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Posted on January 14th, 2019
Asbestos-related diseases mainly occur in the thoracic region and include asbestosis, pleural effusion, pleural plaques, diffuse pleural thickening, malignant mesothelioma, and bronchogenic carcinoma. A second opinion from a specialist plays a significant role in deriving the most accurate diagnosis.
Asbestos-related cancers are complex because of which the path to a mesothelioma diagnosis is often unclear. Generally, patients with asbestos-related respiratory diseases remain asymptomatic until the disease has reached a moderately advanced stage. For instance, pleural plaques do not cause any symptoms. Asbestos-related pleural effusion or pericarditis is usually asymptomatic but can give rise to pleuritic chest pain. However, every case is unique, and most early symptoms of pleural mesothelioma tend to mimic those of several less serious ailments such as asthma, tuberculosis, and chronic bronchitis and emphysema together referred to as chronic obstructive pulmonary disease (COPD). As a result, the early signs of asbestos-related diseases often go unnoticed or misread. This, in fact, will delay the whole process of diagnosis and subsequent treatment planning.
The initial symptoms of pleural mesothelioma include chest discomfort, shortness of breath, and a persistent cough. Patients in the early stages of pleural mesothelioma often receive a diagnosis of emphysema, bronchitis, or other bronchial infections. Only at a later stage do they learn about the much more serious disease they have had all along.
Lung cancer in its early stages is difficult to be diagnosed correctly because of lack of symptoms altogether or the presence of symptoms that cause confusion with other diseases such as COPD, pneumonia, and asthma. Additionally, in some cases, lung cancer and one of these diseases may coexist leading to difficulty in deriving an accurate diagnosis. Misdiagnosis is quite unfortunate as it may worsen the prognosis due to a lack of appropriate treatment at the time when the illness is curable.
Most of the patients who have been heavily exposed to asbestos in the past are now aged between 65 and 85 years. The people of this age-group are at an increased risk of developing other respiratory problems such as COPD, which causes changes in pulmonary functions that are hard to distinguish from those that arise because of asbestosis. Hence, asbestosis could be misdiagnosed as emphysema in the elderly.
Emphysema, a form of COPD is usually associated with smoking. Asbestos exposure may exacerbate certain negative symptoms of emphysema, but there is no scientific proof to conclude that asbestos exposure definitely causes emphysema. However, there has been some research that does suggest a connection between asbestos exposure and emphysema.
A study of high-resolution CT scans of patients with asbestosis revealed that about 10-36% of the patients had emphysema. This suggests that patients with asbestosis are more likely to develop emphysema. Another study among Finnish construction workers established that emphysema is more common among workers heavily exposed to asbestos.