Do We Know What Causes Malignant Mesothelioma?

Researchers have found several factors that increase a person’s risk of mesothelioma, but it’s not yet clear exactly how all of these factors might cause this cancer.

Cancers, including mesotheliomas, occur when cells in the body suffer damage to their DNA. DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than how we look. Some genes control when cells in the body grow, divide into new cells, and die at the right time. Changes in these genes may cause cells to grow out of control, which can lead to cancer.

Asbestos exposure is the main cause of pleural mesothelioma. When asbestos fibers are breathed in, they travel to the ends of small air passages and reach the pleura, where they can cause inflammation and scarring. This may damage cells’ DNA and cause changes that result in uncontrolled cell growth. If swallowed, these fibers can reach the abdominal lining, where they can have a role in causing peritoneal mesothelioma.

But most people exposed to asbestos, even in large amounts, do not get mesothelioma. Other factors, such as a person’s genes, may make them more likely to develop mesothelioma when exposed to asbestos. For example, researchers have found that some people who seem to be at high risk have changes in BAP1, a gene that normally helps keep cell growth under control. Other genes are probably important as well.

Radiation treatments for other cancers have been linked to mesothelioma in some studies. Radiation can damage the cells’ DNA, leading to out-of-control cell growth.

It is still not known if infection with the SV40 virus increases the risk of mesothelioma, or exactly how it might do so. In lab studies, researchers have found that the virus can affect certain genes that have been linked with cancer, but further research in this area is needed.