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Epithelial Mesothelioma

While mesothelioma accounts for less than 2 percent of all known cancers, epithelial mesothelioma is the most common type of this malignancy.

At The Law Offices of Jeffrey S. Glassman, our asbestos injury lawyers recognize that of the three main mesothelioma cell types, epithelial mesothelioma is associated with the best prognosis.

The three cell types of mesothelioma are:

  • Epithelioid
  • Sarcomatoid (link to new Sacomatoid page)
  • Biphasic (link to new Biphasic page)

Epithelioid accounts for 50 to 70 percent of all mesothelioma cases, and it’s considered to be the most treatable. It occurs most often in men (70 to 80 percent) and most often those who are between the ages of 50 and 70. Patients who are between the ages of 20 and 40 typically were exposed to asbestos as children.

Typical symptoms of epithelioid mesothelioma are:

  • Chest pain
  • Loss of appetite
  • Shortness of breath
  • Fluid buildup
  • Constipation
  • Diarrhea
  • Vomiting
  • Weight loss
  • Dysphagia (difficulty swallowing)

Most of these symptoms are non-descript and often are mistaken for other conditions. That’s why it’s so important if you have any known history of exposure to asbestos, you must closely monitor any change in condition.

What is Epithelial Mesothelioma?

The cellular makeup of malignant mesothelioma can vary widely from patient-to-patient. As the International Mesothelioma Interest Group noted, knowing the characteristic of the type of you have and the most effective treatment options associated with that type will help you have a better idea of your prognosis.

Epithelial mesothelioma – also sometimes referred to as epithelioid mesothelioma – is so named because it affects the epithelial cells.

As noted by the U.S. National Library of Medicine, the epithelium refers to the layer of cells that line the hollow organs and glands. These are also the cells that comprise the outer surface of the body.

Epithelial cells are responsible to enclose and protect the organs, and most produce some type of secretion, such as mucus. Epithelial cells are responsible for:

  • Protection
  • Fluid secretion
  • Sensory perception

Mesothelioma can develop on the epithelial cell line.

The reason epithelioid mesothelioma is deemed the most treatable is because the way the cells are shaped and grow. These cells are square-shaped, and they grow right next to one another mostly via local expansion into surrounding tissue.

Of course, mesothelioma in general results in fast division and tumor growth, but the good news for those with epithelioid mesothelioma is that because of the tendency of epithelial cells to stick together, metastasis is slowed.

Epithelioid mesothelioma must be carefully tested because it is sometimes mistaken for other forms of cancer found in the chest, particularly lung cancer.

How Doctors Identify Epithelial Mesothelioma

Epithelial cancer cells typically can’t be identified only using diagnostic imaging tests.

To differentiate between epithelial mesothelioma and the other forms, doctors will rely on histology – or more specifically, histopathology.

As the National Society for Histotechnology notes, histology is the science that deals with the structure of cells and their formation into tissues and organs. Histotechnology involves detecting abnormalities in the cells, and employs the use of chemicals and dyes to produce colors and make it easier to distinguish different tissue structures.

This starts with a biopsy, wherein a tissue sample is taken. Thereafter, the histotechnician will process the sample and then analyze and test it under high-powered microscopes.

One of the biggest challenges with identifying epitheliod mesothelioma is distinguishing it from other forms of cancer. Most often epithelial cancer cells will look like adenocarcinoma, which is a type of lung cancer.

That said, epithelial mesothelioma has a few defining characteristics, which include:

  • Square or elongated, clearly-defined shape
  • Tendency to lump together with like cells
  • Faster tumor growth than other types of cells
  • Nucleus is elongated
  • Cytoplasm is pink
  • Spread mostly to nearby lymph nodes

Epithelioid mesothelioma also tends to be more common in pleural mesothelioma – which occurs in the chest cavity – than in peritoneal mesothelioma, which occurs in the abdomen.

Epithelial Mesothelioma Subtypes

There are several subtypes of epithelial mesothelioma. These are:

  • Adenoid.
  • Cystic.
  • Deciduoid.
  • Papillary.
  • Small Cell.

Treatment for mesothelioma will likely depend more on the stage and location of the cancer rather than the cellular type, but it’s still worthwhile for patients to know.

Because epithelial cells have been shown to respond better to treatment than other forms of mesothelioma, it’s likely that patients who suffer from this form of mesothelioma may opt for a more aggressive treatment plan. They tend to have a better prognosis than those with other forms of mesothelioma.

Grading of Epithelioid Cells

One of the methods medical professionals may use to assess patient outcomes for epithelioid is called “nuclear grading.” This involves scoring the disease based on certain abnormalities in the nuclei of the cancerous cells. Grades can be 1 (low), 2 (intermediate) or 3 (high).

Grade 1 epithelioid mesothelioma has a median patient survival rate or 28 months, while Grade 2 has a survival rate of 14 months and Grade 3 a survival rate of 5 months.

Grading of these cells is a relatively newer method, but can be used in conjunction with other testing.

Treatment for Epithelial Mesothelioma

Because epithelioid cells tend to respond better to treatment than other forms of mesothelioma cells, patients with this form of mesothelioma are considered candidates for multimodal forms of treatment – unless the individual’s mesothelioma tumors are well advanced.

Multimodal treatment means doctors will typically pursue more than one option for treatment, sometimes simultaneously. Those include:

  • Curative Surgery. This is a surgery intended to remove all visible traces of the tumor.
  • Radiation Therapy. This is done to reduce the amount of the tumor that remains after curative surgery.
  • Chemotherapy. This is done either before or after surgery to kill the cancer cells and shrink the tumor.

If epithelial mesothelioma has progressed to a certain point, treatment may include palliative surgery, which is intended to provide comfort to the individual who may be in the advanced stages of the disease.

Although the overall prognosis for mesothelioma is poor, studies have shown that approximately 60 percent of patients who received multimodal treatments for epithelioid mesothelioma lived at least one year after their first treatment. About a quarter of patients survived longer than five years.

Our mesothelioma lawyers know your first order of business is to attend to your health. Our experienced, compassionate team will help you navigate the legal challenges.

Contact the Law Offices of Jeffrey S. Glassman today for a free and confidential consultation.

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