Sarcomatoid Mesothelioma


If a person or a family member has been diagnosed with a type of mesothelioma cancer known as sarcomatoid mesothelioma, it is important to understand what to expect. It is a life-changing moment, but with the right kind of support in managing the symptoms coupled with an appropriate, timely treatment it could improve the prognosis. Sarcomatoid mesothelioma is considered one of the difficult types of mesothelioma cancer to treat because the cells tend to be highly resistant to different types of therapies. If you know what the disease is, your medical needs, and how to manage the symptoms, you can be able to make an informed decision. Sadly, the life expectancy isn’t so impressive with most people surviving for only 12 to 21 months from the time they are diagnosed with the cancer.

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What is Sarcomatoid Mesothelioma?

There are different forms and types of mesothelioma and their classification depends on the tissue they affect and the cells involved. Sarcomatoid mesothelioma affects the body tissues that surround some organs like heart, lungs, stomach, abdominal cavity, and the genitals. Most mesotheliomas affect the tissue lining various organs. These are given the name epithelial mesotheliomas, however, with sarcomatoid mesothelioma; it affects the connective tissue cells.

What is sarcomatoid mesothelioma

The cells of the connective tissue tend to be elongated and form a pattern of crisscross resulting in a mass called histiocytoma that looks like a tumor. For an individual to be diagnosed with sarcomatoid mesothelioma, they should have a mass that is made up of not less than 90 percent of sarcomatoid cells. This implies that the mass may still comprise other types of cells like epithelial cells, but in small quantities.

Among the different forms of mesotheliomas, sarcomatoid is considered the rarest making up only about 10 to 15 percent of the cases.

In about 50 percent of sarcomatoid mesothelioma cases, they are in sarcomatoid cells while about 30 to 40 percent of the cancer cases involve both epithelioid and sarcomatoid cells in what is known as biphasic mesothelioma. Sarcomatoid mesothelioma is mainly found within the pleural cavity. This is the space between the inside of chest wall and the outside of lungs. There are two mesothelial layers lining the lungs that allow them to contract and expand in the chest. As asbestos gets trapped in the tissue lining, it can cause malignant cell to form and grow resulting in restriction of lung movement.

Sarcomatoid Mesothelioma – Causes

Asbestos may be the only known and confirmed cause of mesothelioma sarcomatoid. This is a fiber that occurs naturally and has had wide usage in industrial applications from late 1800s. Asbestos had its most usage reported after the Second World War until the mid of 1970s. Asbestos fibers are very thin and long while also being extremely friable. If jostled, they can break easily and because they are very tiny (microscopic), they are airborne. If inhaled, asbestos particles can lodge in the lung’s tissue lining. A person may also accidentally swallow the particles. With time, the presence of asbestos particles in the body begins to cause inflammation and damage to tissue resulting in cancerous growths. It usually takes a long time before the symptoms of mesothelioma are known. 

Sarcomatoid Mesothelioma – Symptoms

The latency period for mesothelioma symptoms is typically about 20 to 50 years. This is the time from when asbestos exposure occurs and the time a person develops symptoms. Sometimes, it may take more time or a less period for the symptoms to develop depending on the frequency and level of asbestos exposure. Many people tend to live with the cancer without knowing because they don’t show symptoms. They only come to be surprised that they have mesothelioma sarcomatoid or other forms of mesothelioma like biphasic or epithelial.

During the initial stages, the symptoms are mild and will become severe as the cancer progresses. A person will have symptoms such as:

  • Shortness of breath
  • Hoarseness
  • Persistent coughing
  • Anemia
  • Wheezing
  • Unexplained weight loss
  • Unexplained weakness
  • Fatigue
  • Nausea
  • Feeling fullness or pressure in the abdomen
  • Coughing up blood
  • Fluid in lungs or pleural effusion
  • Fever

The symptoms will vary in their severity depending on where the cancer is attacking.  

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Diagnosis

Sarcomatoid malignant mesothelioma

It’s difficult to diagnose sarcomatoid mesothelioma because it tends to mimic other forms of cancer such as emphysema, lung cancer, or epithelial mesothelioma. It is important that a correct diagnosis is performed to ensure appropriate treatment is offered. A doctor may run different tests to confirm the disease.

  • CT and PET scans are helpful in generating images to see the inside of the patient’s body
  • Biopsy is taken to test it and confirm if the cells are malignant

Usually, sarcomatoid mesothelioma cells resemble healthy tissue and without proper diagnosis, it may not be possible to detect the cancer.

Sarcomatoid Mesothelioma Stages

When the cancer cells form, they begin to progress in stages, with every next stage making it harder to treat the disease and its prognosis gets worse. It is important for people to learn more about the cancer stages because it helps find the right treatment options.

  • In stage 1, the cancerous tissue is localized and hasn’t spread to affect other parts of the body like other organs and lymph nodes. Many people may not know they have the cancer at this point. Patients can positively respond to surgery when the sarcomatoid mesothelioma is in the first stage. So, if it is detected quickly at this stage, it is likely that a patient will have full remission.
  • In stage 2, it is difficult to treat the cancer using surgery because it has spread beyond the lining tissue to get into the lungs and other organs. The cancer may also affect lymph nodes at this point.
  • In stage 3, the cancer spreads to attack a certain region of an individual’s body. A patient may have the cancer invading the lining of an organ like the lungs, the lungs themselves, chest wall, and lymph nodes. It is not possible to treat the cancer using surgery at this point.
  • In stage 4, you have the cancer spreading to multiple regions and not possible to get rid of it. The life expectancy of the individual is shorter at this point.

Treatment

Treatment for sarcomatoid malignant mesothelioma is quite limited and there are few therapies that may help improve prognosis and make a patient more comfortable. A doctor may consider immunotherapy to heighten the immune system to fight infections. Gene therapy could alter the cancer, but it is an experimental treatment. A patient may need supplements like cannabis oil and spirulina because these help starve off the growth of tumors and reduce pain. 

Sarcomatoid mesothelioma causes and treatment

Sarcomatoid mesothelioma treatment options aim to provide patients with comfort and extend their life expectancies, but do not cure the cancer. Unfortunately, this type of cancer cannot be cured – particularly for those suffering from a sarcomatoid subtype of mesothelioma.

  • Studies suggest that chemotherapy may extend the lives of certain patients, however, some evidence indicates sarcomatoid cells cannot tolerate chemotherapy treatments.
  • Clinical trials involving mesothelioma sarcomatoid cancer demonstrate that immunotherapy therapies can be successful even for patients who have already undergone chemotherapy.
  • Treatments for Radiation. In certain circumstances, your doctor may suggest radiotherapy as a possible treatment to alleviate symptoms associated with sarcomatoid cancer and improve quality of life.
  • Surgery may be an option in certain cases. Unfortunately, due to how quickly mesothelioma spreads in sarcomatoid, surgery might not be the best choice for everyone.

The ideal treatment for sarcomatoid malignant mesothelioma depends on the individual patient’s needs and diagnosis. Most patients undergo multimodal treatment to maximize effectiveness, meaning there are multiple treatments used together. An optimal mesothelioma therapy regimen can extend a patient’s life expectancy and make them more relaxed.

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Sarcomatoid Mesothelioma Life Expectancy

The prognosis for mesothelioma sarcomatoid patients is poor and survival rates are quite grim. It is estimated that only about 40 percent of mesothelioma patients live past one year from the time of diagnosis. Only about 20 percent of the patients reach two years and in third year after diagnosis, the survival rate goes down to 8 percent. By 5 years, only a few patients can survive.  These survival rates are generalized, but when it comes to sarcomatoid mesothelioma, the survival rates are a bit worse. That being said, this form of mesothelioma doesn’t affect many people. The life expectancy may also vary depending on individual’s circumstances and other factors but the bottom line is that long-term survival is pretty rare. Only a handful of patients survive past 5 years. 

Mesothelioma sarcomatoid

Factors to Determine Life Expectancy for Sarcomatoid Mesothelioma

The life expectancy for people with mesothelioma sarcomatoid may be influenced by the following factors:

 Stage of cancer:  Having early diagnosis of the disease can improve the prognosis and life expectancy greatly. In stage 1 and 2, the cancer hasn’t yet spread, so treatment like use of surgery may be effective. However, in stages 3 and 4, the cancer has spread to attack other locations making it difficult for an individual to respond to treatment therapies. 

Location of mesothelioma: Depending on which part of the body mesothelioma develops, you may find that the life expectancy differs. Patients who have pleural mesothelioma sarcomatoid (affecting the lungs) tend to have a slightly longer survival period than people with peritoneal mesothelioma (affecting the abdomen lining). 

Age of a patient: An older person who has mesothelioma cancer will liver for shorter period because of the individual is already in poor health. It is also likely that at old age, the disease has advanced to its later stages. If you are diagnosed with the cancer at 75 years or above, your survival period is less than 4 months and when the diagnosis is done at 65 years or below, you could survive for 12 months. 

Cell type:  Three groups of cells are involved in mesothelioma and they include sarcomatoid, biphasic, and epithelioid. People with epithelioid mesothelioma cells tend to have a longer life expectancy compared to those who have sarcomatoid mesothelioma cells. People with biphasic mesothelioma tend to have a life expectancy that is between epithelioid and sarcomatoid cell-type patients.  If you have epithelioid mesothelioma affecting the pleural cavity of the lungs, you may have a life expectancy of about 19 months but if you have sarcomatoid mesothelioma affecting the same lungs, the life expectancy drops to about 8 months. 

Sex: Women diagnosed with the cancer can survive for about 5.5 months longer compared to men with the cancer. Often, there are occupational differences as well as risks of exposure to asbestos among males and females. 

Amount and length of exposure: If a patient has been exposed to intense amounts of asbestos at a lengthy period, the cancer may be too aggressive thus reducing the prognosis and life expectancy.