Biphasic mesothelioma is a combination of epithelioid and sarcomatoid cells. A patient’s prognosis heavily depends on the ratio of epithelioid to sarcomatoid cells.
What is Biphasic Mesothelioma?
Biphasic tumors are made up of both epithelioid and sarcomatoid cells. Tumors with a higher epithelioid cell ratio typically grow faster but do not spread as fast. Biphasic tumors that have a higher sarcomatoid cell ratio spread through the body faster.
Characteristics of Biphasic Cells
Biphasic malignant mesothelioma is the second most common diagnosis. Biphasic mesothelioma makes up about 30 to 40 percent of all cases.
Cell Type Description
Biphasic diagnoses have a mixture of epithelioid and sarcomatoid cell types. This means the patient’s prognosis depends on which cell is more prevalent. More epithelioid cells equal a better prognosis.
The behavior of a biphasic diagnosis is dependent on which cell type is more prevalent.
Diagnosing Biphasic Mesothelioma
Biphasic diagnoses are more common among patients with pleural mesothelioma. Besides mesothelioma, biphasic cell types are often found in patients with breast, colon, and renal cell cancers. Symptoms that are linked with biphasic mesothelioma are chest pain, pleural effusions (fluid buildups), and difficulty breathing.
Doctors use a technique called immunohistochemistry to diagnose biphasic mesothelioma. This process coats the cells with dye so that the proteins within the cells are more visible and can be identified. These proteins are used as markers to detect if cancer is present. Mesothelioma specialists are extremely important for diagnosis in patients with a biphasic cell type because treatment can vary depending on whether the tumor is more epithelioid or more sarcomatoid.
Patients with biphasic malignant mesothelioma are treated with chemotherapy, radiation, and curative surgeries. New treatments that are showing successful effects on patients with biphasic mesothelioma are gene therapy, photodynamic therapy, and intensity modulated radiation therapy.
It is important that patients receive a correct diagnosis so they may receive specialized treatment.
An Australian study compared 83 patients with pleural mesothelioma, 19 of which had a biphasic cell type. Of those 19 patients, 11 were initially diagnosed with epithelioid mesothelioma, 5 were told they had mesothelioma biphasic and 3 were not given an original diagnosis.
These patients were studied to see if they were eligible for extrapleural pneumonectomies (EPP). An EPP is most effective when performed on patients with epithelioid mesothelioma.
The second round of diagnoses showed that some patients were being misdiagnosed, and therefore, were not considered for an EPP.
It is important for a patient to receive a correct diagnosis to get the best treatment possible. If a patient is initially diagnosed with biphasic mesothelioma and it is later found that they have epithelioid mesothelioma, they may not be considered for different treatment options or clinical trials shown to help stop metastasis.
Extrapleural pneumonectomies are not usually performed on patients with biphasic mesothelioma because many clinicians believe only patients with epithelioid subtypes are eligible for an EPP.
Mesothelioma patients should always consider getting a second opinion for the reasons above. Get in touch with a specialist for a second opinion using our free Doctor Match program.
Patients whose biphasic mesothelioma is primarily epithelioid cell type tend to have a better prognosis. Although there are new medical advances that are leading towards a cure, there isn’t one yet. Patients whose biphasic mesothelioma comprises more sarcomatoid cells tend to have lower survival rates and a poorer prognosis.
There have been cases of epithelioid biphasic mesothelioma patients living longer than the average survival rate. However, these patients were shown to have led a healthy life before their diagnosis and their cancer was caught in Stage 1.