What Is Malignant Epithelioid Mesothelioma?
Epithelioid malignant mesothelioma is a rare cancer caused by asbestos exposure. It is one of the three cell types of malignant mesothelioma. The other two mesothelioma cell types are sarcomatoid and biphasic.
Epithelial cells are a type of cell that lines the surfaces of your body. They are found on your skin, blood vessels, urinary tract, and organs. Healthy epithelial cells also typically develop from tissue that forms as wounds heal (granuloma).
However, epithelial cells can mutate into mesothelioma tumors after asbestos exposure.
Epithelioid cells have the following characteristics:
- Adhere together in clumps
- Clearly visible nucleus
- Move slowly
- Square, cubed, or flat-shaped
Malignant epithelioid mesothelioma cancer generally responds well to treatment. Patients with this cell type tend to live longer than those with biphasic or sarcomatoid cells, provided an experienced mesothelioma doctor can diagnose their cancer before it spreads.
We can help you find and connect with top epithelioid mesothelioma specialists. Use our Free Doctor Match today to get started.
Epithelial Mesothelioma Symptoms
This cell type usually causes mild symptoms initially and is often mistaken for other health problems with similar symptoms, such as pneumonia or bronchitis.
Signs and symptoms of epithelioid mesothelioma can vary depending on the location of the cancer in the body.
Patients with epithelioid pleural mesothelioma (which forms in the lining of the lungs, called the pleura) will have different symptoms than those with epithelioid peritoneal mesothelioma (which forms in the lining of the abdomen, called the peritoneum).
Symptoms of Epithelioid Pleural Mesothelioma
- Chest pain
- Fatigue
- Fluid buildup in the chest (pleural effusions)
- Shortness of breath
Symptoms of Epithelioid Peritoneal Mesothelioma
- Abdominal pain
- Fluid buildup in the abdomen (ascites)
- Night sweats
- Unexplainable weight loss
Mesothelioma symptoms become more evident and severe as the cancer spreads. That’s why getting a diagnosis as early as possible is critical.
Epithelioid Mesothelioma Diagnosis
Generally, a malignant epithelioid mesothelioma diagnosis begins when a patient complains of symptoms. Doctors will then follow several steps to see if epithelioid mesothelioma is causing the symptoms.
Learn more about the epithelial mesothelioma diagnosis process below.
1. Physical Examination
Most doctors will first perform a physical examination to determine the cause of the symptoms.
Many symptoms of epithelioid mesothelioma can be mistaken for less severe and more common illnesses. A physical examination can help doctors rule out other conditions.
If you are showing signs of pleural or peritoneal mesothelioma, your doctor may ask you about any instances of asbestos exposure (the only known cause of this cancer).
2. Imaging Tests (X-Ray, MRI, CT)
If your doctor thinks you may have cancer based on your physical exam, they will use imaging tests to look for tumors, scar tissue, or other signs of cancer in the lungs or abdomen.
Imaging tests may include X-rays, MRI (magnetic resonance imaging) scans, CT (computed tomography) scans, or PET (positron emission tomography) scans.
Imaging tests are crucial because they can show where cancerous tumors are located in your body.
3. Blood Tests
Some doctors may order blood tests to diagnose epithelioid mesothelioma or look for other conditions.
Through these tests, doctors will look at specific biomarkers (levels of certain substances within the blood) which may mean that cancer is present. This helps doctors distinguish mesothelioma cells from cells of other similar illnesses and avoid misdiagnosis.
According to the American Society of Clinical Oncology (ASCO), the diagnostic process for epithelioid mesothelioma should include immunohistochemistry staining, a biomarker test. This allows doctors to look for specific proteins (such as calretinin) and other signs of mesothelioma cancer.
4. Fluid or Surgical Biopsy
If your doctor find signs of cancer in imaging and blood tests, they will order a biopsy.
A biopsy is the only way to confirm a mesothelioma diagnosis. Doctors will collect small fluid or tissue samples from possibly cancerous tissue through a tiny needle and examine it under a microscope to see if mesothelioma cells are present. The most reliable type of biopsy is a surgical biopsy, where a piece of a potentially cancerous tumor is removed for examination.
Once the doctor confirms the presence of mesothelioma, they can see if the cells are epithelioid.
Need to confirm an epithelioid mesothelioma diagnosis? Get help connecting with local specialists using our Free Doctor Match.
Epithelioid Mesothelioma Prognosis
Patients with this cell type typically have a life expectancy of 1-2 years following their diagnosis.
Epithelioid mesothelioma generally has a better prognosis (expected outcome of a disease) than the sarcomatoid and biphasic cell subtypes since epithelial cells spread fairly slowly.
The table below details epithelioid patient survival compared to the other cell types.
| Mesothelioma Cell Type | Median Survival |
|---|---|
| Epithelioid | 14 months |
| Sarcomatoid | 4 months |
| Biphasic | 10 months |
Factors such as the patient’s age, cancer stage, and mesothelioma type can also affect their survival time. Specialists consider all of these factors when determining a patient’s prognosis and deciding on the best treatment options to help them achieve long-term survival.
Contact us now to find a local specialist — our Patient Advocates are here 24/7 to serve you.
Types of Mesothelioma Treatment
Like all forms of this cancer, epithelial mesothelioma is usually treated with surgery, chemotherapy, radiation therapy, and/or other treatments.
Epithelial cells are more responsive to aggressive mesothelioma treatments than other cell types.
Learn more about the different types of treatment for epithelioid mesothelioma below.
Surgery
Removing tumors through surgery is the most effective way to treat epithelioid mesothelioma, as most or all visible signs of the cancer are removed.
Patients with the epithelioid cell type are more likely to qualify for mesothelioma surgery than those with sarcomatoid cells or biphasic tumors.
Common surgeries for patients with epithelioid mesothelioma include:
- Extrapleural pneumonectomy (EPP) for mesothelioma of the pleura
- Pleurectomy with decortication (P/D) for mesothelioma of the pleura
- Cytoreduction with HIPEC for peritoneal mesothelioma
Speak with a Patient Advocate about getting treatment for epithelioid mesothelioma.
Chemotherapy
Chemotherapy for epithelioid mesothelioma is administered intravenously to stop cancer cells from spreading. Patients will typically need multiple rounds of mesothelioma chemotherapy.
Common chemotherapy drugs for mesothelioma include:
Radiation Therapy
Radiation therapy is administered by a machine that delivers high-energy waves to the tumor site, which causes the epithelioid mesothelioma cells to die and the tumors to shrink.
Radiation may be used to supplement a surgery or as a main treatment if surgery is not an option.
Multimodal Therapy
Mesothelioma treatments are often combined in what’s known as multimodal therapy for the best results.
Research has shown that multimodal treatment can improve the long-term survival rates of epithelioid mesothelioma patients.
According to a 2017 study, patients with epithelioid malignant pleural mesothelioma who received a combination of extrapleural pneumonectomy surgery (EPP), chemotherapy, and radiation lived for 23 months on average.
Emerging Mesothelioma Treatment Options
In addition to the traditional cancer treatment methods, epithelial mesothelioma patients may also get other types of treatment.
Patients with this cell type can access promising new mesothelioma treatment options through clinical trials, which test emerging treatments to improve survival rates and find a cure.
Emerging treatment options such as gene therapy and cryotherapy are becoming more accessible for mesothelioma patients thanks to clinical trials.
Further, mesothelioma immunotherapy was recently approved as a first-line treatment for pleural mesothelioma after it was shown to improve patient survival in clinical trials.
Learn about patients who have increased their survival time by several years in our Free Mesothelioma Survivors Guide.
Rare Types of Epithelial Mesothelioma Cells
There are several subtypes of epithelioid mesothelioma. Some of these subtypes are extremely rare and may even be non-cancerous (benign).
These subtypes grow at different speeds and respond differently to treatments. Identifying a patient’s epithelioid mesothelioma subtype provides oncologists with a more accurate prognosis.
Rare subtypes of epithelioid mesothelioma include:
- Adenoid cystic mesothelioma: These rare and often benign mesothelioma cells do not spread to distant areas of the body.
- Adenomatoid mesothelioma: This subtype generally originates within a patient’s genital glands and accounts for roughly 6% of epithelioid pleural mesothelioma cases.
- Deciduoid mesothelioma: This subtype is characterized by its distinct borders and large oval shapes and often has a poor prognosis.
- Papillary mesothelioma: These mesothelioma cells are more common in women than men and slow progressing.
- Small-cell mesothelioma: This extremely rare subtype is often mistaken for other small-cell cancers.
Find Epithelioid Mesothelioma Treatment Near You Today
Epithelial mesothelioma patients may find hope in knowing this cell type typically responds well to treatments.
You may still have questions or concerns about seeking treatment if you are a victim of asbestos exposure who has been diagnosed with epithelioid mesothelioma.
Thankfully, there are specialists across the country who can help you get treatment for epithelial mesothelioma. These treatments may include surgery, chemotherapy, radiation therapy, and more.
Get matched with a local epithelioid mesothelioma specialist for free today.
Epithelioid Mesothelioma FAQs
What is epithelioid pleural mesothelioma?
Epithelioid pleural mesothelioma is one of three cell types of mesothelioma in addition to sarcomatoid and biphasic. It generally has the best prognosis and survival rates of all cell types because the cells are flat and grow more slowly, allowing for more intervention with treatment.
What causes epithelioid mesothelioma?
The only known cause of epithelial mesothelioma is asbestos exposure.
Asbestos is a dangerous, naturally occurring mineral used for its durability from the 1930s to the early 1980s. Manufacturers of asbestos-based products knew the dangers but kept them a secret to continue making profits.
Unfortunately, many exposed to asbestos have developed mesothelioma as a result.
What is the life expectancy for epithelial mesothelioma?
The average life expectancy for epithelioid mesothelioma patients is 1-2 years after the initial diagnosis.
Thankfully, there are several treatment options available for epithelioid mesothelioma patients to extend their survival, such as chemotherapy, surgery, radiation, and immunotherapy.
Where can I get treatment for epithelioid mesothelioma?
The best way to access epithelioid mesothelioma treatment is to work with a mesothelioma specialist. Doctors with experience treating others with your condition can provide quality care to help you fight your disease.
What is the survival rate of epithelial mesothelioma?
The 2-year and 5-year survival rates for pleural epithelioid mesothelioma patients treated with an EPP, chemotherapy, and radiation are as follows:
- 2-year survival rate: 65%
- 5-year survival rate: 27%
However, it’s important to note that factors such as age, cancer stage, and overall health can all affect a patient’s survival.
What are the stages of epithelioid mesothelioma?
There are four stages of epithelioid pleural mesothelioma. Staging is based on how far the cancer has spread throughout the body. It has a direct effect on what treatments are available to patients.
In stage 1, the cancer is contained to the lining of the lung and is easier to treat with surgery and chemotherapy. By the time the cancer has advanced to stage 4, tumors have spread to distant areas of the body and may not be able to be surgically removed.
