Mesothelioma is rare cancer with only 3,000 cases diagnosed annually, but the prognosis is poor. (NIH.gov). Sarcomatoid mesothelioma is the least common and is often referred to as ‘cell type’ or ‘spindle cell’ mesothelioma. It is estimated that 20% of mesothelioma cases are of this type.
Sarcomatoid Mesothelioma Differences
This type of asbestos cancer is different from other diseases in the following ways: (Cancer.net)
- It almost always occurs in the lining of the lung called the pleura. A small number of cases occur in the abdomen.
- More often diagnosed with signs of asbestos exposure, including asbestosis and pleural plaques.
- More resistant to treatment compared to epithelioid or biphasic mesothelioma.
- Prognosis is worse than with other forms of mesothelioma. Cancer cells tend to form at a further distance from each other in this cell type than in epithelioid-type mesothelioma.
- Diagnosis with pathology alone is difficult.
Sarcomatoid Mesothelioma Diagnosis
This form of cancer is diagnosed when a biopsy is used to remove a small tumor sample. The pathologist applies immunohistochemical stains to the sample to see if the tumor is sarcomatoid mesothelioma or another cancer. Dyes used include WT1, CAM5, and AE1/AE.
Sarcomatoid mesothelioma is harder to diagnose and is frequently confused with other diseases, including sarcomas, sarcomatoid carcinoma, and chronic fibrous pleuritis. This means the cancer patient may have a delay in diagnosis that can lead to a poorer prognosis.
To ensure a proper diagnosis, the physician should consider the person’s clinical history, exposure to asbestos, work history, and radiological findings.
Common symptoms of pleural mesothelioma (in the lungs) include: (Cancer.org)
- Pain in the chest or lower back
- Difficulty breathing
- Regular dry cough
- Extreme fatigue
- Weight loss
- Difficulty swallowing or feeling of fullness in the throat
- Hoarse voice
- Swelling in arms and face
Relationship Between Asbestos Exposure and Sarcomatoid Mesothelioma
All types of mesothelioma are caused by exposure to asbestos, but the connection between sarcomatoid mesothelioma and asbestos is even stronger. Asbestos exposure can be found in virtually all cases of sarcomatoid mesothelioma. Pleural plaques are often present in these patients, more so than in other mesothelioma patients. Asbestosis also is more common in people with sarcomatoid mesothelioma.
Sarcomatoid mesothelioma occurs most often in men, many of whom had heavy asbestos exposure in their work. Asbestos exposure in these occupations can cause sarcomatoid mesothelioma:
- Construction worker
- Floor or ceiling work
- Powerhouse worker
Treatments for Sarcomatoid Mesothelioma
There are three primary treatment options for most forms of mesothelioma, including the sarcomatoid variety: (Medicine.net).
Many doctors will use a combination of two or three of these types to treat the disease.
Several surgeries may be used on sarcomatoid mesothelioma:
- Pleurectomy: Removal of part of the abdomen or chest lining and some tissue surrounding it.
- Pneumonectomy: This is the removal of an entire lung. It may be an option depending on how much the disease has spread.
- Extrapleural pneumonectomy: The doctor removes the entire lung as well as the lung lining and diaphragm on the affected side of the body. The lining of the heart may also be removed.
- Pleurectomy/decortication: The doctor removes the lung lining and as much tumor as possible.
Determining who is a strong candidate for surgery is challenging. Cancer’s stage indicates how advanced it is. (See stage 4 mesothelioma cancer symptoms). Staging procedures may be required for the healthcare professional to determine how much the mesothelioma has spread.
Radiation shoots high-energy X-rays into the body in specific areas to kill cancer cells and shrink the tumor. Radiation can come from a machine that is outside the body or from putting radioactive materials into the body with tiny plastic tubes.
If the fluid has collected in the patient’s chest or abdomen, the physician may drain the fluid by inserting a needle into the body. He will then use gentle suction to take out the liquid. If the physician removes fluid from the chest, this is called thoracentesis. If he removes it from the abdomen, this is known as paracentesis.
Chemotherapy uses drugs to kill mesothelioma cancer cells. Doctors may administer chemotherapy drugs with pills or it can be inserted into the body in a muscle or vein. A chemotherapy drug based on platinum (cisplatin or carboplatin) may be given in combination with another drug called pemetrexed.
Chemotherapy drugs may be given to the patient through the blood or into the pleural cavity itself. When the drugs are delivered intrapleurally, the treatment is concentrated solely at the tumor site.
Life Expectancy for Sarcomatoid Mesothelioma
This form of asbestos cancer has a poor prognosis compared to the other cell types. Studies indicate a life expectancy of one to 30 months. A review of many clinical trials involving these patients found that only 13.9% of patients responded to any treatment, compared to 21.9% with other cell types of the disease. (NIH.gov).
Most patients with sarcomatoid mesothelioma have a life expectancy of no more than six months. Prognosis also depends on whether the mesothelioma is in the lining around the lungs, heart, or abdominal organs. Additional factors are age, gender, and general health.
Sarcomatoid mesothelioma is one of the rarer mesothelioma cancers, and the prognosis is poor. But if the disease is caught early on, your prognosis is better. That is why you should inform your doctor if you have been exposed to asbestos at any time in your life. Mesothelioma can take up to 40 years to develop, so it is critical to keep an eye on your health if you have been exposed to the dangerous mineral asbestos.
If you have been diagnosed with sarcomatoid mesothelioma, it is important to talk to a skilled mesothelioma attorney soon. The attorney can go over your case and decide if you may be eligible for mesothelioma compensation from the companies that exposed you to asbestos. Tracking down those companies and getting them to pay takes time, so make sure to speak to a qualified attorney soon.