Sarcomatoid Mesothelioma

Understanding Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma is a form of cancer that impacts the mesothelium(the tissue layer that surrounds the internal organs). Mesothelioma can affect different areas and have different cell types, each with its own unique symptoms, treatment options, and prognosis.

If you or someone you love has been diagnosed with sarcomatoid mesothelioma, we want to provide you with information about the best treatment options available today.

The Cause of Mesothelioma

Mesothelioma occurs due to exposure to asbestos. Asbestos is a naturally occurring mineral that can break into microscopic particles. Prolonged exposure and inhalation of these particles causes a build-up of asbestos in our bodies that we cannot breakdown. Asbestos can trigger genetic mutations of the mesothelium, which can result in the formation of cancer cells. Oftentimes, and people are often surprised to learn this, mesotheliomaoccurs from 20 to 60 years after exposure to asbestos.

What is Sarcomatoid Mesothelioma?

Sarcomatoid mesothelioma is a rare and aggressive form of mesothelioma. Other names for this condition include sarcomatous mesothelioma, diffuse malignant fibrous mesothelioma, and spindle cell mesothelioma.

Sarcomatoid cells have some key characteristics that make them different from other cells in the mesothelium. Sarcomatoid cell characteristics include:

An oval shape with a large nucleus

The possibility of having more than one nucleus per cell

They form in unstructured nodes and lesions

They have a faster rate of growth and metastasis (spread)

Because of these unique features, sarcomatoid cell mesothelioma is more likely to spread quickly and be less reactive to treatment at later stages.

Sarcomatoid mesothelioma makes up 10-15% of all pleural (lung) mesothelioma cases and less than 4% of peritoneal (abdomen) cases. It is a less common diagnosis compared to biphasic and epithelioid mesothelioma.

Symptoms of Sarcomatoid Mesothelioma

The symptoms of sarcomatoid mesothelioma can differ from person to person, depending on the affected areas of the body. Common sarcomatoid mesothelioma symptoms include:

Shortness of breath with activity or at rest
Recurring fluid buildup on the chest (sometimes requiring draining)
Persistent cough and hoarse voice
Coughing up blood
Anemia (low iron)
Weight loss
Low blood oxygenation levels
Abdominal bloating, nausea, and loss of appetite
Fatigue

Diagnosing Sarcomatoid Mesothelioma

To diagnose sarcomatoid mesothelioma, imaging tests (chest X-ray or CT scan) are often done to identify tumor locations. Blood tests may also be done, as mesothelioma can be diagnosed from the presence of specific biomarkers in our blood.

Proper diagnosis of sarcomatoid mesothelioma is often dependent on a biopsy or fluid draw. The tissue or cells removed during this procedure is used to identify the tumors by staining the tissue or cells, usually in a pathology lab. It is possible to get an inaccurate diagnosis from this method as all of the cell types involved may not be represented in the biopsy. Repeattesting is sometimes needed to get an accurate diagnosis.

Treatment Options

The treatment options available are on a person-to-person basis. Location of the disease, extent of spread, and personal health can all influence which treatment options are pursued.

Chemotherapy and Immunotherapy

Chemotherapy is the first-line treatment option for sarcomatoid mesothelioma. Chemotherapy medications are designed to slow down the growth of cancerous tumors. While it is possible for sarcomatoid cells to be unresponsive to chemotherapy treatment, recent studies have indicated some success in reducing disease symptoms and improving lifespan with modern intravenous (IV) chemotherapy.

Immunotherapy is a relatively new treatment option for sarcomatoid mesothelioma. Cancer immunotherapy treatments use vaccines and other immune system-altering medications to trigger a healing response from the immune system. Immunotherapy can help teach the immune system how to fight cancer cells more effectively. Early studies show that sarcomatoid cells may be more susceptible to immunotherapy than chemotherapy – which is an exciting new development in modern treatment options.

Radiation

Radiation is an available treatment option to relieve symptoms of sarcomatoid mesothelioma. During radiation treatment, exposure to therapeutic radiation disrupts the DNA of the impacted cells, stopping the growth of the treated cancer cells. The location of the tumors and the extent of spread impact the viability of this treatment. In many cases, radiation is done more for patient comfort and symptom control than disease management.

Surgery

Surgery is often not considered as a viable treatment option for sarcomatoid mesothelioma. Sarcomatoid tumors are rigid, spread rapidly, and can be deep-rooted into the chest wall. This can make surgery incredibly difficult and invasive.

Surgery also depends on the stage of the disease. A later stage means that the cancer has metastasized to more areas of the body which complicates a possible surgery.

The Prognosis for Sarcomatoid Mesothelioma

The prognosis for sarcomatoid mesothelioma is different from person-to-person.

On average, the life expectancy for a person with sarcomatoid mesothelioma is six months but that average is improving over time. Many life expectancy statistics are outdated and do not account for the ever-improving treatment options available. Modern mesothelioma treatment options are becoming more accessible and are improving quality of life every year.

Individual factors including age, pre-existing medical conditions, and cancer stage (the extent of spread) also play a significant role in individual survival rates.

Advances in medical trials and treatment technology are extending the lifespan of people with this condition. Getting connected to a mesothelioma
specialist for access to the newest treatment options available is the best way to improve life expectancy and quality of life.

Immunotherapy and Mesothelioma

Immunotherapy is a type of treatment that boosts the body’s natural defenses (its immune system) to fight cancer. In recent years, immunotherapy treatments for mesothelioma have been available through clinical trials and have shown promising results. Many doctors are now using immunotherapy drugs as treatment for mesothelioma.

If you have been diagnosed with mesothelioma and would like to learn more about emerging treatments like immunotherapy, our team of mesothelioma advocates can provide more information about immunotherapy or help connect you to clinical trials or physicians.

How Immunotherapy Works

Normally the body’s immune system would recognize that mesothelioma cells are “foreign” and would quickly attempt to kill them. Mesothelioma tumors, however, grow quickly and metastasize (spread) at a high rate, making it difficult for the immune system to attack. Immunotherapy provides a boost in the immune system, which makes it stronger and helps it target mesothelioma cells more effectively. These “targeted treatments” may be beneficial because they only attack the mesothelioma cells and cause no unintended damage to healthy cells.

Benefits of Mesothelioma Immunotherapy

The main advantage of this type of treatment is that it only targets mesothelioma cells and, in doing so, minimizes damage to healthy cells. Less damage to healthy cells means that a patient might experience fewer side effects. This allows patients who are not in the best overall health to receive treatments that may improve their survival time.

Fewer Side Effects

Specifically targeting mesothelioma cells may allow healthy cells to remain unharmed by the drug.

Improved Prognosis

May experience longer survival times. Results may even be more effective when combined with chemotherapy and/or surgery.

Mesothelioma