In the U.S. the use of asbestos peaked during the mid-1970s. The Environmental Working Group (EWG) estimates that, at that point, the hazardous material was present in more than 3,000 industrial and commercial products, such as insulation and fireproofing materials.

Eventually, the mineral became less prevalent once manufacturers realized they could not deny what scientists had known for years: asbestos is the principal cause of the development of malignant mesothelioma.

Scientists know that an individual’s level of asbestos exposure over time is directly related to his or her risk: the greater the exposure, the higher the likelihood of developing an asbestos-related illness. However, this latency period between contact with the mineral and the development of symptoms may be longer for some individuals than others, regardless of the level of exposure.

This led one team of researchers from Italy to measure the incidence of mesothelioma among nonagenarians.

Mesothelioma festers for decades
The EWG estimates that the latency period for asbestos-related diseases, such as mesothelioma and asbestosis, can take between 20 and 50 years. For this reason, the incidence of these illnesses in industrialized nations is expected to continue to rise for another 10 years or so.

Most people do not know they have an asbestos-related disease until they start experiencing symptoms, such as difficulty breathing. By then, an illness is likely to be in its advanced stages.

Experts from the American Cancer Society note that there is no standardized early screening approach for diagnosing mesothelioma. Doctors may recommend radiology tests to look for changes in the lungs among patients with a history of asbestos exposure, but it is not clear how effective this method is in detecting early disease.

Italian scientists study oldest patients
Researchers from Italy noted that many mesothelioma patients tend to be diagnosed between the ages of 60 and 80. Their diseases are often the result of occupational exposure, particularly if they worked in shipyards.

However, the scientists also recalled that a minority of patients are diagnosed while in their 80s or 90s. It was not immediately clear whether this was because of low asbestos exposure or late contact with the material.

In order to investigate further, the researchers reviewed the medical records of seven men and one woman, all of whom were diagnosed with mesothelioma while in their 90s. After collecting information on their employment histories, the scientists found that the latency periods within this patient group ranged from 64 to 75 years. The duration of asbestos exposure ranged from 11 to more than 40 years.

Examinations of lung tissue revealed that a low level of exposure is not the explanation for the long latency periods.

“In this group of cases, the late development of mesothelioma cannot be attributed to mild exposure to asbestos or to unusually late exposures. Very long latency periods even in people heavily exposed suggest an individual resistance to the oncogenic effects of asbestos,” the researchers wrote in the journal Tumori.

Vigilance can help protect you
At Kazan Law, we believe that vigilance is one of the most important weapons against asbestos-related diseases. The Environmental Protection Agency has many tips on how you can protect yourself from asbestos:

• Hire a professional to inspect your home for asbestos before any remodeling job, or in case parts of the house are falling apart.
• If you find asbestos in the house, inspect it without touching it. If it is intact, make sure no one and nothing disturb it.
• If you are employed in a job that may potentially expose you to asbestos, make sure you know your rights regarding protective equipment and the safety limits of asbestos fiber air concentration.

Although the word “cancer” is not something that any patient wants to hear in a doctor’s office, many of these diseases are treatable. As time passes, chemotherapy and radiation therapy grow more precise in order to target only the malignant tissue while preserving the healthy cells. Doctors are refining their surgical techniques, as well.

One of the keys to determining which treatments may work best is an early diagnosis. However, when it comes to malignant mesothelioma, such an approach has proven exceedingly difficult.

At Kazan Law, we keep track of scientists’ efforts to diagnose mesothelioma, lung cancer and other asbestos-related diseases early. Recently, a binational team from Japan and the University of California, Los Angeles (UCLA) developed a device that can capture tumor cells circulating in the blood. This technology may prove to be valuable in not only diagnosing malignant conditions, but also determining whether tumor cells threaten to colonize other areas of the body.

Early detection is difficult
People usually have no indication that they may have malignant pleural mesothelioma until they develop symptoms. Experts from the American Cancer Society list these as chest pain, shortness of breath, cough, fever, fatigue or weight loss. Peritoneal mesothelioma is characterized by pain or swelling in the abdomen.

Once patients develop symptoms, doctors may use several tools to determine what is wrong. These include a recording of a patient’s history of asbestos exposure, radiological scans of physical changes and possible analysis of any abnormal fluid buildup. One of the more common tests is a biopsy, which collects a cell sample from the body for a closer examination under a microscope.

However, by the time patients develop symptoms, their conditions are likely in their advanced stages. For this reason, scientists are trying to find a way to screen for this disease early in symptom-free individuals. Efforts have included recommendations for x-rays and CT scans of the chest for people with a history of asbestos exposure, or blood tests to measure levels of substances such as osteopontin and soluble mesothelin-related peptides. However, the value of these approaches for early screening remains unclear.

New technology acts like Velcro
In order to improve the chances of early diagnosis of cancer, scientists from UCLA and the Japanese company RIKEN developed a device that allows blood to pass through it like a filter. Within the system is a molecule that attaches itself to tumor cells in a Velcro like fashion. In the laboratory, scientists can cool the molecules down, causing the tumor cells to detach for easy collection for examination.

“Until now, most devices have demonstrated the ability to capture circulating tumor cells with high efficiency. However, it is equally important to release these captured cells, to preserve and study them in order to obtain insightful information about them. This is the big difference with our device,” said Hsiao-hua Yu, who helped lead the development of the technology.

All scientific advances need volunteers
It may take a while before we start seeing devices such as the one RIKEN developed reach the clinic. Often, additional studies are needed to verify that they work. This cannot be done without the help of volunteer subjects.

The National Cancer Institute (NCI) has a handy guide for people who are interested in volunteering for clinical trials, which evaluate therapies, screening tools, diagnostic modalities, preventive medicine and other facets of cancer care. The guide lists both the potential benefits and drawback. When it comes to the former, the NCI states that subjects may help promote better treatments for future patients by teaching scientists more about cancer.

If you’ve recently been diagnosed with malignant mesothelioma or another type of asbestos-related cancer, you want to make sure that you have the best medical treatment possible. This means that you need care from more than just your general practitioner. You will need an entire team behind you, which can include surgeons, dietitians, nurses or other professionals.

Throughout the U.S., many hospitals use what are referred to as tumor boards, or multidisciplinary opinion, in order to decide upon the best care for cancer patients. However, one recent study, published in the Journal of the National Cancer Institute (JNCI), questions how much of an impact these tumor boards actually have on patient care.

Boards bring experts together
Providers from the Sutter Health system in California describe tumor boards as a group of medical professionals who meet regularly in order to discuss the diagnoses and treatments of individual patients. These teams may include medical oncologists, radiation oncologists, nurse oncologists, social workers, dietitians, patients’ primary care doctors and more.

Conversations may also touch upon the latest available information on therapeutic options and clinical trials. In addition to addressing patients’ treatment, tumor boards also provide an opportunity for continuing medical education to all who attend them.

Different medical providers will conduct their tumor boards in a different fashion. Some may meet in person while others gather in virtual, online forums. The regularity with which tumor boards meet may also vary.

Researchers investigate links between tumor boards and care
One team of scientists from Harvard Medical School decided to study the impact that the presence of a tumor board within a healthcare system had on the care of cancer patients. For their research, they analyzed information collected from the tumor boards of 138 medical centers within the Veterans Affairs (VA) network. They gauged stage-specific cancer care based on information from cancer registries and administrative data.

The scope of the review encompassed malignant diseases of the lungs, prostate, breast, circulatory system and colorectal regions.

Results showed that there was only a modest association between the presence of tumor board and the type of care given to patients.

“This could mean that tumor boards did not, in fact, influence quality of cancer care in the VA setting,” the scientists wrote in the JNCI. “Additional research is needed to understand the structure and format of tumor boards that lead to the highest quality care.”

What does this mean for those exposed to asbestos?
However, these results do not necessarily mean that tumor boards serve no purpose at all. Douglas Blayney, M.D., of the Stanford School of Medicine wrote an editorial commenting on the Harvard study, in which he argued that the impact of a tumor board may not be easy to measure in systems such as the VA network because they are large and more integrated in their care. Instead, tumor boards may make a more discernible difference within smaller medical facilities.

“[U]ntil there is carefully constructed public reporting of process adherence and outcome, we are left to hope that cancer doctors, their leaders, and the systems that they build will use recognized measures of structure and process and work toward superior outcomes,” Blayney wrote in the JNCI.

If you have a malignant disease that was caused by exposure to asbestos, a tumor board may make more of a difference if you receive care from a smaller cancer center. However, if you are part of a larger medical group, the tumor board may still serve a purpose because this is an opportunity for healthcare professionals to learn about the best way to tackle diseases like yours.