What Causes Mesothelioma in Children and Young Adults?
Doctors often consider mesothelioma in young people to be spontaneous, with no clear cause.
Mesothelioma is a rare cancer most often diagnosed in people over 65. Worldwide, doctors have reported only a few hundred cases in young adults and children.
The primary cause of this cancer in adults is occupational asbestos exposure. But asbestos-related illnesses typically take several decades to develop after exposure, and most young people diagnosed with mesothelioma have no history of asbestos exposure.
This has led researchers to look for other potential causes of mesothelioma specific to children and young adults. Mesothelioma in youth is so rare, though, that it is difficulty to study.
A study published in Oncotarget in June 2015 reviewed 12,345 mesothelioma patients, and only 2% of the patients were under the age of 40 when they were first diagnosed.
Possible Causes of Mesothelioma in Young Adults and Children
- Exposure to asbestos in products, the environment or through a family member
- Radiation exposure, including radiation therapy for other cancers
- In utero exposure to the antibiotic isoniazid
- Genetic predisposition to mesothelioma
Asbestos Exposure in Childhood
Historically, asbestos exposure has mainly threatened adults working in professions such as construction, heavy industry or the military. But there are a variety of ways children have been exposed to asbestos as well.
Children’s Products Containing Asbestos
Asbestos-contaminated talc has found its way into personal hygiene products, crayons, toys and cosmetics marketed to parents and children.
Before the 1980s, several U.S. brands of talcum powder — also known as baby powder — were made with talc that contained traces of naturally occurring asbestos. In some countries, other types of products are still made with asbestos-contaminated talc.
In 2015, independent tests commissioned by the Environmental Working Group Action Fund found asbestos in crayons and toy crime lab kits made in China.
In 2017, Claire’s and Justice recalled a number of cosmetic products over concerns of asbestos contamination. The U.S. Food and Drug Administration confirmed the asbestos test results in 2019, but the FDA has limited authority to regulate the safety of cosmetics.
Asbestos in Homes and Schools
In the U.S., old asbestos-containing construction materials remain in many buildings built before the 1980s. Millions of homes and close to half of all America’s schools were constructed during the heyday of asbestos products in the 1950s and 1960s.
Any activity that disturbs deteriorating asbestos products, such as improper maintenance or renovation work, can release toxic asbestos dust into the air.
Common Asbestos-Containing Materials in Homes and Schools
- Boiler insulation
- Ceiling tiles
- Duct wrap for HVAC systems
- Pipe insulation
- Vinyl flooring (including backing and glue)
When someone is exposed to asbestos in their workplace and they bring asbestos dust home, this can cause secondhand asbestos exposure among their family members.
Today, regulations require employers to provide decontamination facilities to employees who work with asbestos. Before such regulations began to be passed in the 1970s, however, secondary asbestos exposure was a major problem for many families.
Children may be exposed to asbestos if they live in an area where asbestos is naturally found in sand or soil.
Some communities have also been directly contaminated by asbestos companies, leading to instances where children played on soil from asbestos mine tailings (such as in Libby, Montana) or piles of asbestos factory waste (such as in Ambler, Pennsylvania).
Causes Not Linked to Asbestos Exposure
Because cases of mesothelioma in children and young adults usually do not trace back to asbestos exposure, researchers have proposed other possible causes.
Radiation exposure is a minor risk factor for mesothelioma, and there have been a couple recorded instances of pediatric mesothelioma linked to previously receiving radiation therapy for a disease called Wilms’ tumor.
Childhood mesothelioma has been linked to exposure to isoniazid, an antibiotic used to treat tuberculosis, while in the womb.
Children may have a genetic predisposition to mesothelioma if they are born with certain mutations in their DNA.
In 2013, a team led by Dr. Michele Carbone determined that a BAP1 gene mutation can increase a person’s risk of developing cancer after exposure to asbestiform mineral fibers.
Symptoms in Children
Regardless of a patient’s age, the symptoms of mesothelioma are usually the same, including:
- Breathing problems and chest pain for pleural mesothelioma (which forms around the lungs)
- Digestive problems and abdominal pain for peritoneal mesothelioma (which forms around the abdomen)
Some research suggests mesothelioma may spread more quickly in pediatric cases, causing symptoms to develop sooner than in adult cases. In either case, the early signs of mesothelioma can easily be mistaken for symptoms of more common diseases.
A 2021 clinical case study of a 14-year-old boy who developed peritoneal mesothelioma discussed how radiology plays a crucial role when there are few reference cases in the pediatric population.
Treatment of Mesothelioma in Young People
Young patients receive the same types of mesothelioma treatments as older patients. The most common treatment is chemotherapy with cisplatin and pemetrexed, and the dosing schedule can be adjusted for the weight and size of children.
Younger patients are also more likely to be eligible for tumor-removing surgery, which gives them the best chance of long-term survival.
In 2015, researchers from the National Institutes of Health studied 12,345 mesothelioma patients and discovered some distinct differences among the small fraction of patients under 40.
- Overall, men are three times more likely to develop mesothelioma than women, and pleural mesothelioma is much more common than peritoneal mesothelioma.
- But in younger patients there is little difference in the rate of mesothelioma for each gender or the incidence of the two main types of mesothelioma.
Further, younger patients have a longer median survival and a higher five-year survival rate. This is primarily because older patients usually have additional health problems that interfere with their cancer treatment.
|Patients under age 40||Patients older than age 40|
|Relative Incidence||2% of study population||98% of study population|
|Patient Gender||51% male, 49% female||78% male, 22% female|
|Type of Mesothelioma||47% pleural, 48% peritoneal||90% pleural, 9% peritoneal|
|Median Survival||34 months||8 months|
|Five-Year Survival Rate||38%||3%|
Stories of Mesothelioma in Youth
The following stories show that, like all forms of cancer, mesothelioma can affect anyone — even if they do not seem to have any risk factors.