Asbestos-Related Lung Cancer
Two types of cancer can be caused by exposure to asbestos: mesothelioma and asbestos lung cancer (or asbestos-related lung cancer, as it is also known).
Most people who get lung cancer do so because of smoking. According to Cancer Research UK, 72% of lung cancer cases in the UK result from smoking.
Asbestos-related lung cancer cases may only represent a relatively small percentage of those who get lung cancer each year. Still, statistics published by the Health and Safety Executive (HSE) for 2021 reveal there were approximately 2300 deaths from asbestos-related lung cancer in Great Britain in the last recorded year. This figure estimates one asbestos lung cancer death for every mesothelioma death.
Given most types of asbestos were banned in 1985 and the remainder by 1999, it seems illogical there are still over forty deaths a week from asbestos lung cancer. What needs remembering is that there is a long period (the latency period) between getting exposed to asbestos and diagnosis for all asbestos disease victims. Asbestos lung cancer is no different, with the period lasting on average between fifteen and thirty-five years.
What types of lung cancer are there?
There are two types of lung cancer:
- NSCLC – non-small cell lung cancer
- SCLC -small cell lung cancer
Of the two, non-small cell lung cancer is the most common, accounting for around 85% of all lung cancer diagnoses.
What causes asbestos-related lung cancer?
All types of asbestos-related diseases are caused by inhaling asbestos fibres. Whilst the word fibres might conjure up thoughts of large particles, asbestos fibres are, in fact, microscopic in size.
Nevertheless, the lungs are damaged when someone inhales sufficient fibres over a long period. In the case of asbestos, lung cancer cells become cancerous. As already referred, many years pass before symptoms appear.
Most asbestos-related lung cancer cases come from exposure to asbestos in occupational settings. For this reason, asbestos lung cancer is considered an occupational illness or an industrial disease.
Asbestos use was commonplace in many industries from the early 20th century until its ban. Asbestos was popular because it had heat resistant properties and was cheap and versatile. When left intact, asbestos is relatively harmless.
However, in industrial use, it was constantly being ripped, sawn, drilled and moulded, depending on the use it was to be put. This work caused large clouds of asbestos dust to form in the air. Anyone working with asbestos, or doing other work nearby, was exposed. For these workers, the risk of getting lung disease was high.
Employers rarely provided masks or other types of breathing protection, and exposure was therefore inevitable.
In some cases, the exposure would be considerable and long-lasting, notably if the employee remained in the same occupation year on year.
Workers with significant asbestos exposure were most at risk of developing lung cancer or mesothelioma in later life.
In what industries and occupations were workers most at risk from asbestos exposure?
- Power stations
- Steelworks
- Shipbuilding and repair
- Dockyards
- Construction
- Demolition
- Electrical works
- Carpentry
- Roofing
- Railway engineering works
- Manufacturing
- Boiler and pipe insulation
- Heating and ventilation engineering
- Vehicle body repairs
- Fire service
- Textile industry
- Mining
What are the symptoms of asbestos lung cancer?
The symptoms of lung cancer include:
- A cough that lasts over three weeks
- Shortness of breath
- Blood in phlegm, or mucus
- Wheezing
- Pains in the chest or shoulder
- Dramatic weight loss
As with other types of asbestos disease, many of these symptoms could also indicate a variety of illnesses, often minor ones. It’s imperative for anyone who worked with asbestos to get regular checkups at their local doctor’s surgery. Indeed, at the first sign of symptoms, there should be no hesitation in getting an appointment with a GP.
It’s always sensible for employees who worked in an environment where asbestos use was commonplace to inform their GPs of the fact. Not every doctor will frequently come across patients with asbestos disease, and the generic symptoms can be passed off as a minor illness. If the doctor is made aware of a patient’s work history, it will help them identify the symptoms as asbestos disease.
How is lung cancer diagnosed?
A possible asbestos disease patient who goes to their GP with asbestos lung cancer symptoms is likely to be asked to go for a chest x-ray.
If the x rays results show cause for concern, the patient will undergo a CT scan. A sample of lung tissue taken from the lungs by biopsy will be examined for evidence of cancer. A diagnosis of lung cancer will be made if the tests prove positive.
How much asbestos exposure causes asbestos-related lung cancer?
Proof of a high asbestos dose is needed to establish asbestos exposure as the cause of lung cancer.
A research document, Helsinki Criteria for Diagnosis and Attribution 2014, contains a set of principles to help determine whether someone has asbestos lung cancer instead of lung cancer with another cause.
In short, the criteria are:
- Reliable work histories will provide one of the most reliable methods of assessing whether a person is likely to have had significant asbestos exposure due to their occupation.
- Structured interviewing by trained personnel will identify those whose work histories suggest significant asbestos exposure.
- Taking a sample of lung tissue from the patient will provide data to add weight to the occupational history findings.
Smoking and asbestos-related lung cancer
The most common cause of lung cancer is smoking, and workers exposed to asbestos are at risk of getting asbestos-related lung cancer. Therefore, it follows that a person who smokes and suffers asbestos exposure has a significantly higher chance of getting lung cancer.
Is a person with asbestosis likely to get asbestos lung cancer?
Significant asbestos exposure is the cause of asbestosis. As a result, someone with asbestosis is at greater risk of getting lung cancer (and mesothelioma). It is not, though, inevitable.
What treatments are available to asbestos lung cancer patients?
Asbestos lung cancer patients have the same treatment options as all lung cancer sufferers, irrespective of the cause of the disease. In the UK, NHS healthcare professionals will work out the best forms of treatment for each patient.
Much will depend on how far the disease has progressed. Treatment will also vary depending on the type of cancer a patient has, i.e., Small Cell Lung Cancer or Non-Small Cell Lung Cancer.
However, patients may receive one or more treatments of the following types;
- Surgery – to remove all or part of a lung.
- Radiotherapy
- Chemotherapy
- Immunotherapy
- Targeted Therapies (Biological Therapies)
Can asbestos lung cancer be cured?
Sadly, there is no cure for lung cancer, whether asbestos-related or not. The earlier the disease gets diagnosed, the better the patient’s chances of surviving for a more extended period. Unfortunately, asbestos-related lung cancer has a long latency period, during which time the lungs are slowly but evermore seriously becoming damaged. When a diagnosis of asbestos lung cancer is made, the disease is usually well advanced.
A research study reported in the Japanese Journal of Clinical Oncology in 2009 found:
- The average life expectancy prognosis for a patient with asbestos-related lung cancer is 16.2 months. For non-asbestos related lung cancer, the same research revealed that the average prognosis was 17.2 months.
- Twenty-five per cent of asbestos lung cancer sufferers (who received treatment) survived for five years post-diagnosis.
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