Mesothelioma has three main variations that can take place when it comes to the types of cells. These will include epithelioid, biphasic or sarcomatoid. The cell type will play a large role in the patient’s prognosis and treatment plan.
How Cell Types Make a Difference in Treatment and Prognosis
Each of the three main cell types is also going to have subtypes that need to be taken into consideration when it comes to the patient’s prognosis. All of these differences can be accounted for because of the damage that is done to the healthy cells because of the asbestos.
Different Types of Cells
Epithelioid are the cells that will be the most common when it comes to mesothelioma. Those that have this cell type are going to have the longest amount of time to live when you consider life expectancy. This is also the type that will be the easiest to treat.
This is the type of cell that is the least common. They will spread extremely fast. Those that have this type of cell will have the shortest life expectancy and they will also find that they do not have as many options when it comes to treatment.
This is when both epithelioid and sarcomatoid cells can be found. Patients that have more epithelioid cells in the body will have the best prognosis. More sarcomatoid cells present means a worse prognosis.
It will be important to look at where the cancer is located when it comes to treatment options. But, it is also going to be very important to consider what types of cells are present in order to identify just how aggressive the treatment must be. That is why it is important to see a specialist.
This is when the makeup of tissue is looked at on a very detailed, and microscopic level. It is very important when it comes to looking at the cell type related to mesothelioma, and other cancers as well.
If a patient is thought to have this type of cancer then the doctor will look at the cells on this level to see if they are cancerous. The doctor may take a biopsy or they may even take some fluid that can be tested to determine this.
Every type of mesothelioma cell will have its own shape, size and overall look. Testing will need to be done to ensure that it is mesothelioma and not another type of cancer as they can look similar.
The tissue will be tested through histopathological testing. This is when antibodies and proteins will be studied in order to see if mesothelioma is present. This helps to ensure that you are getting the proper diagnosis. This is completely necessary as many types of cancer will look like each other. One example is the fact that epithelioid mesothelioma is hard to differentiate from a cancer of the glandular tissue known as adenocarcinoma.
It is always important to get a second opinion if you have been exposed to asbestos in the past. This is completely necessary to ensure that you are getting the best treatment.
There are four main types of tissues that can be found throughout your body. These are called the epithelium, connective tissues, muscle tissues and nervous tissue. All of the tissues have cells that will carry out specific purposes. Those cells that are going to make up mesothelioma will make up part of the epithelium.
This tissue will make up the lining of the entire body. The organs, the chest and the abdomen are included in this. These cells are called the epithelial cells. Many different types of cancers can be caused by these cells. That is why it can become so difficult to diagnose mesothelioma.
When the epithelial cells have cancer in them the cancer is called carcinoma. This type of cancer is responsible for 85% of all cases. There are epithelial tissues that have the job of lining organs such as the heart, your stomach and even your lungs. The tissues are called the mesothelium. The tissue has cells that will lubricate the mesothelium. This allows those organs with this lining the ability to move.
Epithelial cells will protect the body by trapping dead cells or particles that should not be in the body. This is a way for your body to protect itself. But, mesothelioma will develop if asbestos fibers become trapped and cause mutation to the cells.
Epithelioid mesothelioma is the most common cellular variation of this disease and it’s also the most treatable. It accounts for anywhere between 50 – 70% of mesothelioma cases.
- The shape is elongated
- Will pair with other cells of this type of seem to lump
- Tumor grows quickly
- The nucleus is also elongated
- Cytoplasm is pink
- Very best prognosis
Sarcomatoid mesothelioma is one of the rarest cell types accounting for 10 – 15% of mesothelioma cases. It’s also much harder to treat and yields a much worst prognosis. It is going to have the worst prognosis since its spreads so fast throughout the cells.
These cells look like sarcoma-type cancers but the mutation of the mesothelial cells is what will cause the cancer. Epithelial cells will be transformed into mesenchymal cells through a process called epithelial-to-mesenchymal transition (EMT).
Mesenchymal cells make up the connective tissue that you are going to find in your body. This will include the bones and cartilage. The cells that are found throughout the connective tissue will become cancerous. That is where name sarcomatoid mesothelioma comes from.
Cancer begins when the cells in the mesothelium become affected and mutated. Epithelioid cells can even be found in patients that are suffering from sarcomatoid mesothelioma. However, it is required that the epithelioid cells account for less than 10 % of the cells in order to be classified as sarcomatoid.
- They overlap and have an irregular shape
- They will be enlarged and the nucleus is elongated
- There are times when they have more than one nuclei
- Quickly spread
- Prognosis is worst
Biphasic mesothelioma is a mixed combination of both epithelioid cells and sarcomatoid cells. They make different groups within the tumor. In situations like this you will find that there may be tissue removed from two different locations on the tumor. This kind has been found to make up roughly 30% of cases.
It will be important to know which cells make up the majority of the tumor. You will see that if there are more epithelioid cells then the tumor is going to remain in the localized area and it is going to grow faster at that point of origin.
If there are more sarcomatoid cells then the cancer will spread to the lymph nodes. The mixture of cells will play a role in the prognosis for the patient so each patient will be different. There have been studies that have shown that those patients with biphasic will have a longer and higher survival rate compared to those that have epithelioid
Treatment by Cell Type
Because of the histological types of mesothelioma each and every person, and their case, will be different. Many debates have been conducted to determine if understanding the subtype is going to play a role in the type of treatment that is given.
When you consider treatment it will be very important to know the location of the cancer and the stage that it is in. The cell type may be considered when it comes to just how aggressive the treatment needs to be in order to assist with the prognosis. Being aggressive may be recommended if the type of cell has a positive prognosis.