Mesothelioma Survivor Walking to Work Again After Treatment

Chuck Gast’s daily work commute consists of a half-mile walk to and from his home in Toledo, Ohio.

It’s something he’s done since joining Yark Automotive Group in 2007. Gast never took it for granted, but he cherishes it more now after pleural mesothelioma took the simple pleasure away for an entire year.

“Life has basically returned to normal for me,” Gast told Asbestos.com. “I’m stronger for the experience.”

Gast, 71, received his mesothelioma diagnosis in July 2016 after experiencing shortness of breath and chest pain for a couple months. During an early checkup, doctors discovered his right lung was three-quarters filled with fluid.

A pulmonologist told him it was likely just an infection.

“They said the least likely scenario would be cancer,” Gast said. “Unfortunately, it came back that they found cancer cells in [the fluid].”

Well-Informed and Ready to Fight

Unlike many mesothelioma patients, Gast was knowledgeable about the rare cancer at the time of his diagnosis.

His former wife, Melva Warnock, was diagnosed just three years earlier.

“When I was working in a plant for like six weeks during the summer for a temporary job, I brought the [asbestos] fibers home on my clothing and she would launder my clothes,” he said.

After learning his diagnosis, Warnock was the first person Gast called. She provided him with all the legal and medical resources he needed.

“I went through all the same ones, because she had already done the groundwork,” he said.

Mesothelioma survivor Chuck Gast

Mesothelioma survivor Chuck Gast enjoys lifting weights in his spare time.

Gast traveled north to Michigan for treatment at University Hospital in Ann Arbor, where he underwent pleurectomy/decortication (P/D), an aggressive surgery that aims to remove the lining of the lung — where pleural mesothelioma forms — and as much cancer growth from the chest cavity as possible.

The surgery lasted nearly nine hours, but it was a much better alternative than an extrapleural pneumonectomy, which removes the entire cancerous lung.

“When I was considering different treatments, [Warnock] said if doctors told me I had to get a lung removed to get a second opinion because she didn’t have to have hers removed,” Gast said.

However, Warnock’s surgery a few years earlier didn’t go as smoothly. Her P/D procedure took 11 hours and she didn’t have the use of her right arm for a year and a half. She never returned to work.

“She couldn’t even drive, whereas I was driving by the weekend after my surgery,” Gast said. “In fact, I could have driven home from the hospital if my wife would have brought my wallet.”

Gast spent two weeks recuperating from the P/D in Michigan before three weeks of rehab and physical therapy back in Toledo. For the first few weeks back in Ohio, Gast underwent four rounds of chemotherapy.

The follow-up scan came back clear.

“I returned to work, and I’ve been gradually building myself up,” he said. “I’ve been walking to work again since [May].”

All It Took Was Six Weeks

Asbestos exposure is the overwhelming cause of mesothelioma. Most cases are linked to heavy, repeated exposures over the span of many years or decades.

For Gast, it only took six weeks.

He was an elementary school teacher for 16 years, but it was a summer job in 1973 that ultimately led to his cancer.

“I needed something to tie us over because the paychecks from teaching stopped in June,” he explained. “For approximately six weeks, I worked in an industrial furnace factory. The furnace insulation was asbestos, so I was directly involved with it, getting it all over me.”

Although many manufacturers and corporate executives knew of the dangers of asbestos in the 1970s, knowledge among the public and workers was low.

Gast would pack insulation into the furnaces by hand. He would also cut asbestos bricks and use a mud trowel to adhere the bricks together.

High concentrations of toxic asbestos fibers were in the air of the factory. Gast unknowingly brought the fibers home, exposing Warnock.

“I was 27 years old and never thought something like this would come back to haunt me,” he said. “That’s one job I should have never taken.”

Warnock’s mesothelioma diagnosis came 40 years later. Although her recovery was rockier compared to Gast, she is now driving again and recently took a vacation.

“When I talk to our daughter, I always ask how [Warnock] is doing,” Gast said. “The last conversation I had with her directly, she said she was doing okay and was glad to at least have a life once again.”

One of Gast’s doctors at ProMedica Flower Hospital in Toledo told him it was extremely rare for two people in the same household to be diagnosed with mesothelioma.

“When I learned that she got it, I thought that I could be next, so I studied up online,” Gast said. “After some time had passed, I started to think I wouldn’t get it because it’s so rare. I just sort of dismissed it from my mind.”

Three years later, when he began experiencing lung problems, Gast wasn’t even considering mesothelioma as the reason.

“I was thinking maybe it was just an infection or something,” he said. “But sure enough, it happened.”

Getting Back to Normal

Gast’s wife and stepdaughter were with him every step of the way through his treatment and recovery, as was his daughter from his previous marriage.

His church family became a huge support system with constant visits and prayers. Many of Gast’s co-workers at Yark Automotive came to visit and give him their best.

“Everyone has been just wonderful with all the support,” Gast said.

Life now has essentially returned to normal. Outside of working, Gast stays busy by lifting weights, playing softball and cheering on the Detroit Tigers and Michigan Wolverines, attending games when he can.

He continues to get scans and checkups at his home hospital in Toledo. His most recent CT scan revealed a tiny tumor on the lining of the lung. Doctors said it was too small to treat with surgery or chemotherapy, but nothing to be concerned with at this point.

“They said I might just need some extra pills,” he said. “I’ll likely have another scan in a few months, depending on how I’m feeling, which right now is 100 percent.”

While Gast never imagined he or those close to him would end up battling this rare cancer, he considers himself stronger for the experience.

He uses that same determination to live life to the fullest — something he is reminded of during that daily walk to and from work.

Unspoken Side Effect of Cancer Treatment

Distress. Hardship. Burden.

These words describe the impact mesothelioma cancer treatment often has on a patient’s personal finances. However, a new term has arisen to give the concept of economic hardship a medical dimension: “Financial toxicity.”

According to the National Cancer Institute, financial toxicity refers to “problems a cancer patient has related to the cost of treatment.”

The medical field is turning its attention to this because an increasing number of studies have shown how unaffordable medical bills can impact a patient’s health as much as the biological side effects of cancer treatments. Research has also demonstrated, unfortunately, that this problem is getting worse.

Health Consequences of Financial Toxicity

Just as chemotherapy drugs are more biologically toxic to some patients than others, depending on the body chemistry of patients, the financial toxicity of a mesothelioma cancer treatment depends on each person’s financial situation.

Risk factors for financial toxicity include nonexistent or low health insurance coverage, lack of a savings or emergency fund and being the primary source of income for your household. It’s easy to see how expensive cancer treatments can lead to long-term debt for many patients and bankruptcy for a small percentage of them.

For example, patients with mesothelioma require specialized treatments at specialty cancer centers that deal with the rare cancer. Often, patients must spend their life savings to travel great distances for treatment at these mesothelioma cancer centers.

Though these are serious problems on their own, doctors generally did not concern themselves with their patients’ finances until a number of research studies over the past decade brought two realities to light:

  • Financially distressed patients often take medications less often or in lower doses than directed in order to make each prescription last longer. Some patients even skip checkups or treatment appointments to save money.
  • Financial problems cause patients so much stress that many survey respondents stated they worry about paying for cancer treatments more than they worry about the cancer itself.

The combination of increased stress and reduced treatment and medication works against everything doctors strive to achieve. Financially distressed patients are susceptible to the following outcomes:

  • Poor quality of life
  • Greater intensity of cancer symptoms
  • Lower survival rates

However, there are many organizations, such as The Mesothelioma Center, which provide financial assistance through grants and legal options for patients and their loved ones.

Why Is Financial Toxicity Getting Worse?

Though scientific progress has made cancer treatments more effective, it hasn’t made them any cheaper. Rather, the cost of cancer treatment has been rising, with one pharmacy benefit manager reporting the average cost of a day’s worth of oral cancer drugs doubled in just 5 years from $20 in 2011 to $40 in 2016.

At the same time, health insurers have been looking for ways to shift more medical costs to patients. Consumers unfamiliar with the jargon of health insurance often don’t realize when their coverage is reduced.

  • Higher premiums mean you must pay more money per month for the same benefits.
  • Higher deductibles mean you must pay more money out of pocket before your insurer pays a claim.
  • Higher coinsurance and copayments mean you must pay more money out of pocket even after you’ve met your deductible.

Perhaps the single greatest threat to the health insurance coverage of cancer patients is the possibility insurers may once again be allowed to impose annual and lifetime limits for benefits.

For example, if a health insurance policy is written with an annual limit of $15,000, and a month of chemotherapy costs $10,000, then it doesn’t matter how low the policy’s premium, deductible and coinsurance is because the patient will run out of insurance coverage halfway through their second month of chemo.

The health insurance reforms of the Affordable Care Act (ACA) banned insurers from imposing annual or lifetime limits on essential health benefits, but if the ACA is repealed by the current administration, the financial toxicity of standard treatments could be multiplied for many cancer patients.

Furthermore, the legislation currently under consideration in Congress could also make health insurance premiums much more expensive for cancer patients.

What Can People Do About Financial Toxicity?

The biological side effects of cancer treatments are usually managed with medication and complementary therapies, and some researchers hope to prevent side effects altogether by developing new types of treatments.

However, the economic side effect presents a completely different challenge — one many doctors have been reluctant to tackle. Dr. S. Yousuf Zafar, an oncologist at Duke University School of Medicine, said it best in his 2016 article: “It’s time to intervene.”

Some have speculated that greater price transparency may be the key to preventing financial toxicity, but studies suggest otherwise.

When patients are given detailed information about how much different cancer treatments cost, it typically doesn’t lead to cost-cutting behavior.

In fact, price transparency sometimes causes patients to insist on the receiving the most expensive treatment because they assume expense is an indicator of effectiveness.

Many experts have instead put forth proposals for changing the way medical professionals are compensated by health insurance providers such as through value-based pricing and other complex reforms.

While these schemes are the subject of much debate, doctors and nurses across the U.S. overwhelmingly agree government policy toward health care should focus on protecting the insured and controlling pharmaceutical prices, rather than deregulating the health insurance industry.

Another solution may lie in the services of “financial navigators,” which are hospital workers who specialize in helping patients understand their medical costs and take advantage of any financial assistance they may be eligible for.

Facing a Possible Cancer Diagnosis

When it came to health and vitality, my husband Brian ticked all the boxes.

After thirty years of marriage, I still marveled at his boundless energy and strength — the rival of men half his age. On the day of his 52nd birthday, he looked the same to me as he had on the day we met, and I remember thinking, with his constitution and love of life, he will probably live to 100.

Less than eight months after Brian’s birthday celebrations, he began to experience shortness of breath. His doctor diagnosed him with pleural mesothelioma from his exposure as a child in the asbestos mining town of Wittenoom in Western Australia.

Brian would never live to be 100; his mesothelioma prognosis was not good. Doctors gave him a life expectancy of less than a year.

The unexpected onset of Brian’s terminal illness, made me aware of how much I had taken his health and mine for granted. Despite my appearance of well-being, I also worried I might suddenly be diagnosed with terminal cancer.

Brian died at age 54, and I became a widow at 51. My anxiety of getting cancer intensified as I got older, and I came to dread my yearly medical checkups and mammograms for fear of a life-changing result.

Fear of a Cancer Diagnosis

For years, my terror proved groundless. But following my regular mammogram this April, I received a call that sent shivers down my spine.

The mammogram showed a lump of calcification about four to six millimeters in size just below the nipple in my left breast. My doctor ordered a more highly magnified mammogram to further examine the lump.

Although I found mammograms unpleasant at the best of times, I was not prepared for the pain caused by this type of mammogram. During the tense wait for the final results, I researched online for calcification in the breast and discovered there are two types of calcification that can form in the breast as we age:

  • Macrocalcifications: These are coarse calcium deposits dispersed randomly within the breast and a natural result of a breast’s natural ageing process. About 50 percent of women over the age of 50 will develop these, and they are nothing to worry about.
  • Microcalcifications:These aretiny calcium deposits that present as fine white specks on a mammogram, and doctors deem these as “suspicious.” Although they are benign in 80 percent of cases, they can be a sign of cancer, particularly if they present in a shape and pattern.

Because mine were microcalcifications, my doctor referred me to a breast specialist who informed me it was highly likely that I had Ductal Carcinoma In-situ, a noninvasive and early form of breast cancer that initially forms in the milk ducts.

My worst nightmare was coming true. It worsened when the doctor warned it could become invasive if cancerous cells traveled from the milk ducts into breast tissue. There was no way of knowing what was going on inside my breast until we had the results of a core biopsy scheduled for the following week.

An Unbearable Wait for Test Results

The wait and apprehension of that procedure only deepened my fear of cancer.

Though my family kept telling me to remain positive, I lay in bed each night thinking the worst. Good or bad, I needed to know what the future held.

Thankfully, the core biopsy wasn’t as painful as I had imagined. But waiting another week for the results was difficult. There were so many questions: Did I have cancer? If I did, was it invasive?

But I didn’t get the answers I wanted. The results of the core biopsy procedure, which required five samples, were inconclusive. I had to undergo a wire hook extraction surgery to remove breast tissue from the calcification area for a thorough biopsy.

Another two weeks of waiting followed, but thankfully, I found a way to deal with my anxiety.

Comfort, Relief in Sight

Using guided imagery, I imagined myself sitting right in the middle of a see-saw suspended equally on both sides.

Whenever I began to slide down into the fear of having cancer, I would push my way back to the middle of the see-saw where I could remain neutral about my outcome.

As I waited to go into surgery, I thought a lot about Brian. Here I was, fearing I might have cancer and finding it extremely difficult to function normally. How on earth did he manage to carry on with his life knowing he had cancer? And worse, knowing he was going to die within a year?

Despite the physical and emotional pain he must have endured, he never once complained. Would I act the same way if I ended up with cancer?

Thankfully, I’ll never know. Five days after having my operation, the doctor called me with the best possible news: All tests were negative. My relief at hearing I didn’t have cancer was beyond measure.

It has taken some weeks to recover from my operation and the emotional turmoil I underwent. But I am so grateful to be once again able to look forward to the future.

How I wish my beloved Brian had been as fortunate.

Mesothelioma Survivor Rising with Immunotherapy

Gene Hartline was ready to concede after doctors at a highly rated, big-city cancer center told him there was little they could do for his advanced-stage mesothelioma.

His family refused to believe it.

Hartline returned home and found innovative medical oncologist Dr. Rama Balaraman.

The two started a patient-doctor relationship that has given him new life as a pleural mesothelioma survivor.

A second opinion has worked wonders.

“The way I feel now, I could live another 20 years,” Hartline, 77, said recently from his home near Lady Lake, Florida. “God works miracles, and he’s working a good one here.”

Hartline, who was first diagnosed in July 2016, has been receiving the experimental immunotherapy drug nivolumab – also known by brand name Opdivo – for the last seven months.

He returns to Balaraman’s nearby office every two weeks for an hour of IV drug delivery, and a spirited, uplifting conversation.

“She’s great to talk with. The big cancer center, which came so highly recommended, told me I had only 4-6 months to live,” Hartline said. “The doctor there said the first 2-3 months would be okay, but then grab your bootstraps because the next two months would kick my ass. I thought it was over for me.”

His family did not.

They found Balaraman at Florida Cancer Affiliates, a community-based practice that focuses on emerging therapies and the unprecedented access to drugs not yet approved by the U.S. Food and Drug Administration.

“I would tell anyone who gets diagnosed with this disease, don’t just take the first advice you get and give up,” Hartline stressed. “Look around and see what is out there. Dr. B told me from the start, ‘We’ll fight this together. We’ll try and come up with something that works for you.’ I was so lucky to find her. Best thing that could have happened to me.”

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Vital Family Support

It helped that his two sons work in the pharmaceutical business, one granddaughter is a doctor, and the other is a nurse. They knew where to look and what questions to ask.

Hartline did three months of chemotherapy, which reduced the tumor burden by more than 50 percent, although side effects made him miserable. After a while, the chemotherapy stopped working, which is typical with pleural mesothelioma, especially with the sarcomatoid subtype he has.

They quickly turned to Opdivo, which has shown promise with several other cancers, including non-small cell lung cancer. Immunotherapy unmasks cancer cells, and allows a patient’s own immune system to attack them. For him, the side effects have been negligible.

Balaraman used it previously with other cancers. She saw it work well with only one other mesothelioma patient.

“I told her up front, I was going to be the second one,” Hartline said. “They say now the cancer is in remission. I feel like 100 percent better than I did before. I almost feel like I got my life back. Who knows how long this will last, but I’m not going to sit here and let the grass grow under my feet.”

Feeling Revitalized, Touring the US

He and his wife, Mickie, are leaving soon to attend a Chesapeake Bay crab festival off the Virginia coast. They also have trips planned to New Jersey and Ohio to see family and friends.

They recently vacationed in the Panhandle region of Florida. Two months ago, Hartline and a son chartered a seaplane trip to explore the state from the air. He is talking now about a future riverboat trip down the Mississippi.

“I’m just crossing things off my bucket list,” he said. “I’m not waiting for anything. My doctor said, if I feel good, just enjoy it. And I feel good now, so ‘Katie bar the door.’”

Hartline, who is a deacon at his church, will be driving 1,200 miles to Buffalo, New York, next month by himself, and then flying home as a favor to a church member who needed help.

When he returns home, he and Mickie will begin renovating their kitchen. He expects to see that job finished and have time to enjoy it.

“It helps to have faith in God and faith in your doctor. I have both,” he said. “That leads to a positive attitude, which has been so important. There’s no doubt in my mind; God has had a hand in this. So has my doctor.”

Built Career as Sheet Metal Contractor

Hartline retired 20 years ago after a career as a sheet metal contractor in Dayton, Ohio, where he first learned the business working for his father. Asbestos products, the primary cause of mesothelioma, filled his professional life.

More than 30 years ago, he was diagnosed with an asbestos disease during a national screening program for sheet metal workers. His disease, though, remained dormant until 2016.

To start his retirement, they moved to Fort Myers Beach, where he opened Six Pack Fishing Charter, mixing his life-long love of boating with a new adventure.

When he moved to Central Florida a decade ago, he embraced his new church in Belleview, where he worked tirelessly on the 25-acre property. He and other parishioners erected almost a mile of fencing. He helped pave the parking lot.

“All of a sudden last year, I started feeling weaker and weaker, and I knew something was wrong. The diagnosis was tough, especially when they said 4-6 months to live,” he said. “But now, with this immunotherapy, I’m not going downhill anymore. I’m on the climb back up. And that feels good.”

Most Common Questions I Hear as a Mesothelioma Specialist

I spent the majority of my career practicing and training in the Northeast, primarily in Pennsylvania.

Since joining the staff at Ochsner Cancer Institute in New Orleans, I have seen a tremendous number of patients with malignant pleural mesothelioma at varying stages and ages.

These patients also have differences in their asbestos exposure profile. Most of them experienced occupational exposure during military service in the U.S. Navy or while working in a shipyard in the Gulf South region. Unfortunately, some family members were exposed from washing the clothes of loved one who worked in a high-risk occupation.

We’re talking about a rare disease with 2,500 to 3,000 cases diagnosed each year in the U.S., as opposed to 215,000 new cases of lung cancer. Because of that and the magnitude of the treatment regimen, there aren’t a lot of cancer centers specializing in mesothelioma.

Patients have to look near and far to find one. At a center such as Ochsner, we can take a well-coordinated multidisciplinary approach between the surgeon, radiologist, medical oncologist and pulmonologist.

We also can better answer questions patients may have about their diagnosis.

Answering Questions About Life Expectancy

After we diagnose a patient with malignant pleural mesothelioma, the most common question I’m asked: “How long do I have?

The outcome is extremely guarded. We look at the outcome in terms of months — on the lower end of months if nothing is done — but I tell all of my patients that you have to take it one step at a time and one day at a time.

None of us are guaranteed to be around in the next 30 seconds. I tell them that, as far as I know, I don’t have cancer, but I’m not guaranteed to be breathing in the next two minutes. I can’t run my life based on that, and I encourage my patients to do the same.

We go over the statistics in terms of survival with and without treatment, and I tell them a lot of that is based on the spread of the disease.

I reassure them that by virtue of being at a cancer center with experience treating mesothelioma, we have the capability of determining the exact stage of the disease, best treatment regimen and potential outcome based on treatments we recommend.

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Multimodal Approach to Treatment

The next most common questions: “How are you going to treat it? Can this be cured?”

For those patients who are eligible for surgery beyond diagnosis, I will tell them it will involve multiple modalities. It will involve surgery, chemotherapy and may or may not involve radiation therapy.

There are two common surgeries for treating malignant pleural mesothelioma — pleurectomy/decortication (P/D) and extrapleural pneumonectomy (EPP).

Each surgery is a pretty invasive procedure, but neither is considered curative.

The goal of both surgeries is to remove all visible disease. The assumption is there will be microscopic disease left behind, hence the need to give patients chemotherapy before and after surgery.

It’s usually at that point when it begins to sink in. Patients start realizing what they are up against.

Compartmentalize the Process

Receiving a diagnosis is the first step.

Although a mesothelioma diagnosis can be devastating, I try to explain to patients the importance of knowing what we’re facing.

You can’t treat what you don’t know.

I tell patients we have to compartmentalize the whole process. We can look at the big picture — the goal of remission — but we must take it one step at a time.

Once we have a diagnosis, it’s time to formulate a treatment plan. I tell patients they’re so special that we’re going to discuss their case at our weekly conference.

Many doctors will weigh in with input. There will never be one person running the show or calling all the shots. This way, we can give the patient what we feel is the best care, what meets or exceeds the standard of care.

I make sure to communicate with the patient’s other health care providers to ensure we’re all on one accord with respect to the treatment plan.

That alone can provide some degree of relief to patients once they arrive in our office.

A Century of Asbestos in American Popular Culture

An early episode of “The Simpsons” exploited an ongoing public health crisis — asbestos in classrooms — for comedic effect in a school election.

When his rival for class president reveals that traces of asbestos were found in their classroom, Bart Simpson deftly turns the argument around, declaring, “That’s not enough! We demand more asbestos!”

Bart leads the class to chant: “More asbestos! More asbestos! More asbestos!” He uses his rhetoric to become the school election favorite.

Despite the humor, that pop culture reference offers a glimpse into America’s century-long complicated relationship with asbestos.

Comics, TV Shows and Movies Joke About Asbestos

Today, asbestos exposure is definitively linked to mesothelioma, which is a rare and incurable cancer that usually develops many years after the toxic mineral dust is inhaled.

Thousands of Americans have lost their lives to mesothelioma cancer and other asbestos-related illnesses because of a lack of awareness about the dangers of asbestos and the negligence of some manufacturers who chose to not inform their workers about the hazards.

But a series of references in comic books, movies, TV shows and video games shows asbestos is often used as a selling point or punch line.

‘Electrobestos’ Ad Promises Quality Product (1929)

Well before the advent of television commercials, and even before the rise of radio advertising, asbestos was already established as a “miracle mineral,” useful in any product requiring strength, heat resistance and insulating properties. This Johns Manville print ad shows how asbestos-containing products were once seen as emerging technologies.

Electrobestos Product

Electrobestos Product

‘I Won’t Dance’ Rhymes Asbestos in Chorus (1935)

Originally performed by Fred Astaire in the musical film “Roberta,” and later famously recorded by Frank Sinatra, one of the original versions of the jazz standard “I Won’t Dance” features the lyrics, “For heaven rest us, I’m not asbestos…I’m not gonna hold an armful of flame.” The “armful of flame” part was cut from later versions, but remarkably, the reference to asbestos survived.

‘Asbestos Lady’ Battles ‘Human Torch’ (1947)

It may be hard to believe that Marvel Comics, the studio behind the popular “Avengers” movies, once based a supervillain on a cancer-causing construction material, but the truth is there in vibrant comic-book colors. Asbestos Lady provided a natural nemesis for the Human Torch to battle — though ultimately, in her last comic book appearance in 1990, the final blow came from mesothelioma.

Asbestos Lady comic book cover

Asbestos Lady

‘Hot Stuff the Little Devil’ Wears Asbestos Diaper (1957)

Harvey Comics is perhaps best known for the classic characters “Richie Rich” and “Casper the Ghost,” but among the publisher’s quirky cartoon lineup, you’ll also find a little red devil-child named Hot Stuff, whose diaper is made of asbestos.

‘Leave It to Beaver’ Uses Asbestos in Punch Line (1960)

A clip from the classic series “Leave It to Beaver” shows an all-American dad explaining that men are more suited for cooking outdoors because they don’t need all the modern conveniences that women rely on in the kitchen. He then asks his son to pass him an asbestos glove. The 1960s studio audience laughed because an asbestos glove is a modern kitchen convenience, intended to keep its wearer safe.

‘Human Torch’ Faces ‘Asbestos Man’ (1963)

Marvel’s search for fireproof villains inevitably led them back to asbestos-based super-science. As with Asbestos Lady, the fate of Asbestos Man aptly summarizes the story of asbestos itself. Almost 50 years after debuting as a formidable adversary, Asbestos Man appeared one more time — as an elderly mesothelioma patient trying to rob a fast-food restaurant while breathing from an oxygen tank.

PSA with ‘Welcome Back, Kotter’ Star (1978)

The show’s lead actor, Gabe Kaplan, starred in a public service announcement about asbestos in schools. The 1970s marked a turning point in asbestos awareness. As victims of exposure began winning lawsuits across the country, asbestos became public enemy No. 1.

“Welcome Back, Kotter” star Gabe Kaplan’s PSA about asbestos.

‘National Lampoon’s Vacation’ Character Laid Off from Asbestos Factory (1983)

From the 1980s onward, asbestos became a source of dark humor. In “National Lampoon’s Vacation,” Cousin Eddie tells the Griswolds he “got laid off when they closed that asbestos factory,” alluding to the catastrophic collapse of the American asbestos industry after the health risks of asbestos were exposed.

‘Hot Shots! Part Deux’ Features President with Asbestos Skin (1996)

In this “Rambo” parody, President Benson accidently swings into a fireplace and then emerges unscathed, explaining that his skin has been made of asbestos since a tanning-parlor accident.

‘Step Brothers’ Cry Asbestos to Prevent a Home Sale (2008)

In the comedy “Step Brothers,” two men living off their parents go to great lengths to prevent their family home from being sold by masquerading as bad neighbors to pretending that one of them has died from asbestos exposure in the house. The preposterous situation points to the real-life effect asbestos-containing materials can have on a home’s desirability.

Video Game Brings Asbestos Back as a Useful Resource (2015)

Smash-hit video game “Fallout 4” allows players to extract asbestos from everyday objects and then use it to upgrade weapons and armor. To put this in context, the Fallout series is set in the irradiated ruins of cities destroyed by nuclear war, where exposure to basically everything causes cancer.

All Fun and Games Until Someone Gets Hurt

As interesting as these references are, does pop culture take asbestos seriously? After all, many Americans are still dismissive of asbestos health concerns, and making jokes is not the way to change peoples’ minds.

Since the first asbestos lawsuits, industry lobbyists have tried to write the issue off. President Donald Trump blamed asbestos regulations for the fall of the Twin Towers at the World Trade Center on 9/11.

The scientific evidence, however, shows asbestos is toxic and asbestos-related diseases are preventable if people take the threat seriously. Employers and manufacturers are responsible for keeping workers and consumers safe from asbestos, and homeowners must leave it to professionals to identify and dispose of asbestos-containing materials.

While there’s no harm in popular culture poking fun at serious topics, people need to remember that in the real world, asbestos is no laughing matter.