Mesothelioma risk misunderstood, says specialist

Lung cancer

By Tessa Hoffman

27 Jun 2018

A medical oncologist is sounding the alarm over mesothelioma, warning a crisis in medical research funding is putting all Australians at risk.

Professor Anna Nowak, director of the National Centre for Asbestos Related Diseases at the University of Western Australia, has developed an infographic to highlight lack of funding for research into the disease which claims about 700 lives in Australia each year, with the burden of disease likely to have not yet peaked.

“The biggest misunderstanding about mesothelioma is that it’s a rare disease and has not got the capacity to affect many Australians,” Dr Nowak, a medical oncologist, tells the limbic.

“Although its relatively uncommon as a cancer, Australia has one of the highest incidences in the world and Western Australia in particular does have the highest incidence in the world.”

Dr Nowak has developed an infographic to highlight a shortage of funding for mesothelioma research.

The incidence of disease varies from state to state: WA is the highest at 4.7 per 100,000, followed by NSW and the ACT both on 2.7, while incidence is lowest in Tasmania, at o.5 per 100,000, according to Dr Nowak’s infographic.

This is largely due to the now-closed mine at Wittenoom, in WA’s Pilbara region, where blue asbestos, the most carcinogenic form of the mineral, was mined until 1966.

Many mistakenly believe that only those who worked in mines – or as tradespeople handling materials containing asbestos – before the dangers were well understood are at risk of developing mesothelioma, which kills 94% of patients within five years of diagnosis with the remainder dying from intercurrent illness.

But “we are also seeing an increased number of people who have been exposed to asbestos through ‘DIY’: when their parents renovated their asbestos home or when they strip up carpet in a house they are renovating. Asbestos is very prevalent in our environment still, so really we’re all at risk.”

People who have potentially been had occupational asbestos exposure – those who worked as plumbers, electricians, construction workers, newspaper printers or in power plants, shipyards and docks, the armed forces and the navy should be considered for low dose CT screening programs, she said “because this group is also at risk of asbestos-related lung cancer which can be cured if caught early”.

With current chemotherapy only able to extend survival for a matter of months, hopes are now pinned on immunotherapy with a recent Australian phase 2 combination chemotherapy/immunotherapy clinical trial showing promise, she said.

But a “funding crisis” in mesothelioma research is hampering progress in developing better treatments, with just two out of 550 applications for grants to study the disease awarded by the NHMRC last year, representing 0.1% of the NHMRC budget.

This needs to change, with mesothelioma posing a real public health problem, she said.

“Most of the previous modelling suggested it would have reached its peak and started going down by now but the actual numbers suggest it’s on a plateau or slightly rising.”

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