Satoshi Village the blog of Daniel Himmelstein

Dangerous dusts and malignant mesotheliomas: Q&A with Alison Grimes

In 2015, Simeonov and I proposed that oxygen is an inhaled carcinogen, resulting in greater lung cancer incidence at lower elevations. Our study proved controversial, even evoking criticism from Cancer Research UK, which we responded to elsewhere on this blog. While the link between elevation and lung cancer is an open question, the association between asbestos and mesothelioma is indisputable, having been cemented by a century of epidemiologic interrogation.

Here, I chat with Alison Grimes regarding what we now know about mesothelioma and asbestos, including what the future may hold. Alison is a Health Advocate at the Mesothelioma + Asbestos Awareness Center.

What is mesothelioma, how common is it, and who does it affect?

Mesothelioma is a rare cancer responsible for taking the lives of approximately 3,000 people each year in the United States. The disease affects people who have been exposed to asbestos in their day-to-day lives, whether that be through occupational exposure or other means.

Mesothelioma mortality in the United States

Data visualization: mesothelioma mortality varies by state (source code).

What is asbestos and how does it cause mesothelioma?

Asbestos was commonly used in the construction of homes, schools and other buildings through the mid 1970s for its fire-resistant properties and, although it’s been decades since asbestos was used for building, U.S. products are still allowed to contain up to 1 percent of the toxin. Exposure to and removal of asbestos can lead to the development of mesothelioma cancer in the lungs (pleural), abdomen (peritoneal) or heart (pericardial), but symptoms can take 10–50 years to present themselves.

What’s the prognosis and what factors determine disease progression?

The prognosis of mesothelioma varies depending on the type of diagnosis. Both pleural and peritoneal mesothelioma have an average life expectancy of 6–12 months, while pericardial mesothelioma has an average life expectancy of 6 months. Although there is no cure for mesothelioma yet, early detection may allow for more options when it comes to treatment and ultimately improve survival rate and quality of life.

How is mesothelioma different from other cancers?

Mesothelioma is different from other cancers because it is an aggressive cancer, but it is also nearly 99 percent preventable. Exposure to asbestos is the main cause of the disease, which is why a ban on asbestos in products would be so vital in the fight against mesothelioma.

What percent of mesothelioma cases result from asbestos exposure?

While asbestos is the cause of most mesothelioma cases, a naturally occurring mineral called erionite has also been linked to the development of small amount of peritoneal mesothelioma diagnoses.

Given the dangers of asbestos, why has it been used in so many industrial applications? Are there any worthwhile uses of asbestos or should it be altogether banned?

Despite deaths linked to asbestos beginning in the 1920s, it continued to be used in the construction of buildings due to its “miracle” properties, including the aforementioned fire-resistance, through the 1970s. Unfortunately, any amount of exposure to asbestos could lead to mesothelioma, or another asbestos-related disease, which is why it is unsafe to have the toxin in any product.

What are some exciting research developments related to mesothelioma from the last five years?

  • Immunotherapy — In recent years, doctors have done clinical trials to see how immunotherapy affects several cancers, including mesothelioma. Immunotherapy, the act of transferring T-cells, is designed to help the immune system recognize cancer cells that it otherwise wouldn’t have been able to. It encourages antibodies to block the PD-L1 protein so that T-cells can recognize it and fight it off.

  • Cancer Moonshot — During its first year of operation, Cancer Moonshot’s mission has been clear: to make more therapies available and work on early detection. This initiative puts a big focus on targeted immunotherapy, allowing more unique treatment options that fit a patient’s specific cancer. Fortunately, with the approval from the National Cancer Institute, researchers at NCI Cancer Centers have quick access to new drugs in hopes of finding effective treatments at a faster pace. With this in mind, people diagnosed with less common cancers, such as mesothelioma, can have more faith in future treatment options as opposed to the limited treatments currently available. As Cancer Moonshot pushes into its second year, it will be interesting to see where it takes the country in terms of advancing cancer treatment, early detection and prevention.

  • Early detection — or simply being aware of lung health by visiting a doctor for a lung screening — could be lifesaving when it comes to mesothelioma. With the help of modern day science and the strides being made in research, the high rate of asbestos-related deaths may one day be a thing of the past, but for now, awareness is key.

Thanks Alison for the information. Lately, I’ve been busy helping lead Project Cognoma, a volunteer project based in Philadelphia to put machine learning in the hands of cancer biologists. So I share your enthusiasm and appreciate you taking the time to spread awareness about a rare cancer!