How can you go 30-40 years without any illness and then suddenly you have cancer? What is the asbestos doing in that time? How does it activate?
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To try and summarize it, the asbestos fibers can be super small and stick to important things in your cells, like their DNA, and eventually cause normal cell replication to go off the rails which is when they become cancerous.
Imagine you get a splinter from a piece of wood so small you can’t take it out and it gets stuck inside your skin.
Now imagine that but in your lungs and also it’s millions of extremely tiny pieces so small it damages your cells.
It’s damaging your lungs in that time.
Friable asbestos pulverizes into an ultra-fine mist of razor-sharp silicate fibers that you then inhale deep into your lungs.
There’s no way to get it out, so your immune system just spends the next few decades desperately trying to destroy them through inflammation and killing and replacing the damaged cells. It doesn’t work, and eventually the over-activation of your immune system for such a long time starts causing cells to malfunction and turn cancerous.
Not mentioned yet, but asbestos is really only dangerous when it is removed or otherwise damaged. So you can live in a house with asbestos insulation for decades and then knock a hole in the wall to put in an extention and end up breathing it in significant volume for the first time. The whole house likely has a small amount of it around from the start, but intense exposure only comes at end of life.
Asbestoes tends to easily fragment into tiny needle shaped splinters. These tiny splinters easily can get airborne and be inhaled into your lungs. Once in the lungs, they get lodged in there due to the sharp points and continually poke and puncture your lungs. The body can’t get rid of them or cough them up and the needles don’t break down in the human body, so they remain there. Over time the repeated damage from these needles and the futile immune response to the needles can lead to cancerous cells. Cancer itself starts small and completely unnoticed, often from just a single rogue cell, its only once its grown and multiplied to a much more substantial infestation that it starts to have a noticeable presence. Even a tiny tumor contains millions of cancer cells that all had to grow from that single original cell.
It’s not sudden. It is the slow, slow, *slow* result of continuous irritation and scarring in the lungs. My paternal grandmother died of mesothelioma, for example.
Essentially, the problem is that the asbestos fibers *never break down.* They’re little hairy filaments, so they seem so soft, but they’re *rocks.* Little tiny rock hairs. Those little tiny rock hairs get into your lungs, and they STAY there. Forever. But your body keeps trying to fight them, because they cause irritation. They’re a foreign body that needs to be driven out. So it sends wave after wave after wave after wave of macrophages and other immune cells, tries to coat the fibers in scar tissues, tries to use inflammation to wall off the area until the problem goes away, etc., etc., etc.
A strong immune response for a few days, even a few weeks, causes no harm to your body. That’s just the cost of doing business. But a *never-ending continuous* response for *decades* slowly causes damage to the cells of the mesothelium (the lining surrounding the lungs) or the lungs in general, causing mesothelioma or general lung cancer.
There is nothing “sudden” about the cancer caused by asbestos. It’s a slow, creeping disease, yes, but the cancer is the product of 15+ years of continuous damage to your lungs that your body makes *worse* by trying to fix it.
Asbestos isn’t chemically toxic.
The problem with asbestos is that it’s like a bunch of little microscopic needles. When it gets into your lungs, it pokes a bunch of microscopic holes in your lungs over the following decades. This damage is was leads to asbestos related diseases.
Source: my dad is an asbestos expert and removed it from hundreds of buildings over his career
[Image of asbestos under a microscope](https://th-thumbnailer.cdn-si-edu.com/SEvn-3svWL9TOMCcb958c5wRig4=/1000×750/filters:no_upscale()/https://tf-cmsv2-smithsonianmag-media.s3.amazonaws.com/filer/59/f8/59f818da-b604-46f3-b896-1816d0070ee6/asbestos_3.jpg)
Asbestos can be *very* thin when it splinters, and will often keep splintering until it is as small as possible. In fact, they can be compared in size to your chromosomes! And being similar sizes, asbestos fibers can mess up chromosomes. This can be an issue anywhere (and can cause wart like scarring if it happens on the skin), but it becomes especially problematic if it happens during *mitosis*. Mitosis is when you cells gather up their DNA into chromosomes, doubles them, and then makes a new cell. It is also where cancer can happen; if the chromosomes are messed up, the new cell will have its instructions messed up. And if the instructions are messed up in a certain way, you get cancer.
So actually triggering cancer is all about random chance. And like all random chance, asbestos causing cancer might take a long time or a short time. If the cancer takes decades to manifest, then the person was just repeatedly lucky. Meanwhile, the asbestos is just going from cell to new cell as each one is being made, because it is too small to filter out.
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