Mesothelioma cells can be categorized as either epithelial, sarcomatoid, or biphasic. Doctors will perform a biopsy to determine the type of cells found in the patient’s tumor. During a biopsy, a tissue sample is taken from the tumor for evaluation. After that evaluation, a treatment plan can be devised.
Malignant epithelioid mesothelioma is the most common form of mesothelioma. Under a microscope, the cells in this type of disease appear organized and structured.
As with all types of malignant mesothelioma, there is no cure for the epithelioid form of the disease, though it can often respond favorably to certain treatments, including surgery and chemotherapy. Therefore, patients with epithelioid mesothelioma are often presented with more aggressive treatment plans because there is indeed more hope for an improved prognosis.
The second cell type is known as sarcomatoid. Unlike epithelial cells, these cells do not appear to follow any order or structure. These are the least common mesothelioma cell types and are found in only about 10 percent of those who are diagnosed with this aggressive asbestos-caused cancer.
Tumors can show a mix of both epithelial and sarcomatoid cells. However, when epithelial cells account for less than 10 percent of all cells, the tumor is considered to be of the sarcomatoid type.
Characteristics of these cells include an elongated nucleus or more than one nuclei and a very irregular shape. They can appear as nodules or lesions but rarely as a localized mass. As with other types, their formation is linked to exposure to asbestos.
Sarcomatoid mesothelioma can sometimes be difficult to diagnose because the cells resemble those of other, more common cancers (like soft tissue tumors) as well as some benign conditions. Delay in diagnosis becomes problematic as these types of cells spread much more quickly than the epithelial variety, so any time lost means a more grim prognosis for the patient.
However, if a patient is clear about his/her work history and mentions to their physician that they have been exposed to asbestos, the diagnosis might happen more quickly. Tests will still need to be done, however, including imaging tests such as a CT scan or MRI as well as the aforementioned biopsy.
The symptoms associated with sarcomatoid mesothelioma do not differ from those associated with epithelial or biphasic tumors. Most victims of mesothelioma will exhibit symptoms such as:
- Persistent chest cough, sometimes with blood appearing
- Chest pain
- Shortness of breath
- Fluid around the lungs or abdomen
- Weakness and/or fatigue
- Weight loss
Sadly, sarcomatoid cells do not respond well to treatment. Surgery is generally not an option because of the nature of the tumors, which often grow into the chest wall, making them just about impossible to remove. Patients with sarcomatoid cells who have tried chemotherapy have had little success.
Radiation therapy is generally not a consideration. There is hope that perhaps immunotherapy drugs may someday be able to better address this disease.
Currently, however, the average life expectancy of an individual whose mesothelioma tumor is judged to be sarcomatoid is less than six months.