ASBESTOS AND LUNG CANCER
Does asbestos cause lung cancer? Is proof of asbestosis required to show that a lung cancer is asbestos related?
In a landmark study, Dr. Irving Selikoff found that many asbestos workers had contracted lung cancer. That study led to legislation ultimately banning asbestos as harmful. With many claims filed, some companies and scientists have questioned these findings. They argue that it is asbestosis, a lung disease, which causes lung cancer, not simply exposure to asbestos:
THE INDUSTRY ARGUMENT
"In 1986 Dr. K. Browne published a
paper in the British Journal of Industrial Medicine titled:
Is asbestos or asbestosis the cause of the increased risk of lung cancer in
asbestos workers? Dr. Browne's basic conclusion was that asbestos per se
may not be completely carcinogenic:
"neoplastic change [cancer] may appear only in the wake of inflammation and subsequent fibrosis...it is not asbestos per se but asbestosis which prepares the soil for subsequent malignancy. This assessment was based on epidemiological and biological evidence that lung cancer in asbestos exposed workers was due to asbestosis and not to asbestos exposure per se" Martin, Asbestos Lung Disease, a primer.
However, many scientists disagree. First, we know that cancer is a multi-stage process involving changes to growth and tumor-suppressor genes. Many who smoke do not contract cancer indicating another carcinogen is required. Secondly, this new theory dovetails with the industry's interest in restricting compensation. Thirdly, many scientists disagree:
"Recent commentaries on the issue of asbestos-related lung cancer have raised important points. One major question is whether lung cancer can be attributed to asbestos exposure in the absence of asbestosis. This review attempts to place the debate in the proper context for establishing causation. Relevant epidemiological and pathologic studies are analyzed, as well as the scientific basis for each position in the debate. The assertion that asbestosis must be present in order to attribute a lung cancer to asbestos exposure does not meet accepted standards for establishing causation. In addition, some evidence has been incorrectly cited in support of this position. This discussion can benefit from clearer definitions of asbestosis, a more thorough evaluation of the available scientific information, and a proper context for determining causation. This review of the available evidence indicates that lung cancers can occur as a result of asbestos exposure, in the absence of clinical or histologic asbestosis. Causation in an individual should be assessed by considering duration of exposure, intensity of exposure, and appropriate latency. " Egilman, Lung Cancer and Asbestos Exposure: Asbestosis is Not Necessary, Am J Ind Med 1996 Oct; 30(4):398-406
Many cases settle, and at trial, a jury must assess the conflicting positions, as well as the nature and extent of the plaintiff's asbestos exposure.
Howard Gutman is a New Jersey attorney based in Parsippany, New Jersey who has handled numerous legal claims involving pulmonary tumors. A member of the board of directors of a leading cancer support group, he is the author of the upcoming book, A Complete Guide to Lung Cancer. He has appeared on Good Day New York, spoken at the National Press Club and been interviewed by NBC Nightly News.
CHAPTER LINKS TO A COMPLETE GUIDE TO LUNG CANCER
Home Page (Complete links and pages) Home Page
Chapter 1-2 cancer overview How cancer develops, staging, different types of lung cancer, difference between non-small cell and small cell
Chapter 4 Non-small cell lung cancer Non-Small Cell treatment categorized by stage, chemotherapy, radiation,
Chapter 6 Chemotherapy (What is chemotherapy, how does it work,
Chapter 17 HMO.htm HMO problems and medical insurance issues.
Tumor stages ) Explanation of the TNM (Tumor, Node, Metastasis) staging system.
keywords, asbestos, lung cancer, asbestosis,