Why Patients with Asbestos-Related Disease Need Follow-Up
You came to CARD to be screened and were diagnosed with Asbestos Related Disease (ARD). Now what?
Many people have the impression that there is nothing that can be done for their disease and therefore there is no use in follow-up visits. That is not true. While ARD cannot be reversed, it’s also not a reason to hide in your house and wait to get sicker. Granted, ARD is considered a progressive disease, but the prognosis varies with from person to person. Some people do get progressively worse over a period of only a few years. However, we also have a large group of people who have been diagnosed but their disease remains stable for many years afterward and they continue to live active, productive lives.
So what is the difference? If we had the answer to that question, we would all be jumping up and down. The best answer is, it’s complicated, but CARD research is working toward finding an answer. The amount and means of exposure to asbestos certainly plays a role. Genetics and possibly gender may also be involved. Smoking and asbestos exposure are synergistic. Disease in those who also smoke tends to be worse, and smoking also increases the risk of developing asbestos-related cancers. Increasingly, an individual’s immune system response is being found to be important. Recent research has shown that those with certain autoimmune markers are statistically more likely to have progressive disease. In the future, such research may help find medications that, by affecting the immune system, also help slow progression of ARD.
Many of our patients come in yearly simply because they are involved in asbestos litigation and their lawyers require annual updates on their condition. This is a patient’s choice, but from a purely medical standpoint, there are other reasons to be re-evaluated regularly.
1. Regular monitoring through history taking, pulmonary function testing, and imaging allows early identification of progression or complications, and sometimes identifies other disease processes like heart disease that can masquerade as respiratory symptoms.
2. While there is no cure, early intervention can lessen symptoms and improve quality of life. Interventions may consist of antibiotics for infection; inhalers/nebulizers/ steroid medications to help open reactive airways; medication to help suppress cough; medication to help alleviate chest wall pain; supplemental oxygen when oxygen levels are low to improve organ function and cognition, as well as exercise tolerance.
Patients can do much to help themselves, the two most important actions being smoking cessation and regular exercise to promote deep breathing. The difference these two interventions make can be seen in positive changes during pulmonary function testing. Immunizations against respiratory illnesses like Influenza and Pneumococcal pneumonia can also help prevent acute exacerbations of ARD. CARD provides free smoking cessation services through our grant-funded screening program even for those who are already diagnosed with an asbestos-related disease. We also have influenza and pneumococcal vaccines available for our patients. As you can see, regular follow ups can be key to living your best life with ARD.