Malignant mesothelioma is a rare type of cancer caused by asbestos. It gets its name because it develops from cells in the mesothelium, a lining which covers and protects the lungs, heart, and other internal organs. The most common form is pleural mesothelioma, which affects the respiratory system; peritoneal mesothelioma affects the chest wall and the abdominal organs. It is hard to detect, difficult to treat, and, at the present time, impossible to cure.
There are three histological types of asbestos-related cancer: epithelioid, sarcomatoid, and biphasic. Epithelioid mesothelioma is the most prevalent, accounting for 50-60% of all mesothelioma cases. Biphasic isn’t a standalone histological type; it combines elements of both epithelioid and sarcomatoid mesothelioma.
Sarcomatoid mesothelioma is the least common of the three histological varieties of mesothelioma cancer. Similar to spindles and somewhat stretched out, sarcomatoid mesothelioma cells tend to be arranged in an irregular fashion. They also differ from epithelioid mesothelioma cells by their lack of a cell nucleus; under a microscope, epithelioid cells exhibit clearly visible nuclei.
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Signs and Symptoms
The biggest problem with sarcomatoid mesothelioma cells is that their oval shape makes them hard to tell apart from other cells found in human tissue. Worse still, sarcomatoid mesothelioma closely resembles another form of cancer, pulmonary sarcomatoid carcinoma, which makes accurate and timely diagnoses difficult. The chameleon-like sarcomatoid mesothelioma cancer cells even have the ability to visually resemble healthy tissue. Their most common points of origin are in supportive structures in the muscular and skeletal systems.
Sarcomatoid mesothelioma does not have its own subset of signs and symptoms. Like all other types, the symptoms of mesothelioma depend on where the tumor is located (the pleural lining of the lungs, the pericardial sac, or the abdominal wall). The most common symptoms include:
- Difficulty in breathing
- Chest pains
- Abdominal pain
- Collapsed lung
- Persistent cough that refuses to clear up
- Unexplained or unwanted weight loss
- Coughing up of bloody phlegm
- Difficulty in swallowing
- Prolonged hoarseness
- General feeling of being unwell
- Low oxygen levels
Another issue with sarcomatoid mesothelioma is that many of the signs and symptoms resemble those of lung cancer and other types of cancer. The existence of these symptoms does not mean that a patient has mesothelioma, but it is always a good idea to ask a physician to order tests to determine the cancer’s presence.
Unfortunately, the prognosis for patients diagnosed with sarcomatoid mesothelioma is not encouraging. Because the insidious and lethal disease is generally detected many decades after a patient’s initial exposure to asbestos, doctors do not know that sarcomatoid mesothelioma is present until the disease is in an advance stage of development.
The long dormancy period associated with mesothelioma, coupled with the highly aggressive nature of the sarcomatoid type of the disease comes with unfortunate limitations. Healthcare providers have limited ways to treat the disease in order to relieve the symptoms and give the patient enough time to settle his or her affairs before death occurs.
Even the best of treatment options, including a mix of surgery with either chemotherapy or targeted radiation of affected body tissue, can only stretch a patient’s life for a maximum of five years. The average survival rate of mesothelioma patients ranges between 8 to 18 months.
As with most diseases, however, survival rates are not universal. In other words, while one victim may survive only a few years, another victim may go on to live another decade. Yet, the general prognosis for sarcomatoid mesothelioma is around five years.
There are three major treatment options for sarcomatoid mesothelioma in any part of the body it affects: surgery, chemotherapy, and radiation. None of these treatments can cure the cancer, but they can add months, even years, to a mesothelioma patient’s life.
The most invasive type of procedure is surgery. Presently, there are two types of surgical procedures for sarcomatoid mesothelioma: pleurectomy/decortication (the removal of the pleural lining), and the more radical extrapleural pneumonectomy (surgical resection of the affected organs and the surrounding parietal and visceral pleura).
In both types of surgery, surgeons may take out either part of or the complete diaphragm and the pericardial sac. In addition, one or more ribs may be removed from the patient’s body in order to successfully perform the surgery.
Pleurectomy surgery has an extremely low death rate, with only a 1% total deaths for all patients who undergo this type of surgery. The biggest complications, however, lie within the initial side effects of the disease. Many pleurectomy surgery patients complain that the side effects of sarcomatoid mesothelioma are not alleviated after the procedure is completed. Being that this type of surgery is considered palliative, most physicians consider the procedure unsuccessful.
Chemotherapy is less invasive than surgery and aids in reducing the size of mesothelioma tumors in the pleural lining. However, this treatment does not cure mesothelioma; chemotherapy only helps to relieve some of the symptoms and extend a patient’s life expectancy.
Radiation, especially when applied in conjunction with extrapleural pneumonectomy surgery, is an effective form of treatment in mesothelioma cases. Radiation involves the destruction of cancer cells with doses of high energy rays. This treatment is used exclusively in cases of pleural mesothelioma due to the negative side effects possible in cases of peritoneal mesothelioma.
Radiation can be used either to prevent cancer from returning to surgically treated areas or to slow down the cancer’s progress in cases where surgery is not a viable option. Targeted radiation treatments also help to relieve a patient’s pain.
Additional Resources and Assistance
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