Asbestosis And Carcinoma Of The Larynx: A Possible Association

Our plain-English summary of Asbestosis And Carcinoma Of The Larynx: A Possible Association, by H.I. Libshitz, M.S. Wershba, G.W. Atkinson, et al (1974).

The study

• Authors: H.I. Libshitz, M.S. Wershba, G.W. Atkinson, M.E. Southard
• Published: Journal Of The American Medical Association 228(12):1571-1572, June 17 (1974)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 001279. The article is still under copyright, so we describe it here rather than post it.

In plain English

This was a short report describing three patients. It was not a study of how often the disease occurs. The authors described three men, each with cancer of the larynx (voice box), a history of asbestos exposure, and chest X-ray changes consistent with asbestosis. One man, aged 65, had worked 26 years as an insulator in a naval yard. A second had installed wiring in the cargo area of ships from 1952 to 1954. The third, aged 60, had worked 30 years as a steam pipe fitter and, as the scan appears to read, a welder. All three had epidermoid carcinoma involving the vocal cords and were treated with radiation. The first man also had his larynx removed. Each was reported as well, or as having no complaints, at last follow-up. All three had smoked cigarettes heavily. The authors wrote that the causal role of asbestosis, if any, was difficult to determine. They raised the possibility that smoking and asbestos exposure acted together, and concluded that an association between asbestosis and laryngeal cancer was suspected. No fiber type was named.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report of three patients
• Who was studied: Three men. Two were aged 65 and 60; the second man's age is partly unreadable in the scan. Each had cancer of the larynx, a history of asbestos exposure, and chest X-ray changes consistent with asbestosis. The authors saw them at a university hospital in Philadelphia, though the affiliation text is garbled in the scan. Diagnoses were made between 1971 and 1973.
• Exposure: Occupational asbestos exposure in three jobs: 26 years as an insulator in a naval yard (patient 1); installing wiring in the cargo area of ships from 1952 to 1954 (patient 2); and 30 years as a steam pipe fitter and, as the scan appears to read, a welder (patient 3). No fiber type or dose was given. All three also smoked cigarettes.
• Main results:
  • Patient 1 (65-year-old insulator): the chest X-ray showed changes the authors called typical of asbestosis. Biopsy showed epidermoid carcinoma of the anterior commissure and right vocal cord.
  • Patient 1 had a total laryngectomy with radical neck dissection, followed by radiation totaling 6,600 rads. He was reported to have no complaints.
  • Patient 2 (ship wiring installer): biopsy of growths on the left vocal cord showed intermediate grade epidermoid carcinoma. He received 6400 rads of radiation and was well and without symptoms eight months after therapy.
  • Patient 3 (60-year-old steam pipe fitter): biopsy of the right vocal cord showed moderately well-differentiated epidermoid carcinoma. Radiation over seven weeks totaled 6,540 rads, and he was well 15 months after therapy.
  • The chest X-rays of patients 2 and 3 showed pleural thickening at the lower lateral pleural surfaces. Patient 2 had pleural calcification at the left hemidiaphragm, and patient 3 had calcification of both diaphragmatic pleurae.
• The authors' conclusion: The authors concluded that an association between carcinoma of the larynx and asbestosis is suspected, and described it as a possible association.
• Limitations the authors state:
  • The authors stated that it is difficult to determine the precise causative role, if any, of asbestosis in these patients' laryngeal cancers.
  • The authors noted that all three patients smoked cigarettes heavily, and they raised the possibility of a combined (synergistic) effect of smoking and asbestos exposure.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Laryngeal Cancer, Asbestos Exposure, Chest X-Ray, Insulator.

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