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Mesothelioma and Interstitial Lung Disease?
Interstitial lung disease (ILD) has a strong correlation to asbestos exposure but not necessarily mesothelioma. However, some treatments for mesothelioma and other cancers have a theorized connection to lung damage that can result in the development of ILD.
The term “interstitial lung disease” refers to a wide range of pathological conditions that all have similar consequences: the permanent and progressive scarring of lung tissues[1]. Those who acquire ILD often experience symptoms related to lowered lung functioning and recurring pain. Shortness of breath, a dry cough, and a piercing pain are all common.
Some of the most common versions of ILD relate to the chronic inhalation of dust or other particulate matter during the course of daily occupational work[2]. “Black lung disease,” for instance, refers to the condition acquired by coal miners who would inhale coal dust and other particulate matter during work. Silicosis can occur as a result of inhaling silica dust, and siderosis can occur in welders who regularly inhale fumes or miners who inhale iron dust.
Asbestosis is one version of ILD that has a direct correlation to asbestos exposure[3]. Asbestos fibers enter the lungs and cause scarring that eventually inhibits the tissue’s natural functioning. For individuals who develop pulmonary fibrosis and especially asbestos-related cancers, such as mesothelioma, the prognosis is often poor[4].
Co-occurring mesothelioma and interstitial lung disease has been recorded, but it is not necessarily common for the two conditions to exist simulataneously. In a study of 384 mesothelioma diagnosed patients in Japan, just 21 had ILD (5.47%), and nine of these cases were related directly to silicosis[5]. Also of note in the study: 15 of the cases were reportedly induced by drug therapies.
The development of ILD as a side effect of therepeutic drug use is, in fact, fairly common. Researchers theorize that the lungs are particularly sensitive to certain substances as a result of their substantial surface area. Over 380 medications are known to cause lung-related side effects[6], and there may potentially be many more.
Additionally, the treatment of mesothelioma and other cancers through radiation may result in lung scarring that can develop into pulmonary fibrosis or ILD[7]. Lung damage incurred during radiation treatment can vary, and symptoms can take up to six months to appear.
One connection between pleural mesothelioma and interstitial lung disease is that some unusual presentations of malignant pleural mesothelioma can superficially resemble ILD[8]. While most presentations of mesothelioma show a consistent plaque, some patients have “spotty” patches of malignancy that can appear similar to ILD-related lung damage in imaging.
Overall, interstitial lung disease has a strong connection to asbestos exposure by way of asbestosis, but the development of mesothelioma is most often a correlation rather than a causation. However, radiation treatment and certain drugs can cause lung damage that results in ILD independent of the development of asbestosis.
[1] https://www.mayoclinic.org/diseases-conditions/interstitial-lung-disease/symptoms-causes/syc-20353108
[2]https://medlineplus.gov/interstitiallungdiseases.html
[3] https://www.mayoclinic.org/diseases-conditions/asbestosis/symptoms-causes/syc-20354637
[4] https://www.myvmc.com/diseases/asbestosis/
[5] http://cancerres.aacrjournals.org/content/68/9_Supplement/1066
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415629/
[7] https://www.pulmonologyadvisor.com/home/decision-support-in-medicine/pulmonary-medicine/radiation-induced-lung-injury/
[8] https://www.ncbi.nlm.nih.gov/pubmed/23797722
