At Asbestos Justice we regularly speak to clients who have sadly been diagnosed with malignant conditions.
Unfortunately, it can prove difficult for medical practitioners to distinguish between diagnoses of mesothelioma as opposed to lung cancers. Both can show similar appearances on x-rays and CT scans. Also, it is common for biopsies taken from the affected site to be inconclusive as they only show part of the picture of any tumour.
Uncovering which of these malignant conditions a person has, is vital in assessing prospects of recovering asbestos compensation for those suffering with a malignant condition. In claims for asbestos related lung cancer compensation, there is a heavy burden placed upon Claimants to prove their entitlement to asbestos compensation. They must prove substantial exposure to asbestos, sufficient to show that this exposure has doubled the risk of them developing the condition. In complete contrast, in a claim for mesothelioma compensation, Claimants can succeed in claims for this condition by obtaining evidence of relatively low level asbestos exposure, providing this is shown to have amounted to negligent asbestos exposure in law.
Recently, more evidence has been gathered confirming that the tumour suppressor gene known as BRCA1 – associated protein 1 (BAP1) could assist medical experts in distinguishing between a diagnosis of asbestos related pleural mesothelioma and other forms of lung cancer.
Whilst pleural mesothelioma stands alone as a cancer which actually first develops on the pleural membrane which protects the lung, when other types of cancer spread to the same region, it can become virtually impossible for experts to decipher the correct diagnosis. This is so as other forms of lung cancer share many of the same symptoms as mesothelioma, including cough, shortness of breath, weight loss and general tiredness and fatigue.
A team of expert pathologists from British Columbia has now discovered that despite their often mirrored appearances, asbestos related mesothelioma and lung can be entirely different in their expression of BAP1.
BAP1 is a protein which is meant to restrict the growth of tumours and this is produced by the BAP1 gene.
Those who carry a mutation of this gene, known as BAP1 Cancer Syndrome, do not produce the BAP1 protein and scientists have uncovered a higher prevalence of developing mesothelioma in these people. Studies have shown that if these people have suffered exposure to asbestos in the past, they are much more likely to develop mesothelioma than others who do produce BAP1. It is thought that this discovery has assisted experts in understanding why only a very small percentage of those exposed to asbestos go on to develop mesothelioma in later life.
Whilst non-small cell lung cancer and pleural mesothelioma do have their similarities, both have different growth patterns and spread in different ways. They also respond differently to treatment. This is the prime reason why a strong diagnosis has to be made early, to assist in combatting the condition affectively.
The latest study covering BAP1 and lung cancer was carried out by experts at the Vancouver General Hospital, Abbotsford Regional Hospital and the British Columbia Cancer Agency tested for BAP1 expression in over 130 patients with non-small cell lung cancer which can be caused by asbestos exposure.
The researchers found that only one per cent of the patients reviewed had cancer cells that exhibited BAP1 loss.
Leading author of the study, Daniel Owen, MD stated:-
“We conclude that loss of BAP1 expression is a rare event in non-small cell lung cancer. Therefore, BAP1 is a potentially useful addition to the immunohistochemical markers used to distinguish mesothelioma from pleural metastasis of non-small cell lung cancer.”
At the University of Hawaii, Dr Michele Carbone and colleagues arrived at a similar view during 2015. Their published study, “Ocotarget”, showed that none of the lung cancer patients showed BAP1 loss, whilst a staggering 63 per cent of asbestos related mesothelioma patients did.
Out of this horrifying discovery, some light can be shone as those with familial BAP1 mutations are considered to have improved odds of surviving mesothelioma.
We will continue to monitor future developments in the diagnosis of mesothelioma and lung cancer and will report back in the future.
Owen, D, et al, “Loss of BRCA1-associated Protein 1 (BAP1) Expression is Rare in Non-Small Cell Lung Cancer”, February 2017, Human Pathology, pp, 92-85.
Carbone, M, et al, “Positive nuclear BAP1 immunostaining helps differentiate non-small cell lung carcinomas from malignant mesothelioma, 18th July 2016, Oncotarget.
Bauman, F, et al, “Mesothelioma Patients with Germline BAP1 Mutations have Seven-fold Improved Ling-term Survival”, 7th November 2014, Carcinogenesis.
If you require assistance in pursuing a mesothelioma claim or believe you have any other valid asbestos claim please contact us today on our freephone number 0800 038 6767. Alternatively, head over to the ‘Contact Us’ page, complete the form and we will be in touch.