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International Journal of Occupational and Environmental Health Features Discovery of Asbestos-Related Pain Origin from Scientists at the Karmanos Cancer Institute in Detroit
Date:7/19/2009

DETROIT, July 20 /PRNewswire-USNewswire/ -- Scientists at the Barbara Ann Karmanos Cancer Institute's National Center for Vermiculite and Asbestos-Related Cancers (NCVAC) have discovered a probable reason for the unrelenting chest pain experienced in certain patients with asbestos-related diseases and cancers. The findings, featured in the July 20, 2009 edition of the International Journal of Occupational and Environmental Health, were published in an academic peer-reviewed manuscript by principal author Michael Harbut, M.D., MPH, co-director of the NCVAC and chief of the Center for Occupational and Environmental Medicine, affiliated with Wayne State University.

(Logo: http://www.newscom.com/cgi-bin/prnh/20071106/KARMANOSLOGO)

Harbut reported the findings after studying a patient who was exposed to taconite dust as a child.

Using a new radiography approach developed by Carmen Endress, M.D., FACR, associate professor of Radiology, Wayne State University School of Medicine and radiologist at the NCVAC, there was a documented increase in pleural plaques, causing erosion on the interior wall of the ribs.

"This action of the pleural plaque against the covering of the bone and the bone itself is a biologically plausible and an anatomically logical explanation of the unrelenting pain which some patients experience," said Dr. Harbut.

This new imaging approach involves enhancing images obtained on the 64-slice high resolution CT scan using the Vitrea(R) imaging software program by Vital Images. By using this imaging approach, Dr. Harbut was able to demonstrate that:

  • Evidence based on the CT findings, the physical examination, pulmonary function studies, epidemiology and history of the patient's intractable pleural pain meets the criteria for diagnosis of asbestosis. Combined with the known science of taconite dust, a link between the mine where the patient's father worked and the patient's disease was established.
  • Due to the clarity and definition of this new imaging approach, it is more likely to detect asbestos-related diseases and cancer at an earlier stage.
  • Earlier detection will allow the possibility for additional treatment options to manage the pain caused by pleural plaque beyond the narcotics often prescribed for patients with advanced stages of asbestos disease. This includes exploring other forms of traditional and nontraditional methods to control pain.

The patient, studied since 2004 and currently 55 years of age, was exposed as a child to taconite dust unknowingly by her father, a taconite miner from 1962 - 1969, who carried the taconite dust on his work clothes. Taconite is used in the production of steel and road-patching material. It has been mined in Michigan and Minnesota.

The patient has experienced increasing pain on her right side for the past 31 years, a persistent cough and wheezing. As the pain increased so did her medication. Using the new imaging approach, Dr. Harbut was able to show the progression of the patient's pleural plaque over a three year period, from 2005 - 2008. The patient's pleuritic pain, as well as the findings of her pulmonary function, physical exam and symptomology are consistent with those diagnosed with asbestosis and pleural plaques, as established by the American Thoracic Society.

These findings also support earlier human and animal reports that dusts produced by taconite mining can evoke the same biological responses as do other fibers already defined as asbestos or asbestiform materials.

Harbut added, "Patients often require a lifetime of narcotics to allow functioning, but we are hopeful that with this new imaging technology, more selective pain management approaches with fewer side effects can be instituted resulting in a better quality of life."

Finally, the report supports the identification of taconite, which has not yet been categorized as asbestos but causes a disease consistent with asbestosis, and recommends a reevaluation of the definition of asbestos. This is especially important within the context of legislative efforts to prohibit the use of asbestos.

Karmanos scientists are continuing their series of patient studies and will submit similar findings for peer review later this summer.

In addition to Dr. Harbut, co-authors of the report include Carmen Endress, M.D., FACR; John J. Graff, Ph.D., MS, assistant professor, Wayne State University School of Medicine, and chief, Cancer Surveillance Research at the Barbara Ann Karmanos Cancer Institute; Christopher Weis, Ph.D., National Enforcement Investigations Center, United States Environmental Protection Agency; and Harvey Pass, M.D., director, New York University's Division of Thoracic Surgery.

About the National Center for Vermiculite and Asbestos-Related Cancers (NCVAC at Karmanos)

In response to the United States Environmental Protection Agency's (EPA) identification of major sources of public asbestos exposure in Michigan, and to address the need for early diagnosis and aggressive treatment of asbestos-related diseases, the Barbara Ann Karmanos Cancer Institute and the Center for Occupational and Environmental Medicine (COEM) affiliated with Wayne State University established Karmanos' National Center for Vermiculite and Asbestos-Related Cancers. The NCVAC is co-directed by Michael Harbut, M.D., MPH, Karmanos Cancer Institute and Chief of the Center for Occupational and Environmental Medicine; and John J. Graff, Ph.D. MS, chief of Cancer Surveillance Research, Karmanos Cancer Institute and assistant professor, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine.

About Barbara Ann Karmanos Cancer Institute

Located in mid-town Detroit, Michigan, the Barbara Ann Karmanos Cancer Institute is one of 40 National Cancer Institute-designated comprehensive cancer centers in the United States. Caring for nearly 6,000 new patients annually on a budget of $216 million, conducting more than 700 cancer-specific scientific investigation programs and clinical trials, the Karmanos Cancer Institute is among the nation's best cancer centers. Through the commitment of 1,000 staff, including nearly 300 faculty members, and supported by thousands of volunteer and financial donors, the Institute strives to prevent, detect and eradicate all forms of cancer. For more information call 1-800-KARMANOS or go to www.karmanos.org.


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