Surgery

Potentially Curative Surgery

Facts about Surgery
Primary Goal: 

• Complete removal of the tumor
• More effective when used with other therapies
• Surgical biopsy is the most reliable way to diagnose mesothelioma

Potentially curative surgery is a major operation - and, as the name suggests, possibly life-changing. But not everybody who has mesothelioma qualifies for such surgery. Patients who want to consider this surgery generally must have good health on their side. Doctors want to be sure that this kind of patient can withstand the rigors of a difficult surgery and arduous rehabilitation.

Typical procedures include pleurectomy/decortication (P/D) and extrapleural pneumonectomy. Developed by Dr. Robert Cameron, P/D has shown to prolong survival in some patients while providing additional complications in others. Dr. Cameron began developing this procedure in 1994 and has performed it on more patients than any other surgeon.

Both P/D and extrapleural pneumonectomy are recommended for patients with an early stage of pleural mesothelioma. When performed on patients with a Stage 3 or 4 diagnosis, survival rates are not as high.

Diagnostic Surgery

Doctors use diagnostic surgery to confirm the presence and whereabouts of cancer. This is typically accomplished with biopsies, removing suspected bad tissue from inside the body to determine that they are, in fact, cancerous. Some of the more common biopsies include fine needle aspiration, incisional/core biopsy and excisional biopsy.

Fine needle aspiration biopsies use a hollow needle to gather sample cells for testing. Results from this biopsy are available within a few minutes. Incisional/core biopsies only remove a small section of suspicious tissue for further evaluation. An excisional biopsy involves the removal of an entire tumor or organ for diagnosis.

Typical biopsies for patients with lung conditions include thoracentesis and thoracoscopy, which can be used to diagnose patients who are suspected to have pleural mesothelioma or another lung condition. 

Lung Cancer Types

Lung Cancer Types

Lung cancer cases typically fall into one of two categories: small cell lung cancer or non-small cell lung cancer. Non-small cell lung cancer forms in lung tissues, while small cell lung cancer typically grows in the breathing tubes. Both small cell lung cancer and non-small cell lung cancer can be caused by asbestos exposure.

Non-Small Cell Lung Cancer

Making up approximately 80 to 85 percent of cases, non-small cell can be further broken down into three major subtypes: adenocarcinoma, squamous cell carcinoma and large cell carcinoma. NSCLC can also refer to carcinoid tumors and salivary gland carcinoma, but these illnesses are rare.

Small Cell Lung Cancer

Responsible for 15 percent of lung cancer cases, small cell is the more aggressive type that spreads quicker and responds less to treatment. This type is further diagnosed as limited (when the cancer is still inside the lungs) or extensive (when the cancer has spread outside the lungs).

While treatments for small cell lung cancer tend to be more aggressive in response to its quicker growth rate, the various types of lung cancer are often treated with the same methods, including radiation therapy, chemotherapy and surgery. To learn more about these treatment options, fill out this form to have an informational packet about sent to you overnight. In addition to treatment options, the packet also discusses doctors familiar with treating lung diseases.

All types of lung cancer can be caused by asbestos, smoking and other carcinogens, but no type is exclusively linked to asbestos exposure. Additionally, asbestos causes less lung cancer cases overall, but the proportion of small cell and non-small cell cases are very similar.

One study revealed that the risk for all types of lung cancer was significantly increased in men who had developed asbestosis, another lung disease caused exclusively by prolonged exposure to asbestos. Although the risk for adenocarcinoma and small cell carcinoma were slightly higher than the risk for squamous cell carcinoma in this study, the risk of developing all types of lung cancer was elevated in the asbestos-exposed patients.

Non-Small Cell Lung Cancer

Approximately 80 percent of lung cancer cases are non-small cell lung cancer (NSCLC). The three types of non-small cell lung cancer typically grow more slowly than small cell lung cancer, with symptoms developing gradually over time. Of the three, large cell carcinomas have been found to grow more quickly than the other types, but symptoms still arise gradually.

Non-small cell lung cancer patients may experience chest pain, shortness of breath and a cough that progressively intensifies as the disease develops. NSCLC may also be accompanied by syndromes that are also considered to be symptoms of the disease, such as hypercalcemia and Ectopic Cushing Syndrome.

The Three Types of Non-Small Cell Lung Cancer 

Adenocarcinoma

the most common of all types of lung cancer (including cases from asbestos and all other causes). This subtype of non-small cell lung cancer is often found in the outer section of the lung. Bronchioloalveolar carcinoma, a form of adenocarcinoma, can originate in the alveoli, or the air flaps, making it harder to detect on imaging scans. Adenocarcinoma is particularly responsive to anti-epidermal growth factor drugs.

Squamous

another subtype of non-small cell lung cancer and is the second-most common form. Squamous cell carcinomas tend to appear in the center of the lung in or near the air tubes, known as bronchi. The cancerous cells are thin and flat. These tumors produce high levels of a hormone-related protein that leads to hypercalcemia.

Large Cell

is responsible for a low percentage of lung cancers. Less than 15 percent of lung cancer cases are diagnosed as large cell, and the tumors can be easily confused with a poorly differentiated adenocarcinoma or a squamous cell carcinoma. The cells that make up these tissue masses are large and abnormally shaped.

Actinolite Asbestos

Actinolite Asbestos

Actinolite is an amphibole, or a straight, needle-like mineral that is generally dark in color. This mineral is also considered to be a type of fibrous mineral used in industrial and manufacturing processes known as asbestos.

Actinolite (pronounced ak-TIN-uh-lyte) can appear in multiple forms such as dense and compact or brittle and fibrous, along with different colors, including white, gray, brown or green. The mineral’s name stems from the Greek “aktinos,” meaning “ray” or “beam,” stemming from its radiating fibrous form. Actinolite is made up of other minerals and substances such as:

• Calcium
• Magnesium
• Iron
• Silicon
• Oxygen
• Hydrogen
• The Industrial Uses of Actinolite

There are six main types of asbestos, and amphiboles are one of the most common forms. Amphiboles are a curlier, or serpentine, variety. Because amphiboles tend to be more brittle than serpentine asbestos, they’re used less often in manufacturing. Actinolite’s internal composition is very similar to other asbestos forms such as tremolite and anthophyllite.

Actinolite is typically used with the similar mineral vermiculite, which expands when heated. Vermiculite and actinolite make for an effective, light-weight insulation material. Other common uses for actinolite and vermiculite include:

• Insulation material
• Gardening
• Concrete materials used in construction
• Structural fire-proofing

How Does Actinolite Affect Our Health?

Today, healthcare and government organizations recognize the dangers of asbestos exposure, as actinolite may still be present in buildings, homes or other locations that were constructed before asbestos was considered to be a hazardous material.

This material has been found in products such as:

• Paints
• Sealants
• Drywall
• Joint compounds
• Children's toys

Individuals may have been unknowingly exposed to this material.

Regardless of the type, asbestos is classified by healthcare groups as a human carcinogen, or a cancer-causing agent. According to the Environmental Working Group, each year more than 10,000 deaths occur in the U.S. due to asbestos.

When inhaled or ingested, the microscopic actinolite asbestos fibers may become lodged into the lining of the lungs, stomach or heart. These fibers are very difficult to expel and can eventually lead to cellular damage. Over time, this can result in increased risks for respiratory and lung conditions including lung cancer and mesothelioma.

Contact with Actinolite

In April 2002, about 30,000 cubic yards of rock that contained asbestos were dumped in a residential area. The New Jersey Meadowlands Commission ordered that the dumping be stopped and the material be removed.

The materials had been dumped by a local university, Stevens Institute of Technology. A New Jerfsey engineering firm tested for asbestos content and found that 10 percent was actinolite. Not only was this much more than reported by the university, but it far exceeded accepted safety standards.

Anthophyllite Asbestos

Anthophyllite Asbestos

Similar to other asbestos types, anthophyllite asbestos is a mineral known to causemesothelioma cancer. However, most studies indicate the risk of developing mesothelioma from anthophyllite exposure is much less than it is from exposure to other types of asbestos.

Although it took much longer for anthophyllite to be recognized as a mesothelioma risk than it did for amosite, chrysotile and crocidolite asbestos, there is a clear connection from exposure to it and to the development of mesothelioma.

In one 1989 study, 19 cases of mesothelioma were analyzed in Finland. Of the 19 cases, six were found to be predominantly affected by anthophyllite asbestos fibers.

Another study from 1994 reported four cases of mesothelioma among 999 miners of anthophyllite. The latency period for mesothelioma development ranged from 39 to 58 years, and the length of exposures varied from 13 years to 31 years. The miners who were diagnosed also had asbestosis and were smokers or former smokers.

Uses of Anthophyllite

Anthophyllite is one of the rarest types of asbestos and does not have a long history of commercial use. The mining of this mineral began in Finland in 1890. Since then, smaller deposits were mined in the southern states of North Carolina and Georgia.

While considered to be among the noncommercial types of asbestos, anthophyllite has been used in products containing minerals such as vermiculite and talc.

Talc plays a part in anthophyllite development. When anthophyllite forms because of the presence of sustained high temperatures, talc destabilizes and falls apart. Traces of anthophyllite may be present in talc and related products such as talcum powder.

Tremolite Asbestos

Tremolite Asbestos

Tremolite is considered to be a major health risk and is classified by the U.S. Environmental Protection Agency (EPA) as one of the six officially recognized types of asbestos. It is considered an amphibole, a mineral group characterized by separable fibers that are thin, long and straight.

Tremolite fibers have been useful for commercial products because they are strong, flexible, heat-resistant, and can be spun and woven into cloth. However, many people exposed to products containing tremolite developed lung cancer, asbestosis and mesothelioma later in life.

In one study conducted in 1988, miners and millers from the Thetford Mines in Quebec, Canada, were evaluated for the presence of asbestos-related diseases. The study revealed that high tremolite fiber concentrations were present in those who developed mesothelioma.

Uses of Tremolite

PaintsTremolite was used in a variety of commercial and industrial products because of its ability to insulate and fireproof materials. Some of the more common products that contained tremolite included:

• Sealants
• Insulation
• Roofing materials
• Plumbing materials

Tremolite contains calcium, magnesium, silicon, hydrogen and oxygen. The mineral can be brown, gray, white or green and may appear to be transparent.

Minerals That Contain Tremolite

Rarely mined on its own, tremolite is often found in large amounts of other minerals such as talc and vermiculite. Researchers found that talc miners and millers experience higher risks for developing lung cancer and other respiratory conditions. When these minerals are used for industrial purposes, exposure to asbestos becomes a concern.

Talc

Talc is the softest known mineral on earth and is used for myriad industrial purposes including chalk, paints, rubber, cosmetics, ceramics and pharmaceuticals (for lung function). Most famously, this mineral is used for making talcum powder. Since 1973, U.S. laws require all commercial talcum products be asbestos-free.

Vermiculite

Vermiculite is a mineral that expands when heated, a process called “exfoliation” or “popping." This process forms a light-weight material used for industrial purposes including insulation, packing materials and soil improvement. Becausevermiculite can contain large amounts of tremolite, exposure may increase a person’s risk of developing an asbestos-related disease.

This health risk is illustrated by the mining and milling operations in Libby, Montana, one of the United States’ largest sources of vermiculite. The tremolite-contaminated vermiculite at Libby was sold as Zolonite attic insulation, which the EPA estimates could be in millions of American homes. Because more than 70 percent of the vermiculite sold in the United States between 1919 and 1990 came from Libby, professionals recommend treating all vermiculite insulation as if it were contaminated with tremolite.

From 1923 to 1990, miners and millers of vermiculite were found to have higher incidences of mesothelioma and other asbestos-related diseases.

Crocidolite Asbestos

Crocidolite Asbestos

Multiple asbestos studies suggest crocidolite may be responsible for more deaths than any other type of asbestos because its fibers are so thin, about the diameter of a strand of hair. When airborne, these fibers can be inhaled easily and become lodged in the lining of the lungs, more so than other forms of asbestos forms. Once inside the body, the fibers do not break down easily. This can lead to potentially life-threatening lung and abdominal conditions, including lung cancer, mesothelioma and asbestosis.

These health risks are especially common among crocidolite miners. An estimated 18 percent of crocidolite miners die from mesothelioma, research shows, and that people living near crocidolite mines may have increased risks for developing mesothelioma and other diseases.

A 2008 study published in Ultrastructural Pathology revealed that crocidolite fibers found in the lung tissue of U.S. mesothelioma patients increased from 4 to 10 percent between 1982 and 2005. The number of cases in which crocidolite was detected increased from 19 to 37 percent.

The existence of crocidolite asbestos was first established in the early 1800s in South Africa. At the time, the mineral was known as "wooly stone," but interest in the naturally occurring mineral didn’t take off until the 1880s – and large mining efforts of the material didn’t begin until the early 1900s.

Crocidolite is also known as "blue" asbestos. This form can be translucent or nearly opaque (which means light can’t penetrate it). The most common mining sites for this type of asbestos were Bolivia, Australia and southern Africa.

Today, crocidolite mining has virtually ceased because of both physical limitations and serious health risks. Crocidolite-containing materials are also more brittle than other amphibole asbestos products, meaning they break down sooner and can more readily lead to asbestos exposure.

Crocidolite is categorized as an amphibole, which is usually a needle-like mineral that forms in crystal groupings, either as fibers or columns. Typically, crocidolite fibers can be curved or straight. While brittle, the fibers are flexible enough to bend beyond 90 degrees before breaking.

Uses of Crocidolite

Like other types of asbestos, crocidolite was used to make a number of commercial and industrial products. It did have a drawback that other asbestos types did not: It is less heat-resistant, making it less useful for industrial manufacturing. Some of the leading uses of crocidolite asbestos included:

• Ceiling tiles
• Fire protection
• Insulation boards
• Chemical insulation
• Spray-on insulation
• Acid storage battery casings
• Water encasement (enclosing)
• Cement sheets containing asbestos
• Electrical or telecommunication wires
• Thermal insulation (lagging and gaskets)
• Millboards (commercial ovens and steam pipes)

Crocidolite asbestos was used less often for commercial products than any other type of asbestos.

Amosite Asbestos

Amosite Asbestos

According to the American Cancer Society, exposure to amosite asbestos has an increased risk to cause cancer in comparison to other types of asbestos. Several asbestos studies suggest exposure to amosite can cause lung cancer, mesothelioma and asbestosis.

One study of 820 former workers who were exposed to amosite asbestos at a Paterson, New Jersey, factory showed that 18.7 percent of them died of lung cancer 17mesothelioma cases occurred. After closing in 1954, the factory relocated to Tyler, Texas, until closing for good in 1972. Among the 1,130 former workers in Tyler, 15.8 percent of them died from lung cancer. Many of these cases were believed to be caused by amosite exposure.

In its natural state, amosite is known as the mineral grunerite. Commercially, grunerite is referred to as amosite or brown asbestos. Approximately 80,000 tons of amosite were mined in the Transvaal province of South Africa by 1970.

Uses of Amosite

Amosite is only useful when utilized as asbestos because its fibers offer good tensile strength and heat-resistance. Commercial products that have been manufactured with amosite include:

• Cement sheets
• Thermal insulation
• Plumbing insulation
• Insulation boards
• Chemical insulation
• Electrical insulation
• Roofing products
• Fire protection
• Gaskets, lagging
• Tiles, including those for ceilings, roofs and floors

The U.S. Environmental Protection Agency (EPA) has determined amosite to be the second most commonly used mineral type of asbestos in the United States.