Painful legacy of asbestos at work
By Dr Ian McKee, The Scotsman, June 19, 2006
THE news that the Prime Minister is keen to compensate all victims of asbestos-induced cancer is welcome to thousands of victims and their relatives.
The problem is that cancer of the lining of the lung, mesothelioma, which is linked with working with asbestos, can occur up to 50 years after exposure. Both the company working with asbestos and its insurer may be out of business by this time. And, as the law stands, it is necessary to identify one particular company to sue, whereas the worker may have been employed by more than one.
For example, asbestos was used extensively in the shipyards of the Clyde for many years and it was common for workers to move from one yard to another. Because as little as one fibre of asbestos can cause the disease, even working in another company using asbestos for as little as a day rules out compensation under the existing rules.
The number of cases of mesothelioma is increasing steadily each year and expected to peak in the next ten years or so. As asbestos is no longer used as an insulating material, we can then expect the number of new cases to start falling unless some other material we use today is equally dangerous.
One of the first signs of illness caused by asbestos is shortness of breath. This is because the soft, elastic lung tissue is gradually replaced with scar tissue, restricting the ability to breathe normally. Asbestosis, as this condition is called, is not in itself a cancer but it can seriously restrict quality of life by causing someone to run out of breathe after even the slightest exertion.
People who have worked in industries in which they are at risk are advised to have regular check ups, including X-rays and lung function tests, to get early warning of possible trouble ahead. The damage cannot be reversed but medicines and oxygen can make the symptoms more bearable.
When disease caused by asbestos turns into mesothelioma, the situation becomes very much worse. The lining of the lung, or pleura, has many nerve endings embedded in it and the developing cancer irritates these, causing severe pain.
As the tumour grows it squeezes healthy lung tissue making breathing very much more difficult. And as it is a fast growing cancer, symptoms worsen over a very short period of time. These symptoms are obviously very distressing for the patient but they also radically affect the lives of those around them who often feel very powerless, even guilty, when faced with so much pain and suffering.
So what can be done to help those with mesothelioma? The sort of treatment a patient gets depends very much on where he or she lives as there is no agreed central management strategy.
Relief of suffering is the main objective, although many powerful painkillers can make breathing problems worse. The doctor responsible for treatment has to balance the effects and side-effects of all the various treatments available.
Some hospitals try a variety of drugs that have been useful in treating other cancers, others think that they are useless and may even make symptoms worse. One medicine, Alimta, which claims to slow the progress of mesothelioma, has been licensed for use in the UK, meaning that it has convinced the authorities that it is safe and effective.
It is presently available for prescription in Scotland but now the authorities are threatening its continuing use on grounds of expense. As the total cost of this medicine in Scotland is only likely to be about £500,000 per year it is difficult to see the logic of this decision.
Surely anything effective is worth trying for such a terrible condition?
In the meantime, this prospect of financial compensation is at least
some small ray of sunshine for mesothelioma patients.