It is always a devastating shock for a family to receive the results of a medical examination confirming a loved one has been diagnosed with malignant pleural mesothelioma. The cough that refused to go away is actually revealed to be a symptom of an incurable cancer of the lung linings caused by exposure to asbestos, up to 30 or 40 years earlier.

Public Health England (PHE) has been running its “Be Clear On Cancer” campaign since mid July 2016, focused upon those individuals who start to experience a persistent cough or who suddenly feel short of breath whilst simply using the vacuum cleaner or mowing the lawn.

Likelihood of a cancer caused by asbestos exposure

As with all cancer campaigns, the clear aim is to prompt an early diagnosis to help improve the survival chances of patients who are diagnosed with common cancers, such as those of the bowel, breast, bladder, kidney, ovaries and the throat.

However, the campaign should also be seen as raising asbestos awareness to the likelihood of a cancer caused by exposure to the deadly fibre dust. Experiencing breathlessness and a cough that lingers for three weeks or more are also known to be two of the earliest asbestosis symptoms of pleural mesothelioma. Other common symptoms usually include:

  • Chest or shoulder pain
  • Fever
  • Loss of appetite
  • Weight loss
  • Sleeping difficulties
  • Coughing up blood

Mesothelioma accounts for a half of cancer fatalities

PHE warn that there are an estimated 80,000 undiagnosed cases of lung cancer and one million cases of COPD (chronic obstructive pulmonary disease). However, there are also around around 4,000 deaths caused by asbestos-related disease every year in England and Wales, according to the Health and Safety Executive (HSE). Latest available figures from the government watchdog show that of the 4,265 new cases of occupational lung diseases in 2013 assessed for Industrial Injuries Disablement Benefit (IIDB), 3,760 (88 per cent) were associated with past asbestos exposure.

Cancers such as asbestos-related mesothelioma now account for a half of cancer fatalities in Britain today, according to data collected from the National Cancer Intelligence Network. The data indicates that the occurrence of rare cancers among fewer than 100,000 people actually represents 47 per cent of all diagnosed cases in the UK. An estimated one per cent of all men and women who are exposed to asbestos will eventually develop the fatal and incurable cancer.

Not always directly exposed to asbestos

Distinguishing between a lung cancer and cancer which has developed from a period of exposure to asbestos may not be straightforward. Those victims, such as asbestos laggers, who are now aged in their 70s and 80s were likely to have been employed in traditional asbestos-using using industries, such as shipbuilding, construction, railway engineering and manufacturing during the peak period during the 1950s, 60s and 70s. Many can still recall working in “clouds of asbestos dust” without protection or receiving any information from their employers that breathing in the fibre dust would fatally impact their lives decades later.

However, a victim’s employment record may not always show that they were directly exposed to asbestos. Since the mid 1980s ban on blue and brown asbestos, and the subsequent decline in use, a victim of exposure in the last 20 – 30 years is now more likely to have worked in a public building constructed with asbestos materials, most notably, some 80 per cent of UK schools.

Similarity of early symptoms to other lung ailments

One of the common problems, which has often prevented early detection of mesothelioma or asbestos-related disease is the similarity of early symptoms to other lung ailments, such as flu or pneumonia. In many cases, a history of cigarette smoking can also confuse the victim into thinking that their cough is nothing to worry about. Even the difference between mesothelioma and lung cancer can also be confused at first as exposure to asbestos can cause both conditions, even though the two occur in different tissues of the body.

Lung cancer affects the lung tissue itself, whereas mesothelioma attacks the pleura, a thin membrane covering both the lungs (and other organs) and lines the inside of the chest cavity. Mesothelioma can also affect the lung tissue at a later stage but it always originates in the membrane.

Tumours concentrated with clearly defined boundaries

Although patients diagnosed with lung cancer may have large or multiple tumours, they tend to be individually concentrated masses with clearly defined boundaries. This makes them easier for a surgeon to remove, thereby increasing the chances of cure and recovery. For the same reasons, lung cancer is more receptive to chemotherapy and radiation, whereas both of these therapies are usually unable to inhibit the growth of the malignant mesothelioma cells.

Neither cancer has a particularly high survival rate, but the prognosis for lung cancer is generally more optimistic than for mesothelioma. Depending on the stage, lung cancer patients have a five-year survival rate between 15 and 75 percent. If detected early, about half of mesothelioma sufferers can expect to live for around two years, with 20 per cent surviving for five years, which drops to only 5 per cent for patients with advanced mesothelioma.