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Asbestosis Treatment - Surgery

There is no known cure once the lungs have been scarred and asbestosis has developed. Doctors will generally treat asbestosis patients with palliative measures (treatments to relieve the symptoms and make life more comfortable). These include medications such as bronchodilators, aspirin, and antibiotics. Please see Asbestos Treatment for information about other types of treatments.

Only under particular circumstances is surgery a recommended treatment for asbestosis.

Biopsy as a Diagnosis for Suspected Asbestosis

Typically, asbestosis is diagnosed through x-rays and CT scans, but there are times when a doctor may order a biopsy to rule out mesothelioma or another lung tumor. This is likely to happen when a patient's x-ray shows a lesion or nodule that may be cancerous. If the doctor is not able to determine whether the lesion is cancerous from the films alone, they may choose to perform a biopsy to obtain a sample of the tumor for testing.

There are several different methods used to obtain a tissue sample for biopsy. They include:

• Needle Aspiration: The doctor will insert a hollow needle through the chest and into the tumor to remove a section of the tissue.
• Thoracentesis: The doctor inserts a hollow needle through the chest wall and into the space between the lungs and the chest to withdraw a sample of the fluid.
• Thoracotomy: The doctor will open the chest while you are under anesthesia to remove a sample of the lesion. This is major surgery and most doctors will only do it if they intend to remove the suspected tumor.
• Mediastinoscopy: The doctor will take tissue samples along the windpipe through an incision in the neck.

Doctors will often perform a biopsy when patients with asbestosis have a higher risk of also developing lung cancer or mesothelioma.

Thoracentesis as a Palliative Treatment

While thoracentesis can help the doctor diagnose the presence of lung cancer or mesothelioma, the procedure may also have a palliative use in the treatment of asbestosis. Sometimes asbestosis can cause or be accompanied by pleural effusion (the collection of fluid between the chest wall and the lungs). This excess fluid compresses the lungs and makes it difficult and painful to breathe. Removing the fluid can relieve chest pain and allow the lungs to work more efficiently.

Thoracentesis is usually an outpatient treatment. The doctor or technician that performs it will generally use local anesthesia to numb an area on the back. Then a thin, hollow needle is inserted through the chest wall, guiding it between the ribs and into the thoracic cavity. The doctor will use the needle to withdraw fluid from around the lungs. Thoracentesis is the most common and least invasive way of withdrawing this buildup of fluid.

There are risks associated with thoracentesis, including a heightened risk of pneumothorax (air in the pleural cavity) and infection. Contraindications to thoracentesis include poor health and recent anti-coagulant use.

Lung Transplant as Asbestosis Treatment

In the most severe cases, a doctor may decide that a lung transplant is warranted. Lung transplantation is the removal of one or both lungs with the replacement of a lung harvested from a deceased donor. Survival rates of those who have undergone lung transplants are approximately 80 percent at one year post transplant and 60 percent at four years post transplant.

Lung transplants are most often considered when the asbestosis is accompanied by more severe lung diseases such as emphysema or lung cancer. The transplant process is a long and involved one that may make it even less suitable for many asbestosis patients. In order to be considered for a lung transplant, a patient will have to undergo extensive tests and screening to determine the relative chances of a successful transplant. It is a last resort treatment.

Sources:

1. http://www.emedicine.com/med/topic171.htm

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