When thinking about lung cancer and its risk factors, it's natural to immediately think about smoking. However, there are other forms of lung cancer and, with them, other risk factors.
Mesothelioma is a rare, but serious, lung cancer heavily linked with exposure to asbestos. Nationally, between 2,000-3,000 Americans are diagnosed with mesothelioma each year. At Roswell Park Comprehensive Cancer Center, we see a slightly elevated number of mesothelioma patients allegedly due to the high number of industrial and factory jobs in Western New York. These jobs were even more prevalent just a few decades ago and many of them were located inside manufacturing plants that may have contained asbestos.
Listen as Sai Yendamuri, MD, FACS discusses the relationship between Asbestos and Mesothelioma, and how to reduce your risk.
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Mesothelioma: Understanding the Dangers of Asbestos Exposure
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Learn more about Sai Yendamuri, MD
Sai Yendamuri, MD
Sai Yendamuri, MD Chair, Department of Thoracic Surgery, Professor of Oncology, Attending Surgeon, Department of Thoracic Surgery and Director, Thoracic Surgery Laboratory.Learn more about Sai Yendamuri, MD
Transcription:
Mesothelioma: Understanding the Dangers of Asbestos Exposure
Bill Klaproth (Host): If you have been diagnosed with mesothelioma or are at a high risk for the disease, rest assured that as a Roswell Park Comprehensive Cancer Center patient, your care will be comprehensive, tailored to your individual needs and preferences, and delivered with compassion and respect. Here to talk with us about asbestos and mesothelioma, is Dr. Sai Yendamuri, Chair of the Department of Thoracic Surgery at the Roswell Park Comprehensive Cancer Center. Dr. Yendamuri, thanks for your time. First off, what is mesothelioma?
Dr. Sai Yendamuri (Guest): Mesothelioma is a special kind of cancer in the chest that arises from the inside lining of the chest wall and the outer lining of the lung. This lining is something called the pleura, which separates out the lung from the chest wall and keeps the lung moving well instead of there being friction. Malignant mesothelioma is a tumor arising from this particular lining.
Bill: And how common of a problem is this today?
Dr. Yendamuri: This problem is not that common. I would say there are on average of about somewhere between 2000, 3000 cases diagnosed in the United States every year.
Bill: It’s a fairly rare cancer then? Who is at risk for mesothelioma?
Dr. Yendamuri: The only really well-established known cause of mesothelioma is asbestos. Anyone who has been exposed to asbestos consistently for a certain period of time are at risk. The people who are typically exposed to asbestos are those who worked in areas surrounding asbestos -- those who work in construction, in shipyards and industries working with, say, brake linings and so on, those are the ones at high risk.
Bill: And there is no cure for this, right?
Dr. Yendamuri: That’s a tough question. Let me put it this way. The way you treat mesothelioma is
with a combination of chemotherapy, surgery, and radiation. Now, if you take 100 patients who have
been treated with surgery, somewhere between 10 and 25 of these patients will be alive at five years.
The chance of beating the disease -- that is, living up to five years without the disease – depends on how much disease there is and how far it has spread. There is a chance for cure, but it’s a small chance.
Bill: What are the symptoms, then? How does this differ than a regular lung cancer?
Dr. Yendamuri: Right, mesothelioma, most of the time, is a very slow-growing tumor, so the symptoms sort of creep up on you. The most common situation in which patients come to us in situations where they are slowly getting short of breath, and when their physician gets a chest X-ray, they found fluid around the lungs. This fluid, typically, is what we call in medical terms, tapped. That is, they put a needle in, get some fluid out, and they send it out for testing. About half the time, even if there is mesothelioma, those cancerous cells are not found in the fluid. Unless physicians specifically suspect mesothelioma and do a special procedure to biopsy the pleura, this tends not to be found. The vast majority of people with fluid around their lungs don’t have mesothelioma. It makes it a particularly difficult diagnosis to make.
Bill: So that’s why it’s important to get the background of the individual to find out if they were around asbestos in their life?
Dr. Yendamuri: Correct.
Bill: We don’t use asbestos anymore in homes or businesses, for the most part, right? Unless there’s a specialized industrial need for it, but some old homes still have asbestos up in the attic. Are there ways that we can protect ourselves from asbestos exposure?
Dr. Yendamuri: Yes, the best way is awareness. You can test for asbestos in the house, and certainly, areas that have asbestos can be replaced, and so on. Those precautions should be taken, but you're right, asbestos has not be used for several decades now. However, what happens with mesothelioma is that it takes about 30 to 40 years after exposure to asbestos for this to actually devil up. There’s a long lag period between exposure and the incidence of disease. The patients we see now are not the patients who were exposed to asbestos today or even ten years ago, but the patients who were exposed to asbestos 40 to 50 years ago. Those are the patients we see today.
Bill: Right, and we weren’t aware of those dangers back then, and a lot of us went to schools that had asbestos insulation inside.
Dr. Yendamuri: That’s correct. It’s in several developing countries.
Bill: Oh, where it’s still being used there?
Dr. Yendamuri: That’s correct.
Bill: Interesting. Someone with mesothelioma, is there a way to manage the disease? Are there any lifestyle changes that someone can incorporate to try to help them live with the disease?
Dr. Yendamuri: Well, the lifestyle changes that we ask patients to adopt are pretty much what you would expect any patient of that age should have. That is more exercise, good food, food rich in protein, and so on, and so forth, but that by itself really doesn’t impact the course of the disease a whole lot. What’s required is an early diagnosis, having what we call a high index of suspicion, getting a biopsy done soon, and getting to a center that’s experienced in treating this disease as soon as possible.
Bill: If someone is listening to this and thinks they may have been exposed to asbestos 20, 30, 40 years ago as you were saying – maybe somebody in their 70s now is like,” Oh, my gosh. I was around asbestos.” Is there a way to get tested to know if you potentially have this or are at a high risk for it?
Dr. Yendamuri: Right, so if someone is at high risk after careful screening, you could consider getting an imaging study done, but that should be done by someone who is familiar with the disease and familiar with the interpretation of the CT scans because even the findings on CT scans of this disease can be very subtle. Unlike lung cancer, there is no standard screening test for mesothelioma, but in those patients who are at a very high risk, particularly if they smoke and have asbestos exposure, we often will do a CT scan to get a baseline understanding of what their chest looks like.
Bill: So you really have to know what you’re looking for?
Dr. Yendamuri: That’s correct.
Bill: And why does Roswell Park Cancer Institute see an above average number of patients with mesothelioma?
Dr. Yendamuri: We are the regional referral center here for most complex cancers. Therefore, we do see patients with mesothelioma. The treatment for this, whether it be radiation surgery or chemotherapy, is fairly sophisticated. It takes a lot of support to get patients through the treatment. There are a lot of options that we have that don’t exist anywhere else in this area. And the clinical trials that we have for meso here also provide resources for these patients. All of this put together provides a resource for patients that very few centers can provide. That’s why we end up seeing these patients and taking care of them.
Bill: And that necessary expertise that is needed. Well, Dr. Yendamuri, thank you, so much for your time today. For more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.
Mesothelioma: Understanding the Dangers of Asbestos Exposure
Bill Klaproth (Host): If you have been diagnosed with mesothelioma or are at a high risk for the disease, rest assured that as a Roswell Park Comprehensive Cancer Center patient, your care will be comprehensive, tailored to your individual needs and preferences, and delivered with compassion and respect. Here to talk with us about asbestos and mesothelioma, is Dr. Sai Yendamuri, Chair of the Department of Thoracic Surgery at the Roswell Park Comprehensive Cancer Center. Dr. Yendamuri, thanks for your time. First off, what is mesothelioma?
Dr. Sai Yendamuri (Guest): Mesothelioma is a special kind of cancer in the chest that arises from the inside lining of the chest wall and the outer lining of the lung. This lining is something called the pleura, which separates out the lung from the chest wall and keeps the lung moving well instead of there being friction. Malignant mesothelioma is a tumor arising from this particular lining.
Bill: And how common of a problem is this today?
Dr. Yendamuri: This problem is not that common. I would say there are on average of about somewhere between 2000, 3000 cases diagnosed in the United States every year.
Bill: It’s a fairly rare cancer then? Who is at risk for mesothelioma?
Dr. Yendamuri: The only really well-established known cause of mesothelioma is asbestos. Anyone who has been exposed to asbestos consistently for a certain period of time are at risk. The people who are typically exposed to asbestos are those who worked in areas surrounding asbestos -- those who work in construction, in shipyards and industries working with, say, brake linings and so on, those are the ones at high risk.
Bill: And there is no cure for this, right?
Dr. Yendamuri: That’s a tough question. Let me put it this way. The way you treat mesothelioma is
with a combination of chemotherapy, surgery, and radiation. Now, if you take 100 patients who have
been treated with surgery, somewhere between 10 and 25 of these patients will be alive at five years.
The chance of beating the disease -- that is, living up to five years without the disease – depends on how much disease there is and how far it has spread. There is a chance for cure, but it’s a small chance.
Bill: What are the symptoms, then? How does this differ than a regular lung cancer?
Dr. Yendamuri: Right, mesothelioma, most of the time, is a very slow-growing tumor, so the symptoms sort of creep up on you. The most common situation in which patients come to us in situations where they are slowly getting short of breath, and when their physician gets a chest X-ray, they found fluid around the lungs. This fluid, typically, is what we call in medical terms, tapped. That is, they put a needle in, get some fluid out, and they send it out for testing. About half the time, even if there is mesothelioma, those cancerous cells are not found in the fluid. Unless physicians specifically suspect mesothelioma and do a special procedure to biopsy the pleura, this tends not to be found. The vast majority of people with fluid around their lungs don’t have mesothelioma. It makes it a particularly difficult diagnosis to make.
Bill: So that’s why it’s important to get the background of the individual to find out if they were around asbestos in their life?
Dr. Yendamuri: Correct.
Bill: We don’t use asbestos anymore in homes or businesses, for the most part, right? Unless there’s a specialized industrial need for it, but some old homes still have asbestos up in the attic. Are there ways that we can protect ourselves from asbestos exposure?
Dr. Yendamuri: Yes, the best way is awareness. You can test for asbestos in the house, and certainly, areas that have asbestos can be replaced, and so on. Those precautions should be taken, but you're right, asbestos has not be used for several decades now. However, what happens with mesothelioma is that it takes about 30 to 40 years after exposure to asbestos for this to actually devil up. There’s a long lag period between exposure and the incidence of disease. The patients we see now are not the patients who were exposed to asbestos today or even ten years ago, but the patients who were exposed to asbestos 40 to 50 years ago. Those are the patients we see today.
Bill: Right, and we weren’t aware of those dangers back then, and a lot of us went to schools that had asbestos insulation inside.
Dr. Yendamuri: That’s correct. It’s in several developing countries.
Bill: Oh, where it’s still being used there?
Dr. Yendamuri: That’s correct.
Bill: Interesting. Someone with mesothelioma, is there a way to manage the disease? Are there any lifestyle changes that someone can incorporate to try to help them live with the disease?
Dr. Yendamuri: Well, the lifestyle changes that we ask patients to adopt are pretty much what you would expect any patient of that age should have. That is more exercise, good food, food rich in protein, and so on, and so forth, but that by itself really doesn’t impact the course of the disease a whole lot. What’s required is an early diagnosis, having what we call a high index of suspicion, getting a biopsy done soon, and getting to a center that’s experienced in treating this disease as soon as possible.
Bill: If someone is listening to this and thinks they may have been exposed to asbestos 20, 30, 40 years ago as you were saying – maybe somebody in their 70s now is like,” Oh, my gosh. I was around asbestos.” Is there a way to get tested to know if you potentially have this or are at a high risk for it?
Dr. Yendamuri: Right, so if someone is at high risk after careful screening, you could consider getting an imaging study done, but that should be done by someone who is familiar with the disease and familiar with the interpretation of the CT scans because even the findings on CT scans of this disease can be very subtle. Unlike lung cancer, there is no standard screening test for mesothelioma, but in those patients who are at a very high risk, particularly if they smoke and have asbestos exposure, we often will do a CT scan to get a baseline understanding of what their chest looks like.
Bill: So you really have to know what you’re looking for?
Dr. Yendamuri: That’s correct.
Bill: And why does Roswell Park Cancer Institute see an above average number of patients with mesothelioma?
Dr. Yendamuri: We are the regional referral center here for most complex cancers. Therefore, we do see patients with mesothelioma. The treatment for this, whether it be radiation surgery or chemotherapy, is fairly sophisticated. It takes a lot of support to get patients through the treatment. There are a lot of options that we have that don’t exist anywhere else in this area. And the clinical trials that we have for meso here also provide resources for these patients. All of this put together provides a resource for patients that very few centers can provide. That’s why we end up seeing these patients and taking care of them.
Bill: And that necessary expertise that is needed. Well, Dr. Yendamuri, thank you, so much for your time today. For more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.