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Biphasic Mesothelioma

Patients diagnosed with biphasic mesothelioma have tumors that contain both of the two other mesothelioma cell types: epithelioid and sarcomatoid. Mesothelioma Hope’s team of caring nurses and Patient Advocates can help you find a doctor who can confirm your biphasic diagnosis and provide the best treatment.

Medically reviewed by: Mark Levin, MD

Last updated:

What Is Biphasic Mesothelioma Cancer?

Biphasic mesothelioma is a rare cancer that affects the lining of the lungs and other organs that’s marked by the presence of two cell types:

Microscopic view of biphasic mesothelioma cells
Illustration of biphasic mesothelioma cells under a microscope
  • Epithelioid cells, which are rectangular, tend to stick together, and spread less quickly
  • Sarcomatoid cells, which look like long narrow spindles and can spread (metastasize) aggressively

According to the American Cancer Society (ACS), biphasic malignant mesothelioma is the second most common mesothelioma cell type, making up 20-30% of the 3,000 cases diagnosed each year.

Biphasic mesothelioma patients tend to have a better prognosis (health outlook) if their cancer tumors contain more epithelioid cells than sarcomatoid cells, because they don’t spread as aggressively.

If you have biphasic mesothelioma or any other type of this cancer, Mesothelioma Hope can provide you with the medical, financial, and supportive care you need to find healing. Get your Free Mesothelioma Guide shipped overnight to learn how we can help.

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What Causes Malignant Biphasic Mesothelioma?

Biphasic malignant mesothelioma (and every other type of this cancer) is caused by asbestos exposure. Asbestos is a naturally occurring mineral widely used in various industries until the early 1980s due to its heat-resistant and insulating properties.

When asbestos fibers are breathed in or swallowed, they can become lodged in the lining of the lungs, abdomen, or other organs. The fibers get trapped in the body and cause irritation for decades. After 10 to 50 years, cell mutation is possible and may cause mesothelioma cancer to form.

Biphasic Mesothelioma Symptoms

The signs and symptoms of biphasic malignant mesothelioma will depend on where the cancer develops in your body.

If your cancer has formed in the lung lining (pleura), you’ll have different mesothelioma symptoms than someone with tumors in the abdominal lining (peritoneum).

Learn what symptoms to watch for below.

Symptoms of Biphasic Pleural Mesothelioma

Biphasic pleural mesothelioma develops in the thin protective lining that surrounds the lungs.

Common symptoms include:

  • Chest pain
  • Fatigue
  • Fluid buildup in the chest (pleural effusion)
  • Shortness of breath
  • Worsening cough

Symptoms of Biphasic Peritoneal Mesothelioma

Biphasic peritoneal mesothelioma starts in the lining that covers the abdominal organs.

Common symptoms include:

  • Abdominal pain
  • Constipation or diarrhea
  • Fluid buildup in the abdomen (peritoneal effusion)
  • Night sweats
  • Unexplainable weight loss

Getting a Biphasic Mesothelioma Diagnosis

The first step to getting a diagnosis is to schedule a physical exam with a mesothelioma doctor.

The doctor will ask about your symptoms and medical history. They’ll also order imaging tests like computed tomography (CT) scans to look for abnormal areas in your lungs or abdomen.

CT scans and X-rays can help doctors identify a tumor or mass, but a biopsy is the only way to confirm a biphasic mesothelioma cancer diagnosis. A biopsy involves taking a small tissue sample from your tumor and sending it to a lab for testing.

Did You Know?

After the biopsy, a pathologist will study the sample under a microscope to see what types of cells are present and if they’re malignant (cancerous) or benign (not cancerous). Your tumor(s) must contain 10% of both sarcomatoid and epithelial cells to be considered biphasic.

Some pathologists use a technique known as immunohistochemistry staining to distinguish mesothelioma from adenocarcinoma, a type of cancer that develops in the mucous glands inside the lungs and other organs.

Our team can connect you with top specialists who are experienced in diagnosing and treating biphasic mesothelioma. Sign up for our Free Doctor Match service to get started.

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Biphasic Mesothelioma Prognosis & Life Expectancy

The prognosis for biphasic mesothelioma depends on the ratio between epithelial and sarcomatoid cells. If the tumor has more epithelial cells, the patient’s mesothelioma prognosis is better since those cells are easier to treat.

Prognosis is typically measured using two main factors: life expectancy (average time a patient lives after a diagnosis) and survival rate (percentage of patients still alive after a certain number of years).

  • The average life expectancy for biphasic mesothelioma patients is 10 months, according to an F1000 Research report.
  • Biphasic mesothelioma patients have an average 2-year survival rate of 22%, according to a review of the National Cancer Database (NCDB).

Some biphasic patients have become long-term survivors with treatment from a qualified mesothelioma specialist.

“Facing biphasic mesothelioma can be a challenging journey, but it’s essential to approach it with hope and a proactive mindset. While every patient’s situation is unique, advancements in treatment options and personalized care plans are continually improving outcomes.”

- Quote from Jenna Tozzi, RN, 15+ years helping cancer patients as a nurse navigator

Call (866) 608-8933 now to connect with our registered nurse and get help navigating a mesothelioma diagnosis.

Biphasic Mesothelioma Treatment Options

If you or a family member has biphasic malignant mesothelioma, there are various treatments that may be able to help you live longer with fewer symptoms.

A mesothelioma doctor can create a treatment plan that considers your age, cancer stage, percentage of sarcomatoid versus epithelial cells, and other key factors.

Learn more about standard and emerging treatment methods below.

Chemotherapy

Chemotherapy is often the first treatment used for mesothelioma and typically includes a combination of the drugs cisplatin or carboplatin and pemetrexed.

This treatment is most effective for patients with a large number of epithelioid mesothelioma cells, especially when combined with surgery.

Chemotherapy can still help even if there are more sarcomatoid cells present, as it circulates through the entire body and can help kill any sarcomatoid cells that may have spread from the original tumor location.

Chemotherapy may be more or less effective depending on the age, health, and cancer stage of the patient, as well as how well they tolerate chemotherapy.

Surgery

Mesothelioma surgery is the most aggressive treatment option but can be very effective if a patient’s biphasic tumors are primarily made up of epithelioid cells.

Epithelioid cells stick together and do not usually spread as quickly through the body, and with surgery, doctors can often remove all visible cancer tumors.

In a study of biphasic pleural mesothelioma patients under 70 who got a pleurectomy with decortication (P/D), the median overall survival was 24 months, according to a 2022 report in The Journal of Thoracic and Cardiovascular Surgery.

If the patient’s biphasic mesothelioma consists of more sarcomatoid cells, a doctor may not suggest surgery, particularly if the cancer has already spread to other organs.

Learn more about the different ways to treat this cancer and improve your prognosis in our Free Mesothelioma Guide.

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Immunotherapy

Immunotherapy for mesothelioma works by stimulating the immune system or enhancing its ability to recognize and destroy cancer cells.

Results from the CheckMate 743 study showed that biphasic pleural mesothelioma patients treated with the immunotherapy drugs Opdivo® and Yervoy® had an overall life expectancy of 18.1 months, according to a report in JCO Oncology Practice.

Research into immunotherapy for biphasic malignant mesothelioma is ongoing, with numerous clinical trials exploring new combinations of medications.

Radiation Therapy

Radiation therapy is mainly used to manage mesothelioma symptoms but can also help shrink tumors. Radiation is a better option for malignant pleural mesothelioma patients because of the potential risks of damage to the abdominal area in peritoneal patients.

It may also be used as part of a multimodal treatment plan, in which several treatments are used together to fight cancer. Chemotherapy, radiation, and surgery can all be used in multimodal therapy to treat biphasic mesothelioma.

Emerging Treatments in Clinical Trials

Patients with biphasic malignant mesothelioma may be able to access emerging treatments by joining a clinical trial.

Mesothelioma clinical trials are currently studying new treatments such as:

  • Gene therapy, which targets genetic abnormalities associated with cancer growth
  • Targeted therapy, which focuses on specific molecules to prevent the growth and metastasis (spread) of tumors
  • Vaccine therapy, which stimulates the body’s immune system to recognize and attack cancer cells

If you’ve been diagnosed with biphasic malignant mesothelioma, make sure to ask your doctor if there are any clinical trials you could join as part of your treatment plan.

Find Biphasic Mesothelioma Doctors Near You

Facing a biphasic mesothelioma diagnosis can be tough, but you don’t have to do it alone.

Our nurses and Patient Advocates have relationships with top mesothelioma doctors and cancer centers across the country. They can help you schedule your first appointment and see if you can get financial aid to help pay for treatment.

Take the first step toward hope. Call us at (866) 608-8933 or join our Free Doctor Match program to get personalized support.

Biphasic Mesothelioma Cancer FAQs

What is biphasic malignant mesothelioma?

Biphasic malignant mesothelioma is a rare type of cancer that develops in the lining of the lungs or abdomen. Biphasic mesothelioma tumors have both epithelioid and sarcomatoid cells.

Epithelioid cells spread slowly, while sarcomatoid cells can spread more aggressively. The prognosis for patients with biphasic mesothelioma depends on the number of epithelioid cells.

In general, if there are more epithelioid cells than sarcomatoid cells, the better the prognosis.

What is the survival rate for biphasic mesothelioma?

According to a 2022 review of the National Cancer Database:

  • The 2-year survival rate is 22%.
    • This is the percentage of biphasic mesothelioma patients alive 2 years after treatment.
  • The 5-year survival rate is 5%.
    • This is the percentage of biphasic mesothelioma patients alive 5 years after treatment.

These are average statistics based on past cases. Everyone’s cancer is unique, and some patients have lived for 5 years or more with treatment from a mesothelioma specialist.

How common is biphasic mesothelioma?

Biphasic mesothelioma is the second most common mesothelioma cell type after epithelioid mesothelioma.

As many as 3 of every 10 patients diagnosed with this cancer have this cell type, according to data from the American Cancer Society.

Can biphasic mesothelioma be treated?

Yes, biphasic mesothelioma can be treated with surgery, chemotherapy, immunotherapy, and radiation therapy.

Since early intervention is crucial with this cancer, you should see a mesothelioma specialist as soon as possible to see which treatments are best for your case.

Call our Patient Advocates at (866) 608-8933 so we can help you schedule an appointment with a mesothelioma doctor in your area.

Dr. Mark LevinReviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD, has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
  1. American Cancer Society. (2019, January 9). Key statistics about malignant mesothelioma. Retrieved January 30, 2024, https://www.cancer.org/cancer/types/malignant-mesothelioma/about/key-statistics.html
  2. American Cancer Society. (2018, November 16). What is malignant mesothelioma? Retrieved January 30, 2024, from https://www.cancer.org/cancer/types/malignant-mesothelioma/about/malignant-mesothelioma.html
  3. American Society of Clinical Oncology. (2021, February 01). Mesothelioma: Introduction. Retrieved January 30, 2024, from https://www.cancer.net/cancer-types/mesothelioma/introduction
  4. Amin, W., Linkov, F., Landsittel, D., Silverstein, J., Bashara, W., Gaudioso, C., . . . Becich, M. (2018, August 3). Factors influencing malignant mesothelioma survival: A retrospective review of the National Mesothelioma Virtual Bank cohort. Retrieved January 30, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198263/
  5. Brcic, L., & Kern, I. (2020, June). Clinical significance of histologic subtyping of malignant pleural mesothelioma. Retrieved January 30, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354152/
  6. Chapel, D. B., Schulte, J. J., Husain, A. N., & Krausz, T. (2020). Application of immunohistochemistry in diagnosis and management of malignant mesothelioma. Translational lung cancer research, 9(Suppl 1), S3–S27. Retrieved January 30, 2024, from https://doi.org/10.21037/tlcr.2019.11.29
  7. Kawabe, K., Sato, H., Kitano, A., Yoshida, R., Yasui, K., Umeda, Y., . . . Fujiwara, T. (2022, May 30). Adenomatoid mesothelioma arising from the diaphragm: A case report and review of the literature – journal of medical case reports. Retrieved January 30, 2024, from https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-022-03420-9
  8. Lapidot, M., Mazzola, E., & Bueno, R. (2022). Outcomes of pleurectomy decortication in patients with biphasic mesothelioma. The Journal of Thoracic and Cardiovascular Surgery, 164(5), 1340-1348.e3. Retrieved January 30, 2024, from https://doi.org/10.1016/j.jtcvs.2022.01.054
  9. Moffitt Cancer Center. (n.d.). Sarcomatoid mesothelioma, symptoms & treatment. Retrieved January 30, 2024, from https://moffitt.org/cancers/mesothelioma/diagnosis/types/sarcomatoid-mesothelioma/
  10. Nowak, A. K., Jackson, A., & Sidhu, C. (2022). Management of advanced pleural mesothelioma—at the crossroads. JCO Oncology Practice, 18(2), 116–124. Retrieved January 30, 2024, from https://doi.org/10.1200/op.21.00426
  11. Rozitis, E., Johnson, B., Cheng, Y. Y., & Lee, K. (2020). The Use of Immunohistochemistry, Fluorescence in situ Hybridization, and Emerging Epigenetic Markers in the Diagnosis of Malignant Pleural Mesothelioma (MPM): A Review. Frontiers in Oncology, 10. Retrieved January 30, 2024, from https://doi.org/10.3389/fonc.2020.01742
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