Understanding Biphasic Mesothelioma
Biphasic mesothelioma accounts for 20 to 35 percent of mesothelioma cases and is the second most common form of mesothelioma cell type.
When diagnosing mesothelioma, doctors must examine the mesothelioma cell type in the samples of tissue they collect. Studying the cancer cells can tell them a lot about the disease, its prognosis and the treatments that will work best for the patient.
Doctors must use extreme care when studying biphasic tumors since they contain two different types of cells. Sometimes doctors may first identify one cell type and then identify a second cell type afterward. It’s important for doctors to fully identify biphasic tumors because their makeup can mimic other malignant diseases, which have different prognoses and treatments.
Biphasic Mesothelioma Features
Biphasic mesothelioma tumors combine both epithelioid and sarcomatoid cells. This means that tumors will present features of both cell types. For this reason, biphasic mesothelioma is also called mixed type.
Biphasic tumors feature:
- Epithelioid cells, which are uniform, round in shape with a central nucleus
- Sarcomatoid cells, which are irregular, random and spindle-shaped
- least 10 percent of each cell type
Biphasic tumors normally contain more of one cell type than another. The different cell types commonly spread out from each other and exist in different areas of the tumor, though in some cases they may be close by.
Biphasic Mesothelioma Behaviors
Biphasic tumors exhibit behaviors from both epithelioid and sarcomatoid cells. The ratio of cells dictates the tumor’s behavior. Biphasic tumors with more sarcomatoid cells in them are considered more aggressive, while those with more epithelioid cells are considered easier to treat.
Epithelioid cells naturally stick together when they divide, which reduces the likelihood of the tumor metastasizing (spreading to other parts of the body).
Sarcomatoid cells grow randomly and spread quickly, which increases the likelihood of metastasis. Tumors with more sarcomatoid cells have a poor prognosis as their fast growth rate makes them difficult to fully treat.
Diagnosing Biphasic Mesothelioma
In order to diagnose biphasic mesothelioma, doctors must take samples from multiple parts of the tumor, because different cells may exist throughout it. Even then it can be difficult to determine how the ratios of each cell type in the tumor.
If both cell types are detected, doctors need to make sure that they are mesothelioma cells. Doctors use a technique called immunochemistry to better see the makeup of sample cells. Using this technique that doctors can reach a biphasic mesothelioma diagnosis.
When diagnosing biphasic mesothelioma, doctors must consider that mixed cells are also present in other cancers like colon, breast and renal cancer. The combination of all these factors helps doctors reach an accurate diagnosis, prevent a misdiagnosis and get patients appropriate treatment as quickly as possible.
Biphasic Mesothelioma Treatments
Treatment options for biphasic tumors depend on which cell type dominates the tumor. Treatments for biphasic tumors can include a multimodal approach of surgery, chemotherapy, and radiation.
Surgery removes as much of the tumor as possible, while radiation and chemotherapy aim to kill any remaining cancer cells that may still exist. Your treatment options will depend on many factors including which cell type is more dominant, your overall health status, and the location and stage of your mesothelioma.
Palliative treatments also exist for patients with biphasic mesothelioma. These treatments include surgical procedures to reduce abdominal fluid buildup and swelling. This helps patients feel more comfortable and improves their ability to breathe.
Biphasic Mesothelioma Survival Rates
At this time, the typical survival rate for patients with biphasic mesothelioma is between 10 and 15 months. However, this depends on the cell type ratio as epithelioid cell dominance has a better prognosis than sarcomatoid cell dominance.
Our understanding of mesothelioma is improving all the time. With this increased knowledge comes emerging treatments that can help extend life expectancy. Talk to your doctor about clinical trials for biphasic mesothelioma so that you can benefit from these upcoming treatment options.