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Mesothelioma and Nephrotic Syndrome
Mesothelioma is an aggressive, rare form of cancer that is almost exclusively caused by asbestos exposure. It most often develops in the lining of the lungs, causing symptoms such shortness of breath, dizziness, digital clubbing, and more. A much more rare symptom of mesothelioma is nephrotic syndrome.
Nephrotic syndrome is a renal condition that causes the kidneys to excrete an excess amount of protein into the urine. Symptoms of nephrotic syndrome include edema around the eyes, ankles, and feet; foamy urine; fatigue; lack of appetite; and weight gain caused by water retention. The condition is often caused by damage to the blood vessels in the kidneys, which are responsible for filtering waste and excess water from the blood[1].
There have been a few different studies, from the 1980s to today, that have documented nephrotic syndrome in association with malignant mesothelioma of the lungs and in other areas of the body. The first study documenting this association, from 1986, reported nephrotic syndrome in a 68-year-old man who was diagnosed with minimal-change glomerular disease[2], which is a kidney condition that can lead to nephrotic syndrome[3].
A similar case was reported in 1997. In this case, minimal change nephropathy, meaning damage to the kidney is difficult to perceive under a microscope, was detected. It eventually developed into nephrotic syndrome[4].
While mesothelioma usually develops in the lungs, it may develop in other areas of the body as well. In very rare cases, mesothelioma may develop in the membrane surrounding the testes. One such case resulted in nephrotic syndrome. Though the syndrome appeared almost a year after the initial diagnosis of the mesothelioma, there seemed to be no other explanation for it[5].
Though there is a connection between mesothelioma and nephrotic syndrome, there have only been a handful of documented cases of the association. As such, it is extremely rare, and often not a concern for patients with mesothelioma.
Treating both mesothelioma and nephrotic syndrome at the same time can be difficult. In the case of mesothelioma of the testis described above, the syndrome was unaffected by treatment, even when the mesothelioma tumor was contained. In other cases, typical treatment for the cancer was ineffective, but it seemed to be effective against nephrotic syndrome.
There are medications available for nephrotic syndrome, but they may not be usable by patients who are undergoing treatment for mesothelioma. For instance, blood thinners and immune system-suppressing drugs may be used to treat the syndrome[6], but may be fatal for mesothelioma patients, especially those whose immune systems are already weakened by chemotherapy.
[1] https://www.mayoclinic.org/diseases-conditions/nephrotic-syndrome/symptoms-causes/syc-20375608
[2] https://www.ncbi.nlm.nih.gov/pubmed/3753125
[3] https://www.kidney.org/atoz/content/minimal-change-disease
[4] https://pmj.bmj.com/content/77/907/333
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726559/
[6] https://www.mayoclinic.org/diseases-conditions/nephrotic-syndrome/diagnosis-treatment/drc-20375613
