Could benign skin tumors be a warning sign formesothelioma? One of the world’s leading authorities on mesothelioma says the same genetic mutation that predispose certain people to skin cancer may also put them at higher risk of malignant mesothelioma.
Mesothelioma is a rare but serious cancer of the membranous tissue that surrounds and encases the lungs, heart and abdominal organs. Its primary cause is exposure to airborne asbestos. However, one of the great mysteries of this highly aggressive cancer is why it strikes some asbestos-exposed individuals and not others?
Dr. Michele Carbone and colleagues at the University of Hawaii Cancer Center, home to one of the world’s leading mesothelioma research programs, have been working on the problem for years. They believe one answer may be BAP1. BAP1 is an enzyme that is vital for regulation of multiple cellular functions including the cell cycle, cellular differentiation, cell death, metabolism and response to DNA damage. But mutations on the gene that encodes for BAP1 have been associated with several different types of cancer.
“Recent findings indicate that germline BAP1 mutations cause a novel cancer syndrome that is characterized… by the onset of an early age of benign melanocytic skin tumours,” reports Dr. Carbone in a recent issue of Nature Reviews, Cancer. The report goes on to say that the same patients who develop these benign skin tumors appear to be more likely to develop mesothelioma, certain types of melanoma, and possibly other cancers later in life.
News of the possible skin tumor/mesothelioma link was first reported last year in the Journal of Translational Medicine. At that time, Dr. Carbone and his team reported the results of a meta-analysis of 118 people from seven unrelated families, about half of whom had the BAP1 mutation. Among those with the mutation, MBAITs, or small, mole-like growths, were much more common. The report called these growths a potential “visual marker” that could help clinicians identify patients at risk for mesothelioma and other cancers.
Because its symptoms may be vague and mimic other, less serious, diseases, mesothelioma can be a diagnostic challenge. In addition to a physical exam, diagnosis typically includes lung function tests, imaging studies, blood tests for biomarkers, and a thorough work history. If continued study confirms the University of Hawaii research, MBAITs could also help point doctors towards a mesothelioma diagnosis.
Carbone, M, et al, “BAP1 cancer syndrome: malignant mesothelioma, uveal and cutaneous melanoma, and MBAITs”, August 30, 2012, Journal of Translational Medicine, Epub ahead of print.