma is extremely long. This means that the time from exposure to the fibers until the appearance of symptoms can be anywhere from twenty to fifty years long. This fact makes treating mesothelioma extremely challenging because the cancer has normally progressed too far by the time of discovery. Also, the symptoms that come with each type of mesothelioma are similar to the symptoms that other major illnesses and diseases have as well. Most time, mesothelioma is misdiagnosed due to these symptom similarities. For example, pleural mesothelioma may cause shortness of breath, coughing, wheezing, exercise intolerance and chest pain. These symptoms are the same symptoms that many major respiratory diseases cause as well. Chronic obstructive pulmonary disease, asthmatic bronchitis and emphysema all carry the same symptoms as pleural mesothelioma.
In any case, it is important to find a reputable oncologist that specializes in mesothelioma and the challenges that it brings with it. By doing this, the oncologist and patient can develop a treatment game plan and begin to fight this horrible cancer.