Asbestos and Mesothelioma: A Medical Student’s Perspective

Sinibaldo R. Romero Arocha attends the University of Minnesota Medical School. He is the second-place winner of the Fall 2020 Asbestos.com scholarship.

The word asbestos was originally derived from the ancient Greek ἄσβεστος, meaning unquenchable, ineffaceable or inextinguishable. It was named for its resistance to fire, heat and electricity.

Asbestos is not a single mineral, but a group of naturally occurring silicates.

Evidence suggests that its discovery by humanity goes as far back as 5,000 years to ancient Greece and Cyprus. Its early uses included the manufacture of cremation cloths, lamp wicks, headgear and footwear.

It was regarded as something of a panacea for centuries — a naturally occurring mineral, soft enough to be worked on with minimal tools, flexible enough to be given shape or even woven, fire-resistant and an excellent heat insulator. Few tasks seemed beyond asbestos’ never-ending cornucopia of wonders.

Asbestos was indeed too good to be true. These minerals are carcinogenic, and asbestos exposure is the leading cause of mesothelioma, an abnormal cell growth on the mesothelium (the thin layer of tissue that envelops many internal organs).

Mesothelioma Poses Health and Financial Risks

When mesothelioma strikes, it is aggressive and often deadly. It usually affects the lungs and, less frequently, the abdominal lining and the tissues surrounding the heart. To date, there is no known cure for this cancer.

Despite robust scientific evidence of an increased risk of developing mesothelioma, our country has not banned asbestos. In fact, we continue to import it for manufacturing needs.

Mesothelioma is not just a public health concern, it also poses significant financial issues. Cost of treatment for this devastating form of cancer places an increasing economic burden on patients and our health care system.

The first time I heard about asbestos and mesothelioma was in 2010, after the earthquake in Haiti. The news was prominent in my hometown in Margarita, a Venezuelan tropical island near Haiti, where I was born and raised.

This catastrophic event resulted in more than 150,000 deaths. The government of Haiti estimated that 250,000 residences and 30,000 commercial buildings had collapsed or were severely damaged. As a result, a great deal of rubble and debris were created.

I was shocked by the loss of so many lives and surprised by international news calling for caution in sending rescue missions to Haiti. This caution stemmed from the fact that many buildings in Haiti were presumed to contain asbestos, which undoubtedly worsened an already horrific situation.

Learning About Mesothelioma Treatments

During my post-baccalaureate training at Mayo Clinic in Rochester, Minnesota, my passion for medicine led me to join “grand rounds” to listen to the latest advances in clinical care.

It was during one of these presentations that I was again confronted by asbestos and mesothelioma. I will never forget the speaker’s words: “Usually patients do not survive more than one year after the diagnosis.”

The only solace the speaker gave us was that mesothelioma was “fortunately not a very common diagnosis,” though I doubt those affected by the disease would find much comfort in that.

This speaker described the use of asbestos products in house construction, repairs and for military purposes. As a result, people involved in occupations such as construction or home repair are particularly at risk of developing mesothelioma.

Our Veterans Affairs hospitals also see a significant number of veterans diagnosed with this disease due to asbestos exposure in the military.

My father, who is retired from the Air Force, has been involved in home repairs and fixing machinery his whole life. The thought of my dad, the strongest man I know and my childhood hero, receiving this deadly diagnosis and only having a year of life left touched me deeply.

Thankfully, the presentation concluded with a synopsis of the latest advances in disease management and treatment. I learned about intraoperative strategies such as pleurectomy and decortication, extrapleural pneumonectomy and peritonectomy.

All these clinical interventions remove diseased tissue to improve life quality and lengthen survival.

Raising Awareness of Mesothelioma

This year, I left Mayo Clinic to join the M.D./Ph.D. program at the University of Minnesota in Minneapolis. As an incoming medical student, I intend to make use of this privilege to foster awareness within the scope of my experience.

For the past several years, I have volunteered as a Spanish interpreter for migrant clinics in Minnesota. Many of the patients we receive are uninsured, speak limited English and come from low socioeconomic backgrounds.

As a first-generation college student and immigrant, I can relate to their plight. I try to treat every one of them as if they were part of my family. Due to their economic hardships and lack of education, many of these patients are exposed to health hazards in their jobs. As a result, their livelihoods and life quality suffer.

Knowledge about potential occupational exposure to hazards such as asbestos should be dispersed in an accessible and culturally appropriate fashion. Awareness of mesothelioma and its repercussions in the health, economic and social dimensions would go a long way toward reducing the number of afflicted people.

Each year, Sept. 26 marks Mesothelioma Awareness Day, and our institution spreads awareness and raises funds to help victims of mesothelioma.

We are particularly aware of this disease because Minnesota has several mines that harvest taconite iron, which involves contact with asbestos.

As a result, some areas have seen a spike in the number of cases of lung scarring, lung cancers and mesothelioma. Our schools of public health and medicine are dedicating many resources to battling the disease.

To protect the health of all patients — now and in the future — it is paramount to continue promoting asbestos and mesothelioma awareness.

Thirty years ago, mesothelioma was a uniformly deadly disease. Advances in biomedical research, patient advocacy and preventive measures have reduced the number of people developing it.

The toll mesothelioma takes on patients and their families creates enormous pain. Awareness efforts on their part could prevent another family from having to go through similar hardships. Their courage could also inspire those who were recently informed of this deadly diagnosis.

These families are not alone. Health care professionals and students support their fight and are working in courts, classrooms, hospitals and research laboratories to help them. I am proud to join this fight.