NEUROLOGICAL SIGNS IN RELATION TO CANCER IN PATIENTS WITH ASBESTOSIS

Objective-To chart the subtle neurological abnormalities in patients w ith asbestosis relative to possible development of cancer. Methods-In 1979-81 a standardised neurological examination was made of 115 patien ts with asbestosis who carried a high risk of occupational cancer and their cancer morbidity was analysed 15 years later. Results-Slight dis turbances of unknown aetiology were found in the central nervous syste m (CNS) of 33 and in the peripheral nervous system (PNS) of 41 patient s. Of these 17 hade disturbances of both the CNS and PNS. This cohort was followed up to the end of 1994. During this time 47 of the patient s developed cancer. Statistical analyses showed that disturbances of t he CNS such as psycho-organic syndrome, cerebellar dysfunction, and mo tor disturbances of unknown origin were significantly associated with cancer, whereas no such association was found for peripheral neuropath y. Interaction between the radiological progression of asbestosis and disturbances of the CNS was an even stronger predictor of cancer. Conc lusions-It seems that slight disturbances of the CNS are predictors of development of cancer. Whether or not these disturbances are manifest ations of involvement of a paraneoplastic nervous system or some facto r associated with progression of asbestosis remains open.