Epithelioid Mesothelioma – What to know?

epithelioid mesothelioma

Epithelioid mesothelioma is a slow-spreading cancer disease. Exposure to asbestos is the main cause of this common disease. With treatment, the patients often survive for about 1 -2 years.

The epithelial cells, typically, have a slower rate of growth. Hence, they can respond favorably to almost any kind of treatment including chemotherapy, surgery, and radiation. For this reason, this disease has the best survival rate and prognosis of all the cell types.

What Is Epithelioid Mesothelioma?

Naturally, the human body consists of four types of tissues – epithelial tissue, connective tissue, nervous tissue, and muscle tissue.

Generally, the epithelial tissue gives covering to the human body. It can be found on the surface of the skin, linings of blood vessels, hollow organs, and also on internal cavities. Typically, these tissues are made up of epithelial cells.

Upon asbestos exposure, these cells mutate and turn cancerous. Epithelioid mesothelioma constitutes about 50 – 70% of mesothelioma cases. However, many mesothelioma centers have required facilities to provide good treatments.

Depending on the location, epithelial cells form single or multiple layers and also different shapes. The shapes often include – columnar, cubed, or flat (squamous).

Medical experts, in general, easily recognize epithelioid mesothelioma cells through their adherence. Sometimes, they identify these cells by their visible nuclei.

These cells also divide faster compared to other types of cells. However, they metastasize slower, due to their way of forming clusters.

What are the Symptoms of This Disease?

Depending on the location of cancer, this disease shows a variety of symptoms. The severity of these symptoms varies depending on the individual’s overall health, age, and also stage of the disease. Some common symptoms include:

Anemia (low iron)
Coughing and hoarseness
Fever and fatigue
Nausea and vomiting
Unexplained weight loss
Difficulty breathing
Abdominal or chest pain
Fluid buildup near the lungs or abdomen
Low blood oxygen levels

Unlike sarcomatoid mesothelioma, Epithelioid mesothelioma tends to spread slower. Therefore, affected individuals may not realize severe symptoms until the disease reaches stage 4. At this stage, cancer spreads to distant organs, tissues, and lymph nodes.

How to Diagnose Epithelioid Mesothelioma

Normally, medical experts begin testing epithelioid mesothelioma with certain image tests. They may include CT scans, X-rays, MRIs, and PET scans.

Doctors may also order a blood test if image tests reveal any sort of abnormalities. Then, they identify specific biomarkers from the results, in the case of the presence of mesothelioma cells.

The doctors may also order a biopsy for confirmation. This can be a surgical or non-surgical procedure, that helps to remove a sample tissue for lab analysis. Lab test results can reveal much important information including the type of mesothelioma cells, their stage of development, and malignancy.

If needed, pathologists may perform immunohistochemistry. This test further confirms the cell type. It also differentiates mesothelioma from adenocarcinoma and other malignancies.

The samples may also contain Sarcomatoid cells, which may an indication of biphasic mesothelioma.

Pathologists may apply certain antibodies in combination including D2-40, calretinin, and WT1. In this way, they can diagnose the disease accurately.

Rare Sub-Types of Epithelial Cells

In some patients, pathologists have found various rare subtypes of epithelial cells. Comparatively, these subtypes may have worse prognoses and limited treatment options.

1.) Adenomatoid mesothelioma – Adenomatoid cells, in general, form in glandular structures. Hence, some experts call them micro-glandular or glandular mesothelioma. These cells usually have a cube or flat shape. They can be malignant or benign.

2.) Adenoid cystic mesothelioma – This rare subtype commonly forms in pleural or peritoneal cavities. In most cases, these cells are benign. However, they can also be malignant in some cases.

Cystic mesothelioma cells most commonly develop in young women, of childbearing age.

3.) Deciduoid mesothelioma – Though these cells often develop in the abdomen, they are sometimes found in lung linings also.

Deciduoid mesothelioma most commonly develops in women. Researchers, still analyze these cells through various studies. However, the exact cause of this cancer is yet to be determined.

4.) WDPM (Well-differentiated papillary mesothelioma): These cells usually develop in the genitals, pleura, and peritoneum of both men and women. However, they are mostly found developing in women.

Asbestos exposure, in general, does not cause papillary mesothelioma. These cells metastasize slowly. The survival of patients usually ranges between 36 – 180 months.

5.) Small cell mesothelioma – These cells form in the pleura and peritoneum. Medical experts, often diagnose small cell mesothelioma in biphasic tumors. These tumors usually contain both sarcomatoid cells and epithelial cells. Sometimes, people mistake this subtype for small cell lung cancer.

What is Epithelioid Mesothelioma Prognosis

Prognosis differs for various cell types. Comparatively, patients suffering from epithelioid mesothelioma often have a favorable prognosis. They also enjoy an extended overall life expectancy. After diagnosis, they usually survive for about 1 -2 years.

In 2017, researchers conducted a study to find the average survival time of patients with Epithelial, Biphasic, and Sarcomatoid mesothelioma. The results indicated:

1.) The patients with Epithelial mesothelioma have an average of 18 months survival time.

2.) The patients with Biphasic mesothelioma have an average of 12 months survival time.

3.) The patients with Sarcomatoid mesothelioma have an average of 6 months survival time.

However, the prognosis for patients depends on many factors. They include the type of cells, location, overall health, age, pre-existing conditions, and also the stage of the disease.

How to Treat Epithelioid Mesothelioma

Typically, the treatments for epithelioid mesothelioma include chemotherapy, surgery, and radiation therapy. In most cases, doctors use multimodal approaches to treat these kinds of diseases.

Sometimes, doctors use certain procedures as palliative treatments to reduce the symptoms.

Early stages of Epithelial pleural mesothelioma in patients may be treated with surgeries. The most common surgeries for this condition include EPP (extrapleural pneumonectomy) and P/D (pleurectomy/decortication).

In 2018, researchers conducted studies on patients who underwent surgeries for different cells. The studies indicated:

1.) Epithelial mesothelioma patients survived for about 20.9 months on average, with surgery.

2.) Biphasic mesothelioma patients survived for about 14.7 months on average, with surgery.

3.) Similarly, sarcomatoid mesothelioma patients survived for about 11.2 months on average, with surgery

It is easy to remove the epithelial cells surgically at early stages. This is because they metastasize slowly.

The multimodal treatments along with surgeries may also increase the survival times further. For treating epithelial mesothelioma, many experts consider chemotherapy as a standard method. Doctors may use it with surgery. They may also use it as first-line therapy if surgery is not a good option.

Doctors may also use Immunotherapy treatments for mesothelioma. According to a recent study, adding bevacizumab drugs to various forms of chemotherapy increased survival times.

For instance, patients who used chemotherapy medications, on average, survived for about 16 months

Similarly, those who used immunotherapy and chemotherapy medications, on average, survived for about 19 months.

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