14-Year Old Briton Diagnosed with Peritoneal Mesothelioma

Macie Greening, a 14-year old girl from Collumpton, in Devon, has become the 9th child in the UK and the 20th child in the world to develop peritoneal mesothelioma.[i]

Peritoneal mesothelioma is 1 of 4 types of mesothelioma: pleural (lung lining); peritoneal (abdominal lining); pericardial (heart sac); and testicular (testicular lining). In the UK, pleural mesothelioma cases account for 90-95% of mesotheliomas, while peritoneal mesothelioma cases account for 5-10%.[ii]

According to Asbestos.com, 300 cases of mesotheliomas have been diagnosed in young adults, children and infants.[iii]

The latency period (time between exposure to asbestos fibres and onset of the condition) for malignant mesothelioma can be as short as 10 years, or as long as 50 years, but the average latency period is 35-40 years.[iv] Miss Greening’s family does not believe that she was exposed to asbestos fibres and medical professionals are unaware as to the cause of her condition. Results of her biopsy are travelling around the world for expert examination.

News of Miss Greening’s mesothelioma coincides with the publication of an Australian study, which found that asbestos-related mesothelioma risk differs among adults and children – and that children are less susceptible.[v]

Participants in this study had experienced non-occupational exposure to crocidolite (blue asbestos) at the Wittenoom mine, in Western Australia, either as adults or as children. 

Those exposed as adults were more likely to have been diagnosed with mesothelioma than those exposed as children. The diagnosis rate among children and adults was 76.8 cases per 100,000 people and 121.3 cases per 100,000 people, respectively. More cases in children may appear in future, however, if age affects the latency period of mesothelioma development.

In edition 229 of BC Disease News (here), we produced a feature article on non-asbestos-related causes of mesothelioma. We discussed, among other causes, the potential role of the BAP-1 (BRCA1-associated-protein-1) gene in increasing susceptibility to cancer. BAP-1 is found in an estimated 70% of mesothelioma cases and this may infer that mesothelioma is hereditary.[vi]

What is more, in edition 213 of BC Disease News (here), we reported on a study, which concluded that 38% of pleural mesotheliomas in females had an ‘unknown’ or ‘not probable’ cause. The same was observed in 47% of peritoneal mesotheliomas in females.[vii]

Asbestos.com lists radiation exposure (e.g. to treat a Wilms’ tumour early in life[viii]), isoniazid (powerful antibiotic drug) use during pregnancy, and a family history of mesothelioma as potential causes of mesothelioma in children, where there is often no history of asbestos exposure.[ix] 

To-date, Miss Greening has received 4 rounds of chemotherapy treatment, without success. Since a laparoscopy revealed that surgery was not an option, she is hoping to participate in future clinical drug (immunotherapy) trials.

Miss Greening’s case of peritoneal mesothelioma is rare, which is why studies of mesothelioma in children often take the form of individual case studies.[x] If, as her family alleges, her mesothelioma is not asbestos-induced, this may suggest that mesothelioma can pass through generations congenitally, or add support to the argument that mesothelioma is caused by an as-yet-unknown factor.[xi]

 

[i] Stephen Matthews, ‘Girl, 14, becomes 'one of the youngest people in the world' to be diagnosed with an aggressive cancer caused by exposure to asbestos’ (4 September 2018 Daily Mail) <http://www.msn.com/en-gb/health/familyhealth/girl-14-becomes-one-of-the-youngest-people-in-the-world-to-be-diagnosed-with-an-aggressive-cancer-caused-by-exposure-to-asbestos/ar-BBMRidZ?ocid=se> accessed 5 September 2018.

[ii] ‘Mesothelioma’ (National Asbestos Helpline) <https://www.nationalasbestos.co.uk/asbestos-diseases/mesothelioma/> accessed 5 September 2018.

[iii] Karen Selby, Walter Pacheco, and Dr Don W. Hill, ‘Mesothelioma in Youth’ (Asbestos.com) <https://www.asbestos.com/mesothelioma/children-young-adults/> accessed 5 September 2018.

[iv] Raising Awareness: Mesothelioma – The Cancer Caused by Asbestos’ (Asbestos Justice UK)<https://www.asbestosjustice.co.uk/raising-awareness-mesothelioma-the-cancer-caused-by-asbestos/> accessed 5 September 2018.

[v]  Reid, A. et al. Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom. Occup Environ Med (2018). doi:10.1136/oemed-2018-105108 https://www.ncbi.nlm.nih.gov/pubmed/30158318 (Accessed 6 September 2018)

[vi] Tim Povtak, ‘BAP1 Mesothelioma Mutation Focus of Upcoming Clinical Trial’ (5 July 2017 Asbestos.com) <https://www.asbestos.com/news/2017/07/05/bap1-mesothelioma-mutation-clinical-trial/> accessed 3 May 2018.

[vii] Marinaccio, A. et al. The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure. Occup Environ Med (2017). doi:10.1136/oemed-2016-104119 <http://oem.bmj.com/content/early/2017/12/21/oemed-2016-104119>  accessed 28 December 2017.

[viii]  Antman, K. H., Ruxer, R. L., Aisner, J. & Vawter, G. Mesothelioma following Wilms’ tumor in childhood. Cancer 54, 367–369 (1984).  https://www.ncbi.nlm.nih.gov/pubmed/6327010 (Accessed 6 September 2018)

[ix] Mesothelioma in Youth,  Asbestos.com https://www.asbestos.com/mesothelioma/children-young-adults/ (Accessed 6 September 2018)

[x]  Brenner, J., Sordillo, P. P. & Magill, G. B. Malignant mesothelioma in children: report of seven cases and review of the literature. Med. Pediatr. Oncol. 9, 367–373 (1981). https://www.ncbi.nlm.nih.gov/pubmed/6790917 (Accessed 7 September 2018)

[xi]   Fraire, A. E., Cooper, S., Greenberg, S. D., Buffler, P. & Langston, C. Mesothelioma of childhood. Cancer 62, 838–847 (1988).  https://www.ncbi.nlm.nih.gov/pubmed/3293765 (Accessed 7 September 2018)