Asbestos Related to Most Common Kidney Cancer

Exposure to asbestos may lead to renal cell carcinoma, the most common type of kidney cancer, an Italian study shows.

The link to kidney cancer adds to the horrific history of asbestos, a substance definitively recognized as a cause of mesothelioma, lung cancer and a variety of other respiratory illnesses. 

In the past, a handful of other cancers were inconclusively linked to asbestos exposure. However, the research team at the University of Pavia in Italy made its case for asbestos as a probable cause of renal cell carcinoma.

“The findings did surprise me. It was something I had not suspected before,” Stefano Candura, Pavia professor and lead author of the study, told Asbestos.com. “This was a case report on a controversial issue. It may imply that asbestos is a multitarget carcinogen.”

Asbestos Causes Both Malignancies

Scientific journal La Medicina del Lavoro published the study earlier this year.

The case involved a 76-year-old man with seven years of occupational exposure in a factory, where his duties included cutting asbestos cement panels with an electric saw.

Doctors diagnosed him with kidney cancer and removed the diseased organ. Fourteen months later, he died of peritoneal mesothelioma, a cancer which begins in the lining of the abdomen.

It is a rare, aggressive cancer, and the second most common form of mesothelioma. Peritoneal mesothelioma is diagnosed in fewer than 500 people annually in the U.S.

“Asbestos might be involved in the causation of both malignancies,” Candura wrote in the study. “A causal role of occupational asbestos exposure in the genesis of kidney cancer is supported by several case-control and cohort studies.”

The Italian study marks the second time scientific literature includes a reported case associating kidney cancer and peritoneal mesothelioma. It’s a rare combination. A Japanese study first noted the relationship in 2007.

Although it is not unusual for peritoneal mesothelioma to metastasize and invade abdominal organs, the study shows there was no evidence of metastasis involving the diseased kidney.

Asbestos Exposure Is Not a Well-Known Risk Factor

Obesity, smoking and genetic predisposition are typical risk factor for kidney cancers.

Some studies have included an association with exposure to several industrial chemicals. Asbestos is mentioned by some epidemiologists.

Many previous patient autopsies have shown the presence of asbestos fibers in the urinary tracts. The kidneys of patients heavily exposed to asbestos contained large amounts of the mineral’s fibers.

“It is conceivable that the two malignancies share some etiologic factors,” the authors of the Italian study wrote. “Asbestos is the most likely candidate. While the role of this agent in the causation of mesothelioma is well established, evidence for a carcinogenic effect on the kidney is conflicting.”

Candura also believes the asbestos and renal carcinoma link could have legal implications withoccupational-related compensation claims and life expectancy predictions.

“There should be greater awareness that peritoneal mesothelioma and renal carcinoma may occur concurrently,” the authors wrote. “The presence of MM [malignant mesothelioma] may in fact prevent accurate recognition of the concomitant kidney neoplasm, and vice versa.”

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ONCOS-102 Mesothelioma Clinical Trial Promises Hope

Scandinavian-based Targovax launched the latest immunotherapy clinical trial for pleural mesothelioma, hoping it delivers a better way to treat patients with asbestos-related diseases.

The randomized phase Ib/II trial evaluates the performance of ONCOS-102, an engineered human adenovirus designed to induce systemic, anti-tumor responses.

Researchers are administering the immunotherapy drug as first-line therapy in combination withchemotherapy using pemetrexed and cisplatin.

“Based on what we’ve seen in our first study of patients with various solid tumor types, which is good tolerance and response in a couple of mesothelioma patients, we’re quite hopeful for something positive from this trial,” Dr. Magnus Jaderberg, chief medical officer at Targovax, told Asbestos.com. “There is a lot of excitement.”

Doctors will inject ONCOS-102 directly into the tumor lesions of the pleura, the thin lining around the lungs. Each patient in the multicenter trial will receive six treatments in a five-month period. The trial involves 30 mesothelioma patients.

How Does ONCOS-102 Work?

The virus is engineered to replicate only in tumor cells while leaving normal cells unharmed.

That process breaks down cancer cells, which release specific tumor signals picked up by immune cells. Those immune cells then find and attack the tumor.

Because ONCOS-102 is derived from an adenovirus, it produces minor flu-like symptoms, such as chills and fevers, which may last a few days.

Impressive Tumor Reduction in Early Phase

The clinical trial’s first patient in Barcelona, Spain, received his initial immunotherapy dosage in June. France, Italy and the U.K. also are serving as host sites for the clinical trial.

Optimism about the drug stems partially from an earlier phase I trial in Finland involving various solid tumors and progressive disease that no longer responded to chemotherapy.

ONCOS-102 elicited a 40 percent disease stabilization rate across all tumor types in that trial. The study group included two mesothelioma patients who responded well. One of those patients showed a 47 percent reduction in tumor size.

Also in Finland, a compassionate-use program of ONCOS-102 that allowed access to the yet unapproved drug included 115 patients with various solid tumors such as mesothelioma. Because it was not a controlled study, there were no definitive conclusions, but Jaderberg reported patients exhibited good tolerance and clinical responses to the drug.

Last summer, a preclinical animal study involving mesothelioma tumor cells also demonstrated synergy between ONCOS-102 and the same chemotherapy combination.

“Mesothelioma is known as a highly malignant disease which is usually diagnosed too late for surgery, and as a result, there is very little that patients can be treated with,” Jaderberg said. “New therapies are needed. We hope our immunotherapy can provide additional benefit to standard of care chemotherapy.”

Currently, the U.S. Food and Drug Administration has no approved second-line treatments for mesothelioma patients with unresectable disease.

Immunotherapy Critical to the Future of Cancer Treatment

The phase I study induced tumor specific immune activation at systemic and lesional levels linked to clinical benefit.

Most medical professionals believe the future of cancer care rests in immunotherapy drugs that use a patient’s own immune system to fight off disease. There are dozens of immunotherapy drugs now in the developmental pipeline.

Patients generally tolerate immunotherapy drugs well and without the harsh side effects of typical chemotherapy. These drugs initially complement traditional multidisciplinary treatment that may include surgery, radiation and chemotherapy.

Targovax also is planning to launch trials of ONCOS-102 later this year for melanoma, prostate cancer and ovarian cancer. The melanoma and ovarian cancer trials will include sites within the United States.

“Based on data we have generated so far, I would say there is a good chance that we will find solid tumors where we will show enhanced efficacy,” he said. “I hope one of those will be mesothelioma.”

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Mesothelioma" is the term used to describe a cancerous tumor which involves the mesothelial cells of an organ, usually the lungs or abdominal organs

Mesothelioma is a rare form of cancer. It is used to describe a cancerous tumor which involves the mesothelial cells of an organ, usually the lungs or abdominal organs.

The most common type of mesothelioma is the pleural mesothelioma. The pleura is a thin membrane found between the lungs and the chest cavity. It provides a lubricated surface so that the lungs do not chafe against the chest walls. Thus, a pleural mesothelioma is often referred to as a “lung” cancer.

Another form of mesothelioma is the peritoneal mesothelioma. The peritoneum is the membrane that encloses the organs of the abdomen. While peritoneal mesothelioma is less common than pleural mesothelioma, it tends to be more invasive, and may thus result in a shorter life expectancy for the patient. Mesothelioma has also been found in the stomach and other abdominal organs.

Why Me?

A common question posed by persons afflicted with mesothelioma is, “Why did this disease develop in me?” The answer is nearly always the same-exposure to asbestos. When diagnosed in the United States, its onset is typically linked to a history of exposure to asbestos fiber. Asbestos is a mineral that was used for decades as a thermal insulation material. It has been widely known since the 1920’s that asbestos is a carcinogen, which means that it causes cancer in humans. However, asbestos was used as an insulator until the mid-1970’s, andis still present in massive quantities in many buildings today. Unfortunately, in many cases very little exposure is required to set this cancer in motion.

Mesothelioma symptoms can be very general and therefore they are often ignored. In most cases, symptoms for this type of cancer arise 2 to 3 months before the cancer is found.

Management of mesothelioma depends largely on the staging of the tumor. Early diagnosis and surgical intervention may lengthen life expectancy. Depending on the age and physical condition of the patient, however, surgery may not be a viable option. In addition to surgical options, radiation treatment and chemotherapy may be helpful in the overall therapeutic program. Pain management and home care are typical alternatives in the later stages of the disease.

See below to learn about the respective symptoms of each type of mesothelioma.

Peritoneal mesothelioma symtoms include:

- Wight loss
- Vomiting
- Nausea
- Belly pain

Pleural mesothelioma symptoms include:

- Trouble swallowing
- Tireness
- Weight loss
- Progressive loss of appetite’
- Fluid in the ches cavity called “Pleural effusions”
- Pain at the side of the chest or the lower back
- Fever
- Difficulty sleeping
- Cough

Where Do I Go From Here?

After diagnosis, it is important to understand your treatment options. Your doctor or oncologist will provide you with information on the treatments that are available to you.

It is also important to know about your legal rights. If you have mesothelioma, or any other asbestos-related disease, you were most likely exposed to asbestos. Many of the manufacturers of asbestos insulation products knew for decades that asbestos was hazardous, yet made a business decision not to warn people of those hazards. As a result, you may have a right of recovery against those manufacturers, which can help defray the costs of treatment and provide compensation for your pain and suffering.

For information on the legal implications of mesothelioma and other asbestos-related diseases

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What an Elimination Diet Taught an Urban Foodie

In part one, One Medical member Susan A. — a San Francisco foodie married to a chef — shared her reasons for trying a strict 30-day elimination diet that forbids sugar, dairy, coffee, alcohol and wheat. In part two, she shares how the experience changed her life. 

Spending a month without red wine and Nutella was one of the hardest things I’ve done as an adult, next to childbirth and a half Ironman. But they say whatever doesn’t kill you makes you stronger.

When my naturopath first suggested an elimination diet, I was consumed with thoughts of all the delicious foods and drinks I had to give up. But by week three, I felt energetic and happy and my skin looked great. My perioral dermatitis went away and hasn’t come back.

My husband, the chef, has started making creative dinners like seared ahi tuna with sticky rice, cucumbers and mushrooms in ponzu sauce that the whole family can eat. Life after the elimination diet really hasn’t changed much. My family and I already ate pretty paleo — we’re lucky to have access to lots of fresh fruits, veggies, fish, etc. The only difference is that my family regularly eats nightshades, dairy and wheat, but I don’t any more.My naturopath Erica Matluck says that gluten, dairy, corn, sugar and alcohol are the most common food intolerances she sees in her practice. She suspects the fact that we eat so much of these foods, and the way they’re processed in the U.S., leads some people to react to them. Now that the diet is over, I’m feeling like I want to continue parts of this cleaner way of eating longer term.

Here’s what I learned on my elimination diet:

1. Fruits and greens are my energy foods.

During the diet, I had much more energy than I’ve ever had. Now that I’m occasionally eating dairy, wheat and sugar again, I don’t feel the same energy I had when most of my diet was fruit and veggies. I need to make a conscious effort to eat greens and savory, not sugary, dressing on salads.

2. I can cook!

I took an extended vacation from cooking when I married a chef. In fact, the kitchen is off limits when he’s cooking. But after a month of making my own elimination diet dinners, I’m a pro at cooking chicken and veggies in the pan. I’ve now earned the right to cook once a week for the family. Tonight I’m making chicken cacciatore for the chef and the kids.

3. Fruit is delicious.

My husband used to make fun of me because before this diet because I hated fruit. Since I’m always cold living by the ocean, the thought of eating cold, wet fruit deterred me from enjoying it. Now I love fruit; especially blackberries, even at $7 a container. The other day, I packed a mango with my lunch, which is very out of character for the old me.

4. I don’t enjoy lots of cheese any more.

Just the thought of eating big meals like cheesy chicken quesadilla, or a saucy calzone from our favorite pizza joint now makes me feel lazy like I need a nap.

5. Gluten-free pasta isn’t so bad.

Pasta Sunday is a long-honored Italian tradition in my husband’s family. I’m fortunate that he discovered gluten-free pasta by Tolerant, which he paired with a delicious zucchini sauce with sliced Kalamata olives. As we ate our pasta, the vocal stylings of Luciano Pavarotti added extra flavor.

6. I can influence what my kids want to eat.

On weekends, we used to pack lunches for the kids while the adults enjoyed leftover pizza. During the diet, I packed lunches like a pro: almond butter with blueberry jam sandwiches, carrot sticks, broccoli, hummus, strawberries, blueberries, rice cakes and water for us to share. I felt great that the kids saw me eating veggies. They were fighting over who would eat more carrots and strawberries!

7. Tea is pretty amazing.

I didn’t think I could live without coffee, but now I’m really into tea. I love rooibos and Mighty Leaf White Orchard — it’s so delicious and it has just the right amount of flavor. There’s a ritual involved in tea, so it’s kind of a cool thing to think about. I was always sensitive to caffeine and now that I’m eating healthier, I don’t need caffeine…almost. The best thing about tea is that you can have it any time of day.

8. Sugar is still a problem for me.

I love Nutella so much and absence has only made my heart grow fonder. I know I shouldn’t want refined sugar, but this is a tough one because it does make me happy. But I know now it’s a slippery slope, so I don’t eat it often.

9. Easy does it with alcohol.

For a while I didn’t drink alcohol and I slept better, and felt better overall. I’ve slowly started having wine again, but I have no tolerance, so I limit my intake to a glass of bubbly or two. As for red wine, I switched from drinking heavy cabernet sauvignons to lighter pinot noirs.

10. Moderation is the key.

Going forward, I believe in moderation. I don’t want to completely give up delicious, crisp champagne or pasta Sundays with pinot noir. I just let myself know that these indulgences do sometimes come at a price. But YOLO!!

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