Women and Mesothelioma

Most mesothelioma patients are male, but there are close to 1,000 women with mesothelioma diagnosed in the United States each year. Around 22% of all mesothelioma cases involve women, and non-occupational asbestos exposure tends to be the cause.

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Written by Jenna Campagna, RN

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Women and Pleural Mesothelioma

Pleural mesothelioma is the most common type of this rare cancer. According to a study published in Lung Cancer International, pleural mesothelioma accounts for approximately 80% of all mesothelioma cases.

Women are most likely to develop pleural mesothelioma than other types of this cancer. According to Duke University researchers, around 78% of women with mesothelioma have the pleural variety. Their average age was 62.

Pleural mesothelioma forms primarily due to inhaling asbestos fibers. When fragmented asbestos dust is in the air, people nearby can breathe in the toxin. The fibers then travel into the thorax and can lodge into the cellular lining within the pleura, which is a thin membrane separating the lung cavity and chest wall.

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Women and Peritoneal Mesothelioma

Peritoneal mesothelioma is the second most common type of the disease. This diagnosis comprises around 20% of all mesothelioma cases. Women are the victims in close to half of peritoneal mesothelioma cases.

Duke University researchers found that around 22% of women with mesothelioma have peritoneal. Their average age at diagnosis was 52.8, nearly 10 years younger than the average for pleural mesothelioma.

Peritoneal mesothelioma develops primarily from swallowing (ingesting) asbestos fibers. The fragments of asbestos can travel from the mouth to the stomach and then lodge into the peritoneum, which is a thin membrane wrapping around the abdominal cavity.

How Women Develop Mesothelioma

Occupational asbestos exposure is the most common cause of mesothelioma. This method accounts for at least 80% of all mesothelioma cases and nearly 100% of male cases.

This fact explains why mesothelioma affects males more than females.

However, occupational asbestos exposure is not the primary reason why women get mesothelioma.

A 2015 study published in Translational Oncology states that women are more likely to be the gender associated with non-occupational asbestos exposure.

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According to the study, women comprised 87.5% of non-occupational exposure cases.

  • Secondhand asbestos exposure
  • Household exposure
  • Using talc-based cosmetic products that include asbestos

A 2019 study conducted by Duke University researchers backed up this long-held belief. The team found that “a majority of the (women with mesothelioma) were exposed to asbestos through a household contact.”

Secondhand Asbestos Exposure for Women

Secondhand asbestos exposure, also called “secondary asbestos exposure,” happens quite often, especially for women. Since males often worked with asbestos in their occupations, they frequently brought home toxic dust that was on their clothes or other belongings. Women also were at risk of washing their loved one’s asbestos-ridden clothes.

Asbestos Exposure Through Household Products

Women were — and still are — at risk of asbestos exposure through household products and appliances. Objects or household components that include heat all could contain asbestos. The manufacturers of most of these everyday household items used asbestos to protect them from fires.

Below are examples of these appliances or items:

  • Toasters
  • Ovens
  • Electrical sockets
  • Hairdryers
  • Oven mitts
  • Coffee pots
  • Irons
  • Portable heaters or dishwashers
  • Ironing board covers

Throughout the 20th century, women were the primary home caretakers. They regularly used many of these products to cook food, clean clothing, wash dishes and handle more daily tasks involving asbestos exposure.

Women Using Talc-Based Products

In the 21st century, researchers have uncovered another way people are exposed to asbestos: through using talc-based products.

Talc, like asbestos, is a mineral mined for commercial goods. The mineral is turned into a powder form (called “talcum powder”) that can soothe dry or irritated skin.

Manufacturers have produced and sold talcum powder for decades. It’s commonly used in:

  • Baby powder
  • Antiperspirants and deodorants
  • Food processing
  • Powders and cleansers used in the shower
  • Various makeup items (lipstick, mascara, blush, eye shadow and even children’s toy makeup)

Talcum is associated with mesothelioma because of the mineral’s link to asbestos. The two cohabitate the earth and often are found close to one another. Mining for talcum often results in asbestos contamination, and people who use talc-based products may expose themselves to asbestos.

The United States Food and Drug Administration routinely conducts tests of cosmetic products, and in 2019 the organization uncovered asbestos in samples of Johnson & Johnson’s baby powder. Women frequently use this product on children, and they likely were exposed to asbestos.

In May 2020, Johnson & Johnson ceased production and sale of its baby powder product in the U.S. and Canada. The decision stems from increased concerns regarding the link between the talc-based product and mesothelioma. Johnson & Johnson Baby Powder has been promoted as a brand since the 1890s.

Studies Connecting Women to Mesothelioma and Talc Cosmetics

The first study, published in the Journal of Occupational and Environmental Medicine, revealed that asbestos-tainted talc could cause mesothelioma. The researchers analyzed 33 mesothelioma patients who all had one shared trait: talc powder as their only substantial asbestos exposure method.

Of those 33 patients, 26 were women. Researchers noted that females were at a higher risk than males of exposure through using talc products.

"Our case study suggests that cosmetic talcum powder use may help explain the high prevalence of idiopathic mesothelioma cases, particularly among women," said Dr. Jacqueline Moline, of the Hofstra/Northwell School of Medicine.

The second study, which was published in the American Journal of Industrial Medicine, analyzed 75 people with mesothelioma. Their only known exposure method was from talc-based cosmetic products.

Of the 75 cases analyzed, 64 were women. These two studies combine for 108 reported cases, 90 of which (83%) were women.

Out of a total 108 reported cases

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90 females

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18 males

Mesothelioma Cell Types for Women

In addition to listing percentages of each form of mesothelioma, the Duke University study broke down how often women are diagnosed with each mesothelioma cell type.

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  • 74% epithelioid mesothelioma
  • 18% biphasic mesothelioma
  • 8% sarcomatoid mesothelioma

Statistics covering both genders indicate that between 50% and 70% of all cases are epithelioid mesothelioma. Women are more likely than men to have this cell type, which is positive news for women with mesothelioma: Epithelioid mesothelioma is attributed to a longer survival time.

Epithelioid mesothelioma cells tend to clump together, have an elongated and visible nucleus, and show a pink cytoplasm. Epithelioid mesothelioma cells are more easily identifiable during surgery and other treatments, which makes this specific diagnosis more treatable.

Sarcomatoid mesothelioma cells have an overlapping, irregular shape and an enlarged and elongated nucleus or nuclei. Sarcomatoid mesothelioma cells are tougher to identify during treatment, metastasize quickly and usually correlate with a worse prognosis than epithelioid cells.

Biphasic mesothelioma is a combination of both epithelioid and sarcomatoid cells. To be diagnosed with biphasic mesothelioma, the patient’s disease must include at least 10% of both cell types.

Treatment for Women With Mesothelioma

Treatment for mesothelioma includes surgery, chemotherapy, radiation and emerging methods like immunotherapy. The treatment a patient receives depends on their diagnosis, age, health and other factors.

The two primary surgeries for women with pleural mesothelioma are extrapleural pneumonectomy (EPP) and pleurectomy with decortication (P/D):

  • EPP removes the affected lung, pleural cavity and other areas impacted by metastasis.
  • P/D is a lung-sparing operation that takes out just the pleural cavity and other affected areas (such as the diaphragm and pericardium).

EPP is usually best for women with a more advanced form of pleural mesothelioma. P/D is often best for women with early-stage pleural mesothelioma.

For women with peritoneal mesothelioma, the most common surgery is cytoreduction with HIPEC (abbreviation that stands for “heated intraperitoneal chemotherapy”). This operation involves “debulking,” which is the scientific term for removing the tumors from the body.

Following cytoreduction, most patients undergo HIPEC. This treatment involves inserting a liquid chemotherapy directly into the abdomen to attack the remaining diseased cells. HIPEC limits chemotherapy’s effect on the body’s healthy cells.

Treatment Lacking Among Women

A study published on the Journal of National Comprehensive Cancer Network compared treatment rates between men and women. The report found that women were less likely to receive life-saving therapy.

The study confirmed that around 22% of pleural mesothelioma cases involve women. Despite better survival rates than men, women were not as likely to undergo chemotherapy or surgery.

Survival Rates for Women

Women have a much better mesothelioma survival rate than men. According to a study published in the Annals of Thoracic Surgery, approximately 13.4% of women survive for five years following their diagnosis. Only 4.5% of males survive for this long.

Survival rates for women are across-the-board better than they are for men:

  • Around half of women with mesothelioma survive for at least one year, but only 40% for men do.
  • Approximately 30% of women survive for at least two years, but only 20% of men do.
  • Around 25% of women survive for three years, compared to just 15% of men.
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Why Women With Mesothelioma Survive For So Long

There are numerous reasons why women survive mesothelioma for longer than men. Many of the explanations tie to the fact that women often are exposed to asbestos in non-occupational settings.

According to a study published in Translational Oncology, non-occupational exposure often causes peritoneal mesothelioma. Numerous studies show that peritoneal mesothelioma patients live longer than those with pleural mesothelioma.

According to the Translational Oncology article:

  • An estimated 91% of peritoneal mesothelioma patients survive for one year, while only 73% of pleural mesothelioma patients do
  • Around 74% of peritoneal mesothelioma patients survive for at least three years, compared to just 23% of those with pleural mesothelioma
  • Nearly 40% of peritoneal mesothelioma patients survive for at least 10 years, and only 5% of pleural mesothelioma patients survive for this long
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Age at the time of diagnosis is another reason why women live longer than men. Numerous studies show women are likely to be diagnosed at a younger age than men are. Women are also more likely to notice symptoms and seek medical care immediately.

A study published in the International Journal of Occupational and Environmental Health found that:

  • 17% of women with mesothelioma were diagnosed at age 54 or younger
  • Only 6% of men were diagnosed at age 54 or younger
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The reasoning for this is most likely due to the asbestos exposure method. According to the Translational Oncology study, non-occupational asbestos exposure usually means a shorter “latency period,” which is the time a disease takes to develop.

The mesothelioma latency period is usually between 20 and 50 years. However, women may develop the cancer sooner than 20 years. A quicker development leads to a younger age at diagnosis, which often means a healthier patient and more aggressive, curative-focused treatment.

A Survival Story for Women With Mesothelioma

Alexis K. is an example of a woman with mesothelioma who has outlived her prognosis and most survival rates. She learned of her peritoneal mesothelioma at age 37 and has survived for more than 12 years.

“Being a survivor, I am thankful each day for still being a part of the living world,” Alexis told Mesothelioma Guide in a 2019 interview. “The intensity of that gratitude only grows as the years pass, because I never want to take that gift for granted.”

Alexis is just one of the many women who have defeated mesothelioma. Our Survivor’s Guide book shares her complete story and those of other mesothelioma survivors.

If you’re a woman with this rare disease, then request a copy of the Survivor’s Guide book to draw inspiration from these brave cancer fighters.

Last Edited: September 11, 2020.

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