A departure today from my typical culture posts, but this too is a part of our culture, although largely unseen...
If you’ve heard of mesothelioma, it’s probably only because you’ve seen some law firm’s commercial on television. That was my story. I had heard the name, but knew nothing about this rare form of cancer. That all changed after my father-in-law was diagnosed with mesothelioma this past August.
Today, I wish I didn’t have to know so much about this aggressive and particularly ugly incurable cancer.
I’m no stranger to disease and dying. Having been born the youngest child of my parents' extended families, and given that both Mom and Dad were on the late end of the spectrum for having a child, I grew up in a family of older uncles and aunts. By the time I came bouncing into the world, only one of my grandparents was still alive. Observing family members in the process of dying from various diseases (heart, vascular, ALS, Alzheimer’s) and cancers (lung, pancreatic, breast) has marked my life. Pretty much, I thought I had seen it all by now. I was wrong. Boy, was I wrong.
Mesothelioma is a cancer contracted by inhaling asbestos fibers that end up in the lungs. The body tries to destroy the invading asbestos and this is likely how the cancer begins, although the exact biological mechanism is unclear. The emergence of the cancer is an unusually long process, typically not presenting itself for decades after asbestos exposure, sometimes as long as 50 years. For example, my father-in-law had been retired for 27 years before he was diagnosed and his exposure to asbestos almost certainly occurred years before he retired. Fortunately, not everyone who inhales asbestos develops mesothelioma. Still, there is no other known cause for the disease.
Once activated, the cancer typically grows and spreads rapidly, metastasizing to other areas of the body. Because mesothelioma is incurable, once diagnosed, an average patient lives only six-months to 1-year. Recent advances in research have resulted in extending some patients’ lives—from months to a few years—but most often this is when the cancer is diagnosed in earlier stages. Unfortunately, most cases are diagnosed at later stages of the disease.
Mesothelioma claims the lives of some 3,000 Americans each year, many of which, like my father-in-law, were exposed by working in areas where asbestos was frequently used as insulation. Asbestos industry officials knew of the dangers of asbestos as early as the 1930s, but it was still unregulated and widely used in the U.S. as late as the 1970s. While highly regulated since 1989, the U.S. remains the only industrialized nation in the world that has not completely banned the use of asbestos.
Mesothelioma results in a particularly cruel death. Having experienced the death of a loved one from this disease, I can say with certainty that no patient or his or her family would wish this fate upon anyone. I’ve never observed anything like it and could never have imagined how insidious the disease is had I not seen it with my own eyes. As the cancer spreads, pain increases, the patient’s oxygen levels are reduced, and organ toxins, unable to be removed from the body in usual ways are released into the bloodstream, all of these affecting the brain. Personality changes appear. Aggravation and agitation ensue. And, in the end, many patients die of suffocation with no way to stop the process. Comfort measures are administered to the patient, but with only marginal success.
In one way, it’s a relief to know that this cancer is rare. There is really no cause to lay awake at night worrying if you might potentially be a victim one day. But mesothelioma’s rare nature also has a negative aspect. Because only 3,000 Americans die from mesothelioma each year, funding for research into therapies and cures is rather small compared to other more frequently contracted cancers. The old adage applies, “the squeaky wheel gets the grease.” If mesotheliomas were contracted at a similar rate of, let’s say breast cancer, no one would allow research into this disease to lag behind other cancers. The disease is just too ugly. I'm not judging anyone for this. It just seems natural that when ugly things happen to only a few people, those ugly things go largely unnoticed.
One might be tempted to think that given the asbestos regulation today, mesothelioma cases have peaked in the U.S. and are on the decline. But, this is difficult to say with certainty given that asbestos can still be found in older buildings and homes. And then there’s this little nugget: It has been estimated that on 9/11, some 1,000 tons (2 million pounds) of asbestos fiber was released into the air when the World Trade Center towers collapsed. It seems reasonable to make the assumption that there will be a spike in mesothelioma cases in 20, 30 or 40-years due to that tragedy alone.
So, now you know. I wish I didn’t. But, if for nothing more than providing some opportunity for broadening awareness, I’m glad I do. Perhaps the next time you see one of those law-firm commercials about mesothelioma on your television, you might wish to offer up a prayer for patients and families who are living or have lived this nightmare.
In loving memory of my father-in-law, Eugene Hodge
Born: February 15, 1929
Died: February 24, 2011