As the second most common mesothelioma histology, or cell type, biphasic accounts for up to 40 percent of all cases. This cell type is a mixture of the two other types of cells — sarcomatoid and epithelial — making it difficult to treat.
Unlike other forms of cell types, biphasic tissue often looks like a patchwork of cells under a microscope. There’s no specific arrangement or structure to the cells like there is in sarcomatoid and epithelial cells. It’s often called a mixed cell type.
Diagnosing biphasic cells can be difficult because of the diagnostic tools used. Typically, doctors take small samples of tissue, called a biopsy, for examination to determine a cell type. However, in the biphasic arrangement, sarcomatoid or epithelial cells may dominate one portion of a tumor, while biphasic cells are in other areas. The biopsy may only contain one of the two types of cells, giving a misdiagnosis. A more accurate diagnosis would come from a larger sample size.
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Doctors also use a process called immunohistochemistry to diagnose cell types. For this technique, the cells are coated with a specialized dye that allows the cells to become more visible under a microscope.
Prognosis for Biphasic Mesothelioma
Getting a good diagnosis of biphasic cells is important because it could affect treatment options. But it’s important to remember that any specific cell type does not change your symptoms or prognosis. Instead, knowing the cell type helps doctors come up with better treatment options and patients get better informed.
Generally, biphasic carries a poorer prognosis than other cell types because it is often misdiagnosed. Many doctors believe that biphasic cells should be treated more aggressively because of the mixed nature.
Common Treatments for biphasic cells are Chemotherapy, Surgery and Radiation.
In many cases, mesothelioma is diagnosed in the later stages of the disease. That means that treatment is only limited to palliative measures. In those cases, the three most common types of treatment are also offered for pain relief.
Symptoms and Treatments
Like other forms of asbestos cancer, the histology does not influence the symptoms. The most common symptoms include shortness of breath, unexplained exhaustion, weakness and weight loss.
The outcome of treatment depends on the ratio of sarcomatoid and epithelial cells in the biphasic tissue. Sarcomatoid cells are known to be aggressive and difficult to treat. Epithelial cells are easier to treat. The larger amount of epithelial cells in a biphasic mix, the more responsive the patient may be to treatment.
Overall, mesothelioma is the most treatable when it is treated in the earliest stages. Early stage patients often benefit from surgery, chemotherapy and, sometimes, radiation in curative measures.
Many patients choose to participate in clinical trials that may have better outcomes than typical treatment protocol. Speak to your mesothelioma specialist about the best clinical trial for you.
American Cancer Society. Treatment of mesothelioma based on the extent of the cancer. Retrieved from http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-treating-by-extent
MD Anderson Cancer Center. Mesothelioma. Retrieved from http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-types/mesothelioma/index.html