Your Good Health: Pathologists can tell if cancer due to occupational exposure

Dear Dr. Roach: My brother recently died from non-small cell carcinoma in his lungs. He was 82 years old. He was a heavy smoker in his younger years, but quit smoking 31 years ago. He worked many years in the construction trade as a union carpenter and also worked with roofing materials. He had been exposed to many toxic materials during those years.

Pathological evaluation of lung cancer tissue often finds asbestos fibers among those who have had occupational exposures, and some expert groups feel that this is a major criterion for determining whether the cancer was due to asbestos exposure. This should have been part of the pathology report that made your brother’s diagnosis of non-small cell lung cancer.

Some experts think the apparent increase in dementia risk may be explained by an issue called confounding. People with early dementia may be more likely to be prescribed these kinds of medications due to other reasons, like the known increased risk of heart disease whose treatment sometimes calls for proton-pump inhibitors to be prescribed.

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