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Shrader Podcast 2

Interviewer: Hi. I’m here with Robert Shuttlesworth of Shrader and Associates, and I’m going to be asking him some questions about mesothelioma. What is mesothelioma?

Robert Shuttlesworth: Mesothelioma is a very rare cancer that affects the linings of either the stomach, the lungs, or the heart. Every organ has a little thin membrane around it, which protects it from the other organs, and mesothelioma is a cancer that develops in that lining.

Interviewer: Is mesothelioma preventable?

Robert: Mesothelioma is preventable in the sense that asbestos companies never should have used asbestos, thereby exposing millions of people to the deadly fiber. But it’s not preventable in the sense that it takes so long to develop. Mesothelioma has got about a 40-year latency period. So if you were to set out today to say, “I don’t want to be exposed to asbestos,” that would protect you 40 years from now. But it didn’t protect you when you were a much younger working person and being exposed in that scenario. So it was preventable from the companies’ end by not putting it into our environment, but it’s not so much preventable on the workers’ end if you’ve already been exposed to asbestos. Going forward, you don’t want to be exposed to asbestos, but there’s nothing you can do about past exposures at this point.

Interviewer: Does everyone exposed to asbestos develop mesothelioma?

Robert: Absolutely not. It’s a very rare cancer. It happens, oh, roughly 2,000 times a year in our country. There’s no rhyme nor reason as to who gets it, but people who were exposed to more asbestos have a higher risk of developing the disease than people who were exposed to less amounts of asbestos. But for the most part you can be exposed to asbestos, and it’s extremely rare to develop the cancer.

Interviewer: Is asbestos still used today?

Robert: Asbestos is still used if you look at the world market. It’s still used in developing countries. It’s still being mined in certain places, Canada, for example. It’s not used so much in the day-to-day products that we were using 30, 40 years ago in this country. It is still used in specialty applications. Obviously, it has a scientific value. Obviously, it’s used in the aerospace industry when you’re dealing with things that have to be super-heated, and it’s still a great insulation in that regard. But on a day-to-day basis it’s not being used anymore.

Interviewer: How do I know if there’s asbestos in my home or workplace?

Robert: The best way to determine that is through research. Obviously, things that were built in the fifties, sixties, and even into the seventies and eighties may contain certain amounts of asbestos in either the dry wall, the ceiling tiles, the floor tiles, different types of cements, siding, things of that nature, roofing shingles. All of those can have a certain amount of asbestos in it. Those products new on the market today do not. But if they were installed 30, 40 years ago, there’s a good bet there could be asbestos in it. The best way to handle that is just to presume that everything that you have in an old house may contain asbestos, and try not to create dust from those products. You don’t want to go drilling down a wall or tearing something up unless you’ve tested it to see if there’s asbestos in it.

Interviewer: What are the symptoms of mesothelioma?

Robert: Well, mesothelioma has a wide degree of symptoms. As we run through them, you’ll see that these symptoms are not unlike anything else that resembles pneumonia or the flu. Some of the first symptoms of mesothelioma can be a pain, a dull pain in the back or the chest, difficulty breathing. Sometimes the body, when the cancer just starts to develop, will start to fill in with fluids. It puts pressure against the lungs, and that makes it very difficult to breathe. Certainly, anything else associated with types of lung cancers would be symptoms–shortness of breath with either exertion or at rest, cold-like symptoms, deep, deep cough. Anything along those lines can be a symptom of mesothelioma, which makes it very difficult to detect because you may think you have a cold, but in fact you may have a deadly cancer in your body at the same time.

Interviewer: So if I have shortness of breath or trouble breathing, should I be concerned that I have mesothelioma?

Robert: No, it doesn’t. What it may mean is that you have something that’s keeping you from breathing correctly. Mesothelioma, one of symptoms is shortness of breath, but so is a cold. So is pneumonia. So is lung cancer. So are a number of things that can cause shortness of breath. When you have shortness of breath, that’s something you want to talk about with your personal physician just as you would with anything else. Maybe you have a chest cold. When you go into your physician and explain your symptoms, they’re going to know what to look for. You want to make sure that your doctors always know that you were exposed to asbestos so they can at least put mesothelioma on the range of things they need to be looking at you for.

Interviewer: Can I have mesothelioma but show no symptoms?

Robert: Yes. Mesothelioma is what we call an occupational disease, meaning that it takes 20 to 40 years sometimes to develop. The exact molecular process on how a regular cell turns into a cancer cell is not completely known, but the asbestos fiber hits the cell. It changes the DNA, and that cell becomes active some 20 to 40 years later. It’s very difficult to detect mesothelioma until it’s expanded and grown into essentially, what you’ve maybe heard of, Stage Four cancer. So until it gets to such a far degree along the path, you had mesothelioma all along but it didn’t trigger it and grow ’til the very end. So yes, it’s possible to have mesothelioma but not feel any other symptoms from it.

Interviewer: How is mesothelioma diagnosed?

Robert: The first step in becoming diagnosed with mesothelioma is to talk to your personal physician. They are the ones who are going to know your health and your body the best. Generally speaking, if there’s a pain in your chest, they’re going to want to do a chest x ray, a CT scan, something along those lines and identify if they see anything, an abnormality, inside the chest. To the extent they see an area that they’re concerned about, a pathologist will come in and do what they call a biopsy. They’ll go in usually through the rib cage and take a little bit of tissue out. Then the pathologist will then look at those cells underneath the microscope. The pathologist is trained to look at the cells and determine what they are. That’s how a full diagnosis of mesothelioma is obtained, through a pathologist.

Interviewer: Can mesothelioma be misdiagnosed?

Robert: Yes. The most common forms of misdiagnosis of mesothelioma would involve on the personal physician level where you presented the flu-like or cold-like symptoms, and they misdiagnose you as having a cold, a touch of pneumonia, or a bacterial infection, something along these lines. When those treatments don’t resolve the problem, then additional testing may be necessary. There are times when the pathologist doesn’t get the tumor when they go in and do a biopsy, and therefore they misdiagnose it as something else. But generally speaking, they may misdiagnose mesothelioma but diagnose you with a different form of cancer. In either event they’ve got you with a diagnosis of cancer. They may not know specifically which kind yet.

But mesothelioma is very rare. Sometimes doctors are not familiar with it. There are only a handful of clinics in the country that specialize in the diagnosis of it. So often, if you’re in a small health care market, they’ll send your tissues off to a Mayo Clinic, a Sloan Kettering, or an MD Anderson type of facility to have the world’s experts take a look at it.

So sometimes it can go undiagnosed or misdiagnosed until the authority figures finally look at it and determine what it is.

Interviewer: Is mesothelioma the same thing as lung cancer?

Robert: No, actually it’s not. Mesothelioma develops outside the lung on that lining around the lung whereas lung cancer generally develops inside the lung. There are different cell lines. They create different forms of cancer. You’ll hear people discuss mesothelioma as lung cancer just mainly because of the close proximity to the lung. But it’s those two different forms of cancer, and there are two different forms of treatments available for them.

Interviewer: What is asbestosis, and can it progress into mesothelioma?

Robert: Asbestosis is a nonmalignant form of asbestos-related diseases. It’s essentially in the most basic sense a difficulty breathing. Asbestos gets into the lung. It doesn’t come back out. It stays in there. It damages lung tissue, and it makes it difficult to breathe. So you’re reducing the volume of your lung by having it essentially backed up with asbestos. Asbestosis itself, the disease of asbestosis, does not progress into mesothelioma. Those are two distinct forms of disease. But the fact that you have asbestosis proves that you were exposed to asbestos, and the asbestos fibers can cause mesothelioma.

Interviewer: Do I need to see a specialized doctor for mesothelioma treatment?

Robert: Generally speaking, when you’re diagnosed with mesothelioma, that’s going to be a pathologist who’s then going to send you to an oncologist. Oncologists are cancer doctors, and those are the ones that would treat mesothelioma. Amongst the oncologists of the world there are some that specialize specifically in mesothelioma. In general you will find those particular types of doctors and physicians at the major hospitals in major metropolitan areas. New York, Philadelphia, Houston, Los Angeles, things of that nature will be where the very specialized mesothelioma doctors reside.

But if you’re concerned about getting a doctor that is specific to mesothelioma, you need to talk to your oncologist and other treating physicians to see if they can give you a name or recommendation for one of those hospitals.

Interviewer: How do I find a mesothelioma doctor?

Robert: The best place to find a mesothelioma doctor is with your current physician. If you’ve been diagnosed with mesothelioma, there’s no doubt that you have a primary care physician. You probably have a pulmonologist. You probably have a pathologist. You probably have an oncologist already on your team. You’re going to want to talk to these physicians to see what their recommendations are on finding a specific mesothelioma doctor. There are a number of treatment places in the country that specialize in mesothelioma treatments. These are traditionally the number one, number two, number three cancer hospitals in the country. Certainly, you can contact those hospitals directly, but first you should start discussing these types of things with your personal physicians.

Interviewer: What is metastasis?

Robert: Metastasis or metastatic disease is the spread of disease from one organ to another. Generally speaking, and especially when you’re dealing with cancer, a cancer will start off someplace, and then they’ll say it spreads or metastasizes to another organ. For example, if you had colon cancer and they find it early, well, then it’s contained all within the colon. They cut it out, and hopefully everything’s fine. Other times they’ll find the cancer because it spread to the liver, the lungs, the brain, or some other organ. When it spreads, it’s much more serious because now it’s affecting more than just the one organ.

Interviewer: If our listeners are seeking additional information, is there a website or a phone number that you can direct them to?

Robert: Oh, certainly. Our website’s very good. It’s, and our phone number is 1-877-637-6347.

Interviewer: Great. Thank you.