Why Some People Get Mesothelioma After Asbestos Exposure and Some Don’t

Mesothelioma is incredibly rare compared to the number of people who undergone asbestos exposure over the years. For instance, it’s possible for two people to work together and encounter the same level of asbestos exposure for years and one person will develop mesothelioma and the other won’t. There are many different reasons for that, one of which is the BAP1 gene mutation.

Mesothelioma Risk Factors

Many different factors play into whether or not an individual is likely to get mesothelioma. The main one is whether or not an individual has undergone asbestos exposure, and how much exposure they’ve had.

Some of the other risk factors, like diet, overall health, alcohol consumption and smoking habits are things that individuals can watch over and change if they want to try to lower the likelihood of getting any cancer. Others, such as age, gender, and genetics, are out of a person’s control. Whether or not a person has the BAP1 gene mutation is an example of a genetic risk factor.

What Is The BAP1 Gene Mutation and What Does It Have to Do with Mesothelioma?

The BAP1 gene is associated with ferroptosis, which is a particular form of cell death. Ferroptosis happens when the BAP1 gene lowers the amounts of cysteine—an amino acid that helps cancer cells grow and survive—in the body. BAP1 also encourages the overproduction of reactive oxygen species (ROS)—molecules that carry oxygen—on lipids.

A study, led by Boyi Gan, Ph.D., associate professor, Department of Experimental Radiation Oncology at MD Anderson Cancer Center, discovered that treatments that contained ROS inducers (a treatment that causes the body to produce more ROS molecules) caused more cancerous cells to die from ferroptosis in cells that express BAP1 than from cells that don’t.

The research teams also learned that BAP1 also encourages ferroptosis by repressing SLC7A11, which is a cysteine ‘transporter.’ Both of these discoveries could potentially create a new type of targeted or epigenetic therapy—a therapy that changes a gene’s activities without changing the gene’s structure—for treating mesothelioma.

Family History of Mesothelioma and BAP1 Gene Mutation

The fact that BAP1 can cause cancer cells to starve isn’t the only way BAP1 is related to mesothelioma. One mutation of the BAP1 gene is found in families with a history of mesothelioma or other cancer.s This is known as tumor predisposition syndrome (TPDS), which means that people with this mutation are more susceptible to getting mesothelioma if they have a history of asbestos exposure.

People with this BAP1 gene mutation tend to get an epithelioid cell-type peritoneal mesothelioma about 10 years younger than people without the mutation. So they’ll be diagnosed when they are 58 instead of 68.

However, while patients with the mutation tended to present with cancer earlier, they also had a better survival rate after diagnosis than those without (60 months instead of 17 months).

BAP1 Gene and Mesothelioma Screening

While having TPDS can feel like your body is a ticking time bomb, knowing you have it can enable you to get screened for cancers on a more regular basis. Like other cancers, mesothelioma is more treatable the earlier it is diagnosed.

If you know you are genetically predisposed to getting mesothelioma and you have a known history of asbestos exposure, you and your doctor can watch out for the signs and symptoms of mesothelioma, and you can have some imaging tests done to watch for changes in your lungs.

This way, if you do get mesothelioma, it will hopefully be discovered when it’s only stage 1 or 2 when the cancer is most treatable, instead of after the cancer has spread and the treatment options might only be palliative.

While mesothelioma is a discouraging diagnosis, it’s important to remember that just because you have a history of asbestos exposure, it doesn’t mean you are destined to have this type of cancer. And if you are diagnosed with mesothelioma, it’s possible to undergo targeted treatments that can help improve prognosis and your quality of life.