Epithelial Mesothelioma
Of the three most common cell types, epithelial cells account for up to 60 percent of all asbestos-cancer diagnoses. These cells have been more thoroughly studied, respond better to treatment and often result in a more favorable outcome than other cell types.
Epithelial cells are naturally found all over the body and are one of the four major tissue types. They act as protection and fluid secretion and can be found in the mouth, eyes, ears and chest cavity, among other places. Normal epithelial cells are very compact and look uniform in shape and size. When they turn cancerous, these cells become more scattered. Cancerous epithelial cells are most commonly found in pleural asbestos-cancer patients.
Diagnosing Epithelial Cells
Because of the nature of the cells, doctors usually must perform advanced testing to diagnose epithelial asbestos cancer. These advanced tests include a surgical biopsy called a thoracoscopy. In this procedure, doctors insert a tiny camera through a small chest incision to get a better look at the cells. The doctor is also able to take several tissue samples for lab review. It’s important that a large tissue sample, also called a biopsy, is removed for review.
When making a final determination, researchers must decide which subtype of epithelial cells are involved. This allows doctors determine to the best course of treatment. There are several epithelial subtypes, including the following:
- Poorly Differentiated - rounded and irregularly shaped cells.
- Small Cell - often misdiagnosed as small cell lung cancer.
- Diffuse - looks shiny and white in color.
- Well-Differentiated Papillary - often develops in the peritoneum.
Epithelial asbestos-cancer cells also resemble adenocarcinoma cells, a cancer that forms in the body’s mucus-secreting glands. It is important to get an accurate diagnosis so the disease can be treated effectively.
Available Treatments
Asbestos cancer treatment largely depends on the location and stage of the cancer rather than the cell type, also called histology. But it is important for doctors and patients to know the cell type because it can affect the type of treatment used and is a better predictor of the overall outcome.
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There are three main types of treatment used in all cases of asbestos cancer:
- Surgery
- Chemotherapy
- Radiation
As with all types of asbestos cancer, the type of treatment can be curative or palliative. Because this cell type is known to respond better to treatment, physicians are more likely to choose an aggressive treatment plan.
Symptoms and Prognosis
Like other forms of asbestos-cancer, the histology does not change the type of symptoms a patient will have. Pleural epithelial cell patients will have a persistent cough, heaviness in the chest and general malaise. Peritoneal epithelial patients will present with stomach bloating, cramps and weakness.
Generally, epithelial cell patients have a better outcome than sarcomatoid and biphasic patients. The average survival time from diagnosis is about a year.
Sources
National Cancer Institute at the National Institutes of Health. Cellular Classification of Malignant Mesothelioma. Retrieved from http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/HealthProfessional/page1/AllPages#2
The Oncologist. “Contemporary Management of Malignant Pleural Mesothelioma.” Retrieved from http://theoncologist.alphamedpress.org/content/4/6/488.full