Do we know what causes malignant mesothelioma?

Do we know what causes malignant
mesothelioma?
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 have instructions for
controlling when cells in the body grow and divide into new cells. Changes in these genes
may cause cells to grow out of control, which can lead to cancer.
Asbestos exposure is the main cause of mesothelioma. After these fibers are breathed in,
they travel to the ends of small air passages and reach the pleura, where they can damage
mesothelial cells. This leads to 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 cavity where they 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 recently 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.
Researchers now understand many of the factors that increase a person’s risk of
mesothelioma, but it's still not clear exactly how these factors cause the gene changes that
lead to cancer. This is an active area of research.

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